SF 2171

3rd 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; appropriating
1.15money for various state boards and councils;amending Minnesota Statutes 2006,
1.16sections 13.3806, by adding a subdivision; 13.46, subdivision 2; 16A.10, by
1.17adding a subdivision; 16B.61, by adding a subdivision; 16D.13, subdivision
1.183; 43A.316; 62A.65, subdivision 3; 62E.141; 62H.02; 62J.04, subdivision
1.193; 62J.17, subdivisions 2, 4a, 7; 62J.41, subdivision 1; 62J.495; 62J.52,
1.20subdivisions 1, 2; 62J.60, subdivisions 2, 3; 62J.692, subdivisions 1, 4, 7a, 8, 10;
1.2162J.81, subdivision 1; 62J.82; 62L.12, subdivisions 2, 4; 62Q.165, subdivisions
1.221, 2; 62Q.80, subdivisions 3, 4, 13, 14, by adding a subdivision; 103I.101,
1.23subdivision 6; 103I.208, subdivisions 1, 2; 103I.235, subdivision 1; 119B.05,
1.24subdivision 1; 119B.09, subdivisions 1, 7, by adding subdivisions; 119B.12;
1.25119B.125, subdivision 2; 119B.13, subdivisions 1, 3a, 6, 7; 119B.21, subdivision
1.265; 144.05, by adding a subdivision; 144.123; 144.125; 144.2215, subdivision 1;
1.27144.3345; 144.565; 144.651, subdivision 26; 144.672, subdivision 1; 144.698,
1.28subdivision 1; 144.699, by adding a subdivision; 144.9502, subdivision
1.293; 144.9504, subdivision 2; 144.9507, by adding a subdivision; 144.9512;
1.30144A.071, subdivision 4c; 144D.03, subdivision 1; 144E.101, subdivision 6;
1.31144E.127; 144E.35, subdivision 1; 145A.17; 145C.05; 145C.07, by adding
1.32a subdivision; 148.235, by adding a subdivision; 148.6445, subdivisions 1,
1.332; 148B.53, subdivision 3; 149A.52, subdivision 3; 149A.97, subdivision 7;
1.34151.37, subdivision 2; 152.11, by adding a subdivision; 156.001, by adding a
1.35subdivision; 156.02, subdivisions 1, 2; 156.04; 156.072, subdivision 2; 156.073;
1.36156.12, subdivisions 2, 4, 6; 156.15, subdivision 2; 156.16, subdivisions 3, 10;
1.37156.18, subdivisions 1, 2; 156.19; 157.16, subdivision 1; 179A.03, subdivision 7;
1.38198.075; 245.462, subdivision 20; 245.465, by adding a subdivision; 245.4874;
1.39245.50, subdivision 5; 245.98, subdivisions 2, 5; 245A.035; 245A.10, subdivision
2.12; 245A.16, subdivisions 1, 3; 245C.02, by adding a subdivision; 245C.04,
2.2subdivision 1; 245C.05, subdivisions 1, 4, 5, 7, by adding a subdivision; 245C.08,
2.3subdivisions 1, 2; 245C.10, by adding a subdivision; 245C.11, subdivisions 1, 2;
2.4245C.12; 245C.16, subdivision 1; 245C.17, by adding a subdivision; 245C.21, by
2.5adding a subdivision; 245C.23, subdivision 2; 245C.24, subdivision 2; 246.54,
2.6subdivision 1; 252.27, subdivision 2a; 252.32, subdivision 3; 252.46, by adding
2.7a subdivision; 253B.185, subdivision 2; 254A.03, subdivision 3; 254A.16,
2.8subdivision 2; 254B.02, subdivisions 1, 5; 254B.03, subdivisions 1, 3; 254B.06,
2.9subdivision 3; 256.01, subdivisions 2, 2b, 4, 18, by adding subdivisions;
2.10256.015, subdivision 7; 256.017, subdivisions 1, 9; 256.0471, subdivision 1;
2.11256.476, subdivisions 1, 2, 3, 4, 5, 10; 256.969, subdivisions 3a, 9, by adding
2.12a subdivision; 256.974; 256.9741, subdivisions 1, 3; 256.9742, subdivisions 3,
2.134, 6; 256.9744, subdivision 1; 256.975, subdivision 7; 256.984, subdivision 1;
2.14256B.04, subdivision 14, by adding a subdivision; 256B.056, subdivisions 1a, 3,
2.155c, by adding a subdivision; 256B.057, subdivision 8; 256B.0621, subdivision
2.1611; 256B.0625, subdivisions 3f, 13c, 13d, 14, 17, 18a, 20, 23, 47, by adding
2.17subdivisions; 256B.0644; 256B.0911, subdivisions 3a, 3b, 4b, 4c, 6, 7, by
2.18adding subdivisions; 256B.0913, subdivisions 4, 5, 5a, 8, 9, 10, 11, 12, 13, 14;
2.19256B.0915; 256B.0917, subdivision 8; 256B.0919, subdivision 3; 256B.0943,
2.20subdivisions 6, 9, 11, 12; 256B.0945, subdivision 4; 256B.095; 256B.0951,
2.21subdivision 1; 256B.199; 256B.431, subdivisions 1, 2e, 3f, 17e; 256B.434,
2.22subdivision 4, by adding subdivisions; 256B.437, by adding a subdivision;
2.23256B.438, subdivision 3; 256B.439, subdivision 1; 256B.441, subdivisions 1, 2,
2.245, 6, 10, 11, 13, 14, 17, 20, 24, 30, 31, 34, 38, by adding subdivisions; 256B.49,
2.25subdivision 11, by adding a subdivision; 256B.5012, by adding a subdivision;
2.26256B.69, subdivisions 5g, 5h, 23, 28; 256B.75; 256B.76; 256B.763; 256D.03,
2.27subdivision 4; 256D.44, subdivisions 2, 5; 256E.35, subdivision 2; 256I.04,
2.28subdivision 3; 256I.05, by adding subdivisions; 256J.01, by adding a subdivision;
2.29256J.02, subdivisions 1, 4; 256J.021; 256J.08, subdivision 65; 256J.21,
2.30subdivision 2; 256J.24, subdivision 10; 256J.42, subdivision 1; 256J.425,
2.31subdivisions 3, 4; 256J.46, by adding a subdivision; 256J.49, subdivision 13;
2.32256J.521, subdivisions 1, 2, by adding a subdivision; 256J.53, subdivision
2.332; 256J.55, subdivision 1; 256J.626, subdivisions 1, 2, 3, 4, 5, 6; 256J.751,
2.34subdivisions 2, 5; 256J.95, subdivisions 3, 13; 256K.45, by adding a subdivision;
2.35256L.01, subdivision 4; 256L.03, subdivisions 1, 5; 256L.035; 256L.04,
2.36subdivisions 1, 12; 256L.11, subdivision 7; 256L.12, subdivision 9a; 259.20,
2.37subdivision 2; 259.24, subdivision 3; 259.29, subdivision 1; 259.41; 259.53,
2.38subdivisions 1, 2; 259.57, subdivisions 1, 2; 259.67, subdivisions 4, 7; 259.75,
2.39subdivision 8; 260.012; 260.755, subdivisions 12, 20; 260.761, subdivision 7;
2.40260.765, subdivision 5; 260.771, subdivisions 1, 2; 260B.157, subdivision 1;
2.41260C.152, subdivision 5; 260C.163, subdivision 1; 260C.201, subdivision 11;
2.42260C.209; 260C.212, subdivisions 1, 2, 4, 9; 260C.317, subdivision 3; 260C.331,
2.43subdivision 1; 270B.14, subdivision 1; 609.115, subdivision 9; 626.556,
2.44subdivisions 2, 3, 10, 10a, 10c, 10f, by adding subdivisions; Laws 2000, chapter
2.45340, section 19; Laws 2005, chapter 98, article 3, section 25; Laws 2005, First
2.46Special Session chapter 4, article 9, section 3, subdivision 2; Laws 2006, chapter
2.47282, article 20, section 37; proposing coding for new law in Minnesota Statutes,
2.48chapters 16A; 62A; 62J; 62Q; 144; 145; 148; 149A; 152; 156; 245A; 245C;
2.49254A; 256B; 256C; 256D; 256F; 256J; 260; 325E; proposing coding for new
2.50law as Minnesota Statutes, chapters 256N; 525A; repealing Minnesota Statutes
2.512006, sections 62J.052, subdivision 1; 62J.17, subdivisions 1, 5a, 6a, 8; 119B.08,
2.52subdivision 4; 144.335; 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
2.53252.275, subdivision 5; 254A.02, subdivisions 7, 9, 12, 14, 15, 16; 254A.085;
2.54254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
2.55254A.18; 256.969, subdivision 27; 256.9743; 256B.0913, subdivisions 5b, 5c,
2.565d, 5e, 5f, 5g, 5h; 256B.441, subdivisions 12, 16, 21, 26, 28, 42, 45; 256J.29;
2.57256J.37, subdivisions 3a, 3b; 256J.561, subdivision 1; 256J.62, subdivision 9;
2.58256J.626, subdivisions 7, 9; 256J.65; 525.921; 525.9211; 525.9212; 525.9213;
3.1525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221;
3.2525.9222; 525.9223; 525.9224; Laws 1997, chapter 8, section 1; Laws 2004,
3.3chapter 288, article 6, section 27; Minnesota Rules, parts 4610.2800; 9503.0035,
3.4subpart 2; 9560.0102, subpart 2, item C; 9585.0030.
3.5BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA:

3.6ARTICLE 1

3.7CHILDREN AND FAMILY

3.8    Section 1. Minnesota Statutes 2006, section 13.46, subdivision 2, is amended to read:
3.9    Subd. 2. General. (a) Unless the data is summary data or a statute specifically
3.10provides a different classification, data on individuals collected, maintained, used, or
3.11disseminated by the welfare system is private data on individuals, and shall not be
3.12disclosed except:
3.13    (1) according to section 13.05;
3.14    (2) according to court order;
3.15    (3) according to a statute specifically authorizing access to the private data;
3.16    (4) to an agent of the welfare system, including a law enforcement person, attorney,
3.17or investigator acting for it in the investigation or prosecution of a criminal or civil
3.18proceeding relating to the administration of a program;
3.19    (5) to personnel of the welfare system who require the data to verify an individual's
3.20identity; determine eligibility, amount of assistance, and the need to provide services to
3.21an individual or family across programs; evaluate the effectiveness of programs; and
3.22investigate suspected fraud;
3.23    (6) to administer federal funds or programs;
3.24    (7) between personnel of the welfare system working in the same program;
3.25    (8) to the Department of Revenue to administer and evaluate tax refund or tax credit
3.26programs and to identify individuals who may benefit from these programs. The following
3.27information may be disclosed under this paragraph: an individual's and their dependent's
3.28names, dates of birth, Social Security numbers, income, addresses, and other data as
3.29required, upon request by the Department of Revenue. Disclosures by the commissioner
3.30of revenue to the commissioner of human services for the purposes described in this clause
3.31are governed by section 270B.14, subdivision 1. Tax refund or tax credit programs include,
3.32but are not limited to, the dependent care credit under section 290.067, the Minnesota
3.33working family credit under section 290.0671, the property tax refund and rental credit
3.34under section 290A.04, and the Minnesota education credit under section 290.0674;
3.35    (9) between the Department of Human Services, the Department of Education, and
3.36the Department of Employment and Economic Development for the purpose of monitoring
4.1the eligibility of the data subject for unemployment benefits, for any employment or
4.2training program administered, supervised, or certified by that agency, for the purpose of
4.3administering any rehabilitation program or child care assistance program, whether alone
4.4or in conjunction with the welfare system, or to monitor and evaluate the Minnesota
4.5family investment program or the child care assistance program by exchanging data on
4.6recipients and former recipients of food support, cash assistance under chapter 256, 256D,
4.7256J, or 256K, child care assistance under chapter 119B, or medical programs under
4.8chapter 256B, 256D, or 256L;
4.9    (10) to appropriate parties in connection with an emergency if knowledge of
4.10the information is necessary to protect the health or safety of the individual or other
4.11individuals or persons;
4.12    (11) data maintained by residential programs as defined in section 245A.02 may
4.13be disclosed to the protection and advocacy system established in this state according
4.14to Part C of Public Law 98-527 to protect the legal and human rights of persons with
4.15developmental disabilities or other related conditions who live in residential facilities for
4.16these persons if the protection and advocacy system receives a complaint by or on behalf
4.17of that person and the person does not have a legal guardian or the state or a designee of
4.18the state is the legal guardian of the person;
4.19    (12) to the county medical examiner or the county coroner for identifying or locating
4.20relatives or friends of a deceased person;
4.21    (13) data on a child support obligor who makes payments to the public agency
4.22may be disclosed to the Minnesota Office of Higher Education to the extent necessary to
4.23determine eligibility under section 136A.121, subdivision 2, clause (5);
4.24    (14) participant Social Security numbers and names collected by the telephone
4.25assistance program may be disclosed to the Department of Revenue to conduct an
4.26electronic data match with the property tax refund database to determine eligibility under
4.27section 237.70, subdivision 4a;
4.28    (15) the current address of a Minnesota family investment program participant
4.29may be disclosed to law enforcement officers who provide the name of the participant
4.30and notify the agency that:
4.31    (i) the participant:
4.32    (A) is a fugitive felon fleeing to avoid prosecution, or custody or confinement after
4.33conviction, for a crime or attempt to commit a crime that is a felony under the laws of the
4.34jurisdiction from which the individual is fleeing; or
4.35    (B) is violating a condition of probation or parole imposed under state or federal law;
5.1    (ii) the location or apprehension of the felon is within the law enforcement officer's
5.2official duties; and
5.3    (iii) the request is made in writing and in the proper exercise of those duties;
5.4    (16) the current address of a recipient of general assistance or general assistance
5.5medical care may be disclosed to probation officers and corrections agents who are
5.6supervising the recipient and to law enforcement officers who are investigating the
5.7recipient in connection with a felony level offense;
5.8    (17) information obtained from food support applicant or recipient households may
5.9be disclosed to local, state, or federal law enforcement officials, upon their written request,
5.10for the purpose of investigating an alleged violation of the Food Stamp Act, according
5.11to Code of Federal Regulations, title 7, section 272.1(c);
5.12    (18) the address, Social Security number, and, if available, photograph of any
5.13member of a household receiving food support shall be made available, on request, to a
5.14local, state, or federal law enforcement officer if the officer furnishes the agency with the
5.15name of the member and notifies the agency that:
5.16    (i) the member:
5.17    (A) is fleeing to avoid prosecution, or custody or confinement after conviction, for a
5.18crime or attempt to commit a crime that is a felony in the jurisdiction the member is fleeing;
5.19    (B) is violating a condition of probation or parole imposed under state or federal
5.20law; or
5.21    (C) has information that is necessary for the officer to conduct an official duty related
5.22to conduct described in subitem (A) or (B);
5.23    (ii) locating or apprehending the member is within the officer's official duties; and
5.24    (iii) the request is made in writing and in the proper exercise of the officer's official
5.25duty;
5.26    (19) the current address of a recipient of Minnesota family investment program,
5.27general assistance, general assistance medical care, or food support may be disclosed to
5.28law enforcement officers who, in writing, provide the name of the recipient and notify the
5.29agency that the recipient is a person required to register under section 243.166, but is not
5.30residing at the address at which the recipient is registered under section 243.166;
5.31    (20) certain information regarding child support obligors who are in arrears may be
5.32made public according to section 518A.74;
5.33    (21) data on child support payments made by a child support obligor and data on
5.34the distribution of those payments excluding identifying information on obligees may be
5.35disclosed to all obligees to whom the obligor owes support, and data on the enforcement
6.1actions undertaken by the public authority, the status of those actions, and data on the
6.2income of the obligor or obligee may be disclosed to the other party;
6.3    (22) data in the work reporting system may be disclosed under section 256.998,
6.4subdivision 7 ;
6.5    (23) to the Department of Education for the purpose of matching Department of
6.6Education student data with public assistance data to determine students eligible for free
6.7and reduced price meals, meal supplements, and free milk according to United States
6.8Code, title 42, sections 1758, 1761, 1766, 1766a, 1772, and 1773; to allocate federal and
6.9state funds that are distributed based on income of the student's family; and to verify
6.10receipt of energy assistance for the telephone assistance plan;
6.11    (24) the current address and telephone number of program recipients and emergency
6.12contacts may be released to the commissioner of health or a local board of health as
6.13defined in section 145A.02, subdivision 2, when the commissioner or local board of health
6.14has reason to believe that a program recipient is a disease case, carrier, suspect case, or at
6.15risk of illness, and the data are necessary to locate the person;
6.16    (25) to other state agencies, statewide systems, and political subdivisions of this
6.17state, including the attorney general, and agencies of other states, interstate information
6.18networks, federal agencies, and other entities as required by federal regulation or law for
6.19the administration of the child support enforcement program;
6.20    (26) to personnel of public assistance programs as defined in section 256.741, for
6.21access to the child support system database for the purpose of administration, including
6.22monitoring and evaluation of those public assistance programs;
6.23    (27) to monitor and evaluate the Minnesota family investment program by
6.24exchanging data between the Departments of Human Services and Education, on
6.25recipients and former recipients of food support, cash assistance under chapter 256, 256D,
6.26256J, or 256K, child care assistance under chapter 119B, or medical programs under
6.27chapter 256B, 256D, or 256L;
6.28    (28) to evaluate child support program performance and to identify and prevent
6.29fraud in the child support program by exchanging data between the Department of Human
6.30Services, Department of Revenue under section 270B.14, subdivision 1, paragraphs (a)
6.31and (b), without regard to the limitation of use in paragraph (c), Department of Health,
6.32Department of Employment and Economic Development, and other state agencies as is
6.33reasonably necessary to perform these functions; or
6.34    (29) counties operating child care assistance programs under chapter 119B may
6.35disseminate data on program participants, applicants, and providers to the commissioner
6.36of 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. 12. Sliding fee. Child care services to families must be made available on
9.25a sliding fee basis.
9.26    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, by July 1, 2008. The commissioner shall report to the 2008
9.29legislature with the necessary statutory changes to codify this conversion to state median
9.30income.

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 12.

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 (d).
50.32    (a) "Case management" means the services provided by or through the county
50.33agency or through the employment services agency to participating families, including
50.34assessment, information, referrals, and assistance in the preparation and implementation
50.35of a family stabilization plan under subdivision 5.
51.1    (b) "Family stabilization plan" means a plan developed by a case manager and
51.2the participant, which identifies the participant's most appropriate path to unsubsidized
51.3employment, family stability, and barrier reduction, taking into account the family's
51.4circumstances.
51.5    (c) "Family stabilization services" means programs, activities, and services in this
51.6section that provide participants and their family members with assistance regarding,
51.7but not limited to:
51.8    (1) obtaining and retaining unsubsidized employment;
51.9    (2) family stability;
51.10    (3) economic stability; and
51.11    (4) barrier reduction.
51.12    The goal of the services is to achieve the greatest degree of economic self-sufficiency
51.13and family well-being possible for the family under the circumstances.
51.14    (d) "Case manager" means the county-designated staff person or employment
51.15services counselor.
51.16    Subd. 3. Eligibility. (a) The following MFIP or diversionary work program (DWP)
51.17participants are eligible for the services under this section:
51.18    (1) a participant identified under section 256J.561, subdivision 2, paragraph (d), who
51.19has or is eligible for an employment plan developed under section 256J.521, subdivision
51.202, paragraph (c);
51.21    (2) a participant identified under section 256J.95, subdivision 12, paragraph (b), as
51.22unlikely to benefit from the DWP;
51.23    (3) a participant who meets the requirements for or has been granted a hardship
51.24extension under section 256J.425, subdivision 2 or 3;
51.25    (4) a participant who is applying for supplemental security income or Social Security
51.26disability insurance;
51.27    (5) a participant who is a noncitizen who has been in the United States for 12 or
51.28fewer months; and
51.29    (6) a new MFIP participant, for the first 30 days the participant receives assistance or
51.30when the participant's employment plan is completed, whichever is sooner.
51.31    (b) Families must meet all other eligibility requirements for MFIP established in
51.32this chapter. Families are eligible for financial assistance to the same extent as if they
51.33were participating in MFIP.
51.34    (c) A participant under paragraph (a), clause (5), must be provided with English as a
51.35second language opportunities and skills training for up to 12 months. After 12 months,
51.36the case manager and participant must determine whether the participant should continue
52.1with English as a second language classes or skills training, or both, or if the participant
52.2should become an MFIP participant.
52.3    Subd. 4. Universal participation. All caregivers must participate in family
52.4stabilization services as defined in subdivision 2.
52.5    Subd. 5. Case management; family stabilization plans; coordinated services. (a)
52.6The county agency shall provide family stabilization services to families through a case
52.7management model. A case manager shall be assigned to each participating family within
52.830 days after the family begins to receive financial assistance as a participant of the family
52.9stabilization services. The case manager, with the full involvement of the participant, shall
52.10recommend, and the county agency shall establish and modify as necessary, a family
52.11stabilization plan for each participating family. If a participant is already assigned to a
52.12county case manager or a county-designated case manager in social services, disability
52.13services, or housing services that case manager already assigned may be the case manager
52.14for purposes of these services.
52.15    (b) The family stabilization plan must include:
52.16    (1) each participant's plan for long-term self-sufficiency, including an employment
52.17goal where applicable;
52.18    (2) an assessment of each participant's strengths and barriers, and any special
52.19circumstances of the participant's family that impact, or are likely to impact, the
52.20participant's progress towards the goals in the plan; and
52.21    (3) an identification of the services, supports, education, training, and
52.22accommodations needed to reduce or overcome any barriers to enable the family to
52.23achieve self-sufficiency and to fulfill each caregiver's personal and family responsibilities.
52.24    (c) The case manager and the participant shall meet within 30 days of the family's
52.25referral to the case manager. The initial family stabilization plan must be completed within
52.2630 days of the first meeting with the case manager. The case manager shall establish a
52.27schedule for periodic review of the family stabilization plan that includes personal contact
52.28with the participant at least once per month. In addition, the case manager shall review
52.29and, if necessary, modify the plan under the following circumstances:
52.30    (1) there is a lack of satisfactory progress in achieving the goals of the plan;
52.31    (2) the participant has lost unsubsidized or subsidized employment;
52.32    (3) a family member has failed or is unable to comply with a family stabilization
52.33plan requirement;
52.34    (4) services, supports, or other activities required by the plan are unavailable;
52.35    (5) changes to the plan are needed to promote the well-being of the children; or
53.1    (6) the participant and case manager determine that the plan is no longer appropriate
53.2for any other reason.
53.3    Subd. 6. Cooperation with services requirements. (a) To be eligible, a participant
53.4shall comply with paragraphs (b) to (e).
53.5    (b) Participants shall engage in family stabilization plan services for the appropriate
53.6number of hours per week that the activities are scheduled and available, unless good
53.7cause exists for not doing so, as defined in section 256J.57, subdivision 1. The appropriate
53.8number of hours must be based on the participant's plan.
53.9    (c) The case manager shall review the participant's progress toward the goals in the
53.10family stabilization plan every six months to determine whether conditions have changed,
53.11including whether revisions to the plan are needed.
53.12    (d) When the participant has increased participation in work-related activities
53.13sufficient to meet the federal participation requirements of TANF, the county agency shall
53.14refer the participant to the MFIP program and assign the participant to a job counselor.
53.15The participant and the job counselor shall meet within 15 days of referral to the MFIP
53.16program to develop an employment plan under section 256J.521. No reapplication is
53.17necessary and financial assistance continues without interruption.
53.18    (e) A participant's requirement to comply with any or all family stabilization plan
53.19requirements under this subdivision is excused when the case management services,
53.20training and educational services, and family support services identified in the participant's
53.21family stabilization plan are unavailable for reasons beyond the control of the participant,
53.22including when money appropriated is not sufficient to provide the services.
53.23    Subd. 7. Sanctions. (a) The financial assistance grant of a participating family is
53.24reduced according to section 256J.46, if a participating adult fails without good cause to
53.25comply or continue to comply with the family stabilization plan requirements in this
53.26subdivision, unless compliance has been excused under subdivision 6, paragraph (e).
53.27    (b) Given the purpose of the family stabilization services in this section and the
53.28nature of the underlying family circumstances that act as barriers to both employment and
53.29full compliance with program requirements, sanctions are appropriate only when it is clear
53.30that there is both the ability to comply and willful noncompliance by the participant, as
53.31confirmed by a behavioral health or medical professional.
53.32    (c) Prior to the imposition of a sanction, the county agency shall review the
53.33participant's case to determine if the family stabilization plan is still appropriate and
53.34meet with the participant face-to-face. The participant may bring an advocate to the
53.35face-to-face meeting.
53.36    During the face-to-face meeting, the county agency must:
54.1    (1) determine whether the continued noncompliance can be explained and mitigated
54.2by providing a needed family stabilization service, as defined in subdivision 2, paragraph
54.3(d);
54.4    (2) determine whether the participant qualifies for a good cause exemption under
54.5section 256J.57, or if the sanction is for noncooperation with child support requirements,
54.6determine if the participant qualifies for a good cause exemption under section 256.741,
54.7subdivision 10;
54.8    (3) determine whether activities in the family stabilization plan are appropriate
54.9based on the family's circumstances;
54.10    (4) explain the consequences of continuing noncompliance;
54.11    (5) identify other resources that may be available to the participant to meet the
54.12needs of the family; and
54.13    (6) inform the participant of the right to appeal under section 256J.40.
54.14    If the lack of an identified activity or service can explain the noncompliance, the
54.15county shall work with the participant to provide the identified activity.
54.16    (d) If the participant fails to come to the face-to-face meeting, the case manager or a
54.17designee shall attempt at least one home visit. If a face-to-face meeting is not conducted,
54.18the county agency shall send the participant a written notice that includes the information
54.19under paragraph (c).
54.20    (e) After the requirements of paragraphs (c) and (d) are met and prior to imposition
54.21of a sanction, the county agency shall provide a notice of intent to sanction under section
54.22256J.57, subdivision 2, and, when applicable, a notice of adverse action under section
54.23256J.31.
54.24    (f) Section 256J.57 applies to this section except to the extent that it is modified
54.25by this subdivision.
54.26    Subd. 8. Funding. (a) The commissioner of human services must treat MFIP
54.27expenditures made to or on behalf of any minor child under this section, who is part of a
54.28household that meets criteria in subdivision 3, as expenditures under a separately funded
54.29state program. These expenditures shall not count toward the state's maintenance of effort
54.30requirements under the federal TANF program.
54.31    (b) A family is no longer part of a separately funded program under this section, if
54.32the caregiver no longer meets the criteria for family stabilization services in subdivision
54.333 or if it is determined at recertification that the caregiver is meeting the federal work
54.34participation rate, whichever occurs sooner.

54.35    Sec. 44. Minnesota Statutes 2006, section 256J.626, subdivision 1, is amended to read:
55.1    Subdivision 1. Consolidated fund. The consolidated fund is established to support
55.2counties and tribes in meeting their duties under this chapter. Counties and tribes must use
55.3funds from the consolidated fund to develop programs and services that are designed to
55.4improve participant outcomes as measured in section 256J.751, subdivision 2. Counties
55.5may use the funds for any allowable expenditures under subdivision 2, and to provide case
55.6management services to participants of the family stabilization services program. Tribes
55.7may use the funds for any allowable expenditures under subdivision 2, except those in
55.8subdivision 2, paragraph (a), clauses (1) and (6).

55.9    Sec. 45. Minnesota Statutes 2006, section 256J.626, subdivision 2, is amended to read:
55.10    Subd. 2. Allowable expenditures. (a) The commissioner must restrict expenditures
55.11under the consolidated fund to benefits and services allowed under title IV-A of the federal
55.12Social Security Act. Allowable expenditures under the consolidated fund may include, but
55.13are not limited to:
55.14    (1) short-term, nonrecurring shelter and utility needs that are excluded from the
55.15definition of assistance under Code of Federal Regulations, title 45, section 260.31, for
55.16families who meet the residency requirement in section 256J.12, subdivisions 1 and 1a.
55.17Payments under this subdivision are not considered TANF cash assistance and are not
55.18counted towards the 60-month time limit;
55.19    (2) transportation needed to obtain or retain employment or to participate in other
55.20approved work activities or activities under a family stabilization plan;
55.21    (3) direct and administrative costs of staff to deliver employment services for
55.22MFIP or, the diversionary work program, or the family stabilization services program;
55.23 to administer financial assistance,; and to provide specialized services intended to assist
55.24hard-to-employ participants to transition to work or transition from the family stabilization
55.25services program to MFIP;
55.26    (4) costs of education and training including functional work literacy and English as
55.27a second language;
55.28    (5) cost of work supports including tools, clothing, boots, telephone service, and
55.29other work-related expenses;
55.30    (6) county administrative expenses as defined in Code of Federal Regulations, title
55.3145, section 260(b);
55.32    (7) services to parenting and pregnant teens;
55.33    (8) supported work;
55.34    (9) wage subsidies;
56.1    (10) child care needed for MFIP or, the diversionary work program, or the family
56.2stabilization services program participants to participate in social services;
56.3    (11) child care to ensure that families leaving MFIP or diversionary work program
56.4will continue to receive child care assistance from the time the family no longer qualifies
56.5for transition year child care until an opening occurs under the basic sliding fee child
56.6care program; and
56.7    (12) services to help noncustodial parents who live in Minnesota and have minor
56.8children receiving MFIP or DWP assistance, but do not live in the same household as the
56.9child, obtain or retain employment; and
56.10    (13) services to help families participating in the family stabilization services
56.11program achieve the greatest possible degree of self-sufficiency.
56.12    (b) Administrative costs that are not matched with county funds as provided in
56.13subdivision 8 may not exceed 7.5 percent of a county's or 15 percent of a tribe's allocation
56.14under this section. The commissioner shall define administrative costs for purposes of
56.15this subdivision.
56.16    (c) The commissioner may waive the cap on administrative costs for a county or tribe
56.17that elects to provide an approved supported employment, unpaid work, or community
56.18work experience program for a major segment of the county's or tribe's MFIP population.
56.19The county or tribe must apply for the waiver on forms provided by the commissioner. In
56.20no case shall total administrative costs exceed the TANF limits.

56.21    Sec. 46. Minnesota Statutes 2006, section 256J.626, subdivision 3, is amended to read:
56.22    Subd. 3. Eligibility for services. Families with a minor child, a pregnant woman,
56.23or a noncustodial parent of a minor child receiving assistance, with incomes below 200
56.24percent of the federal poverty guideline for a family of the applicable size, are eligible
56.25for services funded under the consolidated fund. Counties and tribes must give priority
56.26to families currently receiving MFIP or, the diversionary work program, or the family
56.27stabilization services program, and families at risk of receiving MFIP or diversionary
56.28work program.

56.29    Sec. 47. Minnesota Statutes 2006, section 256J.626, subdivision 4, is amended to read:
56.30    Subd. 4. County and tribal biennial service agreements. (a) Effective January 1,
56.312004, and each two-year period thereafter, each county and tribe must have in place an
56.32approved biennial service agreement related to the services and programs in this chapter.
56.33In counties with a city of the first class with a population over 300,000, the county must
56.34consider a service agreement that includes a jointly developed plan for the delivery of
57.1employment services with the city. Counties may collaborate to develop multicounty,
57.2multitribal, or regional service agreements.
57.3    (b) The service agreements will be completed in a form prescribed by the
57.4commissioner. The agreement must include:
57.5    (1) a statement of the needs of the service population and strengths and resources
57.6in the community;
57.7    (2) numerical goals for participant outcomes measures to be accomplished during
57.8the biennial period. The commissioner may identify outcomes from section 256J.751,
57.9subdivision 2 , as core outcomes for all counties and tribes;
57.10    (3) strategies the county or tribe will pursue to achieve the outcome targets.
57.11Strategies must include specification of how funds under this section will be used and may
57.12include community partnerships that will be established or strengthened; and
57.13    (4) strategies the county or tribe will pursue under the family stabilization services
57.14program; and
57.15    (5) other items prescribed by the commissioner in consultation with counties and
57.16tribes.
57.17    (c) The commissioner shall provide each county and tribe with information needed
57.18to complete an agreement, including: (1) information on MFIP cases in the county or
57.19tribe; (2) comparisons with the rest of the state; (3) baseline performance on outcome
57.20measures; and (4) promising program practices.
57.21    (d) The service agreement must be submitted to the commissioner by October 15,
57.222003, and October 15 of each second year thereafter. The county or tribe must allow
57.23a period of not less than 30 days prior to the submission of the agreement to solicit
57.24comments from the public on the contents of the agreement.
57.25    (e) The commissioner must, within 60 days of receiving each county or tribal service
57.26agreement, inform the county or tribe if the service agreement is approved. If the service
57.27agreement is not approved, the commissioner must inform the county or tribe of any
57.28revisions needed prior to approval.
57.29    (f) The service agreement in this subdivision supersedes the plan requirements
57.30of section 116L.88.

57.31    Sec. 48. Minnesota Statutes 2006, section 256J.626, subdivision 5, is amended to read:
57.32    Subd. 5. Innovation projects. Beginning January 1, 2005, no more than $3,000,000
57.33of the funds annually appropriated to the commissioner for use in the consolidated
57.34fund shall be available to the commissioner for projects testing innovative approaches
57.35to improving outcomes for MFIP participants, family stabilization services program
58.1participants, and persons at risk of receiving MFIP as detailed in subdivision 3, and
58.2for providing incentives to counties and tribes that exceed performance. Projects shall
58.3be targeted to geographic areas with poor outcomes as specified in section 256J.751,
58.4subdivision 5 , or to subgroups within the MFIP case load who are experiencing poor
58.5outcomes. For purposes of an incentive, a county or tribe exceeds performance if the
58.6county or tribe is above the top of the county's or tribe's annualized range of expected
58.7performance on the three-year self-support index under section 256J.751, subdivision 2,
58.8clause (7), and achieves a 50 percent TANF participation rate under section 256J.751,
58.9subdivision 2, clause (7), as averaged across the four quarterly measurements for the most
58.10recent year for which the measurements are available.

58.11    Sec. 49. Minnesota Statutes 2006, section 256J.626, subdivision 6, is amended to read:
58.12    Subd. 6. Base allocation to counties and tribes; definitions. (a) For purposes of
58.13this section, the following terms have the meanings given.
58.14    (1) "2002 historic spending base" means the commissioner's determination of
58.15the sum of the reimbursement related to fiscal year 2002 of county or tribal agency
58.16expenditures for the base programs listed in clause (6), items (i) through (iv), and earnings
58.17related to calendar year 2002 in the base program listed in clause (6), item (v), and the
58.18amount of spending in fiscal year 2002 in the base program listed in clause (6), item (vi),
58.19issued to or on behalf of persons residing in the county or tribal service delivery area.
58.20    (2) "Adjusted caseload factor" means a factor weighted:
58.21    (i) 47 percent on the MFIP cases in each county at four points in time in the most
58.22recent 12-month period for which data is available multiplied by the county's caseload
58.23difficulty factor; and
58.24    (ii) 53 percent on the count of adults on MFIP in each county and tribe at four points
58.25in time in the most recent 12-month period for which data is available multiplied by the
58.26county or tribe's caseload difficulty factor.
58.27    (3) "Caseload difficulty factor" means a factor determined by the commissioner for
58.28each county and tribe based upon the self-support index described in section 256J.751,
58.29subdivision 2 , clause (7).
58.30    (4) "Initial allocation" means the amount potentially available to each county or tribe
58.31based on the formula in paragraphs (b) through (h).
58.32    (5) "Final allocation" means the amount available to each county or tribe based on
58.33the formula in paragraphs (b) through (h), after adjustment by subdivision 7.
58.34    (6) "Base programs" means the:
59.1    (i) MFIP employment and training services under Minnesota Statutes 2002, section
59.2256J.62, subdivision 1 , in effect June 30, 2002;
59.3    (ii) bilingual employment and training services to refugees under Minnesota Statutes
59.42002, section 256J.62, subdivision 6, in effect June 30, 2002;
59.5    (iii) work literacy language programs under Minnesota Statutes 2002, section
59.6256J.62, subdivision 7 , in effect June 30, 2002;
59.7    (iv) supported work program authorized in Laws 2001, First Special Session chapter
59.89, article 17, section 2, in effect June 30, 2002;
59.9    (v) administrative aid program under section 256J.76 in effect December 31, 2002;
59.10and
59.11    (vi) emergency assistance program under Minnesota Statutes 2002, section 256J.48,
59.12in effect June 30, 2002.
59.13    (b) The commissioner shall:
59.14    (1) beginning July 1, 2003, determine the initial allocation of funds available under
59.15this section according to clause (2);
59.16    (2) allocate all of the funds available for the period beginning July 1, 2003, and
59.17ending December 31, 2004, to each county or tribe in proportion to the county's or tribe's
59.18share of the statewide 2002 historic spending base;
59.19    (3) determine for calendar year 2005 the initial allocation of funds to be made
59.20available under this section in proportion to the county or tribe's initial allocation for the
59.21period of July 1, 2003, to December 31, 2004;
59.22    (4) determine for calendar year 2006 the initial allocation of funds to be made
59.23available under this section based 90 percent on the proportion of the county or tribe's
59.24share of the statewide 2002 historic spending base and ten percent on the proportion of
59.25the county or tribe's share of the adjusted caseload factor;
59.26    (5) determine for calendar year 2007 the initial allocation of funds to be made
59.27available under this section based 70 percent on the proportion of the county or tribe's
59.28share of the statewide 2002 historic spending base and 30 percent on the proportion of the
59.29county or tribe's share of the adjusted caseload factor; and
59.30    (6) determine for calendar year 2008 and subsequent years the initial allocation of
59.31funds to be made available under this section based 50 percent on the proportion of the
59.32county or tribe's share of the statewide 2002 historic spending base and 50 percent on the
59.33proportion of the county or tribe's share of the adjusted caseload factor.
59.34    (c) With the commencement of a new or expanded tribal TANF program or an
59.35agreement under section 256.01, subdivision 2, paragraph (g), in which some or all of
60.1the responsibilities of particular counties under this section are transferred to a tribe,
60.2the commissioner shall:
60.3    (1) in the case where all responsibilities under this section are transferred to a tribal
60.4program, determine the percentage of the county's current caseload that is transferring to a
60.5tribal program and adjust the affected county's allocation accordingly; and
60.6    (2) in the case where a portion of the responsibilities under this section are
60.7transferred to a tribal program, the commissioner shall consult with the affected county or
60.8counties to determine an appropriate adjustment to the allocation.
60.9    (d) Effective January 1, 2005, counties and tribes will have their final allocations
60.10adjusted based on the performance provisions of subdivision 7.

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

60.30    Sec. 51. Minnesota Statutes 2006, section 256J.751, subdivision 5, is amended to read:
60.31    Subd. 5. Failure to meet federal performance standards. (a) If sanctions occur
60.32for failure to meet the performance standards specified in title 1 of Public Law 104-193
60.33of the Personal Responsibility and Work Opportunity Act of 1996, and under Public
60.34Law 109-171, the Deficit Reduction Act of 2005, the state shall pay 88 percent of the
61.1sanction. The remaining 12 percent of the sanction will be paid by the counties. The
61.2county portion of the sanction will be distributed across all counties in proportion to each
61.3county's percentage of the MFIP average monthly caseload during the period for which
61.4the sanction was applied.
61.5    (b) If a county fails to meet the performance standards specified in title 1 of Public
61.6Law 104-193 of the Personal Responsibility and Work Opportunity Act of 1996, and
61.7Public Law 109-171, the Deficit Reduction Act of 2005, for any year, the commissioner
61.8shall work with counties to organize a joint state-county technical assistance team to work
61.9with the county. The commissioner shall coordinate any technical assistance with other
61.10departments and agencies including the Departments of Employment and Economic
61.11Development and Education as necessary to achieve the purpose of this paragraph.
61.12    (c) For state performance measures, a low-performing county is one that:
61.13    (1) performs below the bottom of their expected range for the measure in subdivision
61.142, clause (7) (6), in an annualized measurement reported in October of each year; or
61.15    (2) performs below 40 percent for the measure in subdivision 2, clause (8) (7), as
61.16averaged across the four quarterly measurements for the year, or the ten counties with the
61.17lowest rates if more than ten are below 40 percent.
61.18    (d) Low-performing counties under paragraph (c) must engage in corrective action
61.19planning as defined by the commissioner. The commissioner may coordinate technical
61.20assistance as specified in paragraph (b) for low-performing counties under paragraph (c).

61.21    Sec. 52. Minnesota Statutes 2006, section 256J.95, subdivision 3, is amended to read:
61.22    Subd. 3. Eligibility for diversionary work program. (a) Except for the categories
61.23of family units listed below, all family units who apply for cash benefits and who
61.24meet MFIP eligibility as required in sections 256J.11 to 256J.15 are eligible and must
61.25participate in the diversionary work program. Family units that are not eligible for the
61.26diversionary work program include:
61.27    (1) child only cases;
61.28    (2) a single-parent family unit that includes a child under 12 weeks of age. A parent
61.29is eligible for this exception once in a parent's lifetime and is not eligible if the parent
61.30has already used the previously allowed child under age one exemption from MFIP
61.31employment services;
61.32    (3) a minor parent without a high school diploma or its equivalent;
61.33    (4) an 18- or 19-year-old caregiver without a high school diploma or its equivalent
61.34who chooses to have an employment plan with an education option;
61.35    (5) a caregiver age 60 or over;
62.1    (6) family units with a caregiver who received DWP benefits in the 12 months prior
62.2to the month the family applied for DWP, except as provided in paragraph (c);
62.3    (7) family units with a caregiver who received MFIP within the 12 months prior to
62.4the month the family unit applied for DWP;
62.5    (8) a family unit with a caregiver who received 60 or more months of TANF
62.6assistance; and
62.7    (9) a family unit with a caregiver who is disqualified from DWP or MFIP due to
62.8fraud.; and
62.9    (10) refugees as defined in Code of Federal Regulations, title 45, chapter IV, section
62.10444.43, who arrived in the United States in the 12 months prior to the date of application
62.11for family cash assistance.
62.12    (b) A two-parent family must participate in DWP unless both caregivers meet the
62.13criteria for an exception under paragraph (a), clauses (1) through (5), or the family unit
62.14includes a parent who meets the criteria in paragraph (a), clause (6), (7), (8), or (9).
62.15    (c) Once DWP eligibility is determined, the four months run consecutively. If a
62.16participant leaves the program for any reason and reapplies during the four-month period,
62.17the county must redetermine eligibility for DWP.
62.18EFFECTIVE DATE.This section is effective the day following final enactment.

62.19    Sec. 53. Minnesota Statutes 2006, section 256J.95, subdivision 13, is amended to read:
62.20    Subd. 13. Immediate referral to employment services. Within one working day of
62.21determination that the applicant is eligible for the diversionary work program, but before
62.22benefits are issued to or on behalf of the family unit, the county shall refer all caregivers to
62.23employment services. The referral to the DWP employment services must be in writing
62.24and must contain the following information:
62.25    (1) notification that, as part of the application process, applicants are required to
62.26develop an employment plan or the DWP application will be denied;
62.27    (2) the employment services provider name and phone number;
62.28    (3) the date, time, and location of the scheduled employment services interview;
62.29    (4) (3) the immediate availability of supportive services, including, but not limited
62.30to, child care, transportation, and other work-related aid; and
62.31    (5) (4) the rights, responsibilities, and obligations of participants in the program,
62.32including, but not limited to, the grounds for good cause, the consequences of refusing or
62.33failing to participate fully with program requirements, and the appeal process.

63.1    Sec. 54. Minnesota Statutes 2006, section 256K.45, is amended by adding a
63.2subdivision to read:
63.3    Subd. 6. Funding. Any funds appropriated for this section may be expended
63.4on programs described under subdivisions 3 to 5, technical assistance, and capacity
63.5building. In addition, up to five percent of funds appropriated may be used for program
63.6administration and up to eight percent of funds appropriated may be used for the purpose
63.7of monitoring and evaluating runaway and homeless youth programs receiving funding
63.8under this section. Funding shall be directed to meet the greatest need, with a significant
63.9share of the funding focused on homeless youth providers in greater Minnesota.

63.10    Sec. 55. Minnesota Statutes 2006, section 259.24, subdivision 3, is amended to read:
63.11    Subd. 3. Child. When the child to be adopted is over 14 years of age, the child's
63.12written consent to adoption by a particular person is also shall be necessary. A child
63.13of any age who is under the guardianship of the commissioner and is legally available
63.14for adoption may not refuse or waive the commissioner's agent's exhaustive efforts to
63.15recruit, identify, and place the child in an adoptive home required under section 260C.317,
63.16subdivision 3, paragraph (b), or sign a document relieving county social services agencies
63.17of all recruitment efforts on the child's behalf.

63.18    Sec. 56. Minnesota Statutes 2006, section 259.53, subdivision 1, is amended to read:
63.19    Subdivision 1. Notice to commissioner; referral for postplacement assessment.
63.20    (a) Upon the filing of a petition for adoption of a child who is:
63.21    (1) under the guardianship of the commissioner or a licensed child-placing agency
63.22according to section 260C.201, subdivision 11, or 260C.317;
63.23    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
63.24agency after a consent to adopt according to section 259.24 or under an agreement
63.25conferring authority to place for adoption according to section 259.25; or
63.26    (3) placed by preadoptive custody order for a direct adoptive placement ordered
63.27by the district court under section 259.47,
63.28the court administrator shall immediately transmit a copy of the petition to the
63.29commissioner of human services.
63.30    (b) The court shall immediately refer the petition to the agency specified below for
63.31completion of a postplacement assessment and report as required by subdivision 2.
63.32    (1) If the child to be adopted has been committed to the guardianship of the
63.33commissioner or an agency under section 260C.317 or an agency has been given authority
63.34to place the child under section 259.25, the court shall refer the petition to that agency,
64.1unless another agency is supervising the placement, in which case the court shall refer the
64.2petition to the supervising agency.
64.3    (2) If the child to be adopted has been placed in the petitioner's home by a direct
64.4adoptive placement, the court shall refer the petition to the agency supervising the
64.5placement under section 259.47, subdivision 3, paragraph (a), clause (6).
64.6    (3) If the child is to be adopted by an individual who is related to the child as defined
64.7by section 245A.02, subdivision 13, and in all other instances not described in clause (1)
64.8or (2), the court shall refer the petition to the local social services agency of the county in
64.9which the prospective adoptive parent lives.

64.10    Sec. 57. Minnesota Statutes 2006, section 259.57, subdivision 1, is amended to read:
64.11    Subdivision 1. Findings; orders. Upon the hearing,
64.12    (a) if the court finds that it is in the best interests of the child that the petition
64.13be granted, a decree of adoption shall be made and recorded in the office of the court
64.14administrator, ordering that henceforth the child shall be the child of the petitioner. In the
64.15decree the court may change the name of the child if desired. After the decree is granted
64.16for a child who is:
64.17    (1) under the guardianship of the commissioner or a licensed child-placing agency
64.18according to section 260C.201, subdivision 11, or 260C.317;
64.19    (2) placed by the commissioner, commissioner's agent, or licensed child-placing
64.20agency after a consent to adopt according to section 259.24 or under an agreement
64.21conferring authority to place for adoption according to section 259.25; or
64.22    (3) adopted after a direct adoptive placement ordered by the district court under
64.23section 259.47,
64.24the court administrator shall immediately mail a copy of the recorded decree to the
64.25commissioner of human services;
64.26    (b) if the court is not satisfied that the proposed adoption is in the best interests
64.27of the child, the court shall deny the petition, and shall order the child returned to the
64.28custody of the person or agency legally vested with permanent custody or certify the
64.29case for appropriate action and disposition to the court having jurisdiction to determine
64.30the custody and guardianship of the child.

64.31    Sec. 58. Minnesota Statutes 2006, section 259.67, subdivision 4, is amended to read:
64.32    Subd. 4. Eligibility conditions. (a) The placing agency shall use the AFDC
64.33requirements as specified in federal law as of July 16, 1996, when determining the child's
64.34eligibility for adoption assistance under title IV-E of the Social Security Act. If the child
65.1does not qualify, the placing agency shall certify a child as eligible for state funded
65.2adoption assistance only if the following criteria are met:
65.3    (1) Due to the child's characteristics or circumstances it would be difficult to provide
65.4the child an adoptive home without adoption assistance.
65.5    (2)(i) A placement agency has made reasonable efforts to place the child for adoption
65.6without adoption assistance, but has been unsuccessful; or
65.7    (ii) the child's licensed foster parents desire to adopt the child and it is determined by
65.8the placing agency that the adoption is in the best interest of the child.
65.9    (3)(i) The child has been a ward of the commissioner, a Minnesota-licensed
65.10child-placing agency, or a tribal social service agency of Minnesota recognized by the
65.11Secretary of the Interior; or (ii) the child will be adopted according to tribal law without a
65.12termination of parental rights or relinquishment, provided that the tribe has documented
65.13the valid reason why the child cannot or should not be returned to the home of the child's
65.14parent. The placing agency shall not certify a child who remains under the jurisdiction
65.15of the sending agency pursuant to section 260.851, article 5, for state-funded adoption
65.16assistance when Minnesota is the receiving state.
65.17    (b) For purposes of this subdivision, the characteristics or circumstances that may
65.18be considered in determining whether a child is a child with special needs under United
65.19States Code, title 42, chapter 7, subchapter IV, part E, or meets the requirements of
65.20paragraph (a), clause (1), are the following:
65.21    (1) The child is a member of a sibling group to be placed as one unit in which at
65.22least one sibling is older than 15 months of age or is described in clause (2) or (3).
65.23    (2) The child has documented physical, mental, emotional, or behavioral disabilities.
65.24    (3) The child has a high risk of developing physical, mental, emotional, or behavioral
65.25disabilities.
65.26    (4) The child is adopted according to tribal law without a termination of parental
65.27rights or relinquishment, provided that the tribe has documented the valid reason why the
65.28child cannot or should not be returned to the home of the child's parent.
65.29    (4) The child is five years of age or older.
65.30    (c) When a child's eligibility for adoption assistance is based upon the high risk of
65.31developing physical, mental, emotional, or behavioral disabilities, payments shall not be
65.32made under the adoption assistance agreement unless and until the potential disability
65.33manifests itself as documented by an appropriate health care professional.

65.34    Sec. 59. Minnesota Statutes 2006, section 259.67, subdivision 7, is amended to read:
66.1    Subd. 7. Reimbursement of costs. (a) Subject to rules of the commissioner, and
66.2the provisions of this subdivision a child-placing agency licensed in Minnesota or any
66.3other state, or local or tribal social services agency shall receive a reimbursement from the
66.4commissioner equal to 100 percent of the reasonable and appropriate cost of providing
66.5adoption services for a child certified as eligible for adoption assistance under subdivision
66.64. Such assistance. Adoption services under this subdivision may include adoptive family
66.7recruitment, counseling, and special training when needed.
66.8    (b) An eligible child must have a goal of adoption, which may include an adoption
66.9in accordance with tribal law, and meet one of the following criteria:
66.10    (1) is a ward of the commissioner of human services or a ward of tribal court
66.11pursuant to section 260.755, subdivision 20, who meets one of the criteria in subdivision
66.124, paragraph (b), clause (1), (2), or (3); or
66.13    (2) is under the guardianship of a Minnesota-licensed child-placing agency who
66.14meets one of the criteria in subdivision 4, paragraph (b), clause (1) or (2).
66.15    (c) A child-placing agency licensed in Minnesota or any other state shall receive
66.16reimbursement for adoption services it purchases for or directly provides to an eligible
66.17child. Tribal social services shall receive reimbursement for adoption services it purchases
66.18for or directly provides to an eligible child. A local or tribal social services agency shall
66.19receive such reimbursement only for adoption services it purchases for an eligible child.
66.20    (b) A child-placing agency licensed in Minnesota or any other state or local or tribal
66.21social services agency seeking reimbursement under this subdivision shall enter into
66.22Before providing adoption services for which reimbursement will be sought under this
66.23subdivision, a reimbursement agreement, on the designated format, must be entered into
66.24with the commissioner before providing adoption services for which reimbursement
66.25is sought. No reimbursement under this subdivision shall be made to an agency for
66.26services provided prior to entering a reimbursement agreement. Separate reimbursement
66.27agreements shall be made for each child and separate records shall be kept on each child
66.28for whom a reimbursement agreement is made. The commissioner of human services shall
66.29agree that the reimbursement costs are reasonable and appropriate. The commissioner
66.30may spend up to $16,000 for each purchase of service agreement. Only one agreement per
66.31child is allowed, unless an exception is granted by the commissioner. Funds encumbered
66.32and obligated under such an agreement for the child remain available until the terms of
66.33the agreement are fulfilled or the agreement is terminated.
66.34    (c) When a local or tribal social services agency uses a purchase of service agreement
66.35to provide services reimbursable under a reimbursement agreement, The commissioner
66.36may shall make reimbursement payments directly to the agency providing the service if
67.1direct reimbursement is specified by the purchase of service agreement, and if the request
67.2for reimbursement is submitted by the local or tribal social services agency along with a
67.3verification that the service was provided.

67.4    Sec. 60. Minnesota Statutes 2006, section 259.75, subdivision 8, is amended to read:
67.5    Subd. 8. Reasons for deferral. Deferral of the listing of a child with the state
67.6adoption exchange shall be only for one or more of the following reasons:
67.7    (a) the child is in an adoptive placement but is not legally adopted;
67.8    (b) the child's foster parents or other individuals are now considering adoption;
67.9    (c) diagnostic study or testing is required to clarify the child's problem and provide
67.10an adequate description; or
67.11    (d) the child is currently in a hospital and continuing need for daily professional care
67.12will not permit placement in a family setting; or.
67.13    (e) the child is 14 years of age or older and will not consent to an adoption plan.
67.14Approval of a request to defer listing for any of the reasons specified in paragraph (b) or
67.15(c) shall be valid for a period not to exceed 90 days, with no subsequent deferrals for
67.16those reasons.

67.17    Sec. 61. Minnesota Statutes 2006, section 260.012, is amended to read:
67.18260.012 DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY
67.19REUNIFICATION; REASONABLE EFFORTS.
67.20    (a) Once a child alleged to be in need of protection or services is under the court's
67.21jurisdiction, the court shall ensure that reasonable efforts, including culturally appropriate
67.22services, by the social services agency are made to prevent placement or to eliminate the
67.23need for removal and to reunite the child with the child's family at the earliest possible
67.24time, and when a child cannot be reunified with the parent or guardian from whom the
67.25child was removed, the court must ensure that the responsible social services agency
67.26makes reasonable efforts to finalize an alternative permanent plan for the child as provided
67.27in paragraph (e). In determining reasonable efforts to be made with respect to a child and
67.28in making those reasonable efforts, the child's best interests, health, and safety must be of
67.29paramount concern. Reasonable efforts to prevent placement and for rehabilitation and
67.30reunification are always required except upon a determination by the court that a petition
67.31has been filed stating a prima facie case that:
67.32    (1) the parent has subjected a child to egregious harm as defined in section
67.33260C.007, subdivision 14 ;
68.1    (2) the parental rights of the parent to another child have been terminated
68.2involuntarily;
68.3    (3) the child is an abandoned infant under section 260C.301, subdivision 2,
68.4paragraph (a), clause (2);
68.5    (4) the parent's custodial rights to another child have been involuntarily transferred
68.6to a relative under section 260C.201, subdivision 11, paragraph (e), clause (1), or a similar
68.7law of another jurisdiction; or
68.8    (5) the provision of services or further services for the purpose of reunification is
68.9futile and therefore unreasonable under the circumstances.
68.10    (b) When the court makes one of the prima facie determinations under paragraph (a),
68.11either permanency pleadings under section 260C.201, subdivision 11, or a termination
68.12of parental rights petition under sections 260C.141 and 260C.301 must be filed. A
68.13permanency hearing under section 260C.201, subdivision 11, must be held within 30
68.14days of this determination.
68.15    (c) In the case of an Indian child, in proceedings under sections 260B.178 or
68.16260C.178 , 260C.201, and 260C.301 the juvenile court must make findings and conclusions
68.17consistent with the Indian Child Welfare Act of 1978, United States Code, title 25, section
68.181901 et seq., as to the provision of active efforts. In cases governed by the Indian Child
68.19Welfare Act of 1978, United States Code, title 25, section 1901, the responsible social
68.20services agency must provide active efforts as required under United States Code, title
68.2125, section 1911(d).
68.22    (d) "Reasonable efforts to prevent placement" means:
68.23    (1) the agency has made reasonable efforts to prevent the placement of the child in
68.24foster care; or
68.25    (2) given the particular circumstances of the child and family at the time of the
68.26child's removal, there are no services or efforts available which could allow the child to
68.27safely remain in the home.
68.28    (e) "Reasonable efforts to finalize a permanent plan for the child" means due
68.29diligence by the responsible social services agency to:
68.30    (1) reunify the child with the parent or guardian from whom the child was removed;
68.31    (2) assess a noncustodial parent's ability to provide day-to-day care for the child and,
68.32where appropriate, provide services necessary to enable the noncustodial parent to safely
68.33provide the care, as required by section 260C.212, subdivision 4;
68.34    (3) conduct a relative search as required under section 260C.212, subdivision 5; and
68.35    (4) when the child cannot return to the parent or guardian from whom the child was
68.36removed, to plan for and finalize a safe and legally permanent alternative home for the
69.1child, and considers permanent alternative homes for the child inside or outside of the
69.2state, preferably through adoption or transfer of permanent legal and physical custody of
69.3the child.
69.4    (f) Reasonable efforts are made upon the exercise of due diligence by the responsible
69.5social services agency to use culturally appropriate and available services to meet the
69.6needs of the child and the child's family. Services may include those provided by the
69.7responsible social services agency and other culturally appropriate services available in
69.8the community. At each stage of the proceedings where the court is required to review
69.9the appropriateness of the responsible social services agency's reasonable efforts as
69.10described in paragraphs (a), (d), and (e), the social services agency has the burden of
69.11demonstrating that:
69.12    (1) it has made reasonable efforts to prevent placement of the child in foster care;
69.13    (2) it has made reasonable efforts to eliminate the need for removal of the child from
69.14the child's home and to reunify the child with the child's family at the earliest possible time;
69.15    (3) it has made reasonable efforts to finalize an alternative permanent home for
69.16the child, and considers permanent alternative homes for the child inside or outside of
69.17the state; or
69.18    (4) reasonable efforts to prevent placement and to reunify the child with the parent
69.19or guardian are not required. The agency may meet this burden by stating facts in a sworn
69.20petition filed under section 260C.141, by filing an affidavit summarizing the agency's
69.21reasonable efforts or facts the agency believes demonstrate there is no need for reasonable
69.22efforts to reunify the parent and child, or through testimony or a certified report required
69.23under juvenile court rules.
69.24    (g) Once the court determines that reasonable efforts for reunification are not
69.25required because the court has made one of the prima facie determinations under paragraph
69.26(a), the court may only require reasonable efforts for reunification after a hearing according
69.27to section 260C.163, where the court finds there is not clear and convincing evidence of
69.28the facts upon which the court based its prima facie determination. In this case when there
69.29is clear and convincing evidence that the child is in need of protection or services, the
69.30court may find the child in need of protection or services and order any of the dispositions
69.31available under section 260C.201, subdivision 1. Reunification of a surviving child with a
69.32parent is not required if the parent has been convicted of:
69.33    (1) a violation of, or an attempt or conspiracy to commit a violation of, sections
69.34609.185 to 609.20; 609.222, subdivision 2; or 609.223 in regard to another child of the
69.35parent;
70.1    (2) a violation of section 609.222, subdivision 2; or 609.223, in regard to the
70.2surviving child; or
70.3    (3) a violation of, or an attempt or conspiracy to commit a violation of, United States
70.4Code, title 18, section 1111(a) or 1112(a), in regard to another child of the parent.
70.5    (h) The juvenile court, in proceedings under sections 260B.178 or 260C.178,
70.6260C.201 , and 260C.301 shall make findings and conclusions as to the provision of
70.7reasonable efforts. When determining whether reasonable efforts have been made, the
70.8court shall consider whether services to the child and family were:
70.9    (1) relevant to the safety and protection of the child;
70.10    (2) adequate to meet the needs of the child and family;
70.11    (3) culturally appropriate;
70.12    (4) available and accessible;
70.13    (5) consistent and timely; and
70.14    (6) realistic under the circumstances.
70.15    In the alternative, the court may determine that provision of services or further
70.16services for the purpose of rehabilitation is futile and therefore unreasonable under the
70.17circumstances or that reasonable efforts are not required as provided in paragraph (a).
70.18    (i) This section does not prevent out-of-home placement for treatment of a child with
70.19a mental disability when the child's diagnostic assessment or individual treatment plan
70.20indicates that appropriate and necessary treatment cannot be effectively provided outside
70.21of a residential or inpatient treatment program.
70.22    (j) If continuation of reasonable efforts to prevent placement or reunify the child
70.23with the parent or guardian from whom the child was removed is determined by the court
70.24to be inconsistent with the permanent plan for the child or upon the court making one of
70.25the prima facie determinations under paragraph (a), reasonable efforts must be made to
70.26place the child in a timely manner in a safe and permanent home and to complete whatever
70.27steps are necessary to legally finalize the permanent placement of the child.
70.28    (k) Reasonable efforts to place a child for adoption or in another permanent
70.29placement may be made concurrently with reasonable efforts to prevent placement or to
70.30reunify the child with the parent or guardian from whom the child was removed. When
70.31the responsible social services agency decides to concurrently make reasonable efforts for
70.32both reunification and permanent placement away from the parent under paragraph (a), the
70.33agency shall disclose its decision and both plans for concurrent reasonable efforts to all
70.34parties and the court. When the agency discloses its decision to proceed on both plans for
70.35reunification and permanent placement away from the parent, the court's review of the
70.36agency's reasonable efforts shall include the agency's efforts under both plans.

71.1    Sec. 62. Minnesota Statutes 2006, section 260.755, subdivision 12, is amended to read:
71.2    Subd. 12. Indian tribe. "Indian tribe" means an Indian tribe, band, nation, or
71.3other organized group or community of Indians recognized as eligible for the services
71.4provided to Indians by the secretary because of their status as Indians, including any band
71.5Native group under the Alaska Native Claims Settlement Act, United States Code, title 43,
71.6section 1602, and exercising tribal governmental powers.

71.7    Sec. 63. Minnesota Statutes 2006, section 260.755, subdivision 20, is amended to read:
71.8    Subd. 20. Tribal court. "Tribal court" means a court with federally recognized
71.9jurisdiction over child custody proceedings and which is either a court of Indian offenses,
71.10or a court established and operated under the code or custom of an Indian tribe, or the
71.11any other administrative body of a tribe which is vested with authority over child custody
71.12proceedings. Except as provided in section 260.771, subdivision 5, nothing in this chapter
71.13shall be construed as conferring jurisdiction on an Indian tribe.

71.14    Sec. 64. Minnesota Statutes 2006, section 260.761, subdivision 7, is amended to read:
71.15    Subd. 7. Identification of extended family members. Any agency considering
71.16placement of an Indian child shall make reasonable active efforts to identify and locate
71.17extended family members.

71.18    Sec. 65. Minnesota Statutes 2006, section 260.765, subdivision 5, is amended to read:
71.19    Subd. 5. Identification of extended family members. Any agency considering
71.20placement of an Indian child shall make reasonable active efforts to identify and locate
71.21extended family members.

71.22    Sec. 66. Minnesota Statutes 2006, section 260.771, subdivision 1, is amended to read:
71.23    Subdivision 1. Indian tribe jurisdiction. An Indian tribe with a tribal court has
71.24exclusive jurisdiction over a child placement proceeding involving an Indian child who
71.25resides or is domiciled within the reservation of such the tribe at the commencement of
71.26the proceedings, except where jurisdiction is otherwise vested in the state by existing
71.27federal law. When an Indian child is in the legal custody of a person or agency pursuant
71.28to an order of a ward of the tribal court, the Indian tribe retains exclusive jurisdiction,
71.29notwithstanding the residence or domicile of the child.

71.30    Sec. 67. Minnesota Statutes 2006, section 260.771, subdivision 2, is amended to read:
72.1    Subd. 2. Court determination of tribal affiliation of child. In any child placement
72.2proceeding, the court shall establish whether an Indian child is involved and the identity
72.3of the Indian child's tribe. This chapter and the federal Indian Child Welfare Act are
72.4applicable without exception in any child custody proceeding, as defined in the federal act,
72.5involving an Indian child. This chapter applies to child custody proceedings involving
72.6an Indian child whether the child is in the physical or legal custody of an Indian parent,
72.7Indian custodian, Indian extended family member, or other person at the commencement
72.8of the proceedings. A court shall not determine the applicability of this chapter or the
72.9federal Indian Child Welfare Act to a child custody proceeding based upon whether an
72.10Indian child is part of an existing Indian family or based upon the level of contact a child
72.11has with the child's Indian tribe, reservation, society, or off-reservation community.

72.12    Sec. 68. [260.852] PLACEMENT PROCEDURES.
72.13    Subdivision 1. Home study. The state must have procedures for the orderly and
72.14timely interstate placement of children that are implemented in accordance with an
72.15interstate compact and that, within 60 days after the state receives from another state a
72.16request to conduct a study of a home environment for purposes of assessing the safety
72.17and suitability of placing a child in the home, the state shall, directly or by contract,
72.18conduct and complete a home study and return to the other state a report on the results of
72.19the study, which shall address the extent to which placement in the home would meet the
72.20needs of the child; except in the case of a home study begun before October 1, 2008, if the
72.21state fails to comply with conducting and completing the home study within the 60-day
72.22period and this is as a result of circumstances beyond the control of the state, the state has
72.2375 days to comply if the state documents the circumstances involved and certifies that
72.24completing the home study is in the best interests of the child.
72.25    This subdivision does not require the completion within the applicable period of
72.26the parts of the home study involving the education and training of the prospective foster
72.27or adoptive parents.
72.28    Subd. 2. Effect of received report. The state shall treat any report described in
72.29subdivision 1 that is received from another state, an Indian tribe, or a private agency
72.30under contract with another state or Indian tribe as meeting any requirements imposed by
72.31the state for the completion of a home study before placing a child in the home, unless,
72.32within 14 days after receipt of the report, the state determines, based on grounds that
72.33are specific to the content of the report, that making a decision in reliance on the report
72.34would be contrary to the welfare of the child.
73.1    Subd. 3. Resources. The state shall make effective use of cross-jurisdictional
73.2resources, including through contract for the purchase of services, and shall eliminate
73.3legal barriers to facilitate timely adoptive or permanent placements for waiting children.
73.4The state shall not impose any restriction on the use of private agencies for the purpose of
73.5conducting a home study to meet the 60-day requirement.
73.6    Subd. 4. Incentive eligibility. Minnesota is an incentive-eligible state and must:
73.7    (1) have an approved plan as required by the United States Secretary of Health
73.8and Human Services;
73.9    (2) be in compliance with the data requirements of the United States Department of
73.10Health and Human Services; and
73.11    (3) have data that verify that a home study is completed within 30 days.
73.12    Subd. 5. Data requirements. The state shall provide to the United States Secretary
73.13of Health and Human Services a written report, covering the preceding fiscal year, that
73.14specifies:
73.15    (1) the total number of interstate home studies requested by the state with respect
73.16to children in foster care under the responsibility of the state, and with respect to each
73.17study, the identity of the other state involved;
73.18    (2) the total number of timely interstate home studies completed by the state with
73.19respect to children in foster care under the responsibility of other states and, with respect
73.20to each study, the identity of the other state involved; and
73.21    (3) other information the United States Secretary of Health and Human Services
73.22requires in order to determine whether Minnesota is a home study incentive-eligible state.
73.23    Subd. 6. Definitions. (a) The definitions in this subdivision apply to this section.
73.24    (b) "Home study" means an evaluation of a home environment conducted in
73.25accordance with applicable requirements of the state in which the home is located, to
73.26determine whether a proposed placement of a child would meet the individual needs of the
73.27child, including the child's safety; permanency; health; well-being; and mental, emotional,
73.28and physical development.
73.29    (c) "Interstate home study" means a home study conducted by a state at the request
73.30of another state to facilitate an adoptive or foster placement in the state of a child in foster
73.31care under the responsibility of the state.
73.32    (d) "Timely interstate home study" means an interstate home study completed by a
73.33state if the state provides to the state that requested the study, within 30 days after receipt
73.34of the request, a report on the results of the study, except that there is no requirement
73.35for completion within the 30-day period of the parts of the home study involving the
73.36education and training of the prospective foster or adoptive parents.
74.1    Subd. 7. Background study requirements for adoption and foster care. (a)
74.2Background study requirements for an adoption home study must be completed consistent
74.3with section 259.41, subdivisions 1, 2, and 3.
74.4    (b) Background study requirements for a foster care license must be completed
74.5consistent with section 245C.08.
74.6    Subd. 8. Home visits. If a child has been placed in foster care outside the state in
74.7which the home of the parents of the child is located, periodically, but at least every six
74.8months, a caseworker on the staff of the agency of the state in which the home of the
74.9parents of the child is located or the state in which the child has been placed, or a private
74.10agency under contract with either state, must visit the child in the home or institution and
74.11submit a report on each visit to the agency of the state in which the home of the parents of
74.12the child is located.

74.13    Sec. 69. Minnesota Statutes 2006, section 260B.157, subdivision 1, is amended to read:
74.14    Subdivision 1. Investigation. Upon request of the court the local social services
74.15agency or probation officer shall investigate the personal and family history and
74.16environment of any minor coming within the jurisdiction of the court under section
74.17260B.101 and shall report its findings to the court. The court may order any minor coming
74.18within its jurisdiction to be examined by a duly qualified physician, psychiatrist, or
74.19psychologist appointed by the court.
74.20    The court shall have order a chemical use assessment conducted when a child is
74.21(1) found to be delinquent for violating a provision of chapter 152, or for committing a
74.22felony-level violation of a provision of chapter 609 if the probation officer determines
74.23that alcohol or drug use was a contributing factor in the commission of the offense, or
74.24(2) alleged to be delinquent for violating a provision of chapter 152, if the child is being
74.25held in custody under a detention order. The assessor's qualifications and the assessment
74.26criteria shall comply with Minnesota Rules, parts 9530.6600 to 9530.6655. If funds under
74.27chapter 254B are to be used to pay for the recommended treatment, the assessment and
74.28placement must comply with all provisions of Minnesota Rules, parts 9530.6600 to
74.299530.6655 and 9530.7000 to 9530.7030. The commissioner of human services shall
74.30reimburse the court for the cost of the chemical use assessment, up to a maximum of $100.
74.31    The court shall have order a children's mental health screening conducted when
74.32a child is found to be delinquent. The screening shall be conducted with a screening
74.33instrument approved by the commissioner of human services and shall be conducted by a
74.34mental health practitioner as defined in section 245.4871, subdivision 26, or a probation
74.35officer who is trained in the use of the screening instrument. If the screening indicates
75.1a need for assessment, the local social services agency, in consultation with the child's
75.2family, shall have a diagnostic assessment conducted, including a functional assessment,
75.3as defined in section 245.4871.
75.4    With the consent of the commissioner of corrections and agreement of the county to
75.5pay the costs thereof, the court may, by order, place a minor coming within its jurisdiction
75.6in an institution maintained by the commissioner for the detention, diagnosis, custody and
75.7treatment of persons adjudicated to be delinquent, in order that the condition of the minor
75.8be given due consideration in the disposition of the case. Any funds received under the
75.9provisions of this subdivision shall not cancel until the end of the fiscal year immediately
75.10following the fiscal year in which the funds were received. The funds are available for
75.11use by the commissioner of corrections during that period and are hereby appropriated
75.12annually to the commissioner of corrections as reimbursement of the costs of providing
75.13these services to the juvenile courts.

75.14    Sec. 70. Minnesota Statutes 2006, section 260C.152, subdivision 5, is amended to read:
75.15    Subd. 5. Notice to foster parents and preadoptive parents and relatives. The
75.16foster parents, if any, of a child and any preadoptive parent or relative providing care
75.17for the child must be provided notice of and an opportunity a right to be heard in any
75.18review or hearing to be held with respect to the child. Any other relative may also request,
75.19and must be granted, a notice and the opportunity to be heard under this section. This
75.20subdivision does not require that a foster parent, preadoptive parent, or relative providing
75.21care for the child be made a party to a review or hearing solely on the basis of the notice
75.22and opportunity right to be heard.

75.23    Sec. 71. Minnesota Statutes 2006, section 260C.163, subdivision 1, is amended to read:
75.24    Subdivision 1. General. (a) Except for hearings arising under section 260C.425,
75.25hearings on any matter shall be without a jury and may be conducted in an informal
75.26manner. In all adjudicatory proceedings involving a child alleged to be in need of
75.27protection or services, the court shall admit only evidence that would be admissible in a
75.28civil trial. To be proved at trial, allegations of a petition alleging a child to be in need of
75.29protection or services must be proved by clear and convincing evidence.
75.30    (b) Except for proceedings involving a child alleged to be in need of protection or
75.31services and petitions for the termination of parental rights, hearings may be continued or
75.32adjourned from time to time. In proceedings involving a child alleged to be in need of
75.33protection or services and petitions for the termination of parental rights, hearings may not
75.34be continued or adjourned for more than one week unless the court makes specific findings
76.1that the continuance or adjournment is in the best interests of the child. If a hearing is held
76.2on a petition involving physical or sexual abuse of a child who is alleged to be in need of
76.3protection or services or neglected and in foster care, the court shall file the decision with
76.4the court administrator as soon as possible but no later than 15 days after the matter is
76.5submitted to the court. When a continuance or adjournment is ordered in any proceeding,
76.6the court may make any interim orders as it deems in the best interests of the minor in
76.7accordance with the provisions of sections 260C.001 to 260C.421.
76.8    (c) Except as otherwise provided in this paragraph, the court shall exclude the
76.9general public from hearings under this chapter and shall admit only those persons who, in
76.10the discretion of the court, have a direct interest in the case or in the work of the court.
76.11    (d) Adoption hearings shall be conducted in accordance with the provisions of
76.12laws relating to adoptions.
76.13    (e) In any permanency hearing, including the transition of a child from foster care
76.14to independent living, the court shall ensure that any consult with the child is in an
76.15age-appropriate manner.

76.16    Sec. 72. Minnesota Statutes 2006, section 260C.201, subdivision 11, is amended to
76.17read:
76.18    Subd. 11. Review of court-ordered placements; permanent placement
76.19determination. (a) This subdivision and subdivision 11a do not apply in cases where
76.20the child is in placement due solely to the child's developmental disability or emotional
76.21disturbance, where legal custody has not been transferred to the responsible social services
76.22agency, and where the court finds compelling reasons under section 260C.007, subdivision
76.238 , to continue the child in foster care past the time periods specified in this subdivision.
76.24Foster care placements of children due solely to their disability are governed by section
76.25260C.141, subdivision 2a . In all other cases where the child is in foster care or in the care
76.26of a noncustodial parent under subdivision 1, the court shall commence proceedings
76.27to determine the permanent status of a child not later than 12 months after the child is
76.28placed in foster care or in the care of a noncustodial parent. At the admit-deny hearing
76.29commencing such proceedings, the court shall determine whether there is a prima facie
76.30basis for finding that the agency made reasonable efforts, or in the case of an Indian
76.31child active efforts, required under section 260.012 and proceed according to the rules of
76.32juvenile court.
76.33    For purposes of this subdivision, the date of the child's placement in foster care is
76.34the earlier of the first court-ordered placement or 60 days after the date on which the
76.35child has been voluntarily placed in foster care by the child's parent or guardian. For
77.1purposes of this subdivision, time spent by a child under the protective supervision of
77.2the responsible social services agency in the home of a noncustodial parent pursuant to
77.3an order under subdivision 1 counts towards the requirement of a permanency hearing
77.4under this subdivision or subdivision 11a. Time spent on a trial home visit does not count
77.5counts towards the requirement of a permanency hearing under this subdivision or and a
77.6permanency review for a child under eight years of age under subdivision 11a.
77.7    For purposes of this subdivision, 12 months is calculated as follows:
77.8    (1) during the pendency of a petition alleging that a child is in need of protection
77.9or services, all time periods when a child is placed in foster care or in the home of a
77.10noncustodial parent are cumulated;
77.11    (2) if a child has been placed in foster care within the previous five years under one
77.12or more previous petitions, the lengths of all prior time periods when the child was placed
77.13in foster care within the previous five years are cumulated. If a child under this clause
77.14has been in foster care for 12 months or more, the court, if it is in the best interests of the
77.15child and for compelling reasons, may extend the total time the child may continue out
77.16of the home under the current petition up to an additional six months before making a
77.17permanency determination.
77.18    (b) Unless the responsible social services agency recommends return of the child
77.19to the custodial parent or parents, not later than 30 days prior to the admit-deny hearing
77.20required under paragraph (a) and the rules of juvenile court, the responsible social services
77.21agency shall file pleadings in juvenile court to establish the basis for the juvenile court to
77.22order permanent placement of the child, including a termination of parental rights petition,
77.23according to paragraph (d). Notice of the hearing and copies of the pleadings must be
77.24provided pursuant to section 260C.152.
77.25    (c) The permanency proceedings shall be conducted in a timely fashion including
77.26that any trial required under section 260C.163 shall be commenced within 60 days of the
77.27admit-deny hearing required under paragraph (a). At the conclusion of the permanency
77.28proceedings, the court shall:
77.29    (1) order the child returned to the care of the parent or guardian from whom the
77.30child was removed; or
77.31    (2) order a permanent placement or termination of parental rights if permanent
77.32placement or termination of parental rights is in the child's best interests. The "best
77.33interests of the child" means all relevant factors to be considered and evaluated. Transfer
77.34of permanent legal and physical custody, termination of parental rights, or guardianship
77.35and legal custody to the commissioner through a consent to adopt are preferred
77.36permanency options for a child who cannot return home.
78.1    (d) If the child is not returned to the home, the court must order one of the following
78.2dispositions:
78.3    (1) permanent legal and physical custody to a relative in the best interests of the
78.4child according to the following conditions:
78.5    (i) an order for transfer of permanent legal and physical custody to a relative shall
78.6only be made after the court has reviewed the suitability of the prospective legal and
78.7physical custodian;
78.8    (ii) in transferring permanent legal and physical custody to a relative, the juvenile
78.9court shall follow the standards applicable under this chapter and chapter 260, and the
78.10procedures set out in the juvenile court rules;
78.11    (iii) an order establishing permanent legal and physical custody under this
78.12subdivision must be filed with the family court;
78.13    (iv) a transfer of legal and physical custody includes responsibility for the protection,
78.14education, care, and control of the child and decision making on behalf of the child;
78.15    (v) the social services agency may bring a petition or motion naming a fit and
78.16willing relative as a proposed permanent legal and physical custodian. The commissioner
78.17of human services shall annually prepare for counties information that must be given to
78.18proposed custodians about their legal rights and obligations as custodians together with
78.19information on financial and medical benefits for which the child is eligible; and
78.20    (vi) the juvenile court may maintain jurisdiction over the responsible social services
78.21agency, the parents or guardian of the child, the child, and the permanent legal and
78.22physical custodian for purposes of ensuring appropriate services are delivered to the child
78.23and permanent legal custodian or for the purpose of ensuring conditions ordered by the
78.24court related to the care and custody of the child are met;
78.25    (2) termination of parental rights when the requirements of sections 260C.301 to
78.26260C.328 are met or according to the following conditions:
78.27    (i) order the social services agency to file a petition for termination of parental
78.28rights in which case all the requirements of sections 260C.301 to 260C.328 remain
78.29applicable; and
78.30    (ii) an adoption completed subsequent to a determination under this subdivision may
78.31include an agreement for communication or contact under section 259.58;
78.32    (3) long-term foster care according to the following conditions:
78.33    (i) the court may order a child into long-term foster care only if it approves the
78.34responsible social service agency's compelling reasons that neither an award of permanent
78.35legal and physical custody to a relative, nor termination of parental rights is in the child's
78.36best interests;
79.1    (ii) further, the court may only order long-term foster care for the child under this
79.2section if it finds the following:
79.3    (A) the child has reached age 12 and the responsible social services agency has made
79.4reasonable efforts to locate and place the child with an adoptive family or with a fit and
79.5willing relative who will agree to a transfer of permanent legal and physical custody of
79.6the child, but such efforts have not proven successful; or
79.7    (B) the child is a sibling of a child described in subitem (A) and the siblings have
79.8a significant positive relationship and are ordered into the same long-term foster care
79.9home; and
79.10    (iii) at least annually, the responsible social services agency reconsiders its provision
79.11of services to the child and the child's placement in long-term foster care to ensure that:
79.12    (A) long-term foster care continues to be the most appropriate legal arrangement
79.13for meeting the child's need for permanency and stability, including whether there is
79.14another permanent placement option under this chapter that would better serve the child's
79.15needs and best interests;
79.16    (B) whenever possible, there is an identified long-term foster care family that is
79.17committed to being the foster family for the child as long as the child is a minor or under
79.18the jurisdiction of the court;
79.19    (C) the child is receiving appropriate services or assistance to maintain or build
79.20connections with the child's family and community;
79.21    (D) the child's physical and mental health needs are being appropriately provided
79.22for; and
79.23    (E) the child's educational needs are being met;
79.24    (4) foster care for a specified period of time according to the following conditions:
79.25    (i) foster care for a specified period of time may be ordered only if:
79.26    (A) the sole basis for an adjudication that the child is in need of protection or
79.27services is the child's behavior;
79.28    (B) the court finds that foster care for a specified period of time is in the best
79.29interests of the child; and
79.30    (C) the court approves the responsible social services agency's compelling reasons
79.31that neither an award of permanent legal and physical custody to a relative, nor termination
79.32of parental rights is in the child's best interests;
79.33    (ii) the order does not specify that the child continue in foster care for any period
79.34exceeding one year; or
79.35    (5) guardianship and legal custody to the commissioner of human services under
79.36the following procedures and conditions:
80.1    (i) there is an identified prospective adoptive home agreed to by the responsible
80.2social services agency having legal custody of the child pursuant to court order under this
80.3section that has agreed to adopt the child and the court accepts the parent's voluntary
80.4consent to adopt under section 259.24, except that such consent executed by a parent under
80.5this item, following proper notice that consent given under this provision is irrevocable
80.6upon acceptance by the court, shall be irrevocable unless fraud is established and an order
80.7issues permitting revocation as stated in item (vii);
80.8    (ii) if the court accepts a consent to adopt in lieu of ordering one of the other
80.9enumerated permanency dispositions, the court must review the matter at least every 90
80.10days. The review will address the reasonable efforts of the agency to achieve a finalized
80.11adoption;
80.12    (iii) a consent to adopt under this clause vests all legal authority regarding the child,
80.13including guardianship and legal custody of the child, with the commissioner of human
80.14services as if the child were a state ward after termination of parental rights;
80.15    (iv) the court must forward a copy of the consent to adopt, together with a certified
80.16copy of the order transferring guardianship and legal custody to the commissioner, to
80.17the commissioner;
80.18    (v) if an adoption is not finalized by the identified prospective adoptive parent within
80.1912 months of the execution of the consent to adopt under this clause, the commissioner of
80.20human services or the commissioner's delegate shall pursue adoptive placement in another
80.21home unless the commissioner certifies that the failure to finalize is not due to either an
80.22action or a failure to act by the prospective adoptive parent;
80.23    (vi) notwithstanding item (v), the commissioner of human services or the
80.24commissioner's designee must pursue adoptive placement in another home as soon as the
80.25commissioner or commissioner's designee determines that finalization of the adoption with
80.26the identified prospective adoptive parent is not possible, that the identified prospective
80.27adoptive parent is not willing to adopt the child, that the identified prospective adoptive
80.28parent is not cooperative in completing the steps necessary to finalize the adoption, or
80.29upon the commissioner's determination to withhold consent to the adoption.
80.30    (vii) unless otherwise required by the Indian Child Welfare Act, United States Code,
80.31title 25, section 1913, a consent to adopt executed under this section, following proper
80.32notice that consent given under this provision is irrevocable upon acceptance by the court,
80.33shall be irrevocable upon acceptance by the court except upon order permitting revocation
80.34issued by the same court after written findings that consent was obtained by fraud.
80.35    (e) In ordering a permanent placement of a child, the court must be governed by the
80.36best interests of the child, including a review of the relationship between the child and
81.1relatives and the child and other important persons with whom the child has resided or
81.2had significant contact. When the court has determined that permanent placement of the
81.3child away from the parent is necessary, the court shall consider permanent alternative
81.4homes that are available both inside and outside the state.
81.5    (f) Once a permanent placement determination has been made and permanent
81.6placement has been established, further court reviews are necessary if:
81.7    (1) the placement is long-term foster care or foster care for a specified period of time;
81.8    (2) the court orders further hearings because it has retained jurisdiction of a transfer
81.9of permanent legal and physical custody matter;
81.10    (3) an adoption has not yet been finalized; or
81.11    (4) there is a disruption of the permanent or long-term placement.
81.12    (g) Court reviews of an order for long-term foster care, whether under this section
81.13or section 260C.317, subdivision 3, paragraph (d), must be conducted at least yearly and
81.14must review the child's out-of-home placement plan and the reasonable efforts of the
81.15agency to finalize the permanent plan for the child including the agency's efforts to:
81.16    (1) ensure that long-term foster care continues to be the most appropriate legal
81.17arrangement for meeting the child's need for permanency and stability or, if not, to identify
81.18and attempt to finalize another permanent placement option under this chapter that would
81.19better serve the child's needs and best interests;
81.20    (2) identify a specific long-term foster home for the child, if one has not already
81.21been identified;
81.22    (3) support continued placement of the child in the identified home, if one has been
81.23identified;
81.24    (4) ensure appropriate services are provided to address the physical health, mental
81.25health, and educational needs of the child during the period of long-term foster care and
81.26also ensure appropriate services or assistance to maintain relationships with appropriate
81.27family members and the child's community; and
81.28    (5) plan for the child's independence upon the child's leaving long-term foster care
81.29living as required under section 260C.212, subdivision 1.
81.30    (h) In the event it is necessary for a child that has been ordered into foster care for a
81.31specified period of time to be in foster care longer than one year after the permanency
81.32hearing held under this section, not later than 12 months after the time the child was
81.33ordered into foster care for a specified period of time, the matter must be returned to
81.34court for a review of the appropriateness of continuing the child in foster care and of the
81.35responsible social services agency's reasonable efforts to finalize a permanent plan for
81.36the child; if it is in the child's best interests to continue the order for foster care for a
82.1specified period of time past a total of 12 months, the court shall set objectives for the
82.2child's continuation in foster care, specify any further amount of time the child may be in
82.3foster care, and review the plan for the safe return of the child to the parent.
82.4    (i) An order permanently placing a child out of the home of the parent or guardian
82.5must include the following detailed findings:
82.6    (1) how the child's best interests are served by the order;
82.7    (2) the nature and extent of the responsible social service agency's reasonable efforts,
82.8or, in the case of an Indian child, active efforts to reunify the child with the parent or
82.9guardian where reasonable efforts are required;
82.10    (3) the parent's or parents' efforts and ability to use services to correct the conditions
82.11which led to the out-of-home placement; and
82.12    (4) that the conditions which led to the out-of-home placement have not been
82.13corrected so that the child can safely return home.
82.14    (j) An order for permanent legal and physical custody of a child may be modified
82.15under sections 518.18 and 518.185. The social services agency is a party to the proceeding
82.16and must receive notice. A parent may only seek modification of an order for long-term
82.17foster care upon motion and a showing by the parent of a substantial change in the parent's
82.18circumstances such that the parent could provide appropriate care for the child and that
82.19removal of the child from the child's permanent placement and the return to the parent's
82.20care would be in the best interest of the child. The responsible social services agency may
82.21ask the court to vacate an order for long-term foster care upon a prima facie showing
82.22that there is a factual basis for the court to order another permanency option under this
82.23chapter and that such an option is in the child's best interests. Upon a hearing where
82.24the court determines that there is a factual basis for vacating the order for long-term
82.25foster care and that another permanent order regarding the placement of the child is in
82.26the child's best interests, the court may vacate the order for long-term foster care and
82.27enter a different order for permanent placement that is in the child's best interests. The
82.28court shall not require further reasonable efforts to reunify the child with the parent or
82.29guardian as a basis for vacating the order for long-term foster care and ordering a different
82.30permanent placement in the child's best interests. The county attorney must file pleadings
82.31and give notice as required under the rules of juvenile court in order to modify an order for
82.32long-term foster care under this paragraph.
82.33    (k) The court shall issue an order required under this section within 15 days of the
82.34close of the proceedings. The court may extend issuing the order an additional 15 days
82.35when necessary in the interests of justice and the best interests of the child.
83.1    (l) This paragraph applies to proceedings required under this subdivision when
83.2the child is on a trial home visit:
83.3    (1) if the child is on a trial home visit 12 months after the child was placed in
83.4foster care or in the care of a noncustodial parent as calculated in this subdivision, the
83.5responsible social services agency may file a report with the court regarding the child's and
83.6parent's progress on the trial home visit and its reasonable efforts to finalize the child's safe
83.7and permanent return to the care of the parent in lieu of filing the pleadings required under
83.8paragraph (b). The court shall make findings regarding reasonableness of the responsible
83.9social services efforts to finalize the child's return home as the permanent order in the best
83.10interests of the child. The court may continue the trial home visit to a total time not to
83.11exceed six months as provided in subdivision 1. If the court finds the responsible social
83.12services agency has not made reasonable efforts to finalize the child's return home as the
83.13permanent order in the best interests of the child, the court may order other or additional
83.14efforts to support the child remaining in the care of the parent; and
83.15    (2) if a trial home visit ordered or continued at proceedings under this subdivision
83.16terminates, the court shall re-commence proceedings under this subdivision to determine
83.17the permanent status of the child not later than 30 days after the child is returned to foster
83.18care.

83.19    Sec. 73. Minnesota Statutes 2006, section 260C.212, subdivision 1, is amended to read:
83.20    Subdivision 1. Out-of-home placement; plan. (a) An out-of-home placement plan
83.21shall be prepared within 30 days after any child is placed in a residential facility by court
83.22order or by the voluntary release of the child by the parent or parents.
83.23    For purposes of this section, a residential facility means any group home, family
83.24foster home or other publicly supported out-of-home residential facility, including any
83.25out-of-home residential facility under contract with the state, county or other political
83.26subdivision, or any agency thereof, to provide those services or foster care as defined in
83.27section 260C.007, subdivision 18.
83.28    (b) An out-of-home placement plan means a written document which is prepared by
83.29the responsible social services agency jointly with the parent or parents or guardian of the
83.30child and in consultation with the child's guardian ad litem, the child's tribe, if the child is
83.31an Indian child, the child's foster parent or representative of the residential facility, and,
83.32where appropriate, the child. For a child in placement due solely or in part to the child's
83.33emotional disturbance, preparation of the out-of-home placement plan shall additionally
83.34include the child's mental health treatment provider. As appropriate, the plan shall be:
83.35    (1) submitted to the court for approval under section 260C.178, subdivision 7;
84.1    (2) ordered by the court, either as presented or modified after hearing, under section
84.2260C.178, subdivision 7 , or 260C.201, subdivision 6; and
84.3    (3) signed by the parent or parents or guardian of the child, the child's guardian ad
84.4litem, a representative of the child's tribe, the responsible social services agency, and, if
84.5possible, the child.
84.6    (c) The out-of-home placement plan shall be explained to all persons involved in its
84.7implementation, including the child who has signed the plan, and shall set forth:
84.8    (1) a description of the residential facility including how the out-of-home placement
84.9plan is designed to achieve a safe placement for the child in the least restrictive, most
84.10family-like, setting available which is in close proximity to the home of the parent or
84.11parents or guardian of the child when the case plan goal is reunification, and how the
84.12placement is consistent with the best interests and special needs of the child according to
84.13the factors under subdivision 2, paragraph (b);
84.14    (2) the specific reasons for the placement of the child in a residential facility, and
84.15when reunification is the plan, a description of the problems or conditions in the home of
84.16the parent or parents which necessitated removal of the child from home and the changes
84.17the parent or parents must make in order for the child to safely return home;
84.18    (3) a description of the services offered and provided to prevent removal of the child
84.19from the home and to reunify the family including:
84.20    (i) the specific actions to be taken by the parent or parents of the child to eliminate
84.21or correct the problems or conditions identified in clause (2), and the time period during
84.22which the actions are to be taken; and
84.23    (ii) the reasonable efforts, or in the case of an Indian child, active efforts to be made
84.24to achieve a safe and stable home for the child including social and other supportive
84.25services to be provided or offered to the parent or parents or guardian of the child, the
84.26child, and the residential facility during the period the child is in the residential facility;
84.27    (4) a description of any services or resources that were requested by the child or the
84.28child's parent, guardian, foster parent, or custodian since the date of the child's placement
84.29in the residential facility, and whether those services or resources were provided and if
84.30not, the basis for the denial of the services or resources;
84.31    (5) the visitation plan for the parent or parents or guardian, other relatives as defined
84.32in section 260C.007, subdivision 27, and siblings of the child if the siblings are not placed
84.33together in the residential facility, and whether visitation is consistent with the best interest
84.34of the child, during the period the child is in the residential facility;
84.35    (6) documentation of steps to finalize the adoption or legal guardianship of the child
84.36if the court has issued an order terminating the rights of both parents of the child or of
85.1the only known, living parent of the child, and. At a minimum, the documentation must
85.2include child-specific recruitment efforts such as relative search and the use of state,
85.3regional, and national adoption exchanges to facilitate orderly and timely placements in
85.4and outside of the state. A copy of this documentation shall be provided to the court in the
85.5review required under section 260C.317, subdivision 3, paragraph (b);
85.6    (7) to the extent available and accessible, the health and educational records of the
85.7child including the most recent information available regarding:
85.8    (i) the names and addresses of the child's health and educational providers;
85.9    (ii) the child's grade level performance;
85.10    (iii) the child's school record;
85.11    (iv) assurances that the child's placement in foster care takes into account proximity
85.12to the school in which the child is enrolled at the time of placement;
85.13    (v) a record of the child's immunizations;
85.14    (vi) the child's known medical problems, including any known communicable
85.15diseases, as defined in section 144.4172, subdivision 2;
85.16    (vii) the child's medications; and
85.17    (viii) any other relevant health and education information;
85.18    (8) an independent living plan for a child age 16 or older who is in placement as
85.19a result of a permanency disposition. The plan should include, but not be limited to,
85.20the following objectives:
85.21    (i) educational, vocational, or employment planning;
85.22    (ii) health care planning and medical coverage;
85.23    (iii) transportation including, where appropriate, assisting the child in obtaining a
85.24driver's license;
85.25    (iv) money management;
85.26    (v) planning for housing;
85.27    (vi) social and recreational skills; and
85.28    (vii) establishing and maintaining connections with the child's family and
85.29community; and
85.30    (9) for a child in placement due solely or in part to the child's emotional disturbance,
85.31diagnostic and assessment information, specific services relating to meeting the mental
85.32health care needs of the child, and treatment outcomes.
85.33    (d) The parent or parents or guardian and the child each shall have the right to legal
85.34counsel in the preparation of the case plan and shall be informed of the right at the time
85.35of placement of the child. The child shall also have the right to a guardian ad litem.
85.36If unable to employ counsel from their own resources, the court shall appoint counsel
86.1upon the request of the parent or parents or the child or the child's legal guardian. The
86.2parent or parents may also receive assistance from any person or social services agency
86.3in preparation of the case plan.
86.4    After the plan has been agreed upon by the parties involved or approved or ordered
86.5by the court, the foster parents shall be fully informed of the provisions of the case plan
86.6and shall be provided a copy of the plan.
86.7    Upon discharge from foster care, the parent, adoptive parent, or permanent legal and
86.8physical custodian, as appropriate, and the child, if appropriate, must be provided with
86.9a current copy of the child's health and education record.

86.10    Sec. 74. Minnesota Statutes 2006, section 260C.212, subdivision 4, is amended to read:
86.11    Subd. 4. Responsible social service agency's duties for children in placement. (a)
86.12When a child is in placement, the responsible social services agency shall make diligent
86.13efforts to identify, locate, and, where appropriate, offer services to both parents of the child.
86.14    (1) The responsible social services agency shall assess whether a noncustodial or
86.15nonadjudicated parent is willing and capable of providing for the day-to-day care of the
86.16child temporarily or permanently. An assessment under this clause may include, but
86.17is not limited to, obtaining information under section 260C.209. If after assessment,
86.18the responsible social services agency determines that a noncustodial or nonadjudicated
86.19parent is willing and capable of providing day-to-day care of the child, the responsible
86.20social services agency may seek authority from the custodial parent or the court to have
86.21that parent assume day-to-day care of the child. If a parent is not an adjudicated parent,
86.22the responsible social services agency shall require the nonadjudicated parent to cooperate
86.23with paternity establishment procedures as part of the case plan.
86.24    (2) If, after assessment, the responsible social services agency determines that the
86.25child cannot be in the day-to-day care of either parent, the agency shall:
86.26    (i) prepare an out-of-home placement plan addressing the conditions that each parent
86.27must meet before the child can be in that parent's day-to-day care; and
86.28    (ii) provide a parent who is the subject of a background study under section
86.29260C.209 15 days' notice that it intends to use the study to recommend against putting the
86.30child with that parent, as well as the notice provided in section 260C.209, subdivision 4,
86.31and the court shall afford the parent an opportunity to be heard concerning the study.
86.32    The results of a background study of a noncustodial parent shall not be used by the
86.33agency to determine that the parent is incapable of providing day-to-day care of the child
86.34unless the agency reasonably believes that placement of the child into the home of that
86.35parent would endanger the child's health, safety, or welfare.
87.1    (3) If, after the provision of services following an out-of-home placement plan under
87.2this section, the child cannot return to the care of the parent from whom the child was
87.3removed or who had legal custody at the time the child was placed in foster care, the
87.4agency may petition on behalf of a noncustodial parent to establish legal custody with
87.5that parent under section 260C.201, subdivision 11. If paternity has not already been
87.6established, it may be established in the same proceeding in the manner provided for
87.7under chapter 257.
87.8    (4) The responsible social services agency may be relieved of the requirement to
87.9locate and offer services to both parents by the juvenile court upon a finding of good cause
87.10after the filing of a petition under section 260C.141.
87.11    (b) The responsible social services agency shall give notice to the parent or parents
87.12or guardian of each child in a residential facility, other than a child in placement due
87.13solely to that child's developmental disability or emotional disturbance, of the following
87.14information:
87.15    (1) that residential care of the child may result in termination of parental rights or an
87.16order permanently placing the child out of the custody of the parent, but only after notice
87.17and a hearing as required under chapter 260C and the juvenile court rules;
87.18    (2) time limits on the length of placement and of reunification services, including
87.19the date on which the child is expected to be returned to and safely maintained in the
87.20home of the parent or parents or placed for adoption or otherwise permanently removed
87.21from the care of the parent by court order;
87.22    (3) the nature of the services available to the parent;
87.23    (4) the consequences to the parent and the child if the parent fails or is unable to use
87.24services to correct the circumstances that led to the child's placement;
87.25    (5) the first consideration for placement with relatives;
87.26    (6) the benefit to the child in getting the child out of residential care as soon as
87.27possible, preferably by returning the child home, but if that is not possible, through a
87.28permanent legal placement of the child away from the parent;
87.29    (7) when safe for the child, the benefits to the child and the parent of maintaining
87.30visitation with the child as soon as possible in the course of the case and, in any event,
87.31according to the visitation plan under this section; and
87.32    (8) the financial responsibilities and obligations, if any, of the parent or parents for
87.33the support of the child during the period the child is in the residential facility.
87.34    (c) The responsible social services agency shall inform a parent considering
87.35voluntary placement of a child who is not developmentally disabled or emotionally
87.36disturbed of the following information:
88.1    (1) the parent and the child each has a right to separate legal counsel before signing a
88.2voluntary placement agreement, but not to counsel appointed at public expense;
88.3    (2) the parent is not required to agree to the voluntary placement, and a parent
88.4who enters a voluntary placement agreement may at any time request that the agency
88.5return the child. If the parent so requests, the child must be returned within 24 hours of
88.6the receipt of the request;
88.7    (3) evidence gathered during the time the child is voluntarily placed may be used
88.8at a later time as the basis for a petition alleging that the child is in need of protection
88.9or services or as the basis for a petition seeking termination of parental rights or other
88.10permanent placement of the child away from the parent;
88.11    (4) if the responsible social services agency files a petition alleging that the child is
88.12in need of protection or services or a petition seeking the termination of parental rights
88.13or other permanent placement of the child away from the parent, the parent would have
88.14the right to appointment of separate legal counsel and the child would have a right to the
88.15appointment of counsel and a guardian ad litem as provided by law, and that counsel will
88.16be appointed at public expense if they are unable to afford counsel; and
88.17    (5) the timelines and procedures for review of voluntary placements under
88.18subdivision 3, and the effect the time spent in voluntary placement on the scheduling of a
88.19permanent placement determination hearing under section 260C.201, subdivision 11.
88.20    (d) When an agency accepts a child for placement, the agency shall determine
88.21whether the child has had a physical examination by or under the direction of a licensed
88.22physician within the 12 months immediately preceding the date when the child came into
88.23the agency's care. If there is documentation that the child has had an examination within
88.24the last 12 months, the agency is responsible for seeing that the child has another physical
88.25examination within one year of the documented examination and annually in subsequent
88.26years. If the agency determines that the child has not had a physical examination within
88.27the 12 months immediately preceding placement, the agency shall ensure that the child
88.28has an examination within 30 days of coming into the agency's care and once a year
88.29in subsequent years.
88.30    (e) If a child leaves foster care by reason of having attained the age of majority
88.31under state law, the child must be given at no cost a copy of the child's health and
88.32education report.

88.33    Sec. 75. Minnesota Statutes 2006, section 260C.212, subdivision 9, is amended to read:
88.34    Subd. 9. Review of certain child placements. (a) When a developmentally
88.35disabled child or emotionally disturbed child needs placement in a residential facility for
89.1the sole reason of accessing services or a level of skilled care that cannot be provided in
89.2the parent's home, the child must be placed pursuant to a voluntary placement agreement
89.3between the responsible social services agency and the child's parent. The voluntary
89.4placement agreement must give the responsible social services agency legal responsibility
89.5for the child's physical care, custody, and control, but must not transfer legal custody of
89.6the child to the agency. The voluntary placement agreement must be executed in a form
89.7developed and promulgated by the commissioner of human services. The responsible
89.8social services agency shall report to the commissioner the number of children who are the
89.9subject of a voluntary placement agreement under this subdivision and other information
89.10regarding these children as the commissioner may require.
89.11    (b) If a developmentally disabled child or a child diagnosed as emotionally disturbed
89.12has been placed in a residential facility pursuant to a voluntary release by the child's parent
89.13or parents because of the child's disabling conditions or need for long-term residential
89.14treatment or supervision, the social services agency responsible for the placement shall
89.15report to the court and bring a petition for review of the child's foster care status as
89.16required in section 260C.141, subdivision 2a.
89.17    (b) (c) If a child is in placement due solely to the child's developmental disability or
89.18emotional disturbance, and the court finds compelling reasons not to proceed under section
89.19260C.201, subdivision 11 , and custody of the child is not transferred to the responsible
89.20social services agency under section 260C.201, subdivision 1, paragraph (a), clause (2),
89.21and no petition is required by section 260C.201, subdivision 11.
89.22    (c) (d) Whenever a petition for review is brought pursuant to this subdivision, a
89.23guardian ad litem shall be appointed for the child.

89.24    Sec. 76. Minnesota Statutes 2006, section 260C.317, subdivision 3, is amended to read:
89.25    Subd. 3. Order; retention of jurisdiction. (a) A certified copy of the findings and
89.26the order terminating parental rights, and a summary of the court's information concerning
89.27the child shall be furnished by the court to the commissioner or the agency to which
89.28guardianship is transferred. The orders shall be on a document separate from the findings.
89.29The court shall furnish the individual to whom guardianship is transferred a copy of the
89.30order terminating parental rights.
89.31    (b) The court shall retain jurisdiction in a case where adoption is the intended
89.32permanent placement disposition until the child's adoption is finalized, the child is 18 years
89.33of age, or the child is otherwise ordered discharged from the jurisdiction of the court. The
89.34guardian ad litem and counsel for the child shall continue on the case until an adoption
89.35decree is entered. A hearing must be held every 90 days following termination of parental
90.1rights for the court to review progress toward an adoptive placement and the specific
90.2recruitment efforts the agency has taken to find an adoptive family or other placement
90.3living arrangement for the child and to finalize the adoption or other permanency plan.
90.4    (c) The responsible social services agency may make a determination of compelling
90.5reasons for a child to be in long-term foster care when the agency has made exhaustive
90.6efforts to recruit, identify, and place the child in an adoptive home, and the child continues
90.7in foster care for at least 24 months after the court has issued the order terminating
90.8parental rights. A child of any age who is under the guardianship of the commissioner of
90.9the Department of Human Services and is legally available for adoption may not refuse
90.10or waive the commissioner's agent's exhaustive efforts to recruit, identify, and place the
90.11child in an adoptive home required under paragraph (b) or sign a document relieving
90.12county social services agencies of all recruitment efforts on the child's behalf. Upon
90.13approving the agency's determination of compelling reasons, the court may order the
90.14child placed in long-term foster care. At least every 12 months thereafter as long as the
90.15child continues in out-of-home placement, the court shall conduct a permanency review
90.16hearing to determine the future status of the child using the review requirements of section
90.17260C.201, subdivision 11 , paragraph (g).
90.18    (d) The court shall retain jurisdiction through the child's minority in a case where
90.19long-term foster care is the permanent disposition whether under paragraph (c) or section
90.20260C.201, subdivision 11 .

90.21    Sec. 77. Minnesota Statutes 2006, section 260C.331, subdivision 1, is amended to read:
90.22    Subdivision 1. Care, examination, or treatment. (a) Except where parental rights
90.23are terminated,
90.24    (1) whenever legal custody of a child is transferred by the court to a responsible
90.25social services agency,
90.26    (2) whenever legal custody is transferred to a person other than the responsible social
90.27services agency, but under the supervision of the responsible social services agency, or
90.28    (3) whenever a child is given physical or mental examinations or treatment under
90.29order of the court, and no provision is otherwise made by law for payment for the care,
90.30examination, or treatment of the child, these costs are a charge upon the welfare funds of
90.31the county in which proceedings are held upon certification of the judge of juvenile court.
90.32    (b) The court shall order, and the responsible social services agency shall require,
90.33the parents or custodian of a child, while the child is under the age of 18, to use the
90.34total income and resources attributable to the child for the period of care, examination,
90.35or treatment, except for clothing and personal needs allowance as provided in section
91.1256B.35 , to reimburse the county for the cost of care, examination, or treatment. Income
91.2and resources attributable to the child include, but are not limited to, Social Security
91.3benefits, supplemental security income (SSI), veterans benefits, railroad retirement
91.4benefits and child support. When the child is over the age of 18, and continues to receive
91.5care, examination, or treatment, the court shall order, and the responsible social services
91.6agency shall require, reimbursement from the child for the cost of care, examination, or
91.7treatment from the income and resources attributable to the child less the clothing and
91.8personal needs allowance. Income does not include earnings from a child over the age of
91.918 who is working as part of a plan under section 260C.212, subdivision 1, paragraph (c),
91.10clause (8), to transition from foster care.
91.11    (c) If the income and resources attributable to the child are not enough to reimburse
91.12the county for the full cost of the care, examination, or treatment, the court shall inquire
91.13into the ability of the parents to support the child and, after giving the parents a reasonable
91.14opportunity to be heard, the court shall order, and the responsible social services agency
91.15shall require, the parents to contribute to the cost of care, examination, or treatment of
91.16the child. When determining the amount to be contributed by the parents, the court shall
91.17use a fee schedule based upon ability to pay that is established by the responsible social
91.18services agency and approved by the commissioner of human services. The income of
91.19a stepparent who has not adopted a child shall be excluded in calculating the parental
91.20contribution under this section.
91.21    (d) The court shall order the amount of reimbursement attributable to the parents
91.22or custodian, or attributable to the child, or attributable to both sources, withheld under
91.23chapter 518A from the income of the parents or the custodian of the child. A parent or
91.24custodian who fails to pay without good reason may be proceeded against for contempt, or
91.25the court may inform the county attorney, who shall proceed to collect the unpaid sums,
91.26or both procedures may be used.
91.27    (e) If the court orders a physical or mental examination for a child, the examination
91.28is a medically necessary service for purposes of determining whether the service is
91.29covered by a health insurance policy, health maintenance contract, or other health
91.30coverage plan. Court-ordered treatment shall be subject to policy, contract, or plan
91.31requirements for medical necessity. Nothing in this paragraph changes or eliminates
91.32benefit limits, conditions of coverage, co-payments or deductibles, provider restrictions,
91.33or other requirements in the policy, contract, or plan that relate to coverage of other
91.34medically necessary services.

91.35    Sec. 78. Minnesota Statutes 2006, section 270B.14, subdivision 1, is amended to read:
92.1    Subdivision 1. Disclosure to commissioner of human services. (a) On the request
92.2of the commissioner of human services, the commissioner shall disclose return information
92.3regarding taxes imposed by chapter 290, and claims for refunds under chapter 290A, to
92.4the extent provided in paragraph (b) and for the purposes set forth in paragraph (c).
92.5    (b) Data that may be disclosed are limited to data relating to the identity,
92.6whereabouts, employment, income, and property of a person owing or alleged to be owing
92.7an obligation of child support.
92.8    (c) The commissioner of human services may request data only for the purposes of
92.9carrying out the child support enforcement program and to assist in the location of parents
92.10who have, or appear to have, deserted their children. Data received may be used only
92.11as set forth in section 256.978.
92.12    (d) The commissioner shall provide the records and information necessary to
92.13administer the supplemental housing allowance to the commissioner of human services.
92.14    (e) At the request of the commissioner of human services, the commissioner of
92.15revenue shall electronically match the Social Security numbers and names of participants
92.16in the telephone assistance plan operated under sections 237.69 to 237.711, with those of
92.17property tax refund filers, and determine whether each participant's household income is
92.18within the eligibility standards for the telephone assistance plan.
92.19    (f) The commissioner may provide records and information collected under sections
92.20295.50 to 295.59 to the commissioner of human services for purposes of the Medicaid
92.21Voluntary Contribution and Provider-Specific Tax Amendments of 1991, Public Law
92.22102-234. Upon the written agreement by the United States Department of Health and
92.23Human Services to maintain the confidentiality of the data, the commissioner may provide
92.24records and information collected under sections 295.50 to 295.59 to the Centers for
92.25Medicare and Medicaid Services section of the United States Department of Health and
92.26Human Services for purposes of meeting federal reporting requirements.
92.27    (g) The commissioner may provide records and information to the commissioner of
92.28human services as necessary to administer the early refund of refundable tax credits.
92.29    (h) The commissioner may disclose information to the commissioner of human
92.30services necessary to verify income for eligibility and premium payment under the
92.31MinnesotaCare program, under section 256L.05, subdivision 2.
92.32    (i) The commissioner may disclose information to the commissioner of human
92.33services necessary to verify whether applicants or recipients for the Minnesota family
92.34investment program, general assistance, food support, and Minnesota supplemental aid
92.35program, and child care assistance have claimed refundable tax credits under chapter 290
92.36and the property tax refund under chapter 290A, and the amounts of the credits.

93.1    Sec. 79. Minnesota Statutes 2006, section 626.556, subdivision 2, is amended to read:
93.2    Subd. 2. Definitions. As used in this section, the following terms have the meanings
93.3given them unless the specific content indicates otherwise:
93.4    (a) "Family assessment" means a comprehensive assessment of child safety, risk
93.5of subsequent child maltreatment, and family strengths and needs that is applied to a
93.6child maltreatment report that does not allege substantial child endangerment. Family
93.7assessment does not include a determination as to whether child maltreatment occurred
93.8but does determine the need for services to address the safety of family members and the
93.9risk of subsequent maltreatment.
93.10    (b) "Investigation" means fact gathering related to the current safety of a child
93.11and the risk of subsequent maltreatment that determines whether child maltreatment
93.12occurred and whether child protective services are needed. An investigation must be used
93.13when reports involve substantial child endangerment, and for reports of maltreatment in
93.14facilities required to be licensed under chapter 245A or 245B; under sections 144.50 to
93.15144.58 and 241.021; in a school as defined in sections 120A.05, subdivisions 9, 11, and
93.1613, and 124D.10; or in a nonlicensed personal care provider association as defined in
93.17sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a.
93.18    (c) "Substantial child endangerment" means a person responsible for a child's care,
93.19and in the case of sexual abuse includes a person who has a significant relationship to the
93.20child as defined in section 609.341, or a person in a position of authority as defined in
93.21section 609.341, who by act or omission commits or attempts to commit an act against a
93.22child under their care that constitutes any of the following:
93.23    (1) egregious harm as defined in section 260C.007, subdivision 14;
93.24    (2) sexual abuse as defined in paragraph (d);
93.25    (3) abandonment under section 260C.301, subdivision 2;
93.26    (4) neglect as defined in paragraph (f), clause (2), that substantially endangers the
93.27child's physical or mental health, including a growth delay, which may be referred to as
93.28failure to thrive, that has been diagnosed by a physician and is due to parental neglect;
93.29    (5) murder in the first, second, or third degree under section 609.185, 609.19, or
93.30609.195;
93.31    (6) manslaughter in the first or second degree under section 609.20 or 609.205;
93.32    (7) assault in the first, second, or third degree under section 609.221, 609.222, or
93.33609.223;
93.34    (8) solicitation, inducement, and promotion of prostitution under section 609.322;
93.35    (9) criminal sexual conduct under sections 609.342 to 609.3451;
93.36    (10) solicitation of children to engage in sexual conduct under section 609.352;
94.1    (11) malicious punishment or neglect or endangerment of a child under section
94.2609.377 or 609.378;
94.3    (12) use of a minor in sexual performance under section 617.246; or
94.4    (13) parental behavior, status, or condition which mandates that the county attorney
94.5file a termination of parental rights petition under section 260C.301, subdivision 3,
94.6paragraph (a).
94.7    (d) "Sexual abuse" means the subjection of a child by a person responsible for the
94.8child's care, by a person who has a significant relationship to the child, as defined in
94.9section 609.341, or by a person in a position of authority, as defined in section 609.341,
94.10subdivision 10, to any act which constitutes a violation of section 609.342 (criminal sexual
94.11conduct in the first degree), 609.343 (criminal sexual conduct in the second degree),
94.12609.344 (criminal sexual conduct in the third degree), 609.345 (criminal sexual conduct
94.13in the fourth degree), or 609.3451 (criminal sexual conduct in the fifth degree). Sexual
94.14abuse also includes any act which involves a minor which constitutes a violation of
94.15prostitution offenses under sections 609.321 to 609.324 or 617.246. Sexual abuse includes
94.16threatened sexual abuse.
94.17    (e) "Person responsible for the child's care" means (1) an individual functioning
94.18within the family unit and having responsibilities for the care of the child such as a
94.19parent, guardian, or other person having similar care responsibilities, or (2) an individual
94.20functioning outside the family unit and having responsibilities for the care of the child
94.21such as a teacher, school administrator, other school employees or agents, or other lawful
94.22custodian of a child having either full-time or short-term care responsibilities including,
94.23but not limited to, day care, babysitting whether paid or unpaid, counseling, teaching,
94.24and coaching.
94.25    (f) "Neglect" means:
94.26    (1) failure by a person responsible for a child's care to supply a child with necessary
94.27food, clothing, shelter, health, medical, or other care required for the child's physical or
94.28mental health when reasonably able to do so;
94.29    (2) failure to protect a child from conditions or actions that seriously endanger the
94.30child's physical or mental health when reasonably able to do so, including a growth delay,
94.31which may be referred to as a failure to thrive, that has been diagnosed by a physician and
94.32is due to parental neglect;
94.33    (3) failure to provide for necessary supervision or child care arrangements
94.34appropriate for a child after considering factors as the child's age, mental ability, physical
94.35condition, length of absence, or environment, when the child is unable to care for the
94.36child's own basic needs or safety, or the basic needs or safety of another child in their care;
95.1    (4) failure to ensure that the child is educated as defined in sections 120A.22 and
95.2260C.163, subdivision 11, which does not include a parent's refusal to provide the parent's
95.3child with sympathomimetic medications, consistent with section 125A.091, subdivision 5;
95.4    (5) nothing in this section shall be construed to mean that a child is neglected solely
95.5because the child's parent, guardian, or other person responsible for the child's care in
95.6good faith selects and depends upon spiritual means or prayer for treatment or care of
95.7disease or remedial care of the child in lieu of medical care; except that a parent, guardian,
95.8or caretaker, or a person mandated to report pursuant to subdivision 3, has a duty to report
95.9if a lack of medical care may cause serious danger to the child's health. This section does
95.10not impose upon persons, not otherwise legally responsible for providing a child with
95.11necessary food, clothing, shelter, education, or medical care, a duty to provide that care;
95.12    (6) prenatal exposure to a controlled substance, as defined in section 253B.02,
95.13subdivision 2, used by the mother for a nonmedical purpose, as evidenced by withdrawal
95.14symptoms in the child at birth, results of a toxicology test performed on the mother at
95.15delivery or the child at birth, or medical effects or developmental delays during the child's
95.16first year of life that medically indicate prenatal exposure to a controlled substance;
95.17    (7) "medical neglect" as defined in section 260C.007, subdivision 6, clause (5);
95.18    (8) chronic and severe use of alcohol or a controlled substance by a parent or
95.19person responsible for the care of the child that adversely affects the child's basic needs
95.20and safety; or
95.21    (9) emotional harm from a pattern of behavior which contributes to impaired
95.22emotional functioning of the child which may be demonstrated by a substantial and
95.23observable effect in the child's behavior, emotional response, or cognition that is not
95.24within the normal range for the child's age and stage of development, with due regard to
95.25the child's culture.
95.26    (g) "Physical abuse" means any physical injury, mental injury, or threatened injury,
95.27inflicted by a person responsible for the child's care on a child other than by accidental
95.28means, or any physical or mental injury that cannot reasonably be explained by the child's
95.29history of injuries, or any aversive or deprivation procedures, or regulated interventions,
95.30that have not been authorized under section 121A.67 or 245.825. Abuse does not include
95.31reasonable and moderate physical discipline of a child administered by a parent or legal
95.32guardian which does not result in an injury. Abuse does not include the use of reasonable
95.33force by a teacher, principal, or school employee as allowed by section 121A.582. Actions
95.34which are not reasonable and moderate include, but are not limited to, any of the following
95.35that are done in anger or without regard to the safety of the child:
95.36    (1) throwing, kicking, burning, biting, or cutting a child;
96.1    (2) striking a child with a closed fist;
96.2    (3) shaking a child under age three;
96.3    (4) striking or other actions which result in any nonaccidental injury to a child
96.4under 18 months of age;
96.5    (5) unreasonable interference with a child's breathing;
96.6    (6) threatening a child with a weapon, as defined in section 609.02, subdivision 6;
96.7    (7) striking a child under age one on the face or head;
96.8    (8) purposely giving a child poison, alcohol, or dangerous, harmful, or controlled
96.9substances which were not prescribed for the child by a practitioner, in order to control or
96.10punish the child; or other substances that substantially affect the child's behavior, motor
96.11coordination, or judgment or that results in sickness or internal injury, or subjects the
96.12child to medical procedures that would be unnecessary if the child were not exposed
96.13to the substances;
96.14    (9) unreasonable physical confinement or restraint not permitted under section
96.15609.379, including but not limited to tying, caging, or chaining; or
96.16    (10) in a school facility or school zone, an act by a person responsible for the child's
96.17care that is a violation under section 121A.58.
96.18    (h) "Report" means any report received by the local welfare agency, police
96.19department, county sheriff, or agency responsible for assessing or investigating
96.20maltreatment pursuant to this section.
96.21    (i) "Facility" means:
96.22    (1) a licensed or unlicensed day care facility, residential facility, agency, hospital,
96.23sanitarium, or other facility or institution required to be licensed under sections 144.50 to
96.24144.58, 241.021, or 245A.01 to 245A.16, or chapter 245B;
96.25    (2) a school as defined in sections 120A.05, subdivisions 9, 11, and 13; and
96.26124D.10; or
96.27    (3) a nonlicensed personal care provider organization as defined in sections 256B.04,
96.28subdivision 16, and 256B.0625, subdivision 19a.
96.29    (j) "Operator" means an operator or agency as defined in section 245A.02.
96.30    (k) "Commissioner" means the commissioner of human services.
96.31    (l) "Practice of social services," for the purposes of subdivision 3, includes but is
96.32not limited to employee assistance counseling and the provision of guardian ad litem and
96.33parenting time expeditor services.
96.34    (m) "Mental injury" means an injury to the psychological capacity or emotional
96.35stability of a child as evidenced by an observable or substantial impairment in the child's
97.1ability to function within a normal range of performance and behavior with due regard to
97.2the child's culture.
97.3    (n) "Threatened injury" means a statement, overt act, condition, or status that
97.4represents a substantial risk of physical or sexual abuse or mental injury. Threatened
97.5injury includes, but is not limited to, exposing a child to a person responsible for the
97.6child's care, as defined in paragraph (e), clause (1), who has:
97.7    (1) subjected a child to, or failed to protect a child from, an overt act or condition
97.8that constitutes egregious harm, as defined in section 260C.007, subdivision 14, or a
97.9similar law of another jurisdiction;
97.10    (2) been found to be palpably unfit under section 260C.301, paragraph (b), clause
97.11(4), or a similar law of another jurisdiction;
97.12    (3) committed an act that has resulted in an involuntary termination of parental rights
97.13under section 260C.301, or a similar law of another jurisdiction; or
97.14    (4) committed an act that has resulted in the involuntary transfer of permanent legal
97.15and physical custody of a child to a relative under section 260C.201, subdivision 11,
97.16paragraph (d), clause (1), or a similar law of another jurisdiction.
97.17    (o) Persons who conduct assessments or investigations under this section shall take
97.18into account accepted child-rearing practices of the culture in which a child participates
97.19and accepted teacher discipline practices, which are not injurious to the child's health,
97.20welfare, and safety.

97.21    Sec. 80. Minnesota Statutes 2006, section 626.556, subdivision 3, is amended to read:
97.22    Subd. 3. Persons mandated to report. (a) A person who knows or has reason
97.23to believe a child is being neglected or physically or sexually abused, as defined in
97.24subdivision 2, or has been neglected or physically or sexually abused within the preceding
97.25three years, shall immediately report the information to the local welfare agency, agency
97.26responsible for assessing or investigating the report, police department, or the county
97.27sheriff if the person is:
97.28    (1) a professional or professional's delegate who is engaged in the practice of
97.29the healing arts, social services, hospital administration, psychological or psychiatric
97.30treatment, child care, education, correctional supervision, probation and correctional
97.31services, or law enforcement; or
97.32    (2) employed as a member of the clergy and received the information while
97.33engaged in ministerial duties, provided that a member of the clergy is not required by
97.34this subdivision to report information that is otherwise privileged under section 595.02,
97.35subdivision 1 , paragraph (c).
98.1    The police department or the county sheriff, upon receiving a report, shall
98.2immediately notify the local welfare agency or agency responsible for assessing or
98.3investigating the report, orally and in writing. The local welfare agency, or agency
98.4responsible for assessing or investigating the report, upon receiving a report, shall
98.5immediately notify the local police department or the county sheriff orally and in writing.
98.6The county sheriff and the head of every local welfare agency, agency responsible
98.7for assessing or investigating reports, and police department shall each designate a
98.8person within their agency, department, or office who is responsible for ensuring that
98.9the notification duties of this paragraph and paragraph (b) are carried out. Nothing in
98.10this subdivision shall be construed to require more than one report from any institution,
98.11facility, school, or agency.
98.12    (b) Any person may voluntarily report to the local welfare agency, agency
98.13responsible for assessing or investigating the report, police department, or the county
98.14sheriff if the person knows, has reason to believe, or suspects a child is being or has been
98.15neglected or subjected to physical or sexual abuse. The police department or the county
98.16sheriff, upon receiving a report, shall immediately notify the local welfare agency or
98.17agency responsible for assessing or investigating the report, orally and in writing. The
98.18local welfare agency or agency responsible for assessing or investigating the report, upon
98.19receiving a report, shall immediately notify the local police department or the county
98.20sheriff orally and in writing.
98.21    (c) A person mandated to report physical or sexual child abuse or neglect occurring
98.22within a licensed facility shall report the information to the agency responsible for
98.23licensing the facility under sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or
98.24chapter 245B; or a nonlicensed personal care provider organization as defined in sections
98.25256B.04, subdivision 16 ; and 256B.0625, subdivision 19. A health or corrections agency
98.26receiving a report may request the local welfare agency to provide assistance pursuant
98.27to subdivisions 10, 10a, and 10b. A board or other entity whose licensees perform work
98.28within a school facility, upon receiving a complaint of alleged maltreatment, shall provide
98.29information about the circumstances of the alleged maltreatment to the commissioner of
98.30education. Section 13.03, subdivision 4, applies to data received by the commissioner of
98.31education from a licensing entity.
98.32    (d) Any person mandated to report shall receive a summary of the disposition of
98.33any report made by that reporter, including whether the case has been opened for child
98.34protection or other services, or if a referral has been made to a community organization,
98.35unless release would be detrimental to the best interests of the child. Any person who is
98.36not mandated to report shall, upon request to the local welfare agency, receive a concise
99.1summary of the disposition of any report made by that reporter, unless release would be
99.2detrimental to the best interests of the child.
99.3    (e) For purposes of this subdivision section, "immediately" means as soon as
99.4possible but in no event longer than 24 hours.

99.5    Sec. 81. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
99.6to read:
99.7    Subd. 3e. Agency responsibility for assessing or investigating reports of sexual
99.8abuse. The local welfare agency is the agency responsible for investigating allegations
99.9of sexual abuse if the alleged offender is the parent, guardian, sibling, or an individual
99.10functioning within the family unit as a person responsible for the child's care, or a person
99.11with a significant relationship to the child if that person resides in the child's household.

99.12    Sec. 82. Minnesota Statutes 2006, section 626.556, is amended by adding a subdivision
99.13to read:
99.14    Subd. 3f. Law enforcement agency responsibility for investigating
99.15maltreatment. The local law enforcement agency has responsibility for investigating any
99.16report of child maltreatment if a violation of a criminal statute is alleged. Law enforcement
99.17and the responsible agency must coordinate their investigations or assessments as required
99.18under subdivision 10.

99.19    Sec. 83. Minnesota Statutes 2006, section 626.556, subdivision 10, is amended to read:
99.20    Subd. 10. Duties of local welfare agency and local law enforcement agency upon
99.21receipt of a report. (a) Upon receipt of a report, the local welfare agency shall determine
99.22whether to conduct a family assessment or an investigation as appropriate to prevent or
99.23provide a remedy for child maltreatment. The local welfare agency:
99.24    (1) shall conduct an investigation on reports involving substantial child
99.25endangerment;
99.26    (2) shall begin an immediate investigation if, at any time when it is using a family
99.27assessment response, it determines that there is reason to believe that substantial child
99.28endangerment or a serious threat to the child's safety exists;
99.29    (3) may conduct a family assessment for reports that do not allege substantial child
99.30endangerment. In determining that a family assessment is appropriate, the local welfare
99.31agency may consider issues of child safety, parental cooperation, and the need for an
99.32immediate response; and
100.1    (4) may conduct a family assessment on a report that was initially screened and
100.2assigned for an investigation. In determining that a complete investigation is not required,
100.3the local welfare agency must document the reason for terminating the investigation and
100.4notify the local law enforcement agency if the local law enforcement agency is conducting
100.5a joint investigation.
100.6    If the report alleges neglect, physical abuse, or sexual abuse by a parent, guardian,
100.7or individual functioning within the family unit as a person responsible for the child's
100.8care, or sexual abuse by a person with a significant relationship to the child when that
100.9person resides in the child's household or by a sibling, the local welfare agency shall
100.10immediately conduct a family assessment or investigation as identified in clauses (1) to
100.11(4). In conducting a family assessment or investigation, the local welfare agency shall
100.12gather information on the existence of substance abuse and domestic violence and offer
100.13services for purposes of preventing future child maltreatment, safeguarding and enhancing
100.14the welfare of the abused or neglected minor, and supporting and preserving family
100.15life whenever possible. If the report alleges a violation of a criminal statute involving
100.16sexual abuse, physical abuse, or neglect or endangerment, under section 609.378, the
100.17local law enforcement agency and local welfare agency shall coordinate the planning and
100.18execution of their respective investigation and assessment efforts to avoid a duplication of
100.19fact-finding efforts and multiple interviews. Each agency shall prepare a separate report of
100.20the results of its investigation. In cases of alleged child maltreatment resulting in death,
100.21the local agency may rely on the fact-finding efforts of a law enforcement investigation
100.22to make a determination of whether or not maltreatment occurred. When necessary the
100.23local welfare agency shall seek authority to remove the child from the custody of a parent,
100.24guardian, or adult with whom the child is living. In performing any of these duties, the
100.25local welfare agency shall maintain appropriate records.
100.26    If the family assessment or investigation indicates there is a potential for abuse of
100.27alcohol or other drugs by the parent, guardian, or person responsible for the child's care,
100.28the local welfare agency shall conduct a chemical use assessment pursuant to Minnesota
100.29Rules, part 9530.6615. The local welfare agency shall report the determination of the
100.30chemical use assessment, and the recommendations and referrals for alcohol and other
100.31drug treatment services to the state authority on alcohol and drug abuse.
100.32    (b) When a local agency receives a report or otherwise has information indicating
100.33that a child who is a client, as defined in section 245.91, has been the subject of physical
100.34abuse, sexual abuse, or neglect at an agency, facility, or program as defined in section
100.35245.91 , it shall, in addition to its other duties under this section, immediately inform the
100.36ombudsman established under sections 245.91 to 245.97. The commissioner of education
101.1shall inform the ombudsman established under sections 245.91 to 245.97 of reports
101.2regarding a child defined as a client in section 245.91 that maltreatment occurred at a
101.3school as defined in sections 120A.05, subdivisions 9, 11, and 13, and 124D.10.
101.4    (c) Authority of the local welfare agency responsible for assessing or investigating
101.5the child abuse or neglect report, the agency responsible for assessing or investigating
101.6the report, and of the local law enforcement agency for investigating the alleged abuse or
101.7neglect includes, but is not limited to, authority to interview, without parental consent,
101.8the alleged victim and any other minors who currently reside with or who have resided
101.9with the alleged offender. The interview may take place at school or at any facility or
101.10other place where the alleged victim or other minors might be found or the child may be
101.11transported to, and the interview conducted at, a place appropriate for the interview of a
101.12child designated by the local welfare agency or law enforcement agency. The interview
101.13may take place outside the presence of the alleged offender or parent, legal custodian,
101.14guardian, or school official. For family assessments, it is the preferred practice to request
101.15a parent or guardian's permission to interview the child prior to conducting the child
101.16interview, unless doing so would compromise the safety assessment. Except as provided in
101.17this paragraph, the parent, legal custodian, or guardian shall be notified by the responsible
101.18local welfare or law enforcement agency no later than the conclusion of the investigation
101.19or assessment that this interview has occurred. Notwithstanding rule 49.02 32 of the
101.20Minnesota Rules of Procedure for Juvenile Courts, the juvenile court may, after hearing on
101.21an ex parte motion by the local welfare agency, order that, where reasonable cause exists,
101.22the agency withhold notification of this interview from the parent, legal custodian, or
101.23guardian. If the interview took place or is to take place on school property, the order shall
101.24specify that school officials may not disclose to the parent, legal custodian, or guardian the
101.25contents of the notification of intent to interview the child on school property, as provided
101.26under this paragraph, and any other related information regarding the interview that may
101.27be a part of the child's school record. A copy of the order shall be sent by the local welfare
101.28or law enforcement agency to the appropriate school official.
101.29    (d) When the local welfare, local law enforcement agency, or the agency responsible
101.30for assessing or investigating a report of maltreatment determines that an interview should
101.31take place on school property, written notification of intent to interview the child on school
101.32property must be received by school officials prior to the interview. The notification
101.33shall include the name of the child to be interviewed, the purpose of the interview, and
101.34a reference to the statutory authority to conduct an interview on school property. For
101.35interviews conducted by the local welfare agency, the notification shall be signed by the
101.36chair of the local social services agency or the chair's designee. The notification shall be
102.1private data on individuals subject to the provisions of this paragraph. School officials
102.2may not disclose to the parent, legal custodian, or guardian the contents of the notification
102.3or any other related information regarding the interview until notified in writing by the
102.4local welfare or law enforcement agency that the investigation or assessment has been
102.5concluded, unless a school employee or agent is alleged to have maltreated the child.
102.6Until that time, the local welfare or law enforcement agency or the agency responsible
102.7for assessing or investigating a report of maltreatment shall be solely responsible for any
102.8disclosures regarding the nature of the assessment or investigation.
102.9    Except where the alleged offender is believed to be a school official or employee,
102.10the time and place, and manner of the interview on school premises shall be within the
102.11discretion of school officials, but the local welfare or law enforcement agency shall have
102.12the exclusive authority to determine who may attend the interview. The conditions as to
102.13time, place, and manner of the interview set by the school officials shall be reasonable and
102.14the interview shall be conducted not more than 24 hours after the receipt of the notification
102.15unless another time is considered necessary by agreement between the school officials and
102.16the local welfare or law enforcement agency. Where the school fails to comply with the
102.17provisions of this paragraph, the juvenile court may order the school to comply. Every
102.18effort must be made to reduce the disruption of the educational program of the child, other
102.19students, or school staff when an interview is conducted on school premises.
102.20    (e) Where the alleged offender or a person responsible for the care of the alleged
102.21victim or other minor prevents access to the victim or other minor by the local welfare
102.22agency, the juvenile court may order the parents, legal custodian, or guardian to produce
102.23the alleged victim or other minor for questioning by the local welfare agency or the local
102.24law enforcement agency outside the presence of the alleged offender or any person
102.25responsible for the child's care at reasonable places and times as specified by court order.
102.26    (f) Before making an order under paragraph (e), the court shall issue an order to
102.27show cause, either upon its own motion or upon a verified petition, specifying the basis for
102.28the requested interviews and fixing the time and place of the hearing. The order to show
102.29cause shall be served personally and shall be heard in the same manner as provided in
102.30other cases in the juvenile court. The court shall consider the need for appointment of a
102.31guardian ad litem to protect the best interests of the child. If appointed, the guardian ad
102.32litem shall be present at the hearing on the order to show cause.
102.33    (g) The commissioner of human services, the ombudsman for mental health and
102.34developmental disabilities, the local welfare agencies responsible for investigating reports,
102.35the commissioner of education, and the local law enforcement agencies have the right to
102.36enter facilities as defined in subdivision 2 and to inspect and copy the facility's records,
103.1including medical records, as part of the investigation. Notwithstanding the provisions of
103.2chapter 13, they also have the right to inform the facility under investigation that they are
103.3conducting an investigation, to disclose to the facility the names of the individuals under
103.4investigation for abusing or neglecting a child, and to provide the facility with a copy of
103.5the report and the investigative findings.
103.6    (h) The local welfare agency responsible for conducting a family assessment or
103.7investigation shall collect available and relevant information to determine child safety,
103.8risk of subsequent child maltreatment, and family strengths and needs and share not public
103.9information with an Indian's tribal social services agency without violating any law of the
103.10state that may otherwise impose duties of confidentiality on the local welfare agency in
103.11order to implement the tribal state agreement. The local welfare agency or the agency
103.12responsible for investigating the report shall collect available and relevant information
103.13to ascertain whether maltreatment occurred and whether protective services are needed.
103.14Information collected includes, when relevant, information with regard to the person
103.15reporting the alleged maltreatment, including the nature of the reporter's relationship to the
103.16child and to the alleged offender, and the basis of the reporter's knowledge for the report;
103.17the child allegedly being maltreated; the alleged offender; the child's caretaker; and other
103.18collateral sources having relevant information related to the alleged maltreatment. The
103.19local welfare agency or the agency responsible for assessing or investigating the report
103.20may make a determination of no maltreatment early in an assessment, and close the case
103.21and retain immunity, if the collected information shows no basis for a full assessment or
103.22investigation.
103.23    Information relevant to the assessment or investigation must be asked for, and
103.24may include:
103.25    (1) the child's sex and age, prior reports of maltreatment, information relating
103.26to developmental functioning, credibility of the child's statement, and whether the
103.27information provided under this clause is consistent with other information collected
103.28during the course of the assessment or investigation;
103.29    (2) the alleged offender's age, a record check for prior reports of maltreatment, and
103.30criminal charges and convictions. The local welfare agency or the agency responsible for
103.31assessing or investigating the report must provide the alleged offender with an opportunity
103.32to make a statement. The alleged offender may submit supporting documentation relevant
103.33to the assessment or investigation;
103.34    (3) collateral source information regarding the alleged maltreatment and care of the
103.35child. Collateral information includes, when relevant: (i) a medical examination of the
103.36child; (ii) prior medical records relating to the alleged maltreatment or the care of the
104.1child maintained by any facility, clinic, or health care professional and an interview with
104.2the treating professionals; and (iii) interviews with the child's caretakers, including the
104.3child's parent, guardian, foster parent, child care provider, teachers, counselors, family
104.4members, relatives, and other persons who may have knowledge regarding the alleged
104.5maltreatment and the care of the child; and
104.6    (4) information on the existence of domestic abuse and violence in the home of
104.7the child, and substance abuse.
104.8    Nothing in this paragraph precludes the local welfare agency, the local law
104.9enforcement agency, or the agency responsible for assessing or investigating the report
104.10from collecting other relevant information necessary to conduct the assessment or
104.11investigation. Notwithstanding section 13.384 or 144.335, the local welfare agency has
104.12access to medical data and records for purposes of clause (3). Notwithstanding the data's
104.13classification in the possession of any other agency, data acquired by the local welfare
104.14agency or the agency responsible for assessing or investigating the report during the course
104.15of the assessment or investigation are private data on individuals and must be maintained
104.16in accordance with subdivision 11. Data of the commissioner of education collected
104.17or maintained during and for the purpose of an investigation of alleged maltreatment
104.18in a school are governed by this section, notwithstanding the data's classification as
104.19educational, licensing, or personnel data under chapter 13.
104.20    In conducting an assessment or investigation involving a school facility as defined
104.21in subdivision 2, paragraph (i), the commissioner of education shall collect investigative
104.22reports and data that are relevant to a report of maltreatment and are from local law
104.23enforcement and the school facility.
104.24    (i) Upon receipt of a report, the local welfare agency shall conduct a face-to-face
104.25contact with the child reported to be maltreated and with the child's primary caregiver
104.26sufficient to complete a safety assessment and ensure the immediate safety of the child.
104.27The face-to-face contact with the child and primary caregiver shall occur immediately
104.28if substantial child endangerment is alleged and within five calendar days for all other
104.29reports. If the alleged offender was not already interviewed as the primary caregiver, the
104.30local welfare agency shall also conduct a face-to-face interview with the alleged offender
104.31in the early stages of the assessment or investigation. At the initial contact, the local child
104.32welfare agency or the agency responsible for assessing or investigating the report must
104.33inform the alleged offender of the complaints or allegations made against the individual in
104.34a manner consistent with laws protecting the rights of the person who made the report.
104.35The interview with the alleged offender may be postponed if it would jeopardize an active
104.36law enforcement investigation.
105.1    (j) When conducting an investigation, the local welfare agency shall use a question
105.2and answer interviewing format with questioning as nondirective as possible to elicit
105.3spontaneous responses. For investigations only, the following interviewing methods and
105.4procedures must be used whenever possible when collecting information:
105.5    (1) audio recordings of all interviews with witnesses and collateral sources; and
105.6    (2) in cases of alleged sexual abuse, audio-video recordings of each interview with
105.7the alleged victim and child witnesses.
105.8    (k) In conducting an assessment or investigation involving a school facility as
105.9defined in subdivision 2, paragraph (i), the commissioner of education shall collect
105.10available and relevant information and use the procedures in paragraphs (i), (k), and
105.11subdivision 3d, except that the requirement for face-to-face observation of the child
105.12and face-to-face interview of the alleged offender is to occur in the initial stages of the
105.13assessment or investigation provided that the commissioner may also base the assessment
105.14or investigation on investigative reports and data received from the school facility and
105.15local law enforcement, to the extent those investigations satisfy the requirements of
105.16paragraphs (i) and (k), and subdivision 3d.

105.17    Sec. 84. Minnesota Statutes 2006, section 626.556, subdivision 10a, is amended to
105.18read:
105.19    Subd. 10a. Abuse outside family unit Law enforcement agency responsibility
105.20for investigation; welfare agency reliance on law enforcement fact-finding; welfare
105.21agency offer of services. (a) If the report alleges neglect, physical abuse, or sexual abuse
105.22by a person who is not a parent, guardian, sibling, person responsible for the child's care
105.23functioning outside within the family unit, or a person who lives in the child's household
105.24and who has a significant relationship to the child, in a setting other than a facility as
105.25defined in subdivision 2, the local welfare agency shall immediately notify the appropriate
105.26law enforcement agency, which shall conduct an investigation of the alleged abuse or
105.27neglect if a violation of a criminal statute is alleged.
105.28    (b) The local agency may rely on the fact-finding efforts of the law enforcement
105.29investigation conducted under this subdivision to make a determination whether or not
105.30threatened harm or other maltreatment has occurred under subdivision 2 if an alleged
105.31offender has minor children or lives with minors.
105.32    (c) The local welfare agency shall offer appropriate social services for the purpose of
105.33safeguarding and enhancing the welfare of the abused or neglected minor.

106.1    Sec. 85. Minnesota Statutes 2006, section 626.556, subdivision 10c, is amended to
106.2read:
106.3    Subd. 10c. Duties of local social service agency upon receipt of a report of
106.4medical neglect. If the report alleges medical neglect as defined in section 260C.007,
106.5subdivision 4 6 , clause (5), the local welfare agency shall, in addition to its other duties
106.6under this section, immediately consult with designated hospital staff and with the parents
106.7of the infant to verify that appropriate nutrition, hydration, and medication are being
106.8provided; and shall immediately secure an independent medical review of the infant's
106.9medical charts and records and, if necessary, seek a court order for an independent medical
106.10examination of the infant. If the review or examination leads to a conclusion of medical
106.11neglect, the agency shall intervene on behalf of the infant by initiating legal proceedings
106.12under section 260C.141 and by filing an expedited motion to prevent the withholding
106.13of medically indicated treatment.

106.14    Sec. 86. Minnesota Statutes 2006, section 626.556, subdivision 10f, is amended to read:
106.15    Subd. 10f. Notice of determinations. Within ten working days of the conclusion
106.16of a family assessment, the local welfare agency shall notify the parent or guardian of
106.17the child of the need for services to address child safety concerns or significant risk of
106.18subsequent child maltreatment. The local welfare agency and the family may also jointly
106.19agree that family support and family preservation services are needed. Within ten working
106.20days of the conclusion of an investigation, the local welfare agency or agency responsible
106.21for assessing or investigating the report shall notify the parent or guardian of the child, the
106.22person determined to be maltreating the child, and if applicable, the director of the facility,
106.23of the determination and a summary of the specific reasons for the determination. The
106.24notice must also include a certification that the information collection procedures under
106.25subdivision 10, paragraphs (h), (i), and (j), were followed and a notice of the right of a
106.26data subject to obtain access to other private data on the subject collected, created, or
106.27maintained under this section. In addition, the notice shall include the length of time that
106.28the records will be kept under subdivision 11c. The investigating agency shall notify the
106.29parent or guardian of the child who is the subject of the report, and any person or facility
106.30determined to have maltreated a child, of their appeal or review rights under this section
106.31or section 256.022. The notice must also state that a finding of maltreatment may result
106.32in denial of a license application or background study disqualification under chapter
106.33245C related to employment or services that are licensed by the Department of Human
106.34Services under chapter 245A, the Department of Health under chapter 144 or 144A, the
107.1Department of Corrections under section 241.021, and from providing services related to
107.2an unlicensed personal care provider organization under chapter 256B.

107.3    Sec. 87. KINSHIP NAVIGATOR PROGRAM; DEMONSTRATION GRANT.
107.4    (a) The commissioner of human services shall fund a two-year demonstration grant
107.5to be transferred to a nonprofit organization experienced in kinship advocacy and policy
107.6that has:
107.7    (1) experience working with grandparents and relatives who are raising kinship
107.8children;
107.9    (2) an established statewide outreach network;
107.10    (3) established kinship support groups;
107.11    (4) an intergenerational approach to programming; and
107.12    (5) a board of directors consisting of 50 percent grandparents and relatives raising
107.13kinship children.
107.14    (b) The purpose of the grant is to provide support to grandparents or relatives raising
107.15kinship children. One site must be in the metropolitan area, and the other in the Bemidji
107.16region. One-stop services may include, but are not limited to, legal services, education,
107.17information, family activities, support groups, mental health access, advocacy, mentors,
107.18and information related to foster care licensing. Funds may also be used for a media
107.19campaign to inform kinship families about available information and services, support
107.20sites, and other program development.

107.21    Sec. 88. MFIP PILOT PROGRAM; WORKFORCE U.
107.22    Subdivision 1. Establishment. A pilot program is established in Stearns and
107.23Benton Counties to expand the Workforce U program administered by the Stearns-Benton
107.24Employment and Training Council.
107.25    Subd. 2. Evaluation. The Workforce U pilot program must be evaluated by a
107.26research and evaluation organization with experience evaluating welfare programs. The
107.27evaluation must include information on the total number of persons served, percentage
107.28of participants exiting the program, percentage of former participants reentering the
107.29program, average wages of program participants, and recommendations to the legislature
107.30for possible statewide implementation of the program. The evaluation must be presented
107.31to the legislature by February 15, 2011.
107.32    Subd. 3. Expiration. The Workforce U pilot program expires on June 30, 2011.

107.33    Sec. 89. LEECH LAKE YOUTH TREATMENT CENTER PROPOSAL.
108.1    (a) The commissioner of human services shall provide a planning grant to address
108.2the unmet need for local, effective, culturally relevant alcohol and drug treatment for
108.3American Indian youth, and develop a plan for a family-based youth treatment center in
108.4the Leech Lake area. The planning grant must be provided to a volunteer board consisting
108.5of at least four members appointed by the commissioner, to include at least the following:
108.6    (1) two members of the Leech Lake Tribal Council or their designees;
108.7    (2) one member appointed by the Cass County Social Services administrator; and
108.8    (3) one member appointed by the Cass Lake-Bena Public School superintendent.
108.9    (b) The plan must include:
108.10    (1) an interest, feasibility, and suitability of location study;
108.11    (2) defining scope of programs and services to be offered;
108.12    (3) defining site use limitations and restrictions, including physical and capacity;
108.13    (4) defining facilities required for programs and services offered;
108.14    (5) identifying partners, partnership roles, and partner resources;
108.15    (6) developing proposed operating and maintenance budgets;
108.16    (7) identifying funding sources;
108.17    (8) developing a long-term funding plan; and
108.18    (9) developing a formal steering committee, structure, and bylaws.
108.19    (c) The plan is due to the legislative committees having jurisdiction over chemical
108.20health issues no later than September 2008 in order to provide the 12 months necessary to
108.21complete the plan.

108.22    Sec. 90. MINNESOTA FOOD SUPPORT PROGRAM SIMPLIFIED
108.23APPLICATION.
108.24    The Department of Human Services shall create a simplified application for the
108.25Minnesota food support program for persons over the age of 60 and persons with
108.26disabilities. The application must be no longer than three pages in length.
108.27EFFECTIVE DATE.This section is effective January 1, 2008.

108.28    Sec. 91. INSPECTION OF LEGAL UNLICENSED CHILD CARE PROVIDERS.
108.29    The commissioner of human services, in consultation with the commissioners of
108.30health and education and the counties, shall develop and present recommendations to
108.31the legislature in January 2008 in order for each legally unlicensed child care provider
108.32receiving child care assistance funds to receive a onetime home visit to receive information
108.33on health and safety, and school readiness.

109.1    Sec. 92. COMMISSIONER OF HUMAN SERVICES DUTIES; EARLY
109.2CHILDHOOD AND SCHOOL-AGE PROFESSIONAL DEVELOPMENT
109.3TRAINING.
109.4    Subdivision 1. Development and implementation of an early childhood and
109.5school-age professional development system. (a) The commissioner of human services,
109.6in cooperation with the commissioners of education and health, shall develop and phase-in
109.7the implementation of a professional development system for practitioners serving
109.8children in early childhood and school-age programs. The system shall provide training
109.9options and supports for practitioners to voluntarily choose, as they complete or exceed
109.10existing licensing requirements.
109.11    The system must, at a minimum, include the following features:
109.12    (1) a continuum of training content based on the early childhood and school-age
109.13care practitioner core competencies that translates knowledge into improved practice to
109.14support children's school success;
109.15    (2) training strategies that provide direct feedback about practice to practitioners
109.16through ongoing consultation, mentoring, or coaching with special emphasis on early
109.17literacy and early mathematics;
109.18    (3) an approval process for trainers;
109.19    (4) a professional development registry for early childhood and school-age care
109.20practitioners that will provide tracking and recognition of practitioner training/career
109.21development progress;
109.22    (5) a career lattice that includes a range of professional development and educational
109.23opportunities that provide appropriate coursework and degree pathways;
109.24    (6) development of a plan with public higher education institutions for an articulated
109.25system of education, training, and professional development that includes credit for prior
109.26learning and development of equivalences to two- and four-year degrees;
109.27    (7) incentives and supports for early childhood and school-age care practitioners
109.28to seek additional training and education, including TEACH, other scholarships, and
109.29career guidance; and
109.30    (8) coordinated and accessible delivery of training to early childhood and school-age
109.31care practitioners.
109.32    (b) By January 1, 2008, the commissioner, in consultation with the organizations
109.33named in subdivision 2 shall develop additional opportunities in order to qualify more
109.34licensed family child care providers under section 119B.13, subdivision 3a.
109.35    (c) The commissioner of human services must evaluate the professional development
109.36system and make continuous improvements.
110.1    (d) Beginning July 1, 2007, as appropriations permit, the commissioner shall
110.2phase-in the professional development system.
110.3    Subd. 2. Two-hour early childhood training. By January 15, 2008, the
110.4commissioner of human services, with input from the Minnesota Licensed Family Child
110.5Care Association and the Minnesota Professional Development Council, shall identify
110.6trainings that qualify for the two-hour early childhood development training requirement
110.7for new child care practitioners under Minnesota Statutes, section 245A.14, subdivision
110.89a, paragraphs (a) and (b). For licensed family child care, the commissioner shall also
110.9seek the input of labor unions that serve licensed family child care providers, if the union
110.10has been recognized by a county to serve licensed family child care providers.

110.11    Sec. 93. SCHOOL READINESS SERVICE AGREEMENTS.
110.12    Subdivision 1. Overview. (a) Effective July 1, 2007, funds must be made available
110.13to allow the commissioner to pay higher rates to up to 50 child care providers who are
110.14deemed by the commissioner to meet the requirements of a school readiness service
110.15agreement (SRSA) provider and perform services that support school readiness for
110.16children and economic stability for parents.
110.17    (b) A provider may be paid a rate above that currently allowed under Minnesota
110.18Statutes, section 119B.13, if:
110.19    (1) the provider has entered into an SRSA with the commissioner;
110.20    (2) a family using that provider receives child care assistance under any provision in
110.21Minnesota Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
110.22    (3) the family using that provider meets the criteria in this section; and
110.23    (4) funding is available under this section.
110.24    Subd. 2. Provider eligibility. (a) To be considered for an SRSA, a provider shall
110.25apply to the commissioner. To be eligible to apply for an SRSA, a provider shall:
110.26    (1) be eligible for child care assistance payments under Minnesota Statutes, chapter
110.27119B;
110.28    (2) have at least 25 percent of the children enrolled with the provider subsidized
110.29through the child care assistance program;
110.30    (3) provide full-time, full-year child care services; and
110.31    (4) serve at least one child who is subsidized through the child care assistance
110.32program and who is expected to enter kindergarten within the following 30 months.
110.33    (b) The commissioner may waive the 25 percent requirement in paragraph (a), clause
110.34(2), if necessary to achieve geographic distribution of SRSA providers and diversity of
110.35types of care provided by SRSA providers.
111.1    (c) An eligible provider who would like to enter into an SRSA with the commissioner
111.2shall submit an SRSA application. To determine whether to enter into an SRSA with a
111.3provider, the commissioner shall evaluate the following factors:
111.4    (1) the qualifications of the provider and the provider's staff;
111.5    (2) the provider's staff-child ratios;
111.6    (3) the provider's curriculum;
111.7    (4) the provider's current or planned parent education activities;
111.8    (5) the provider's current or planned social service and employment linkages;
111.9    (6) the provider's child development assessment plan;
111.10    (7) the geographic distribution needed for SRSA providers;
111.11    (8) the inclusion of a variety of child care delivery models; and
111.12    (9) other related factors determined by the commissioner.
111.13    Subd. 3. Family and child eligibility. (a) A family eligible to choose an SRSA
111.14provider for their children shall:
111.15    (1) be eligible to receive child care assistance under any provision in Minnesota
111.16Statutes, chapter 119B, except Minnesota Statutes, section 119B.035;
111.17    (2) be in an authorized activity for an average of at least 35 hours per week when
111.18initial eligibility is determined; and
111.19    (3) include a child who has not yet entered kindergarten.
111.20    (b) A family who is determined to be eligible to choose an SRSA provider remains
111.21eligible to be paid at a higher rate through the SRSA provider when the following
111.22conditions exist:
111.23    (1) the child attends child care with the SRSA provider a minimum of 25 hours per
111.24week, on average;
111.25    (2) the family has a child who has not yet entered kindergarten; and
111.26    (3) the family maintains eligibility under Minnesota Statutes, chapter 119B, except
111.27Minnesota Statutes, section 119B.035.
111.28    (c) For the 12 months after initial eligibility has been determined, a decrease in
111.29the family's authorized activities to an average of less than 35 hours per week does not
111.30result in ineligibility for the SRSA rate.
111.31    (d) A family that moves between counties but continues to use the same SRSA
111.32provider shall continue to receive SRSA funding for the increased payments.
111.33    Subd. 4. Requirements of providers. An SRSA must include assessment,
111.34evaluation, and reporting requirements that promote the goals of improved school
111.35readiness and movement toward appropriate child development milestones. A provider
112.1who enters into an SRSA shall comply with the assessment, evaluation, and reporting
112.2requirements in the SRSA.
112.3    Subd. 5. Relationship to current law. (a) The following provisions in Minnesota
112.4Statutes, chapter 119B, must be waived or modified for families receiving services under
112.5this section.
112.6    (b) Notwithstanding Minnesota Statutes, section 119B.13, subdivisions 1 and 1a,
112.7maximum weekly rates under this section are 125 percent of the existing maximum
112.8weekly rate for like-care. Providers eligible for a differential rate under Minnesota
112.9Statutes, section 119B.13, subdivision 3a, remain eligible for the differential above the
112.10rate identified in this section. Only care for children who have not yet entered kindergarten
112.11may be paid at the maximum rate under this section. The provider's charge for service
112.12provided through an SRSA may not exceed the rate that the provider charges a private-pay
112.13family for like-care arrangements.
112.14    (c) A family or child care provider may not be assessed an overpayment for care
112.15provided through an SRSA unless:
112.16    (1) there was an error in the amount of care authorized for the family; or
112.17    (2) the family or provider did not timely report a change as required under the law.
112.18    (d) Care provided through an SRSA is authorized on a weekly basis.
112.19    (e) Funds appropriated under this section to serve families eligible under Minnesota
112.20Statutes, section 119B.03, are not allocated through the basic sliding fee formula under
112.21Minnesota Statutes, section 119B.03. Funds appropriated under this section are used to
112.22offset increased costs when payments are made under SRSA's.
112.23    (f) Notwithstanding Minnesota Statutes, section 119B.09, subdivision 6, the
112.24maximum amount of child care assistance that may be authorized for a child receiving
112.25care through an SRSA in a two-week period is 160 hours per child.
112.26    Subd. 6. Establishment of service agreements. (a) The commissioner shall
112.27approve SRSA's for up to 50 providers that represent diverse parts of the state and a
112.28variety of child care delivery models. Entering into a service agreement does not guarantee
112.29that a provider will receive payment at a higher rate for families receiving child care
112.30assistance. A family eligible under this section shall choose a provider participating in an
112.31SRSA in order for a higher rate to be paid. Payments through SRSA's are also limited by
112.32the availability of SRSA funds.
112.33    (b) Nothing in this section shall be construed to limit parent choice as defined in
112.34Minnesota Statutes, section 119B.09, subdivision 5.
113.1    (c) The commissioner may allow for startup time for some providers if failing to
113.2do so would limit geographic diversity of SRSA providers or a variety of child care
113.3delivery models.

113.4    Sec. 94. FAMILY, FRIEND, AND NEIGHBOR GRANT PROGRAM.
113.5    Subdivision 1. Establishment. A family, friend, and neighbor (FFN) grant program
113.6is established to promote children's early literacy, healthy development, and school
113.7readiness, and to foster community partnerships to promote children's school readiness.
113.8The commissioner shall attempt to ensure that grants are made in all areas of the state. The
113.9commissioner of human services shall make grants available to fund: community-based
113.10organizations, nonprofit organizations, and Indian tribes working with FFN caregivers
113.11under subdivision 2, paragraph (a); and community-based partnerships to implement early
113.12literacy programs under subdivision 2, paragraph (b).
113.13    Subd. 2. Program components. (a)(1) Grants that the commissioner awards under
113.14this section must be used by community-based organizations, nonprofit organizations, and
113.15Indian tribes working with FFN caregivers in local communities, cultural communities,
113.16and Indian tribes to:
113.17    (i) provide training, support, and resources to FFN caregivers in order to improve
113.18and promote children's health, safety, nutrition, and school readiness;
113.19    (ii) connect FFN caregivers and children's families with appropriate community
113.20resources that support the families' health, mental health, economic, and developmental
113.21needs;
113.22    (iii) connect FFN caregivers and children's families to early childhood screening
113.23programs and facilitate referrals where appropriate;
113.24    (iv) provide FFN caregivers and children's families with information about early
113.25learning guidelines from the Departments of Human Services and Education;
113.26    (v) provide FFN caregivers and children's families with information about becoming
113.27a licensed family child care provider; and
113.28    (vi) provide FFN caregivers and children's families with information about early
113.29learning allowances and enrollment opportunities in high quality community-based
113.30child-care and preschool programs.
113.31    (2) Grants that the commissioner awards under this paragraph also may be used for:
113.32    (i) health and safety and early learning kits for FFN caregivers;
113.33    (ii) play-and-learn groups with FFN caregivers;
113.34    (iii) culturally appropriate early childhood training for FFN caregivers;
114.1    (iv) transportation for FFN caregivers and children's families to school readiness and
114.2other early childhood training activities;
114.3    (v) other activities that promote school readiness;
114.4    (vi) data collection and evaluation;
114.5    (vii) staff outreach and outreach activities;
114.6    (viii) translation needs; or
114.7    (ix) administrative costs that equal up to 12 percent of the recipient's grant award.
114.8    (b) Grants that the commissioner awards under this section also must be used to fund
114.9partnerships among Minnesota public and regional library systems, community-based
114.10organizations, nonprofit organizations, and Indian tribes to implement early literacy
114.11programs in low-income communities, including tribal communities, to:
114.12    (1) purchase and equip early childhood read-mobiles that provide FFN caregivers
114.13and children's families with books, training, and early literacy activities;
114.14    (2) provide FFN caregivers and children's families with translations of early
114.15childhood books, training, and early literacy activities in native languages; or
114.16    (3) provide FFN caregivers and children's families with early literacy activities in
114.17local libraries.
114.18    Subd. 3. Grant awards. Interested entities eligible to receive a grant under
114.19this section may apply to the commissioner in the form and manner the commissioner
114.20determines. The commissioner shall awards grants to eligible entities consistent with
114.21the requirements of this section.
114.22    Subd. 4. Evaluation. The commissioner, in consultation with early childhood
114.23care and education experts at the University of Minnesota, must evaluate the impact of
114.24the grants under subdivision 2 on children's school readiness and submit a written report
114.25to the human services and education finance and policy committees of the legislature by
114.26February 15, 2010.
114.27EFFECTIVE DATE.This section is effective the day following final enactment.

114.28    Sec. 95. CHILD CARE PROVIDER STUDY.
114.29    The commissioner of human services is directed to study the implications of
114.30restricting the use of state subsidies in center-based child care to centers meeting state
114.31quality standards under Minnesota Statutes, section 124D.175, paragraph (c), and to
114.32publish the results no later than January 1, 2010. The study must include:
114.33    (1) the likelihood of there being sufficient child care providers meeting the standards;
114.34    (2) the cost to bring providers up to the standards and how this cost would be funded;
115.1    (3) how the standards and the ratings would be communicated to both parents and
115.2the general public; and
115.3    (4) a determination whether a similar system could be implemented for
115.4non-center-based care.

115.5    Sec. 96. DIRECTION TO COMMISSIONER.
115.6    (a) The commissioner of human services shall offer a request for proposals to
115.7identify a research and evaluation firm with experience working with:
115.8    (1) homeless youth providers;
115.9    (2) data; and
115.10    (3) the topics of housing, homelessness, and a continuum of care for youth.
115.11    (b) The research and evaluation firm identified under paragraph (a) shall monitor and
115.12evaluate the programs receiving funding under Minnesota Statutes, section 256K.45.

115.13    Sec. 97. REVISOR'S INSTRUCTION.
115.14    (a) The revisor shall renumber Minnesota Statutes, section 626.556, subdivision 3d,
115.15as Minnesota Statutes, section 626.556, subdivision 3g.
115.16    (b) The revisor shall change references to Minnesota Statutes, section 260.851,
115.17to section 260.853 and references to Minnesota Statutes, section 260.851, article 5, to
115.18section 260.853, article 4, wherever those references appear in Minnesota Statutes and
115.19Minnesota Rules.

115.20    Sec. 98. REPEALER.
115.21(a) Minnesota Statutes 2006, sections 119B.08, subdivision 4; 256J.29; 256J.37,
115.22subdivisions 3a and 3b; and 256J.626, subdivisions 7 and 9, are repealed.
115.23(b) Laws 1997, chapter 8, section 1, is repealed.
115.24(c) Minnesota Rules, part 9560.0102, subpart 2, item C, is repealed.

115.25ARTICLE 2

115.26LICENSING

115.27    Section 1. Minnesota Statutes 2006, section 245A.035, is amended to read:
115.28245A.035 RELATIVE FOSTER CARE; UNLICENSED EMERGENCY
115.29LICENSE RELATIVE PLACEMENT.
115.30    Subdivision 1. Grant of Emergency license placement. Notwithstanding section
115.31245A.03, subdivision 2a , or 245C.13, subdivision 2, a county agency may place a child
115.32for foster care with a relative who is not licensed to provide foster care, provided the
116.1requirements of subdivision 2 this section are met. As used in this section, the term
116.2"relative" has the meaning given it under section 260C.007, subdivision 27.
116.3    Subd. 2. Cooperation with emergency licensing placement process. (a) A county
116.4agency that places a child with a relative who is not licensed to provide foster care must
116.5begin the process of securing an emergency license for the relative as soon as possible
116.6and must conduct the initial inspection required by subdivision 3, clause (1), whenever
116.7possible, prior to placing the child in the relative's home, but no later than three working
116.8days after placing the child in the home. A child placed in the home of a relative who is
116.9not licensed to provide foster care must be removed from that home if the relative fails
116.10to cooperate with the county agency in securing an emergency foster care license. The
116.11commissioner may issue an emergency foster care license to a relative with whom the
116.12county agency wishes to place or has placed a child for foster care, or to a relative with
116.13whom a child has been placed by court order.
116.14    (b) If a child is to be placed in the home of a relative not licensed to provide foster
116.15care, either the placing agency or the county agency in the county in which the relative
116.16lives shall conduct the emergency licensing placement process as required in this section.
116.17    Subd. 3. Requirements for emergency license placement. Before an emergency
116.18license placement may be issued made, the following requirements must be met:
116.19    (1) the county agency must conduct an initial inspection of the premises where
116.20the foster care placement is to be provided made to ensure the health and safety of any
116.21child placed in the home. The county agency shall conduct the inspection using a form
116.22developed by the commissioner;
116.23    (2) at the time of the inspection or placement, whichever is earlier, the county
116.24agency must provide the relative being considered for an emergency license shall receive
116.25placement an application form for a child foster care license;
116.26    (3) whenever possible, prior to placing the child in the relative's home, the relative
116.27being considered for an emergency license placement shall provide the information
116.28required by section 245C.05; and
116.29    (4) if the county determines, prior to the issuance of an emergency license
116.30placement, that anyone requiring a background study may be prior to licensure of the
116.31home is disqualified under section 245C.14 and chapter 245C, and the disqualification
116.32is one which the commissioner cannot set aside, an emergency license shall placement
116.33must not be issued made.
116.34    Subd. 4. Applicant study. When the county agency has received the information
116.35required by section 245C.05, the county agency shall begin an applicant study according to
116.36the procedures in chapter 245C. The commissioner may issue an emergency license upon
117.1recommendation of the county agency once the initial inspection has been successfully
117.2completed and the information necessary to begin the applicant background study has been
117.3provided. If the county agency does not recommend that the emergency license be granted,
117.4the agency shall notify the relative in writing that the agency is recommending denial to the
117.5commissioner; shall remove any child who has been placed in the home prior to licensure;
117.6and shall inform the relative in writing of the procedure to request review pursuant to
117.7subdivision 6. An emergency license shall be effective until a child foster care license is
117.8granted or denied, but shall in no case remain in effect more than 120 days from the date
117.9of placement submit the information to the commissioner according to section 245C.05.
117.10    Subd. 5. Child foster care license application. (a) The relatives with whom the
117.11emergency license holder placement has been made shall complete the child foster care
117.12license application and necessary paperwork within ten days of the placement. The county
117.13agency shall assist the emergency license holder applicant to complete the application.
117.14The granting of a child foster care license to a relative shall be under the procedures in this
117.15chapter and according to the standards set forth by foster care rule in Minnesota Rules,
117.16chapter 2960. In licensing a relative, the commissioner shall consider the importance of
117.17maintaining the child's relationship with relatives as an additional significant factor in
117.18determining whether to a background study disqualification should be set aside a licensing
117.19disqualifier under section 245C.22, or to grant a variance of licensing requirements should
117.20be granted under sections 245C.21 to 245C.27 section 245C.30.
117.21    (b) When the county or private child-placing agency is processing an application
117.22for child foster care licensure of a relative as defined in section 260B.007, subdivision
117.2312 , or 260C.007, subdivision 27, the county agency or child-placing agency must explain
117.24the licensing process to the prospective licensee, including the background study process
117.25and the procedure for reconsideration of an initial disqualification for licensure. The
117.26county or private child-placing agency must also provide the prospective relative licensee
117.27with information regarding appropriate options for legal representation in the pertinent
117.28geographic area. If a relative is initially disqualified under section 245C.14, the county
117.29or child-placing agency commissioner must provide written notice of the reasons for the
117.30disqualification and the right to request a reconsideration by the commissioner as required
117.31under section 245C.17.
117.32    (c) The commissioner shall maintain licensing data so that activities related to
117.33applications and licensing actions for relative foster care providers may be distinguished
117.34from other child foster care settings.
117.35    Subd. 6. Denial of emergency license. If the commissioner denies an application
117.36for an emergency foster care license under this section, that denial must be in writing and
118.1must include reasons for the denial. Denial of an emergency license is not subject to
118.2appeal under chapter 14. The relative may request a review of the denial by submitting
118.3to the commissioner a written statement of the reasons an emergency license should be
118.4granted. The commissioner shall evaluate the request for review and determine whether
118.5to grant the emergency license. The commissioner's review shall be based on a review
118.6of the records submitted by the county agency and the relative. Within 15 working
118.7days of the receipt of the request for review, the commissioner shall notify the relative
118.8requesting review in written form whether the emergency license will be granted. The
118.9commissioner's review shall be based on a review of the records submitted by the county
118.10agency and the relative. A child shall not be placed or remain placed in the relative's home
118.11while the request for review is pending. Denial of an emergency license shall not preclude
118.12an individual from reapplying for an emergency license or from applying for a child foster
118.13care license. The decision of the commissioner is the final administrative agency action.

118.14    Sec. 2. Minnesota Statutes 2006, section 245A.10, subdivision 2, is amended to read:
118.15    Subd. 2. County fees for background studies and licensing inspections. (a) For
118.16purposes of family and group family child care licensing under this chapter, a county
118.17agency may charge a fee to an applicant or license holder to recover the actual cost of
118.18background studies, but in any case not to exceed $100 annually. A county agency may
118.19also charge a license fee to an applicant or license holder to recover the actual cost of
118.20licensing inspections, but in any case not to exceed $150 annually $50 for a one-year
118.21license or $100 for a two-year license.
118.22    (b) A county agency may charge a fee to a legal nonlicensed child care provider or
118.23applicant for authorization to recover the actual cost of background studies completed
118.24under section 119B.125, but in any case not to exceed $100 annually.
118.25    (c) Counties may elect to reduce or waive the fees in paragraph (a) or (b):
118.26    (1) in cases of financial hardship;
118.27    (2) if the county has a shortage of providers in the county's area;
118.28    (3) for new providers; or
118.29    (4) for providers who have attained at least 16 hours of training before seeking
118.30initial licensure.
118.31    (d) Counties may allow providers to pay the applicant fees in paragraph (a) or (b) on
118.32an installment basis for up to one year. If the provider is receiving child care assistance
118.33payments from the state, the provider may have the fees under paragraph (a) or (b)
118.34deducted from the child care assistance payments for up to one year and the state shall
118.35reimburse the county for the county fees collected in this manner.
119.1EFFECTIVE DATE.This section is effective the day following final enactment.

119.2    Sec. 3. Minnesota Statutes 2006, section 245A.16, subdivision 1, is amended to read:
119.3    Subdivision 1. Delegation of authority to agencies. (a) County agencies and
119.4private agencies that have been designated or licensed by the commissioner to perform
119.5licensing functions and activities under section 245A.04 and background studies for adult
119.6foster care, family adult day services, and until December 31, 2007, family child care,
119.7under chapter 245C,; to recommend denial of applicants under section 245A.05,; to issue
119.8correction orders, to issue variances, and recommend a conditional license under section
119.9245A.06 , or to recommend suspending or revoking a license or issuing a fine under section
119.10245A.07 , shall comply with rules and directives of the commissioner governing those
119.11functions and with this section. The following variances are excluded from the delegation
119.12of variance authority and may be issued only by the commissioner:
119.13    (1) dual licensure of family child care and child foster care, dual licensure of child
119.14and adult foster care, and adult foster care and family child care;
119.15    (2) adult foster care maximum capacity;
119.16    (3) adult foster care minimum age requirement;
119.17    (4) child foster care maximum age requirement;
119.18    (5) variances regarding disqualified individuals except that county agencies may
119.19issue variances under section 245C.30 regarding disqualified individuals when the county
119.20is responsible for conducting a consolidated reconsideration according to sections 245C.25
119.21and 245C.27, subdivision 2, clauses (a) and (b), of a county maltreatment determination
119.22and a disqualification based on serious or recurring maltreatment; and
119.23    (6) the required presence of a caregiver in the adult foster care residence during
119.24normal sleeping hours.
119.25    (b) County agencies must report:
119.26    (1) information about disqualification reconsiderations under sections 245C.25 and
119.27245C.27, subdivision 2 , clauses paragraphs (a) and (b), and variances granted under
119.28paragraph (a), clause (5), to the commissioner at least monthly in a format prescribed by
119.29the commissioner; and.
119.30    (2) for relative child foster care applicants and license holders, the number of
119.31relatives, as defined in section 260C.007, subdivision 27, and household members of
119.32relatives who are disqualified under section 245C.14; the disqualifying characteristics
119.33under section 245C.15; the number of these individuals who requested reconsideration
119.34under section 245C.21; the number of set-asides under section 245C.22; and variances
120.1under section 245C.30 issued. This information shall be reported to the commissioner
120.2annually by January 15 of each year in a format prescribed by the commissioner.
120.3    (c) For family day care programs, the commissioner may authorize licensing reviews
120.4every two years after a licensee has had at least one annual review.
120.5    (d) For family adult day services programs, the commissioner may authorize
120.6licensing reviews every two years after a licensee has had at least one annual review.
120.7    (e) A license issued under this section may be issued for up to two years.

120.8    Sec. 4. Minnesota Statutes 2006, section 245A.16, subdivision 3, is amended to read:
120.9    Subd. 3. Recommendations to the commissioner. The county or private agency
120.10shall not make recommendations to the commissioner regarding licensure without
120.11first conducting an inspection, and for adult foster care, family adult day services, and
120.12until December 31, 2007, family child care, a background study of the applicant, and
120.13evaluation pursuant to under chapter 245C. The county or private agency must forward its
120.14recommendation to the commissioner regarding the appropriate licensing action within 20
120.15working days of receipt of a completed application.
120.16EFFECTIVE DATE.This section is effective January 1, 2008.

120.17    Sec. 5. Minnesota Statutes 2006, section 245C.02, is amended by adding a subdivision
120.18to read:
120.19    Subd. 14a. Private agency. "Private agency" has the meaning given in section
120.20245A.02, subdivision 12.

120.21    Sec. 6. Minnesota Statutes 2006, section 245C.04, subdivision 1, is amended to read:
120.22    Subdivision 1. Licensed programs. (a) The commissioner shall conduct a
120.23background study of an individual required to be studied under section 245C.03,
120.24subdivision 1 , at least upon application for initial license for all license types.
120.25    (b) The commissioner shall conduct a background study of an individual required
120.26to be studied under section 245C.03, subdivision 1, at reapplication for a license for
120.27family child care, child foster care, and adult foster care, family adult day services, and
120.28until January 1, 2008, family child care.
120.29    (c) The commissioner is not required to conduct a study of an individual at the time
120.30of reapplication for a license if the individual's background study was completed by the
120.31commissioner of human services for an adult foster care license holder that is also:
120.32    (1) registered under chapter 144D; or
121.1    (2) licensed to provide home and community-based services to people with
121.2disabilities at the foster care location and the license holder does not reside in the foster
121.3care residence; and
121.4    (3) the following conditions are met:
121.5    (i) a study of the individual was conducted either at the time of initial licensure or
121.6when the individual became affiliated with the license holder;
121.7    (ii) the individual has been continuously affiliated with the license holder since
121.8the last study was conducted; and
121.9    (iii) the last study of the individual was conducted on or after October 1, 1995.
121.10    (d) From July 1, 2007, to June 30, 2009, the commissioner of human services
121.11shall conduct a study of an individual required to be studied under section 245C.03, at
121.12the time of reapplication for a child foster care license. The county or private agency
121.13shall collect and forward to the commissioner the information required under section
121.14245C.05, subdivisions 1, paragraphs (a) and (b), and 5, paragraphs (a) and (b). The
121.15background study conducted by the commissioner of human services under this paragraph
121.16must include a review of the information required under section 245C.08, subdivisions
121.171, paragraph (a), clauses (1) to (4), and 3.
121.18    (e) From January 1, 2008, to December 31, 2009, the commissioner shall conduct
121.19a study of an individual required to be studied under section 245C.03, at the time of
121.20reapplication for a family child care license. The county shall collect and forward to the
121.21commissioner the information required under section 245C.05, subdivisions 1 and 5. The
121.22background study conducted by the commissioner under this paragraph must include a
121.23review of the information required under section 245C.08, subdivisions 1, paragraph
121.24(a), and 3.
121.25    (f) The commissioner of human services shall conduct a background study of an
121.26individual specified under section 245C.03, subdivision 1, paragraph (a), clauses (2)
121.27to (6), who is newly affiliated with a child foster care license holder. The county or
121.28private agency shall collect and forward to the commissioner the information required
121.29under section 245C.05, subdivisions 1 and 5. The background study conducted by the
121.30commissioner of human services under this paragraph must include a review of the
121.31information required under section 245C.08, subdivisions 1, paragraph (a), and 3.
121.32    (g) Applicants for licensure, license holders, and other entities as provided in this
121.33chapter must submit completed background study forms to the commissioner before
121.34individuals specified in section 245C.03, subdivision 1, begin positions allowing direct
121.35contact in any licensed program.
122.1    (e) (h) For purposes of this section, a physician licensed under chapter 147 is
122.2considered to be continuously affiliated upon the license holder's receipt from the
122.3commissioner of health or human services of the physician's background study results.

122.4    Sec. 7. Minnesota Statutes 2006, section 245C.05, subdivision 1, is amended to read:
122.5    Subdivision 1. Individual studied. (a) The individual who is the subject of the
122.6background study must provide the applicant, license holder, or other entity under section
122.7245C.04 with sufficient information to ensure an accurate study, including:
122.8    (1) the individual's first, middle, and last name and all other names by which the
122.9individual has been known;
122.10    (2) home address, city, and state of residence;
122.11    (3) zip code;
122.12    (4) sex;
122.13    (5) date of birth; and
122.14    (6) Minnesota driver's license number or state identification number.
122.15    (b) Every subject of a background study conducted or initiated by counties or private
122.16agencies under this chapter must also provide the home address, city, county, and state of
122.17residence for the past five years.
122.18    (c) Every subject of a background study related to child foster care licensed through
122.19a private agency shall also provide the commissioner a signed consent for the release of
122.20any information received from national crime information databases to the private agency
122.21that initiated the background study.
122.22    (d) The subject of a background study shall provide fingerprints as required in
122.23subdivision 5, paragraph (c).

122.24    Sec. 8. Minnesota Statutes 2006, section 245C.05, is amended by adding a subdivision
122.25to read:
122.26    Subd. 2a. County or private agency. For background studies related to child
122.27foster care, and beginning January 1, 2008, for studies related to family child care, county
122.28and private agencies must collect the information under subdivision 1 and forward it to
122.29the commissioner.

122.30    Sec. 9. Minnesota Statutes 2006, section 245C.05, subdivision 4, is amended to read:
122.31    Subd. 4. Electronic transmission. For background studies conducted by the
122.32Department of Human Services, the commissioner shall implement a system for the
122.33electronic transmission of:
123.1    (1) background study information to the commissioner; and
123.2    (2) background study results to the license holder; and
123.3    (3) background study results to county and private agencies for background studies
123.4conducted by the commissioner for child foster care, and beginning January 1, 2008,
123.5also for family child care.
123.6EFFECTIVE DATE.This section is effective January 1, 2008.

123.7    Sec. 10. Minnesota Statutes 2006, section 245C.05, subdivision 5, is amended to read:
123.8    Subd. 5. Fingerprints. (a) Except as provided in paragraph (c), for any background
123.9study completed under this chapter, when the commissioner has reasonable cause to
123.10believe that further pertinent information may exist on the subject of the background
123.11study, the subject shall provide the commissioner with a set of classifiable fingerprints
123.12obtained from an authorized law enforcement agency.
123.13    (b) For purposes of requiring fingerprints, the commissioner has reasonable cause
123.14when, but not limited to, the:
123.15    (1) information from the Bureau of Criminal Apprehension indicates that the subject
123.16is a multistate offender;
123.17    (2) information from the Bureau of Criminal Apprehension indicates that multistate
123.18offender status is undetermined; or
123.19    (3) commissioner has received a report from the subject or a third party indicating
123.20that the subject has a criminal history in a jurisdiction other than Minnesota.
123.21    (c) Except as specified under section 245C.04, subdivision 1, paragraph (d), for
123.22background studies conducted by the commissioner for child foster care, the subject of the
123.23background study shall provide the commissioner with a set of classifiable fingerprints
123.24obtained from an authorized agency.

123.25    Sec. 11. Minnesota Statutes 2006, section 245C.05, subdivision 7, is amended to read:
123.26    Subd. 7. Probation officer and corrections agent. (a) A probation officer or
123.27corrections agent shall notify the commissioner of an individual's conviction if the
123.28individual is:
123.29    (1) affiliated with a program or facility regulated by the Department of Human
123.30Services or Department of Health, a facility serving children or youth licensed by the
123.31Department of Corrections, or any type of home care agency or provider of personal care
123.32assistance services; and
123.33    (2) convicted of a crime constituting a disqualification under section 245C.14.
124.1    (b) For the purpose of this subdivision, "conviction" has the meaning given it
124.2in section 609.02, subdivision 5.
124.3    (c) The commissioner, in consultation with the commissioner of corrections, shall
124.4develop forms and information necessary to implement this subdivision and shall provide
124.5the forms and information to the commissioner of corrections for distribution to local
124.6probation officers and corrections agents.
124.7    (d) The commissioner shall inform individuals subject to a background study that
124.8criminal convictions for disqualifying crimes will be reported to the commissioner by the
124.9corrections system.
124.10    (e) A probation officer, corrections agent, or corrections agency is not civilly or
124.11criminally liable for disclosing or failing to disclose the information required by this
124.12subdivision.
124.13    (f) Upon receipt of disqualifying information, the commissioner shall provide the
124.14notice required under section 245C.17, as appropriate, to agencies on record as having
124.15initiated a background study or making a request for documentation of the background
124.16study status of the individual.
124.17    (g) This subdivision does not apply to family child care and child foster care
124.18programs until January 1, 2008.

124.19    Sec. 12. Minnesota Statutes 2006, section 245C.08, subdivision 1, is amended to read:
124.20    Subdivision 1. Background studies conducted by commissioner of human
124.21services. (a) For a background study conducted by the commissioner, the commissioner
124.22shall review:
124.23    (1) information related to names of substantiated perpetrators of maltreatment of
124.24vulnerable adults that has been received by the commissioner as required under section
124.25626.557, subdivision 9c , paragraph (i);
124.26    (2) the commissioner's records relating to the maltreatment of minors in licensed
124.27programs, and from county agency findings of maltreatment of minors as indicated
124.28through the social service information system;
124.29    (3) information from juvenile courts as required in subdivision 4 for individuals
124.30listed in section 245C.03, subdivision 1, clauses (2), (5), and (6); and
124.31    (4) information from the Bureau of Criminal Apprehension.;
124.32    (5) except as provided in clause (6), information from the national crime information
124.33system when the commissioner has reasonable cause as defined under section 245C.05,
124.34subdivision 5; and
125.1    (6) for a background study related to a child foster care application for licensure, the
125.2commissioner shall also review:
125.3    (i) information from the child abuse and neglect registry for any state in which the
125.4background study subject has resided in for the past five years; and
125.5    (ii) information from national crime information databases.
125.6    (b) Notwithstanding expungement by a court, the commissioner may consider
125.7information obtained under paragraph (a), clauses (3) and (4), unless the commissioner
125.8received notice of the petition for expungement and the court order for expungement is
125.9directed specifically to the commissioner.

125.10    Sec. 13. Minnesota Statutes 2006, section 245C.08, subdivision 2, is amended to read:
125.11    Subd. 2. Background studies conducted by a county or private agency. (a) For
125.12a background study conducted by a county or private agency for child foster care, adult
125.13foster care, family adult day services, and until January 1, 2008, family child care homes
125.14services, the commissioner shall review:
125.15    (1) information from the county agency's record of substantiated maltreatment
125.16of adults and the maltreatment of minors;
125.17    (2) information from juvenile courts as required in subdivision 4 for individuals
125.18listed in section 245C.03, subdivision 1, clauses (2), (5), and (6);
125.19    (3) information from the Bureau of Criminal Apprehension; and
125.20    (4) arrest and investigative records maintained by the Bureau of Criminal
125.21Apprehension, county attorneys, county sheriffs, courts, county agencies, local police, the
125.22National Criminal Records Repository, and criminal records from other states.
125.23    (b) If the individual has resided in the county for less than five years, the study shall
125.24include the records specified under paragraph (a) for the previous county or counties of
125.25residence for the past five years.
125.26    (c) Notwithstanding expungement by a court, the county or private agency may
125.27consider information obtained under paragraph (a), clauses (3) and (4), unless the
125.28commissioner received notice of the petition for expungement and the court order for
125.29expungement is directed specifically to the commissioner.

125.30    Sec. 14. Minnesota Statutes 2006, section 245C.10, is amended by adding a
125.31subdivision to read:
125.32    Subd. 4. Temporary personnel agencies, educational programs, and professional
125.33services agencies. The commissioner shall recover the cost of the background studies
125.34initiated by temporary personnel agencies, educational programs, and professional
126.1services agencies that initiate background studies under section 245C.03, subdivision 4,
126.2through a fee of no more than $20 per study charged to the agency. In fiscal years 2008
126.3and 2009, the fees collected under this subdivision are appropriated to the commissioner
126.4for the purpose of conducting background studies.

126.5    Sec. 15. Minnesota Statutes 2006, section 245C.11, subdivision 1, is amended to read:
126.6    Subdivision 1. Adult foster care; criminal conviction data. For individuals who
126.7are required to have background studies under section 245C.03, subdivisions 1 and 2, and
126.8who have been continuously affiliated with a an adult foster care provider that is licensed
126.9in more than one county, criminal conviction data may be shared among those counties in
126.10which the adult foster care programs are licensed. A county agency's receipt of criminal
126.11conviction data from another county agency shall meet the criminal data background
126.12study requirements of this chapter.

126.13    Sec. 16. Minnesota Statutes 2006, section 245C.11, subdivision 2, is amended to read:
126.14    Subd. 2. Jointly licensed programs. A county agency may accept a background
126.15study completed by the commissioner under this chapter in place of the background study
126.16required under section 245A.16, subdivision 3, in programs with joint licensure as home
126.17and community-based services and adult foster care for people with developmental
126.18disabilities when the license holder does not reside in the adult foster care residence and
126.19the subject of the study has been continuously affiliated with the license holder since the
126.20date of the commissioner's study.

126.21    Sec. 17. Minnesota Statutes 2006, section 245C.12, is amended to read:
126.22245C.12 BACKGROUND STUDY; TRIBAL ORGANIZATIONS.
126.23    (a) For the purposes of background studies completed by tribal organizations
126.24performing licensing activities otherwise required of the commissioner under this chapter,
126.25after obtaining consent from the background study subject, tribal licensing agencies shall
126.26have access to criminal history data in the same manner as county licensing agencies and
126.27private licensing agencies under this chapter.
126.28    (b) Tribal organizations may contract with the commissioner to obtain background
126.29study data on individuals under tribal jurisdiction related to adoptions according to
126.30section 245C.34. Tribal organizations may also contract with the commissioner to obtain
126.31background study data on individuals under tribal jurisdiction related to child foster care
126.32according to section 245C.34.

127.1    Sec. 18. Minnesota Statutes 2006, section 245C.16, subdivision 1, is amended to read:
127.2    Subdivision 1. Determining immediate risk of harm. (a) If the commissioner
127.3determines that the individual studied has a disqualifying characteristic, the commissioner
127.4shall review the information immediately available and make a determination as to the
127.5subject's immediate risk of harm to persons served by the program where the individual
127.6studied will have direct contact.
127.7    (b) The commissioner shall consider all relevant information available, including the
127.8following factors in determining the immediate risk of harm:
127.9    (1) the recency of the disqualifying characteristic;
127.10    (2) the recency of discharge from probation for the crimes;
127.11    (3) the number of disqualifying characteristics;
127.12    (4) the intrusiveness or violence of the disqualifying characteristic;
127.13    (5) the vulnerability of the victim involved in the disqualifying characteristic;
127.14    (6) the similarity of the victim to the persons served by the program where the
127.15individual studied will have direct contact; and
127.16    (7) whether the individual has a disqualification from a previous background study
127.17that has not been set aside.
127.18    (c) This section does not apply when the subject of a background study is regulated
127.19by a health-related licensing board as defined in chapter 214, and the subject is determined
127.20to be responsible for substantiated maltreatment under section 626.556 or 626.557.
127.21    (d) This section does not apply to a background study related to an initial application
127.22for a child foster care license.
127.23    (e) If the commissioner has reason to believe, based on arrest information or an
127.24active maltreatment investigation, that an individual poses an imminent risk of harm to
127.25persons receiving services, the commissioner may order that the person be continuously
127.26supervised or immediately removed pending the conclusion of the maltreatment
127.27investigation or criminal proceedings.

127.28    Sec. 19. Minnesota Statutes 2006, section 245C.17, is amended by adding a
127.29subdivision to read:
127.30    Subd. 5. Notice to county or private agency. For studies on individuals related
127.31to a license to provide child foster care, and beginning January 1, 2008, for family child
127.32care, the commissioner shall also provide a notice of the background study results to the
127.33county or private agency that initiated the background study.

128.1    Sec. 20. Minnesota Statutes 2006, section 245C.21, is amended by adding a
128.2subdivision to read:
128.3    Subd. 1a. Submission of reconsideration request to county or private agency.
128.4    (a) For disqualifications related to studies conducted by county agencies, and for
128.5disqualifications related to studies conducted by the commissioner for child foster care, and
128.6beginning January 1, 2008, for family child care, the individual shall submit the request
128.7for reconsideration to the county or private agency that initiated the background study.
128.8    (b) A reconsideration request shall be submitted within the time frames specified in
128.9subdivision 2.
128.10    (c) The county or private agency shall forward the individual's request for
128.11reconsideration and provide the commissioner with a recommendation whether to set aside
128.12the individual's disqualification.

128.13    Sec. 21. Minnesota Statutes 2006, section 245C.23, subdivision 2, is amended to read:
128.14    Subd. 2. Commissioner's notice of disqualification that is not set aside. (a) The
128.15commissioner shall notify the license holder of the disqualification and order the license
128.16holder to immediately remove the individual from any position allowing direct contact
128.17with persons receiving services from the license holder if:
128.18    (1) the individual studied does not submit a timely request for reconsideration
128.19under section 245C.21;
128.20    (2) the individual submits a timely request for reconsideration, but the commissioner
128.21does not set aside the disqualification for that license holder under section 245C.22;
128.22    (3) an individual who has a right to request a hearing under sections 245C.27 and
128.23256.045 , or 245C.28 and chapter 14 for a disqualification that has not been set aside, does
128.24not request a hearing within the specified time; or
128.25    (4) an individual submitted a timely request for a hearing under sections 245C.27
128.26and 256.045, or 245C.28 and chapter 14, but the commissioner does not set aside the
128.27disqualification under section 245A.08, subdivision 5, or 256.045.
128.28    (b) If the commissioner does not set aside the disqualification under section 245C.22,
128.29and the license holder was previously ordered under section 245C.17 to immediately
128.30remove the disqualified individual from direct contact with persons receiving services or
128.31to ensure that the individual is under continuous, direct supervision when providing direct
128.32contact services, the order remains in effect pending the outcome of a hearing under
128.33sections 245C.27 and 256.045, or 245C.28 and chapter 14.
129.1    (c) For background studies related to child foster care, and beginning January
129.21, 2008, for family child care, the commissioner shall also notify the county or private
129.3agency that initiated the study of the results of the reconsideration.

129.4    Sec. 22. Minnesota Statutes 2006, section 245C.24, subdivision 2, is amended to read:
129.5    Subd. 2. Permanent bar to set aside a disqualification. (a) Except as provided in
129.6paragraph (b), the commissioner may not set aside the disqualification of any individual
129.7disqualified pursuant to this chapter, in connection with a license to provide family child
129.8care for children, foster care for children in the provider's home, or foster care or day care
129.9services for adults in the provider's home regardless of how much time has passed, if the
129.10individual was disqualified for a crime or conduct listed in section 245C.15, subdivision 1.
129.11    (b) For an individual in the chemical dependency field who was disqualified for a
129.12crime or conduct listed under section 245C.15, subdivision 1, and whose disqualification
129.13was set aside prior to July 1, 2005, the commissioner must consider granting a variance
129.14pursuant to section 245C.30 for the license holder for a program dealing primarily with
129.15adults. A request for reconsideration evaluated under this paragraph must include a
129.16letter of recommendation from the license holder that was subject to the prior set-aside
129.17decision addressing the individual's quality of care to children or vulnerable adults and the
129.18circumstances of the individual's departure from that service.

129.19    Sec. 23. [245C.33] ADOPTION BACKGROUND STUDY REQUIREMENTS.
129.20    Subdivision 1. Background studies conducted by commissioner. Before
129.21placement of a child for purposes of adoption, the commissioner shall conduct a
129.22background study on individuals listed in section 259.41, subdivision 3, for county
129.23agencies and private agencies licensed to place children for adoption.
129.24    Subd. 2. Information and data provided to county or private agency. The
129.25subject of the background study shall provide the following information to the county
129.26or private agency:
129.27    (1) the information specified in section 245C.05;
129.28    (2) a set of classifiable fingerprints obtained from an authorized agency; and
129.29    (3) for studies initiated by a private agency, a signed consent for the release of
129.30information received from national crime information databases to the private agency.
129.31    Subd. 3. Information and data provided to commissioner. The county or private
129.32agency shall forward the data collected under subdivision 2 to the commissioner.
129.33    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
129.34the following information regarding the background study subject:
130.1    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
130.2    (2) information from the child abuse and neglect registry for any state in which the
130.3subject has resided for the past five years; and
130.4    (3) information from national crime information databases.
130.5    (b) The commissioner shall provide any information collected under this subdivision
130.6to the county or private agency that initiated the background study. The commissioner
130.7shall indicate if the information collected shows that the subject of the background study
130.8has a conviction listed in United States Code, title 42, section 671(a)(20)(A).

130.9    Sec. 24. [245C.34] ADOPTION AND CHILD FOSTER CARE BACKGROUND
130.10STUDIES; TRIBAL ORGANIZATIONS.
130.11    Subdivision 1. Background studies may be conducted by commissioner. (a)
130.12Tribal organizations may contract with the commissioner under section 245C.12 to obtain
130.13background study data on individuals under tribal jurisdiction related to adoptions.
130.14    (b) Tribal organizations may contract with the commissioner under section 245C.12
130.15to obtain background study data on individuals under tribal jurisdiction related to child
130.16foster care.
130.17    (c) Background studies initiated by tribal organizations under paragraphs (a) and (b)
130.18must be conducted as provided in subdivisions 2 and 3.
130.19    Subd. 2. Information and data provided to tribal organization. The background
130.20study subject must provide the following information to the tribal organization:
130.21    (1) for background studies related to adoptions, the information under section
130.22245C.05;
130.23    (2) for background studies related to child foster care, the information under section
130.24245C.05;
130.25    (3) a set of classifiable fingerprints obtained from an authorized agency; and
130.26    (4) a signed consent for the release of information received from national crime
130.27information databases to the tribal organization.
130.28    Subd. 3. Information and data provided to commissioner. The tribal organization
130.29shall forward the data collected under subdivision 2 to the commissioner.
130.30    Subd. 4. Information commissioner reviews. (a) The commissioner shall review
130.31the following information regarding the background study subject:
130.32    (1) the information under section 245C.08, subdivisions 1, 3, and 4;
130.33    (2) information from the child abuse and neglect registry for any state in which the
130.34subject has resided for the past five years; and
130.35    (3) information from national crime information databases.
131.1    (b) The commissioner shall provide any information collected under this subdivision
131.2to the tribal organization that initiated the background study. The commissioner shall
131.3indicate if the information collected shows that the subject of the background study has a
131.4conviction listed in United States Code, title 42, section 671(a)(20)(A).

131.5    Sec. 25. Minnesota Statutes 2006, section 259.20, subdivision 2, is amended to read:
131.6    Subd. 2. Other applicable law. (a) Portions of chapters 245A, 245C, 257, 260, and
131.7317A may also affect the adoption of a particular child.
131.8    (b) Provisions of the Indian Child Welfare Act, United States Code, title 25, chapter
131.921, sections 1901-1923, may also apply in the adoption of an Indian child, and may
131.10preempt specific provisions of this chapter.
131.11    (c) Consistent with section 245C.33 and Public Law 109-248, a completed
131.12background study is required before the approval of any foster or adoptive placement in
131.13a related or an unrelated home.

131.14    Sec. 26. Minnesota Statutes 2006, section 259.29, subdivision 1, is amended to read:
131.15    Subdivision 1. Best interests of the child. (a) The policy of the state of Minnesota
131.16is to ensure that the best interests of the child are met by requiring individualized
131.17determination of the needs of the child and of how the adoptive placement will serve the
131.18needs of the child.
131.19    (b) Among the factors the agency shall consider in determining the needs of the child
131.20are those specified under section 260C.193, subdivision 3, paragraph (b).
131.21    (c) Except for emergency placements provided for in section 245A.035, a completed
131.22background study is required under section 245C.33 before the approval of an adoptive
131.23placement in a home.

131.24    Sec. 27. Minnesota Statutes 2006, section 259.41, is amended to read:
131.25259.41 ADOPTION STUDY.
131.26    Subdivision 1. Study required before placement; certain relatives excepted. (a)
131.27An approved adoption study; completed background study, as required under section
131.28245C.33; and written report must be completed before the child is placed in a prospective
131.29adoptive home under this chapter, except as allowed by section 259.47, subdivision 6.
131.30In an agency placement, the report must be filed with the court at the time the adoption
131.31petition is filed. In a direct adoptive placement, the report must be filed with the court in
131.32support of a motion for temporary preadoptive custody under section 259.47, subdivision
131.333 , or, if the study and report are complete, in support of an emergency order under section
132.1259.47, subdivision 6 . The study and report shall be completed by a licensed child-placing
132.2agency and must be thorough and comprehensive. The study and report shall be paid for
132.3by the prospective adoptive parent, except as otherwise required under section 259.67
132.4or 259.73.
132.5    (b) A placement for adoption with an individual who is related to the child, as
132.6defined by section 245A.02, subdivision 13, is not subject to this section except as required
132.7by section sections 245C.33 and 259.53, subdivision 2, paragraph (c).
132.8    (c) In the case of a licensed foster parent seeking to adopt a child who is in the foster
132.9parent's care, any portions of the foster care licensing process that duplicate requirements
132.10of the home study may be submitted in satisfaction of the relevant requirements of this
132.11section.
132.12    Subd. 2. Form of study. (a) The adoption study must include at least one in-home
132.13visit with the prospective adoptive parent. At a minimum, the study must include
132.14document the following information about the prospective adoptive parent:
132.15    (1) a background check study as required by subdivision 3 and section 245C.33,
132.16and including:
132.17    (i) an evaluation assessment of the data and information provided by section
132.18245C.33, subdivision 4, to determine if the prospective adoptive parent and any other
132.19person over the age of 13 living in the home has a felony conviction consistent with
132.20subdivision 3 and section 471(a)(2) of the Social Security Act; and
132.21    (ii) an assessment of the effect of a any conviction or finding of substantiated
132.22maltreatment on the ability to capacity of the prospective adoptive parent to safely care
132.23for and parent a child;
132.24    (2) a medical and social history and assessment of current health;
132.25    (3) an assessment of potential parenting skills;
132.26    (4) an assessment of ability to provide adequate financial support for a child; and
132.27    (5) an assessment of the level of knowledge and awareness of adoption issues
132.28including, where appropriate, matters relating to interracial, cross-cultural, and special
132.29needs adoptions.
132.30    (b) The adoption study is the basis for completion of a written report. The report
132.31must be in a format specified by the commissioner and must contain recommendations
132.32regarding the suitability of the subject of the study to be an adoptive parent.
132.33    Subd. 3. Background check; affidavit of history study. (a) At the time an adoption
132.34study is commenced, each prospective adoptive parent must:
132.35    (1) authorize access by the agency to any private data needed to complete the study;
133.1    (2) provide all addresses at which the prospective adoptive parent and anyone in the
133.2household over the age of 13 has resided in the previous five years; and
133.3    (3) disclose any names used previously other than the name used at the time of
133.4the study.
133.5    (b) When the requirements of paragraph (a) have been met, the agency shall
133.6immediately begin initiate a background check, study under section 245C.33 to be
133.7completed by the commissioner on each person over the age of 13 living in the home,
133.8consisting, at a minimum, of the following:. As required under section 245C.33 and Public
133.9Law 109-248, a completed background study is required before the approval of any foster
133.10or adoptive placement in a related or an unrelated home. The required background study
133.11must be completed as part of the home study.
133.12    (1) a check of criminal conviction data with the Bureau of Criminal Apprehension
133.13and local law enforcement authorities;
133.14    (2) a check for data on substantiated maltreatment of a child or vulnerable adult
133.15and domestic violence data with local law enforcement and social services agencies and
133.16district courts; and
133.17    (3) for those persons under the age of 25, a check of juvenile court records.
133.18    Notwithstanding the provisions of section 260B.171 or 260C.171, the Bureau of
133.19Criminal Apprehension, local law enforcement and social services agencies, district courts,
133.20and juvenile courts shall release the requested information to the agency completing
133.21the adoption study.
133.22    (c) When paragraph (b) requires checking the data or records of local law
133.23enforcement and social services agencies and district and juvenile courts, the agency
133.24shall check with the law enforcement and social services agencies and courts whose
133.25jurisdictions cover the addresses under paragraph (a), clause (2). In the event that the
133.26agency is unable to complete any of the record checks required by paragraph (b), the
133.27agency shall document the fact and the agency's efforts to obtain the information.
133.28    (d) For a study completed under this section, when the agency has reasonable
133.29cause to believe that further information may exist on the prospective adoptive parent or
133.30household member over the age of 13 that may relate to the health, safety, or welfare of
133.31the child, the prospective adoptive parent or household member over the age of 13 shall
133.32provide the agency with a set of classifiable fingerprints obtained from an authorized law
133.33enforcement agency and the agency may obtain criminal history data from the National
133.34Criminal Records Repository by submitting fingerprints to the Bureau of Criminal
133.35Apprehension. The agency has reasonable cause when, but not limited to, the:
134.1    (1) information from the Bureau of Criminal Apprehension indicates that the
134.2prospective adoptive parent or household member over the age of 13 is a multistate
134.3offender;
134.4    (2) information from the Bureau of Criminal Apprehension indicates that multistate
134.5offender status is undetermined;
134.6    (3) the agency has received a report from the prospective adoptive parent or
134.7household member over the age of 13 or a third party indicating that the prospective
134.8adoptive parent or household member over the age of 13 has a criminal history in a
134.9jurisdiction other than Minnesota; or
134.10    (4) the prospective adoptive parent or household member over the age of 13 is or has
134.11been a resident of a state other than Minnesota in the prior five years.
134.12    (e) At any time prior to completion of the background check required under
134.13paragraph (b), a prospective adoptive parent may submit to the agency conducting the
134.14study a sworn affidavit stating whether they or any person residing in the household have
134.15been convicted of a crime. The affidavit shall also state whether the adoptive parent or any
134.16other person residing in the household is the subject of an open investigation of, or have
134.17been the subject of a substantiated allegation of, child or vulnerable-adult maltreatment
134.18within the past ten years. A complete description of the crime, open investigation, or
134.19substantiated abuse, and a complete description of any sentence, treatment, or disposition
134.20must be included. The affidavit must contain an acknowledgment that if, at any time
134.21before the adoption is final, a court receives evidence leading to a conclusion that a
134.22prospective adoptive parent knowingly gave false information in the affidavit, it shall be
134.23determined that the adoption of the child by the prospective adoptive parent is not in the
134.24best interests of the child.
134.25    (f) For the purposes of subdivision 1 and section 259.47, subdivisions 3 and 6, an
134.26adoption study is complete for placement, even though the background checks required by
134.27paragraph (b) have not been completed, if each prospective adoptive parent has completed
134.28the affidavit allowed by paragraph (e) and the other requirements of this section have been
134.29met. The background checks required by paragraph (b) must be completed before an
134.30adoption petition is filed. If an adoption study has been submitted to the court under section
134.31259.47, subdivision 3 or 6, before the background checks required by paragraph (b) were
134.32complete, an updated adoption study report which includes the results of the background
134.33check must be filed with the adoption petition. In the event that an agency is unable to
134.34complete any of the records checks required by paragraph (b), the agency shall submit with
134.35the petition to adopt an affidavit documenting the agency's efforts to complete the checks.
135.1    (c) A home study under paragraph (b) used to consider placement of any child
135.2on whose behalf Title IV-E adoption assistance payments are to be made must not be
135.3approved if a background study reveals a felony conviction at any time for:
135.4    (1) child abuse or neglect;
135.5    (2) spousal abuse;
135.6    (3) a crime against children, including child pornography; or
135.7    (4) a crime involving violence, including rape, sexual assault, or homicide, but not
135.8including other physical assault or battery.
135.9    (d) A home study under paragraph (b) used to consider placement of any child
135.10on whose behalf Title IV-E adoption assistance payments are to be made must not be
135.11approved if a background study reveals a felony conviction within the past five years for:
135.12    (1) physical assault or battery; or
135.13    (2) a drug-related offense.
135.14    Subd. 4. Updates to adoption study; period of validity. An agency may update
135.15an adoption study and report as needed, regardless of when the original study and report
135.16or most recent update was completed. An update must be in a format specified by the
135.17commissioner and must verify the continuing accuracy of the elements of the original
135.18report and document any changes to elements of the original report. An update to a study
135.19and report not originally completed under this section must ensure that the study and
135.20report, as updated, meet the requirements of this section. An adoption study is valid if the
135.21report has been completed or updated within the previous 12 months.

135.22    Sec. 28. Minnesota Statutes 2006, section 259.53, subdivision 2, is amended to read:
135.23    Subd. 2. Adoption agencies; postplacement assessment and report. (a) The
135.24agency to which the petition has been referred under subdivision 1 shall conduct a
135.25postplacement assessment and file a report with the court within 90 days of receipt
135.26of a copy of the adoption petition. The agency shall send a copy of the report to the
135.27commissioner at the time it files the report with the court. The assessment and report
135.28must evaluate the environment and antecedents of the child to be adopted, the home of
135.29the petitioners, whether placement with the petitioners meets the needs of the child as
135.30described in section 259.57, subdivision 2. The report must include a recommendation to
135.31the court as to whether the petition should or should not be granted.
135.32    In making evaluations and recommendations, the postplacement assessment and
135.33report must, at a minimum, address the following:
135.34    (1) the level of adaptation by the prospective adoptive parents to parenting the child;
135.35    (2) the health and well-being of the child in the prospective adoptive parents' home;
136.1    (3) the level of incorporation by the child into the prospective adoptive parents'
136.2home, extended family, and community; and
136.3    (4) the level of inclusion of the child's previous history into the prospective adoptive
136.4home, such as cultural or ethnic practices, or contact with former foster parents or
136.5biological relatives.
136.6    (b) A postplacement adoption report is valid for 12 months following its date
136.7of completion.
136.8    (c) If the petitioner is an individual who is related to the child, as defined by section
136.9245A.02, subdivision 13, the agency, as part of its postplacement assessment and report
136.10under paragraph (a), shall conduct a background check meeting the requirements of
136.11section 259.41, subdivision 3, paragraph (b). The prospective adoptive parent shall
136.12cooperate in the completion of the background check by supplying the information and
136.13authorizations described in section 259.41, subdivision 3, paragraph (a).
136.14    (d) (c) If the report recommends that the court not grant the petition to adopt the
136.15child, the provisions of this paragraph apply. Unless the assessment and report were
136.16completed by the local social services agency, the agency completing the report, at the
136.17time it files the report with the court under paragraph (a), must provide a copy of the report
136.18to the local social services agency in the county where the prospective adoptive parent
136.19lives. The agency or local social services agency may recommend that the court dismiss
136.20the petition. If the local social services agency determines that continued placement in the
136.21home endangers the child's physical or emotional health, the agency shall seek a court
136.22order to remove the child from the home.
136.23    (e) (d) If, through no fault of the petitioner, the agency to whom the petition was
136.24referred under subdivision 1, paragraph (b), fails to complete the assessment and file the
136.25report within 90 days of the date it received a copy of the adoption petition, the court may
136.26hear the petition upon giving the agency and the local social services agency, if different,
136.27five days' notice by mail of the time and place of the hearing.

136.28    Sec. 29. Minnesota Statutes 2006, section 259.57, subdivision 2, is amended to read:
136.29    Subd. 2. Protection of child's best interests. (a) The policy of the state of
136.30Minnesota is to ensure that the best interests of children are met by requiring an
136.31individualized determination of the needs of the child and how the adoptive placement
136.32will serve the needs of the child.
136.33    (b) Among the factors the court shall consider in determining the needs of the child
136.34are those specified under section 260C.193, subdivision 3, paragraph (b). Consistent with
137.1section 245C.33 and Public Law 109-248, a complete background study is required before
137.2the approval of an adoptive placement in a home.
137.3    (c) In reviewing adoptive placement and in determining appropriate adoption,
137.4the court shall consider placement, consistent with the child's best interests and in the
137.5following order, with (1) a relative or relatives of the child, or (2) an important friend with
137.6whom the child has resided or had significant contact. Placement of a child cannot be
137.7delayed or denied based on race, color, or national origin of the adoptive parent or the
137.8child. Whenever possible, siblings should be placed together unless it is determined
137.9not to be in the best interests of a sibling.
137.10    (d) If the child's birth parent or parents explicitly request that relatives and important
137.11friends not be considered, the court shall honor that request consistent with the best
137.12interests of the child.
137.13    If the child's birth parent or parents express a preference for placing the child in an
137.14adoptive home of the same or a similar religious background to that of the birth parent
137.15or parents, the court shall place the child with a family that also meets the birth parent's
137.16religious preference. Only if no family is available as described in clause (a) or (b)
137.17may the court give preference to a family described in clause (c) that meets the parent's
137.18religious preference.
137.19    (e) This subdivision does not affect the Indian Child Welfare Act, United States
137.20Code, title 25, sections 1901 to 1923, and the Minnesota Indian Family Preservation
137.21Act, sections 260.751 to 260.835.

137.22    Sec. 30. Minnesota Statutes 2006, section 260C.209, is amended to read:
137.23260C.209 BACKGROUND CHECKS.
137.24    Subdivision 1. Subjects. The responsible social services agency must conduct
137.25initiate a background check study to be completed by the commissioner under this section
137.26of chapter 245C on the following individuals:
137.27    (1) a noncustodial parent or nonadjudicated parent who is being assessed for
137.28purposes of providing day-to-day care of a child temporarily or permanently under section
137.29260C.212, subdivision 4 , and any member of the parent's household who is over the age of
137.3013 when there is a reasonable cause to believe that the parent or household member over
137.31age 13 has a criminal history or a history of maltreatment of a child or vulnerable adult
137.32which would endanger the child's health, safety, or welfare;
137.33    (2) an individual whose suitability for relative placement under section 260C.212,
137.34subdivision 5 , is being determined and any member of the relative's household who is
137.35over the age of 13 when:
138.1    (i) the relative must be licensed for foster care; or
138.2    (ii) the agency must conduct a background study is required under section 259.53,
138.3subdivision 2 ; or
138.4    (iii) the agency or the commissioner has reasonable cause to believe the relative
138.5or household member over the age of 13 has a criminal history which would not make
138.6transfer of permanent legal and physical custody to the relative under section 260C.201,
138.7subdivision 11 , in the child's best interest; and
138.8    (3) a parent, following an out-of-home placement, when the responsible social
138.9services agency has reasonable cause to believe that the parent has been convicted of a
138.10crime directly related to the parent's capacity to maintain the child's health, safety, or
138.11welfare or the parent is the subject of an open investigation of, or has been the subject
138.12of a substantiated allegation of, child or vulnerable-adult maltreatment within the past
138.13ten years.
138.14"Reasonable cause" means that the agency has received information or a report from the
138.15subject or a third person that creates an articulable suspicion that the individual has a
138.16history that may pose a risk to the health, safety, or welfare of the child. The information
138.17or report must be specific to the potential subject of the background check and shall not
138.18be based on the race, religion, ethnic background, age, class, or lifestyle of the potential
138.19subject.
138.20    Subd. 2. General procedures. (a) When conducting initiating a background check
138.21under subdivision 1, the agency may shall require the individual being assessed to provide
138.22sufficient information to ensure an accurate assessment under this section, including:
138.23    (1) the individual's first, middle, and last name and all other names by which the
138.24individual has been known;
138.25    (2) home address, zip code, city, county, and state of residence for the past ten five
138.26years;
138.27    (3) sex;
138.28    (4) date of birth; and
138.29    (5) driver's license number or state identification number.
138.30    (b) When notified by the commissioner or the responsible social services agency that
138.31it is conducting an assessment under this section, the Bureau of Criminal Apprehension,
138.32commissioners of health and human services, law enforcement, and county agencies must
138.33provide the commissioner or the responsible social services agency or county attorney
138.34with the following information on the individual being assessed: criminal history data,
138.35reports about the maltreatment of adults substantiated under section 626.557, and reports
138.36of maltreatment of minors substantiated under section 626.556.
139.1    Subd. 3. Multistate information. (a) For any assessment every background study
139.2completed under this section, if the responsible social services agency has reasonable
139.3cause to believe that the individual is a multistate offender, the individual must the subject
139.4of the background study shall provide the responsible social services agency or the
139.5county attorney with a set of classifiable fingerprints obtained from an authorized law
139.6enforcement agency. The responsible social services agency or county attorney may shall
139.7provide the fingerprints to the commissioner, and the commissioner shall obtain criminal
139.8history data from the National Criminal Records Repository by submitting the fingerprints
139.9to the Bureau of Criminal Apprehension.
139.10    (b) For purposes of this subdivision, the responsible social services agency has
139.11reasonable cause when, but not limited to:
139.12    (1) information from the Bureau of Criminal Apprehension indicates that the
139.13individual is a multistate offender;
139.14    (2) information from the Bureau of Criminal Apprehension indicates that multistate
139.15offender status is undetermined;
139.16    (3) the social services agency has received a report from the individual or a third
139.17party indicating that the individual has a criminal history in a jurisdiction other than
139.18Minnesota; or
139.19    (4) the individual is or has been a resident of a state other than Minnesota at any
139.20time during the prior ten years.
139.21    Subd. 4. Notice upon receipt. The responsible social services agency commissioner
139.22must provide the subject of the background study with the results of the study as required
139.23under this section within 15 business days of receipt or at least 15 days prior to the hearing
139.24at which the results will be presented, whichever comes first. The subject may provide
139.25written information to the agency that the results are incorrect and may provide additional
139.26or clarifying information to the agency and to the court through a party to the proceeding.
139.27This provision does not apply to any background study conducted under chapters 245A
139.28and chapter 245C.

139.29    Sec. 31. Minnesota Statutes 2006, section 260C.212, subdivision 2, is amended to read:
139.30    Subd. 2. Placement decisions based on best interest of the child. (a) The policy
139.31of the state of Minnesota is to ensure that the child's best interests are met by requiring an
139.32individualized determination of the needs of the child and of how the selected placement
139.33will serve the needs of the child being placed. The authorized child-placing agency shall
139.34place a child, released by court order or by voluntary release by the parent or parents, in
140.1a family foster home selected by considering placement with relatives and important
140.2friends in the following order:
140.3    (1) with an individual who is related to the child by blood, marriage, or adoption; or
140.4    (2) with an individual who is an important friend with whom the child has resided or
140.5had significant contact.
140.6    (b) Among the factors the agency shall consider in determining the needs of the
140.7child are the following:
140.8    (1) the child's current functioning and behaviors;
140.9    (2) the medical, educational, and developmental needs of the child;
140.10    (3) the child's history and past experience;
140.11    (4) the child's religious and cultural needs;
140.12    (5) the child's connection with a community, school, and church;
140.13    (6) the child's interests and talents;
140.14    (7) the child's relationship to current caretakers, parents, siblings, and relatives; and
140.15    (8) the reasonable preference of the child, if the court, or the child-placing agency
140.16in the case of a voluntary placement, deems the child to be of sufficient age to express
140.17preferences.
140.18    (c) Placement of a child cannot be delayed or denied based on race, color, or national
140.19origin of the foster parent or the child.
140.20    (d) Siblings should be placed together for foster care and adoption at the earliest
140.21possible time unless it is determined not to be in the best interests of a sibling or unless it
140.22is not possible after appropriate efforts by the responsible social services agency.
140.23    (e) Except for emergency placement as provided for in section 245A.035, a
140.24completed background study is required under section 245C.08 before the approval of a
140.25foster placement in a related or unrelated home.

140.26    Sec. 32. EFFECTIVE DATE.
140.27Changes made to sections in this article related to family child care are effective
140.28January 1, 2008.

140.29ARTICLE 3

140.30HEALTH CARE

140.31    Section 1. Minnesota Statutes 2006, section 256.969, subdivision 3a, is amended to
140.32read:
140.33    Subd. 3a. Payments. (a) Acute care hospital billings under the medical
140.34assistance program must not be submitted until the recipient is discharged. However,
141.1the commissioner shall establish monthly interim payments for inpatient hospitals that
141.2have individual patient lengths of stay over 30 days regardless of diagnostic category.
141.3Except as provided in section 256.9693, medical assistance reimbursement for treatment
141.4of mental illness shall be reimbursed based on diagnostic classifications. Individual
141.5hospital payments established under this section and sections 256.9685, 256.9686, and
141.6256.9695 , in addition to third party and recipient liability, for discharges occurring during
141.7the rate year shall not exceed, in aggregate, the charges for the medical assistance covered
141.8inpatient services paid for the same period of time to the hospital. This payment limitation
141.9shall be calculated separately for medical assistance and general assistance medical
141.10care services. The limitation on general assistance medical care shall be effective for
141.11admissions occurring on or after July 1, 1991. Services that have rates established under
141.12subdivision 11 or 12, must be limited separately from other services. After consulting with
141.13the affected hospitals, the commissioner may consider related hospitals one entity and
141.14may merge the payment rates while maintaining separate provider numbers. The operating
141.15and property base rates per admission or per day shall be derived from the best Medicare
141.16and claims data available when rates are established. The commissioner shall determine
141.17the best Medicare and claims data, taking into consideration variables of recency of the
141.18data, audit disposition, settlement status, and the ability to set rates in a timely manner.
141.19The commissioner shall notify hospitals of payment rates by December 1 of the year
141.20preceding the rate year. The rate setting data must reflect the admissions data used to
141.21establish relative values. Base year changes from 1981 to the base year established for the
141.22rate year beginning January 1, 1991, and for subsequent rate years, shall not be limited
141.23to the limits ending June 30, 1987, on the maximum rate of increase under subdivision
141.241. The commissioner may adjust base year cost, relative value, and case mix index data
141.25to exclude the costs of services that have been discontinued by the October 1 of the year
141.26preceding the rate year or that are paid separately from inpatient services. Inpatient stays
141.27that encompass portions of two or more rate years shall have payments established based
141.28on payment rates in effect at the time of admission unless the date of admission preceded
141.29the rate year in effect by six months or more. In this case, operating payment rates for
141.30services rendered during the rate year in effect and established based on the date of
141.31admission shall be adjusted to the rate year in effect by the hospital cost index.
141.32    (b) For fee-for-service admissions occurring on or after July 1, 2002, the total
141.33payment, before third-party liability and spenddown, made to hospitals for inpatient
141.34services is reduced by .5 percent from the current statutory rates.
141.35    (c) In addition to the reduction in paragraph (b), the total payment for fee-for-service
141.36admissions occurring on or after July 1, 2003, made to hospitals for inpatient services
142.1before third-party liability and spenddown, is reduced five percent from the current
142.2statutory rates. Mental health services within diagnosis related groups 424 to 432, and
142.3facilities defined under subdivision 16, and, effective for admissions occurring on or after
142.4July 1, 2007, a long-term hospital as designated by the Medicare program that is located in
142.5a city of the first class as defined in section 410.01, are excluded from this paragraph.
142.6    (d) In addition to the reduction in paragraphs (b) and (c), the total payment for
142.7fee-for-service admissions occurring on or after July 1, 2005, made to hospitals for
142.8inpatient services before third-party liability and spenddown, is reduced 6.0 percent from
142.9the current statutory rates. Mental health services within diagnosis related groups 424 to
142.10432 and, facilities defined under subdivision 16, and, effective for admissions occurring
142.11on or after July 1, 2007, a long-term hospital as designated by the Medicare program
142.12that is located in a city of the first class as defined in section 410.01, are excluded from
142.13this paragraph. Notwithstanding section 256.9686, subdivision 7, for purposes of this
142.14paragraph, medical assistance does not include general assistance medical care. Payments
142.15made to managed care plans shall be reduced for services provided on or after January
142.161, 2006, to reflect this reduction.

142.17    Sec. 2. Minnesota Statutes 2006, section 256.969, subdivision 9, is amended to read:
142.18    Subd. 9. Disproportionate numbers of low-income patients served. (a) For
142.19admissions occurring on or after October 1, 1992, through December 31, 1992, the
142.20medical assistance disproportionate population adjustment shall comply with federal law
142.21and shall be paid to a hospital, excluding regional treatment centers and facilities of the
142.22federal Indian Health Service, with a medical assistance inpatient utilization rate in excess
142.23of the arithmetic mean. The adjustment must be determined as follows:
142.24    (1) for a hospital with a medical assistance inpatient utilization rate above the
142.25arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
142.26federal Indian Health Service but less than or equal to one standard deviation above the
142.27mean, the adjustment must be determined by multiplying the total of the operating and
142.28property payment rates by the difference between the hospital's actual medical assistance
142.29inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
142.30treatment centers and facilities of the federal Indian Health Service; and
142.31    (2) for a hospital with a medical assistance inpatient utilization rate above one
142.32standard deviation above the mean, the adjustment must be determined by multiplying
142.33the adjustment that would be determined under clause (1) for that hospital by 1.1. If
142.34federal matching funds are not available for all adjustments under this subdivision, the
142.35commissioner shall reduce payments on a pro rata basis so that all adjustments qualify for
143.1federal match. The commissioner may establish a separate disproportionate population
143.2operating payment rate adjustment under the general assistance medical care program.
143.3For purposes of this subdivision medical assistance does not include general assistance
143.4medical care. The commissioner shall report annually on the number of hospitals likely to
143.5receive the adjustment authorized by this paragraph. The commissioner shall specifically
143.6report on the adjustments received by public hospitals and public hospital corporations
143.7located in cities of the first class.
143.8    (b) For admissions occurring on or after July 1, 1993, the medical assistance
143.9disproportionate population adjustment shall comply with federal law and shall be paid to
143.10a hospital, excluding regional treatment centers and facilities of the federal Indian Health
143.11Service, with a medical assistance inpatient utilization rate in excess of the arithmetic
143.12mean. The adjustment must be determined as follows:
143.13    (1) for a hospital with a medical assistance inpatient utilization rate above the
143.14arithmetic mean for all hospitals excluding regional treatment centers and facilities of the
143.15federal Indian Health Service but less than or equal to one standard deviation above the
143.16mean, the adjustment must be determined by multiplying the total of the operating and
143.17property payment rates by the difference between the hospital's actual medical assistance
143.18inpatient utilization rate and the arithmetic mean for all hospitals excluding regional
143.19treatment centers and facilities of the federal Indian Health Service;
143.20    (2) for a hospital with a medical assistance inpatient utilization rate above one
143.21standard deviation above the mean, the adjustment must be determined by multiplying
143.22the adjustment that would be determined under clause (1) for that hospital by 1.1. The
143.23commissioner may establish a separate disproportionate population operating payment
143.24rate adjustment under the general assistance medical care program. For purposes of this
143.25subdivision, medical assistance does not include general assistance medical care. The
143.26commissioner shall report annually on the number of hospitals likely to receive the
143.27adjustment authorized by this paragraph. The commissioner shall specifically report on
143.28the adjustments received by public hospitals and public hospital corporations located
143.29in cities of the first class;
143.30    (3) for a hospital that had medical assistance fee-for-service payment volume during
143.31calendar year 1991 in excess of 13 percent of total medical assistance fee-for-service
143.32payment volume, a medical assistance disproportionate population adjustment shall be
143.33paid in addition to any other disproportionate payment due under this subdivision as
143.34follows: $1,515,000 due on the 15th of each month after noon, beginning July 15, 1995.
143.35For a hospital that had medical assistance fee-for-service payment volume during calendar
143.36year 1991 in excess of eight percent of total medical assistance fee-for-service payment
144.1volume and was the primary hospital affiliated with the University of Minnesota, a
144.2medical assistance disproportionate population adjustment shall be paid in addition to any
144.3other disproportionate payment due under this subdivision as follows: $505,000 due on
144.4the 15th of each month after noon, beginning July 15, 1995; and
144.5    (4) effective August 1, 2005, the payments in paragraph (b), clause (3), shall be
144.6reduced to zero.
144.7    (c) The commissioner shall adjust rates paid to a health maintenance organization
144.8under contract with the commissioner to reflect rate increases provided in paragraph (b),
144.9clauses (1) and (2), on a nondiscounted hospital-specific basis but shall not adjust those
144.10rates to reflect payments provided in clause (3).
144.11    (d) If federal matching funds are not available for all adjustments under paragraph
144.12(b), the commissioner shall reduce payments under paragraph (b), clauses (1) and (2), on a
144.13pro rata basis so that all adjustments under paragraph (b) qualify for federal match.
144.14    (e) For purposes of this subdivision, medical assistance does not include general
144.15assistance medical care.
144.16    (f) For hospital services occurring on or after July 1, 2005, to June 30, 2007, general
144.17assistance medical care expenditures for fee-for-service inpatient and outpatient hospital
144.18services made by the department and by prepaid health plans participating in general
144.19assistance medical care effective July 1, 2007, payments under section 256B.199 shall be
144.20considered Medicaid disproportionate share hospital payments, except as limited below:
144.21by clauses (1) to (5);
144.22    (1) only the portion of Minnesota's disproportionate share hospital allotment under
144.23section 1923(f) of the Social Security Act that is not spent on the disproportionate
144.24population adjustments in paragraph (b), clauses (1) and (2), may be used for general
144.25assistance medical care expenditures;
144.26    (2) only those general assistance medical care expenditures made to hospitals that
144.27qualify for disproportionate share payments under section 1923 of the Social Security Act
144.28and the Medicaid state plan may be considered disproportionate share hospital payments;
144.29    (3) only those general assistance medical care expenditures made to an individual
144.30hospital that would not cause the hospital to exceed its individual hospital limits under
144.31section 1923 of the Social Security Act may be considered; and
144.32    (4) general assistance medical care expenditures may be considered only to the
144.33extent of Minnesota's aggregate allotment under section 1923 of the Social Security Act.
144.34All hospitals and prepaid health plans participating in general assistance medical care
144.35must provide any necessary expenditure, cost, and revenue information required by
144.36the commissioner as necessary for purposes of obtaining federal Medicaid matching
145.1funds for general assistance medical care expenditures. Medicaid disproportionate share
145.2payments; and
145.3    (5) expenditures under general assistance medical care shall be used to the fullest
145.4extent before payments under section 256B.199.
145.5    (g) Upon federal approval of the related state plan amendment, paragraph (f) is
145.6effective retroactively from July 1, 2005, or the earliest effective date approved by the
145.7Centers for Medicare and Medicaid Services.

145.8    Sec. 3. Minnesota Statutes 2006, section 256.969, is amended by adding a subdivision
145.9to read:
145.10    Subd. 28. Long-term hospital payment adjustment. For admissions occurring on
145.11or after July 1, 2009, the commissioner shall increase the medical assistance payments
145.12to a long-term hospital with a medical assistance inpatient utilization rate of 17.95
145.13percent of total patient days as of the base year in effect on July 1, 2005, by an amount
145.14equal to 13 percent of the total of the operating and property payment rates. Payments
145.15made to managed care plans shall not reflect this payment increase. For purposes of
145.16this subdivision, medical assistance does not include general assistance medical care.
145.17Payments to a hospital under this subdivision shall be reduced by the amount of any
145.18payments made under subdivision 27.

145.19    Sec. 4. Minnesota Statutes 2006, section 256B.04, subdivision 14, is amended to read:
145.20    Subd. 14. Competitive bidding. (a) When determined to be effective, economical,
145.21and feasible, the commissioner may utilize volume purchase through competitive bidding
145.22and negotiation under the provisions of chapter 16C, to provide items under the medical
145.23assistance program including but not limited to the following:
145.24    (1) eyeglasses;
145.25    (2) oxygen. The commissioner shall provide for oxygen needed in an emergency
145.26situation on a short-term basis, until the vendor can obtain the necessary supply from
145.27the contract dealer;
145.28    (3) hearing aids and supplies; and
145.29    (4) durable medical equipment, including but not limited to:
145.30    (i) hospital beds;
145.31    (ii) commodes;
145.32    (iii) glide-about chairs;
145.33    (iv) patient lift apparatus;
145.34    (v) wheelchairs and accessories;
146.1    (vi) oxygen administration equipment;
146.2    (vii) respiratory therapy equipment;
146.3    (viii) electronic diagnostic, therapeutic and life support systems;
146.4    (5) special nonemergency transportation services level of need determinations,
146.5disbursement of public transportation passes and tokens, and volunteer and recipient
146.6mileage and parking reimbursements; and
146.7    (6) drugs.
146.8    (b) Rate changes under this chapter and chapters 256D and 256L do not affect
146.9contract payments under this subdivision unless specifically identified.

146.10    Sec. 5. Minnesota Statutes 2006, section 256B.04, is amended by adding a subdivision
146.11to read:
146.12    Subd. 14a. Level of need determination. Nonemergency medical transportation
146.13level of need determinations must be performed by a physician, a registered nurse working
146.14under direct supervision of a physician, a physician's assistant, a nurse practitioner, a
146.15licensed practical nurse, or a discharge planner. Nonemergency medical transportation
146.16level of need determinations must not be performed more than semiannually on any
146.17individual, unless the individual's circumstances have sufficiently changed so as to
146.18require a new level of need determination. Individuals residing in licensed nursing
146.19facilities and individuals requiring stretcher transportation are exempt from a level of need
146.20determination and are eligible for special transportation services until the individual no
146.21longer resides in a licensed nursing facility or no longer requires stretcher transportation.

146.22    Sec. 6. Minnesota Statutes 2006, section 256B.056, is amended by adding a
146.23subdivision to read:
146.24    Subd. 1d. Treatment of certain monetary gifts. The commissioner shall disregard
146.25as income any portion of a monetary gift received by an applicant or enrollee that is
146.26designated to purchase a prosthetic device not covered by insurance, other third-party
146.27payers, or medical assistance.

146.28    Sec. 7. Minnesota Statutes 2006, section 256B.0625, subdivision 3f, is amended to
146.29read:
146.30    Subd. 3f. Circumcision for newborns. Newborn Circumcision is not covered,
146.31unless the procedure is medically necessary or required because of a well-established
146.32religious practice.

147.1    Sec. 8. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
147.2subdivision to read:
147.3    Subd. 8d. Chiropractic services. Medical assistance covers the following
147.4medically necessary chiropractic services: one initial or progress exam per year, manual
147.5manipulation of the spine, and x-rays.
147.6EFFECTIVE DATE.This section is effective July 1, 2007.

147.7    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 13c, is amended to
147.8read:
147.9    Subd. 13c. Formulary committee. The commissioner, after receiving
147.10recommendations from professional medical associations and professional pharmacy
147.11associations, and consumer groups shall designate a Formulary Committee to carry
147.12out duties as described in subdivisions 13 to 13g. The Formulary Committee shall be
147.13comprised of four licensed physicians actively engaged in the practice of medicine in
147.14Minnesota one of whom must be actively engaged in the treatment of persons with mental
147.15illness; at least three licensed pharmacists actively engaged in the practice of pharmacy
147.16in Minnesota; and one consumer representative; the remainder to be made up of health
147.17care professionals who are licensed in their field and have recognized knowledge in the
147.18clinically appropriate prescribing, dispensing, and monitoring of covered outpatient drugs.
147.19Members of the Formulary Committee shall not be employed by the Department of
147.20Human Services, but the committee shall be staffed by an employee of the department
147.21who shall serve as an ex officio, nonvoting member of the board committee. The
147.22department's medical director shall also serve as an ex officio, nonvoting member for the
147.23committee. Committee members shall serve three-year terms and may be reappointed
147.24by the commissioner. The Formulary Committee shall meet at least quarterly. The
147.25commissioner may require more frequent Formulary Committee meetings as needed. An
147.26honorarium of $100 per meeting and reimbursement for mileage shall be paid to each
147.27committee member in attendance.

147.28    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 13d, is amended to
147.29read:
147.30    Subd. 13d. Drug formulary. (a) The commissioner shall establish a drug
147.31formulary. Its establishment and publication shall not be subject to the requirements of the
147.32Administrative Procedure Act, but the Formulary Committee shall review and comment
147.33on the formulary contents.
147.34    (b) The formulary shall not include:
148.1    (1) drugs or products for which there is no federal funding;
148.2    (2) over-the-counter drugs, except as provided in subdivision 13;
148.3    (3) drugs used for weight loss, except that medically necessary lipase inhibitors may
148.4be covered for a recipient with type II diabetes;
148.5    (4) drugs when used for the treatment of impotence or erectile dysfunction;
148.6    (5) drugs for which medical value has not been established; and
148.7    (6) drugs from manufacturers who have not signed a rebate agreement with the
148.8Department of Health and Human Services pursuant to section 1927 of title XIX of the
148.9Social Security Act.
148.10    (c) If a single-source drug used by at least two percent of the fee-for-service
148.11medical assistance recipients is removed from the formulary due to the failure of the
148.12manufacturer to sign a rebate agreement with the Department of Health and Human
148.13Services, the commissioner shall notify prescribing practitioners within 30 days of
148.14receiving notification from the Centers for Medicare and Medicaid Services (CMS) that a
148.15rebate agreement was not signed.
148.16EFFECTIVE DATE.This section is effective the day following final enactment.

148.17    Sec. 11. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
148.18subdivision to read:
148.19    Subd. 13i. Medicare Part D. Notwithstanding subdivision 13, paragraph (d), for
148.20recipients who are enrolled in a Medicare Part D prescription drug plan or Medicare
148.21Advantage special needs plan, medical assistance covers co-payments which the recipient
148.22is responsible for under a Medicare Part D prescription drug plan or Medicare Advantage
148.23special needs plan, once the recipient has paid $12 per month in prescription drug
148.24co-payments, and according to the requirements of the plan.

148.25    Sec. 12. Minnesota Statutes 2006, section 256B.0625, subdivision 17, is amended to
148.26read:
148.27    Subd. 17. Transportation costs. (a) Medical assistance covers transportation costs
148.28incurred solely for obtaining emergency medical care or transportation costs incurred
148.29by eligible persons in obtaining emergency or nonemergency medical care when paid
148.30directly to an ambulance company, common carrier, or other recognized providers of
148.31transportation services.
148.32    (b) Medical assistance covers special transportation, as defined in Minnesota Rules,
148.33part 9505.0315, subpart 1, item F, if the recipient has a physical or mental impairment that
149.1would prohibit the recipient from safely accessing and using a bus, taxi, other commercial
149.2transportation, or private automobile.
149.3The commissioner may use an order by the recipient's attending physician to certify that
149.4the recipient requires special transportation services. Special transportation includes
149.5driver-assisted service to eligible individuals. Driver-assisted service includes passenger
149.6pickup at and return to the individual's residence or place of business, assistance with
149.7admittance of the individual to the medical facility, and assistance in passenger securement
149.8or in securing of wheelchairs or stretchers in the vehicle. Special transportation providers
149.9must obtain written documentation from the health care service provider who is serving
149.10the recipient being transported, identifying the time that the recipient arrived. Special
149.11transportation providers may not bill for separate base rates for the continuation of a trip
149.12beyond the original destination. Special transportation providers must take recipients
149.13to the nearest appropriate health care provider, using the most direct quickest route
149.14available as determined by a commercially available mileage software program approved
149.15by the commissioner. The maximum medical assistance reimbursement rates for special
149.16transportation services are:
149.17    (1) $17 for the base rate and $1.35 $1.43 per mile for services to eligible persons
149.18who need a wheelchair-accessible van;
149.19    (2) $11.50 for the base rate and $1.30 per mile for services to eligible persons who
149.20do not need a wheelchair-accessible van; and
149.21    (3) $60 for the base rate and $2.40 per mile, and an attendant rate of $9 per trip, for
149.22services to eligible persons who need a stretcher-accessible vehicle.

149.23    Sec. 13. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
149.24read:
149.25    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
149.26meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
149.27$6.50 for lunch, or $8 for dinner.
149.28    (b) Medical assistance reimbursement for lodging for persons traveling to receive
149.29medical care may not exceed $50 per day unless prior authorized by the local agency.
149.30    (c) Medical assistance direct mileage reimbursement to the an eligible person or the
149.31an eligible person's driver may not exceed 20 cents per mile friend, neighbor, or relative
149.32that is providing direct transportation to a covered service shall be at 15 cents below the
149.33current Internal Revenue Service mileage reimbursement for business purposes.
150.1    (d) Medical assistance covers oral language interpreter services when provided by
150.2an enrolled health care provider during the course of providing a direct, person-to-person
150.3covered health care service to an enrolled recipient with limited English proficiency.

150.4    Sec. 14. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
150.5subdivision to read:
150.6    Subd. 49. Community health worker. (a) Medical assistance covers the care
150.7coordination and patient education services provided by a community health worker if
150.8the community health worker has:
150.9    (1) received a certificate from the Minnesota State Colleges and Universities System
150.10approved community health worker curriculum; or
150.11    (2) at least five years of supervised experience with an enrolled physician or
150.12advanced practice registered nurse.
150.13Community health workers eligible for payment under clause (2) must complete the
150.14certification program by January 1, 2010, to continue to be eligible for payment.
150.15    (b) Community health workers must work under the supervision of a medical
150.16assistance enrolled physician or advanced practice registered nurse.

150.17    Sec. 15. Minnesota Statutes 2006, section 256B.0644, is amended to read:
150.18256B.0644 REIMBURSEMENT UNDER OTHER STATE HEALTH CARE
150.19PROGRAMS.
150.20    (a) A vendor of medical care, as defined in section 256B.02, subdivision 7, and a
150.21health maintenance organization, as defined in chapter 62D, must participate as a provider
150.22or contractor in the medical assistance program, general assistance medical care program,
150.23and MinnesotaCare as a condition of participating as a provider in health insurance plans
150.24and programs or contractor for state employees established under section 43A.18, the
150.25public employees insurance program under section 43A.316, for health insurance plans
150.26offered to local statutory or home rule charter city, county, and school district employees,
150.27the workers' compensation system under section 176.135, and insurance plans provided
150.28through the Minnesota Comprehensive Health Association under sections 62E.01 to
150.2962E.19 . The limitations on insurance plans offered to local government employees shall
150.30not be applicable in geographic areas where provider participation is limited by managed
150.31care contracts with the Department of Human Services.
150.32    (b) For providers other than health maintenance organizations, participation in the
150.33medical assistance program means that:
151.1     (1) the provider accepts new medical assistance, general assistance medical care,
151.2and MinnesotaCare patients or;
151.3    (2) for providers other than dental service providers, at least 20 percent of the
151.4provider's patients are covered by medical assistance, general assistance medical care, and
151.5MinnesotaCare as their primary source of coverage, or; or
151.6    (3) for dental service providers, at least ten percent of the provider's patients are
151.7covered by medical assistance, general assistance medical care, and MinnesotaCare as
151.8their primary source of coverage, or the provider accepts new medical assistance and
151.9MinnesotaCare patients who are children with special health care needs. For purposes
151.10of this section, "children with special health care needs" means children up to age 18
151.11who: (i) require health and related services beyond that required by children generally;
151.12and (ii) have or are at risk for a chronic physical, developmental, behavioral, or emotional
151.13condition, including: bleeding and coagulation disorders; immunodeficiency disorders;
151.14cancer; endocrinopathy; developmental disabilities; epilepsy, cerebral palsy, and other
151.15neurological diseases; visual impairment or deafness; Down syndrome and other genetic
151.16disorders; autism; fetal alcohol syndrome; and other conditions designated by the
151.17commissioner after consultation with representatives of pediatric dental providers and
151.18consumers.
151.19    (c) Patients seen on a volunteer basis by the provider at a location other than the
151.20provider's usual place of practice may be considered in meeting this the participation
151.21requirement in this section. The commissioner shall establish participation requirements
151.22for health maintenance organizations. The commissioner shall provide lists of
151.23participating medical assistance providers on a quarterly basis to the commissioner of
151.24employee relations, the commissioner of labor and industry, and the commissioner of
151.25commerce. Each of the commissioners shall develop and implement procedures to exclude
151.26as participating providers in the program or programs under their jurisdiction those
151.27providers who do not participate in the medical assistance program. The commissioner
151.28of employee relations shall implement this section through contracts with participating
151.29health and dental carriers.

151.30    Sec. 16. [256B.0751] CARE COORDINATION FOR CHILDREN WITH
151.31HIGH-COST MEDICAL CONDITIONS.
151.32    Subdivision 1. Care coordination required. (a) The commissioner of human
151.33services shall contract with the U special kids program to provide care coordination,
151.34beginning October 1, 2007, for medical assistance enrollees who are children with
151.35high-cost medical conditions, and to perform the other duties specified in this section.
152.1    (b) For purposes of this section, "care coordination" means collaboration with
152.2primary care physicians and specialists to manage care, development of medical
152.3management plans for recurrent acute illnesses, oversight and coordination of all aspects
152.4of care in partnership with families, organization of medical information into a summary
152.5of critical information, coordination and appropriate sequencing of tests and multiple
152.6appointments, information and assistance with accessing resources, and telephone triage
152.7for acute illnesses or problems.
152.8    Subd. 2. Referrals. The commissioner shall develop a mechanism to refer
152.9children to the U special kids program for care coordination. Beginning October 1, 2007,
152.10and subject to the limits on total program enrollment specified in subdivision 3, the
152.11commissioner shall refer to the U special kids program children who:
152.12    (1) incur medical expenses that exceed the qualifying level specified in subdivision 3;
152.13    (2) have medical conditions that involve four or more major systems; require
152.14multiple specialists; require use of technology such as G-tube, trach, central line, or
152.15oxygen; and require multiple medications;
152.16    (3) do not have a medical case manager for cancer, organ transplantation, epilepsy,
152.17or bone marrow replacement; and
152.18    (4) voluntarily agree to participate in the program.
152.19    Subd. 3. Qualifying level of medical expenses. (a) For the period October 1, 2007,
152.20through September 30, 2008, the commissioner shall refer children for care coordination
152.21under this section if they incurred medical expenses of $500,000 or more during the
152.22fiscal year ending June 30, 2007.
152.23    (b) For the period October 1, 2008, through September 30, 2009, the commissioner
152.24shall refer children for care coordination under this section if they incurred medical
152.25expenses of $400,000 or more during the fiscal year ending June 30, 2008.
152.26    (c) For the period October 1, 2009, through September 30, 2010, the commissioner
152.27shall refer children for care coordination under this section if they incurred medical
152.28expenses of $300,000 or more during the fiscal year ending June 30, 2009.
152.29    (d) Beginning October 1, 2010, the commissioner shall refer children for care
152.30coordination under this section if they incurred medical expenses of $250,000 or more
152.31during the previous fiscal year.
152.32    (e) The commissioner shall limit referrals to the extent necessary to ensure that
152.33total enrollment in the U special kids program does not exceed 100 children for the
152.34period October 1, 2007, through September 30, 2008, and does not exceed 150 children
152.35beginning October 1, 2008.
153.1    Subd. 4. Case management. Beginning October 1, 2007, the U special kids
153.2program shall coordinate all nonmedical case management services provided to children
153.3who are required to receive care coordination under this section. The program may
153.4require all nonmedical case managers, including, but not limited to, county case managers
153.5and case managers for children served under a home and community-based waiver,
153.6to submit care plans for approval, and to document client compliance with the care
153.7plans. The U special kids program, beginning October 1, 2008, may employ or contract
153.8with nonmedical case managers to provide all nonmedical case management services to
153.9children required to receive care coordination under this section. The commissioner shall
153.10reimburse the U special kids program for case management services through the medical
153.11assistance program.
153.12    Subd. 5. Statewide availability of care coordination. The U special kids program
153.13may contract with other entities to provide care coordination services as defined in
153.14subdivision 1, in order to ensure the availability of these services in all regions of the state.
153.15    Subd. 6. Advance practice nurse telephone triage system. The U special kids
153.16program shall establish and operate an advance practice nurse telephone triage system that
153.17is available statewide, 24 hours a day, seven days per week. The system must provide
153.18advance practice nurses with access to a Web-based information system to appropriately
153.19triage medical problems, manage care, and reduce unnecessary hospitalizations.
153.20    Subd. 7. Monitoring and evaluation. The commissioner shall monitor program
153.21outcomes and evaluate the extent to which referrals to the U special kids program have
153.22improved the quality and coordination of care and provided financial savings to the
153.23medical assistance program. The U special kids program shall submit to the commissioner,
153.24in the form and manner specified by the commissioner, all data and information necessary
153.25to monitor program outcomes and evaluate the program. The commissioner shall present a
153.26preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
153.27legislature by January 15, 2010.
153.28EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal
153.29approval, whichever is later.

153.30    Sec. 17. [256B.0752] CARE COORDINATION FOR CHILDREN WITH
153.31HIGH-COST MENTAL HEALTH CONDITIONS.
153.32    Subdivision 1. Care coordination required. (a) The commissioner of human
153.33services shall contract with the U special kids program to provide care coordination,
153.34beginning October 1, 2007, for medical assistance enrollees who are children with
154.1high-cost mental health conditions and behavioral problems, and to perform the other
154.2duties specified in this section.
154.3    (b) For purposes of this section, "care coordination" means: collaboration with
154.4primary care physicians and specialists to manage care; development of mental health
154.5management plans for recurrent mental health issues; oversight and coordination of all
154.6aspects of care in partnership with families; organization of medical, treatment, and
154.7therapy information into a summary of critical information; coordination and appropriate
154.8sequencing of evaluations and multiple appointments; information and assistance with
154.9accessing resources; and telephone triage for behavior or other problems.
154.10    Subd. 2. Referrals. The commissioner shall develop a mechanism to refer children
154.11to the program for care coordination. Beginning October 1, 2007, and subject to the limits
154.12on total program enrollment specified in subdivision 3, the commissioner shall refer to
154.13the U special kids program children who:
154.14    (1) incur mental health expenses that exceed the qualifying level specified in
154.15subdivision 3;
154.16    (2) are currently receiving or at risk of needing inpatient mental health treatment,
154.17foster home care, or both; and
154.18    (3) voluntarily agree to participate in the program.
154.19    Subd. 3. Qualifying level of medical expenses. (a) Beginning October 1, 2007, the
154.20commissioner shall refer children for care coordination under this section if they incurred
154.21medical and mental health expenses of $250,000 or more in the previous fiscal year.
154.22    (b) The commissioner shall limit referrals to the extent necessary to ensure that total
154.23enrollment in the U special kids program does not exceed 25 children for the period
154.24October 1, 2007, through September 30, 2008; does not exceed 75 children for the
154.25period October 1, 2008, through September 30, 2009; and does not exceed 125 children
154.26beginning October 1, 2009.
154.27    Subd. 4. Case management. The U special kids program, beginning October 1,
154.282007, shall coordinate all nonmedical case management services provided to children who
154.29are required to receive care coordination under this section. The program may require all
154.30nonmedical case managers, including but not limited to county case managers and case
154.31managers for children served under a home and community-based waiver, to submit care
154.32plans for approval, and to document client compliance with the care plans. The U special
154.33kids program, beginning October 1, 2008, may employ or contract with nonmedical case
154.34managers to provide all nonmedical case management services to children required to
154.35receive care coordination under this section. The commissioner shall reimburse the
155.1U special kids program for case management services through the medical assistance
155.2program.
155.3    Subd. 5. Statewide availability of care coordination. The program may contract
155.4with other entities to provide care coordination services as defined in subdivision 1, in
155.5order to ensure the availability of these services in all regions of the state.
155.6    Subd. 6. Monitoring and evaluation. The commissioner shall monitor program
155.7outcomes and shall evaluate the extent to which referrals to the U special kids program
155.8have improved the quality and coordination of care and provided financial savings to the
155.9medical assistance program. The U special kids program shall submit to the commissioner,
155.10in the form and manner specified by the commissioner, all data and information necessary
155.11to monitor program outcomes and evaluate the program. The commissioner shall present a
155.12preliminary evaluation to the legislature by January 15, 2008, and a final evaluation to the
155.13legislature by January 15, 2010.
155.14EFFECTIVE DATE.This section is effective October 1, 2007, or upon federal
155.15approval, whichever is later. The commissioner shall notify the Office of the Revisor of
155.16Statutes when federal approval is obtained.

155.17    Sec. 18. [256B.194] FEDERAL PAYMENTS.
155.18    Subdivision 1. Payments at actual cost. If the Centers for Medicare & Medicaid
155.19Services (CMS) promulgates a final rule consistent with its stated intent in the proposed
155.20rule published at 72 Federal Register, No. 11, January 18, 2007, regarding limiting
155.21payments to units of government, and notwithstanding Minnesota Statutes or Minnesota
155.22Rules to the contrary, for providers that are units of government, the commissioner may
155.23limit medical assistance and MinnesotaCare payments to a provider's actual cost of
155.24providing services, in accordance with the CMS final rule. If a final rule is promulgated,
155.25the commissioner may also require medical assistance and MinnesotaCare providers to
155.26provide any information necessary to determine Medicaid-related costs, and require the
155.27cooperation of providers in any audit or review necessary to ensure payments are limited
155.28to cost. This section does not apply to providers who are exempt from the provisions of
155.29the CMS final rule.
155.30    Subd. 2. Loss of federal financial participation. For all transfers, certified
155.31expenditures, and medical assistance payments listed below, if the commissioner
155.32determines that federal financial participation is no longer available for the medical
155.33assistance payments listed, then related obligations for the nonfederal share of payments
155.34and the medical assistance payments shall terminate. The commissioner shall notify all
155.35affected parties of the loss of federal financial participation, and the resulting payments
156.1and obligations that are terminated. If the commissioner determines that federal financial
156.2participation is no longer available for any medical assistance payments or contributions
156.3to the nonfederal share of medical assistance payments that have already been made, the
156.4commissioner may collect the medical assistance payments from providers and return
156.5contributions of the nonfederal share to its source. The transfers, certified expenditures,
156.6and medical assistance payments subject to this section are those specified in: sections
156.762J.692, subdivision 7, paragraphs (b) and (c); 256B.19, subdivisions 1c and 1d;
156.8256B.195; 256B.431, subdivision 23; and 256B.69, subdivision 5c, paragraph (a), clauses
156.9(2), (3), and (4); Laws 2002, chapter 220, article 17, section 2, subdivision 3; and Laws
156.102005, First Special Session chapter 4, article 9, section 2, subdivision 1.

156.11    Sec. 19. Minnesota Statutes 2006, section 256B.199, is amended to read:
156.12256B.199 PAYMENTS REPORTED BY GOVERNMENTAL ENTITIES.
156.13    (a) Hennepin County, and Hennepin County Medical Center, Ramsey County,
156.14Regions Hospital, the University of Minnesota, and Fairview-University Medical Center
156.15shall report quarterly to the commissioner beginning June 1, 2007, payments made during
156.16the second previous quarter that may qualify for reimbursement under federal law.
156.17    (b) Based on these reports, the commissioner shall apply for federal matching funds.
156.18These funds are appropriated to the commissioner for the payments under section 256.969,
156.19subdivision 27 to Hennepin County Medical Center.
156.20    (c) By May 1 of each year, beginning May 1, 2007, the commissioner shall inform
156.21the nonstate entities listed in paragraph (a) of the amount of federal disproportionate share
156.22hospital payment money expected to be available in the current federal fiscal year.
156.23    (d) This section sunsets on June 30, 2009. The commissioner shall report to
156.24the legislature by December 15, 2008, with recommendations for maximizing federal
156.25disproportionate share hospital payments after June 30, 2009.

156.26    Sec. 20. Minnesota Statutes 2006, section 256B.75, is amended to read:
156.27256B.75 HOSPITAL OUTPATIENT REIMBURSEMENT.
156.28    (a) For outpatient hospital facility fee payments for services rendered on or after
156.29October 1, 1992, the commissioner of human services shall pay the lower of (1) submitted
156.30charge, or (2) 32 percent above the rate in effect on June 30, 1992, except for those
156.31services for which there is a federal maximum allowable payment. Effective for services
156.32rendered on or after January 1, 2000, payment rates for nonsurgical outpatient hospital
156.33facility fees and emergency room facility fees shall be increased by eight percent over the
156.34rates in effect on December 31, 1999, except for those services for which there is a federal
157.1maximum allowable payment. Services for which there is a federal maximum allowable
157.2payment shall be paid at the lower of (1) submitted charge, or (2) the federal maximum
157.3allowable payment. Total aggregate payment for outpatient hospital facility fee services
157.4shall not exceed the Medicare upper limit. If it is determined that a provision of this
157.5section conflicts with existing or future requirements of the United States government with
157.6respect to federal financial participation in medical assistance, the federal requirements
157.7prevail. The commissioner may, in the aggregate, prospectively reduce payment rates to
157.8avoid reduced federal financial participation resulting from rates that are in excess of
157.9the Medicare upper limitations.
157.10    (b) Notwithstanding paragraph (a), payment for outpatient, emergency, and
157.11ambulatory surgery hospital facility fee services for critical access hospitals designated
157.12under section 144.1483, clause (10), shall be paid on a cost-based payment system that
157.13is based on the cost-finding methods and allowable costs of the Medicare program. All
157.14hospital outpatient services provided by any hospital exclusively devoted to the care of
157.15pediatric patients under age 21 that is located in a Minnesota metropolitan statistical area
157.16must be paid for using the methodology established for critical access hospitals at a rate
157.17equal to fee-for-service rates plus 46 percent, as limited by allowable costs.
157.18    (c) Effective for services provided on or after July 1, 2003, rates that are based
157.19on the Medicare outpatient prospective payment system shall be replaced by a budget
157.20neutral prospective payment system that is derived using medical assistance data. The
157.21commissioner shall provide a proposal to the 2003 legislature to define and implement
157.22this provision.
157.23    (d) For fee-for-service services provided on or after July 1, 2002, the total payment,
157.24before third-party liability and spenddown, made to hospitals for outpatient hospital
157.25facility services is reduced by .5 percent from the current statutory rate.
157.26    (e) In addition to the reduction in paragraph (d), the total payment for fee-for-service
157.27services provided on or after July 1, 2003, made to hospitals for outpatient hospital
157.28facility services before third-party liability and spenddown, is reduced five percent from
157.29the current statutory rates. Facilities defined under section 256.969, subdivision 16, are
157.30excluded from this paragraph.
157.31EFFECTIVE DATE.This section is effective July 1, 2007, and applies to services
157.32provided on or after that date.

157.33    Sec. 21. Minnesota Statutes 2006, section 256B.76, is amended to read:
157.34256B.76 PHYSICIAN AND DENTAL REIMBURSEMENT.
158.1    (a) Effective for services rendered on or after October 1, 1992, the commissioner
158.2shall make payments for physician services as follows:
158.3    (1) payment for level one Centers for Medicare and Medicaid Services' common
158.4procedural coding system codes titled "office and other outpatient services," "preventive
158.5medicine new and established patient," "delivery, antepartum, and postpartum care,"
158.6"critical care," cesarean delivery and pharmacologic management provided to psychiatric
158.7patients, and level three codes for enhanced services for prenatal high risk, shall be paid
158.8at the lower of (i) submitted charges, or (ii) 25 percent above the rate in effect on June
158.930, 1992. If the rate on any procedure code within these categories is different than the
158.10rate that would have been paid under the methodology in section 256B.74, subdivision 2,
158.11then the larger rate shall be paid;
158.12    (2) payments for all other services shall be paid at the lower of (i) submitted charges,
158.13or (ii) 15.4 percent above the rate in effect on June 30, 1992;
158.14    (3) all physician rates shall be converted from the 50th percentile of 1982 to the 50th
158.15percentile of 1989, less the percent in aggregate necessary to equal the above increases
158.16except that payment rates for home health agency services shall be the rates in effect
158.17on September 30, 1992;
158.18    (4) effective for services rendered on or after January 1, 2000, payment rates for
158.19physician and professional services shall be increased by three percent over the rates in
158.20effect on December 31, 1999, except for home health agency and family planning agency
158.21services; and
158.22    (5) the increases in clause (4) shall be implemented January 1, 2000, for managed
158.23care.
158.24    (b) Effective for services rendered on or after October 1, 1992, the commissioner
158.25shall make payments for dental services as follows:
158.26    (1) dental services shall be paid at the lower of (i) submitted charges, or (ii) 25
158.27percent above the rate in effect on June 30, 1992;
158.28    (2) dental rates shall be converted from the 50th percentile of 1982 to the 50th
158.29percentile of 1989, less the percent in aggregate necessary to equal the above increases;
158.30    (3) effective for services rendered on or after January 1, 2000, payment rates for
158.31dental services shall be increased by three percent over the rates in effect on December
158.3231, 1999;
158.33    (4) the commissioner shall award grants to community clinics or other nonprofit
158.34community organizations, political subdivisions, professional associations, or other
158.35organizations that demonstrate the ability to provide dental services effectively to public
158.36program recipients. Grants may be used to fund the costs related to coordinating access for
159.1recipients, developing and implementing patient care criteria, upgrading or establishing
159.2new facilities, acquiring furnishings or equipment, recruiting new providers, or other
159.3development costs that will improve access to dental care in a region. In awarding grants,
159.4the commissioner shall give priority to applicants that plan to serve areas of the state in
159.5which the number of dental providers is not currently sufficient to meet the needs of
159.6recipients of public programs or uninsured individuals. The commissioner shall consider
159.7the following in awarding the grants:
159.8    (i) potential to successfully increase access to an underserved population;
159.9    (ii) the ability to raise matching funds;
159.10    (iii) the long-term viability of the project to improve access beyond the period
159.11of initial funding;
159.12    (iv) the efficiency in the use of the funding; and
159.13    (v) the experience of the proposers in providing services to the target population.
159.14    The commissioner shall monitor the grants and may terminate a grant if the grantee
159.15does not increase dental access for public program recipients. The commissioner shall
159.16consider grants for the following:
159.17    (i) implementation of new programs or continued expansion of current access
159.18programs that have demonstrated success in providing dental services in underserved
159.19areas;
159.20    (ii) a pilot program for utilizing hygienists outside of a traditional dental office to
159.21provide dental hygiene services; and
159.22    (iii) a program that organizes a network of volunteer dentists, establishes a system to
159.23refer eligible individuals to volunteer dentists, and through that network provides donated
159.24dental care services to public program recipients or uninsured individuals;
159.25    (5) beginning October 1, 1999, the payment for tooth sealants and fluoride treatments
159.26shall be the lower of (i) submitted charge, or (ii) 80 percent of median 1997 charges;
159.27    (6) the increases listed in clauses (3) and (5) shall be implemented January 1, 2000,
159.28for managed care; and
159.29    (7) effective for services provided on or after January 1, 2002, payment for
159.30diagnostic examinations and dental x-rays provided to children under age 21 shall be the
159.31lower of (i) the submitted charge, or (ii) 85 percent of median 1999 charges.
159.32    (c) Effective for dental services rendered on or after January 1, 2002, the
159.33commissioner may, within the limits of available appropriation, increase reimbursements
159.34to dentists and dental clinics deemed by the commissioner to be critical access dental
159.35providers. Reimbursement to a critical access dental provider may be increased by not
159.36more than 50 percent above the reimbursement rate that would otherwise be paid to the
160.1provider. Payments to For dental services rendered after June 30, 2007, the commissioner
160.2shall increase reimbursement by 33 percent above the reimbursement rate that would
160.3otherwise be paid to the provider. The commissioner shall pay the health plan companies
160.4shall be adjusted in amounts sufficient to reflect increased reimbursements to critical
160.5access dental providers as approved by the commissioner. In determining which dentists
160.6and dental clinics shall be deemed critical access dental providers, the commissioner
160.7shall review:
160.8    (1) the utilization rate in the service area in which the dentist or dental clinic operates
160.9for dental services to patients covered by medical assistance, general assistance medical
160.10care, or MinnesotaCare as their primary source of coverage;
160.11    (2) the level of services provided by the dentist or dental clinic to patients covered
160.12by medical assistance, general assistance medical care, or MinnesotaCare as their primary
160.13source of coverage; and
160.14    (3) whether the level of services provided by the dentist or dental clinic is critical to
160.15maintaining adequate levels of patient access within the service area.
160.16In the absence of a critical access dental provider in a service area, the commissioner may
160.17designate a dentist or dental clinic as a critical access dental provider if the dentist or
160.18dental clinic is willing to provide care to patients covered by medical assistance, general
160.19assistance medical care, or MinnesotaCare at a level which significantly increases access
160.20to dental care in the service area.
160.21    The commissioner shall annually establish a reimbursement schedule for critical
160.22access dental providers and provider-specific limits on total reimbursement received
160.23under the reimbursement schedule, and shall notify each critical access dental provider
160.24of the schedule and limit.
160.25    (d) An entity that operates both a Medicare certified comprehensive outpatient
160.26rehabilitation facility and a facility which was certified prior to January 1, 1993, that is
160.27licensed under Minnesota Rules, parts 9570.2000 to 9570.3600, and for whom at least 33
160.28percent of the clients receiving rehabilitation services in the most recent calendar year are
160.29medical assistance recipients, shall be reimbursed by the commissioner for rehabilitation
160.30services at rates that are 38 percent greater than the maximum reimbursement rate
160.31allowed under paragraph (a), clause (2), when those services are (1) provided within the
160.32comprehensive outpatient rehabilitation facility and (2) provided to residents of nursing
160.33facilities owned by the entity.
160.34    (e) Effective for services rendered on or after January 1, 2007, the commissioner
160.35shall make payments for physician and professional services based on the Medicare
161.1relative value units (RVU's). This change shall be budget neutral and the cost of
161.2implementing RVU's will be incorporated in the established conversion factor.

161.3    Sec. 22. Minnesota Statutes 2006, section 256D.03, subdivision 4, is amended to read:
161.4    Subd. 4. General assistance medical care; services. (a)(i) For a person who is
161.5eligible under subdivision 3, paragraph (a), clause (2), item (i), general assistance medical
161.6care covers, except as provided in paragraph (c):
161.7    (1) inpatient hospital services;
161.8    (2) outpatient hospital services;
161.9    (3) services provided by Medicare certified rehabilitation agencies;
161.10    (4) prescription drugs and other products recommended through the process
161.11established in section 256B.0625, subdivision 13;
161.12    (5) equipment necessary to administer insulin and diagnostic supplies and equipment
161.13for diabetics to monitor blood sugar level;
161.14    (6) eyeglasses and eye examinations provided by a physician or optometrist;
161.15    (7) hearing aids;
161.16    (8) prosthetic devices;
161.17    (9) laboratory and X-ray services;
161.18    (10) physician's services;
161.19    (11) medical transportation except special transportation;
161.20    (12) chiropractic services as covered under the medical assistance program;
161.21    (13) podiatric services;
161.22    (14) dental services as covered under the medical assistance program;
161.23    (15) outpatient services provided by a mental health center or clinic that is under
161.24contract with the county board and is established under section 245.62;
161.25    (16) day treatment services for mental illness provided under contract with the
161.26county board;
161.27    (17) prescribed medications for persons who have been diagnosed as mentally ill as
161.28necessary to prevent more restrictive institutionalization;
161.29    (18) psychological services, medical supplies and equipment, and Medicare
161.30premiums, coinsurance and deductible payments;
161.31    (19) medical equipment not specifically listed in this paragraph when the use of
161.32the equipment will prevent the need for costlier services that are reimbursable under
161.33this subdivision;
161.34    (20) services performed by a certified pediatric nurse practitioner, a certified family
161.35nurse practitioner, a certified adult nurse practitioner, a certified obstetric/gynecological
162.1nurse practitioner, a certified neonatal nurse practitioner, or a certified geriatric nurse
162.2practitioner in independent practice, if (1) the service is otherwise covered under this
162.3chapter as a physician service, (2) the service provided on an inpatient basis is not included
162.4as part of the cost for inpatient services included in the operating payment rate, and (3) the
162.5service is within the scope of practice of the nurse practitioner's license as a registered
162.6nurse, as defined in section 148.171;
162.7    (21) services of a certified public health nurse or a registered nurse practicing in
162.8a public health nursing clinic that is a department of, or that operates under the direct
162.9authority of, a unit of government, if the service is within the scope of practice of the
162.10public health nurse's license as a registered nurse, as defined in section 148.171;
162.11    (22) telemedicine consultations, to the extent they are covered under section
162.12256B.0625, subdivision 3b ; and
162.13    (23) mental health telemedicine and psychiatric consultation as covered under
162.14section 256B.0625, subdivisions 46 and 48.;
162.15    (24) care coordination and patient education services provided by a community
162.16health worker according to section 256B.0625, subdivision 49; and
162.17    (25) regardless of the number of employees that an enrolled health care provider
162.18may have, sign language interpreter services when provided by an enrolled health care
162.19provider during the course of providing a direct, person-to-person covered health care
162.20service to an enrolled recipient who has a hearing loss and uses interpreting services.
162.21    (ii) Effective October 1, 2003, for a person who is eligible under subdivision 3,
162.22paragraph (a), clause (2), item (ii), general assistance medical care coverage is limited
162.23to inpatient hospital services, including physician services provided during the inpatient
162.24hospital stay. A $1,000 deductible is required for each inpatient hospitalization.
162.25    (b) Effective August 1, 2005, sex reassignment surgery is not covered under this
162.26subdivision.
162.27    (c) In order to contain costs, the commissioner of human services shall select
162.28vendors of medical care who can provide the most economical care consistent with high
162.29medical standards and shall where possible contract with organizations on a prepaid
162.30capitation basis to provide these services. The commissioner shall consider proposals by
162.31counties and vendors for prepaid health plans, competitive bidding programs, block grants,
162.32or other vendor payment mechanisms designed to provide services in an economical
162.33manner or to control utilization, with safeguards to ensure that necessary services are
162.34provided. Before implementing prepaid programs in counties with a county operated or
162.35affiliated public teaching hospital or a hospital or clinic operated by the University of
162.36Minnesota, the commissioner shall consider the risks the prepaid program creates for the
163.1hospital and allow the county or hospital the opportunity to participate in the program in a
163.2manner that reflects the risk of adverse selection and the nature of the patients served by
163.3the hospital, provided the terms of participation in the program are competitive with the
163.4terms of other participants considering the nature of the population served. Payment for
163.5services provided pursuant to this subdivision shall be as provided to medical assistance
163.6vendors of these services under sections 256B.02, subdivision 8, and 256B.0625. For
163.7payments made during fiscal year 1990 and later years, the commissioner shall consult
163.8with an independent actuary in establishing prepayment rates, but shall retain final control
163.9over the rate methodology.
163.10    (d) Effective January 1, 2008, drug coverage under general assistance medical care
163.11is limited to prescription drugs that:
163.12    (i) are covered under the medical assistance program as described in section
163.13256B.0625, subdivisions 13 and 13d; and
163.14    (ii) are provided by manufacturers that have fully executed general assistance
163.15medical care rebate agreements with the commissioner and comply with the agreements.
163.16Prescription drug coverage under general assistance medical care must conform to
163.17coverage under the medical assistance program according to section 256B.0625,
163.18subdivisions 13 to 13g.
163.19    (d) (e) Recipients eligible under subdivision 3, paragraph (a), shall pay the following
163.20co-payments for services provided on or after October 1, 2003:
163.21    (1) $25 for eyeglasses;
163.22    (2) $25 for nonemergency visits to a hospital-based emergency room;
163.23    (3) $3 per brand-name drug prescription and $1 per generic drug prescription,
163.24subject to a $12 per month maximum for prescription drug co-payments. No co-payments
163.25shall apply to antipsychotic drugs when used for the treatment of mental illness; and
163.26    (4) 50 percent coinsurance on restorative dental services.
163.27    (e) (f) Co-payments shall be limited to one per day per provider for nonpreventive
163.28visits, eyeglasses, and nonemergency visits to a hospital-based emergency room.
163.29Recipients of general assistance medical care are responsible for all co-payments in this
163.30subdivision. The general assistance medical care reimbursement to the provider shall be
163.31reduced by the amount of the co-payment, except that reimbursement for prescription
163.32drugs shall not be reduced once a recipient has reached the $12 per month maximum for
163.33prescription drug co-payments. The provider collects the co-payment from the recipient.
163.34Providers may not deny services to recipients who are unable to pay the co-payment,
163.35except as provided in paragraph (f).
164.1    (f) (g) If it is the routine business practice of a provider to refuse service to an
164.2individual with uncollected debt, the provider may include uncollected co-payments
164.3under this section. A provider must give advance notice to a recipient with uncollected
164.4debt before services can be denied.
164.5    (g) (h) Any county may, from its own resources, provide medical payments for
164.6which state payments are not made.
164.7    (h) (i) Chemical dependency services that are reimbursed under chapter 254B must
164.8not be reimbursed under general assistance medical care.
164.9    (i) (j) The maximum payment for new vendors enrolled in the general assistance
164.10medical care program after the base year shall be determined from the average usual and
164.11customary charge of the same vendor type enrolled in the base year.
164.12    (j) (k) The conditions of payment for services under this subdivision are the same
164.13as the conditions specified in rules adopted under chapter 256B governing the medical
164.14assistance program, unless otherwise provided by statute or rule.
164.15    (k) (l) Inpatient and outpatient payments shall be reduced by five percent, effective
164.16July 1, 2003. This reduction is in addition to the five percent reduction effective July 1,
164.172003, and incorporated by reference in paragraph (i).
164.18    (l) (m) Payments for all other health services except inpatient, outpatient, and
164.19pharmacy services shall be reduced by five percent, effective July 1, 2003.
164.20    (m) (n) Payments to managed care plans shall be reduced by five percent for services
164.21provided on or after October 1, 2003.
164.22    (n) (o) A hospital receiving a reduced payment as a result of this section may apply
164.23the unpaid balance toward satisfaction of the hospital's bad debts.
164.24    (o) (p) Fee-for-service payments for nonpreventive visits shall be reduced by $3
164.25for services provided on or after January 1, 2006. For purposes of this subdivision, a
164.26visit means an episode of service which is required because of a recipient's symptoms,
164.27diagnosis, or established illness, and which is delivered in an ambulatory setting by
164.28a physician or physician ancillary, chiropractor, podiatrist, advance practice nurse,
164.29audiologist, optician, or optometrist.
164.30    (p) (q) Payments to managed care plans shall not be increased as a result of the
164.31removal of the $3 nonpreventive visit co-payment effective January 1, 2006.

164.32    Sec. 23. Minnesota Statutes 2006, section 256L.01, subdivision 4, is amended to read:
164.33    Subd. 4. Gross individual or gross family income. (a) "Gross individual or gross
164.34family income" for nonfarm self-employed means income calculated for the six-month
164.35period of eligibility using the net profit or loss reported on the applicant's federal income
165.1tax form for the previous year and using the medical assistance families with children
165.2methodology for determining allowable and nonallowable self-employment expenses and
165.3countable income.
165.4    (b) "Gross individual or gross family income" for farm self-employed means income
165.5calculated for the six-month period of eligibility using as the baseline the adjusted gross
165.6income reported on the applicant's federal income tax form for the previous year and
165.7adding back in reported depreciation amounts that apply to the business in which the
165.8family is currently engaged.
165.9    (c) "Gross individual or gross family income" means the total income for all family
165.10members, calculated for the six-month period of eligibility.
165.11EFFECTIVE DATE.This section is effective July 1, 2007, or upon federal
165.12approval, whichever is later.

165.13    Sec. 24. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
165.14    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
165.15and (c), the MinnesotaCare benefit plan shall include the following co-payments and
165.16coinsurance requirements for all enrollees:
165.17    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
165.18subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
165.19$3,000 per family;
165.20    (2) $3 per prescription for adult enrollees;
165.21    (3) $25 for eyeglasses for adult enrollees;
165.22    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
165.23episode of service which is required because of a recipient's symptoms, diagnosis, or
165.24established illness, and which is delivered in an ambulatory setting by a physician or
165.25physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
165.26audiologist, optician, or optometrist; and
165.27    (5) $6 for nonemergency visits to a hospital-based emergency room.
165.28    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
165.29children under the age of 21 in households with family income equal to or less than 175
165.30percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
165.31parents and relative caretakers of children under the age of 21 in households with family
165.32income greater than 175 percent of the federal poverty guidelines for inpatient hospital
165.33admissions occurring on or after January 1, 2001.
165.34    (c) Paragraph (a), clauses (1) to (4), do does not apply to pregnant women and
165.35children under the age of 21.
166.1    (d) Adult enrollees with family gross income that exceeds 175 percent of the
166.2federal poverty guidelines and who are not pregnant shall be financially responsible for
166.3the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
166.4hospital benefit limit.
166.5    (e) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
166.6or changes from one prepaid health plan to another during a calendar year, any charges
166.7submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
166.8expenses incurred by the enrollee for inpatient services, that were submitted or incurred
166.9prior to enrollment, or prior to the change in health plans, shall be disregarded.

166.10    Sec. 25. Minnesota Statutes 2006, section 256L.04, subdivision 1, is amended to read:
166.11    Subdivision 1. Families with children. (a) Families with children with family
166.12income equal to or less than 275 percent of the federal poverty guidelines for the
166.13applicable family size shall be eligible for MinnesotaCare according to this section. All
166.14other provisions of sections 256L.01 to 256L.18, including the insurance-related barriers
166.15to enrollment under section 256L.07, shall apply unless otherwise specified.
166.16    (b) Parents who enroll in the MinnesotaCare program must also enroll their children,
166.17if the children are eligible. Children may be enrolled separately without enrollment by
166.18parents. However, if one parent in the household enrolls, both parents must enroll, unless
166.19other insurance is available. If one child from a family is enrolled, all children must
166.20be enrolled, unless other insurance is available. If one spouse in a household enrolls,
166.21the other spouse in the household must also enroll, unless other insurance is available.
166.22Families cannot choose to enroll only certain uninsured members.
166.23    (c) Beginning October 1, 2003, the dependent sibling definition no longer applies
166.24to the MinnesotaCare program. These persons are no longer counted in the parental
166.25household and may apply as a separate household.
166.26    (d) Beginning July 1, 2003, or upon federal approval, whichever is later, parents
166.27are not eligible for MinnesotaCare if their gross income exceeds $50,000 $25,000 for the
166.28six-month period of eligibility.

166.29    Sec. 26. Minnesota Statutes 2006, section 256L.04, subdivision 12, is amended to read:
166.30    Subd. 12. Persons in detention. Beginning January 1, 1999, an applicant residing
166.31in a correctional or detention facility is not eligible for MinnesotaCare. An enrollee
166.32residing in a correctional or detention facility is not eligible at renewal of eligibility under
166.33section 256L.05, subdivision 3b 3a.

167.1    Sec. 27. Minnesota Statutes 2006, section 256L.11, subdivision 7, is amended to read:
167.2    Subd. 7. Critical access dental providers. Effective for dental services provided
167.3to MinnesotaCare enrollees on or after between January 1, 2007, and June 30, 2007, the
167.4commissioner shall increase payment rates to dentists and dental clinics deemed by the
167.5commissioner to be critical access providers under section 256B.76, paragraph (c), by 50
167.6percent above the payment rate that would otherwise be paid to the provider. Effective
167.7for dental services provided to MinnesotaCare enrollees on or after July 1, 2007, the
167.8commissioner shall increase payment rates to dentists and dental clinics deemed by the
167.9commissioner to be critical access providers under section 256B.76, paragraph (c), by
167.1033 percent above the payment rate that would otherwise be paid to the provider. The
167.11commissioner shall adjust the rates paid on or after January 1, 2007, to pay the prepaid
167.12health plans under contract with the commissioner amounts sufficient to reflect this rate
167.13increase. The prepaid health plan must pass this rate increase to providers who have
167.14been identified by the commissioner as critical access dental providers under section
167.15256B.76 , paragraph (c).

167.16    Sec. 28. HENNEPIN COUNTY PILOT PROJECT.
167.17    The commissioner of human services shall support a pilot project in Hennepin
167.18County to demonstrate the effectiveness of alternative strategies to redetermine eligibility
167.19for certain recipient populations in the medical assistance program. The target populations
167.20for the demonstration are persons who are eligible based upon disability or age, who have
167.21chronic medical conditions, and who are expected to experience minimal change in income
167.22or assets from month to month. The commissioner and the county shall analyze the issues
167.23and strategies employed and the outcomes to determine reasonable efforts to streamline
167.24eligibility statewide. The duration of the pilot project shall be no more than two years.
167.25The commissioner shall apply for any federal waivers needed to implement this section.

167.26    Sec. 29. COUNTY-BASED PURCHASING STUDY.
167.27    The commissioner of health shall study county-based purchasing initiatives
167.28established under Minnesota Statutes, section 256B.692, and compare these initiatives
167.29to managed care plans serving medical assistance, general assistance medical care, and
167.30MinnesotaCare enrollees. The study must:
167.31    (1) provide a history and description of county-based purchasing initiatives,
167.32including state and federal requirements and any federal waivers Minnesota counties have
167.33applied for or received;
168.1    (2) provide a history and description of managed care plan participation in the
168.2prepaid medical assistance, prepaid general assistance medical care, and prepaid
168.3Minnesota programs, and the provision by managed care plans of third-party administrator
168.4services for county-based purchasing initiatives;
168.5    (3) provide relevant data, including limitations on data, data that was requested but
168.6not received, and explanations for why requested data was not received;
168.7    (4) provide recommendations for further data collection and research;
168.8    (5) summarize successes and challenges of the two service delivery methods;
168.9    (6) provide recommendations for possible expansion of county-based purchasing
168.10in rural and urban settings; and
168.11    (7) identify and describe features of county-based purchasing and managed care
168.12plans serving medical assistance, general assistance medical care, and MinnesotaCare
168.13enrollees, to provide a comparison of cost, quality, access, and community health
168.14improvement that includes, but is not limited to:
168.15    (i) descriptions of how health care and social services are integrated and coordinated
168.16for persons with complex care needs, including persons with high-risk pregnancies,
168.17adolescents, persons who are disabled, persons who are elderly, and persons with chronic
168.18health care and social needs;
168.19    (ii) use of monetary grants and surpluses to:
168.20    (A) increase provider reimbursement, including dental care reimbursement, in order
168.21to improve health care access; and
168.22    (B) improve community health beyond the requirements of the public health care
168.23programs, such as the funding of public education, research, and community initiatives to
168.24enhance utilization of preventive services, social services, or mental health care;
168.25    (iii) administrative costs, including billing and collection of unpaid fees, co-pays or
168.26other charges, and top five management salaries;
168.27    (iv) reporting requirements of contracts with the Department of Human Services;
168.28    (v) public access to all information about management and administration, including
168.29but not limited to provider contracts and reimbursement, models of care management and
168.30coordination, utilization review, contracts with consultants and other vendors, handling of
168.31monetary grants and surpluses, and health outcomes data;
168.32    (vi) provider reimbursement by clinical practice area;
168.33    (vii) populations served, described by age, disability, income, race, language,
168.34occupation, and other demographic characteristics;
168.35    (viii) utilization of community-based prevention interventions, including but not
168.36limited to public health nursing visits to new parents, use of nurse-managed interventions
169.1to reduce cardiac hospitalizations, and the use of medical homes for chronic disease
169.2management;
169.3    (ix) utilization of cancer screening;
169.4    (x) utilization of interpreter services;
169.5    (xi) immunization rates for children age five and under;
169.6    (xii) hospitalization rates for conditions related to diabetes, asthma, or cardiac
169.7illnesses;
169.8    (xiii) rates of rehospitalization within a month of hospital discharge;
169.9    (xiv) coordination with county agencies to increase enrollment;
169.10    (xv) number of new program enrollees and the rate of enrollment, including the
169.11percentage of eligible persons who become enrollees;
169.12    (xvi) enrollee satisfaction with their care; and
169.13    (xvii) number of enrollees who do not receive care.
169.14    Managed care plans, county-based purchasing initiatives, health care providers,
169.15counties, and the commissioner of human services shall, upon request, provide data to
169.16the commissioner of health that is necessary to complete the study. The commissioner of
169.17health shall submit the study to the legislature by December 31, 2007.

169.18    Sec. 30. GRANT FOR TOLL-FREE HEALTH CARE ACCESS NUMBER.
169.19    The commissioner of human services shall award a grant to the Neighborhood
169.20Health Care Network to pay the costs of maintaining and staffing a toll-free telephone
169.21number to provide callers with information on health coverage options, eligibility for
169.22MinnesotaCare and other health care programs, and health care providers that offer free or
169.23reduced-cost health care services.

169.24    Sec. 31. IMPLEMENTATION OF PHARMACY DISPENSING FEE INCREASE.
169.25    The commissioner, after consulting with the Pharmacy Payment Reform Advisory
169.26Committee established under Laws 2006, chapter 282, article 16, section 15, may
169.27proportionally increase or decrease the dispensing fee for multiple-source generic drugs
169.28under Minnesota Statutes, section 256B.0625, subdivision 13e, paragraph (a), to reflect
169.29the actual amount of reductions in program cost for ingredient reimbursement savings
169.30obtained.
169.31EFFECTIVE DATE.This section is effective upon implementation of changes to
169.32the federal upper reimbursement limit under title VI, chapter IV of the federal Deficit
169.33Reduction Act of 2005, United States Code, title 42, section 1396r-8(e)(5).

170.1    Sec. 32. REPEALER.
170.2Minnesota Statutes 2006, section 256.969, subdivision 27, is repealed effective
170.3July 1, 2007.

170.4ARTICLE 4

170.5CONTINUING CARE

170.6    Section 1. Minnesota Statutes 2006, section 144A.071, subdivision 4c, is amended to
170.7read:
170.8    Subd. 4c. Exceptions for replacement beds after June 30, 2003. (a) The
170.9commissioner of health, in coordination with the commissioner of human services, may
170.10approve the renovation, replacement, upgrading, or relocation of a nursing home or
170.11boarding care home, under the following conditions:
170.12    (1) to license and certify an 80-bed city-owned facility in Nicollet County to be
170.13constructed on the site of a new city-owned hospital to replace an existing 85-bed facility
170.14attached to a hospital that is also being replaced. The threshold allowed for this project
170.15under section 144A.073 shall be the maximum amount available to pay the additional
170.16medical assistance costs of the new facility;
170.17    (2) to license and certify 29 beds to be added to an existing 69-bed facility in St.
170.18Louis County, provided that the 29 beds must be transferred from active or layaway status
170.19at an existing facility in St. Louis County that had 235 beds on April 1, 2003.
170.20The licensed capacity at the 235-bed facility must be reduced to 206 beds, but the payment
170.21rate at that facility shall not be adjusted as a result of this transfer. The operating payment
170.22rate of the facility adding beds after completion of this project shall be the same as it was
170.23on the day prior to the day the beds are licensed and certified. This project shall not
170.24proceed unless it is approved and financed under the provisions of section 144A.073;
170.25    (3) to license and certify a new 60-bed facility in Austin, provided that: (i) 45 of
170.26the new beds are transferred from a 45-bed facility in Austin under common ownership
170.27that is closed and 15 of the new beds are transferred from a 182-bed facility in Albert Lea
170.28under common ownership; (ii) the commissioner of human services is authorized by the
170.292004 legislature to negotiate budget-neutral planned nursing facility closures; and (iii)
170.30money is available from planned closures of facilities under common ownership to make
170.31implementation of this clause budget-neutral to the state. The bed capacity of the Albert
170.32Lea facility shall be reduced to 167 beds following the transfer. Of the 60 beds at the
170.33new facility, 20 beds shall be used for a special care unit for persons with Alzheimer's
170.34disease or related dementias; and
171.1    (4) to license and certify up to 80 beds transferred from an existing state-owned
171.2nursing facility in Cass County to a new facility located on the grounds of the
171.3Ah-Gwah-Ching campus. The operating cost payment rates for the new facility shall be
171.4determined based on the interim and settle-up payment provisions of Minnesota Rules,
171.5part 9549.0057, and the reimbursement provisions of section 256B.431. The property
171.6payment rate for the first three years of operation shall be $35 per day. For subsequent
171.7years, the property payment rate of $35 per day shall be adjusted for inflation as provided
171.8in section 256B.434, subdivision 4, paragraph (c), as long as the facility has a contract
171.9under section 256B.434.; and
171.10    (5) to license and certify 180 beds transferred from an existing facility in
171.11Minneapolis to a new facility in Robbinsdale; provided that the beds are transferred from a
171.12219-bed facility under common ownership that shall be closed following the transfer. The
171.13operating payment rate of the new facility after completion of this project shall be adjusted
171.14upward by $35 per day and the property payment rate shall be $34.049 per day.
171.15    (b) Projects approved under this subdivision shall be treated in a manner equivalent
171.16to projects approved under subdivision 4a.
171.17EFFECTIVE DATE.This section is effective the day following final enactment.

171.18    Sec. 2. Minnesota Statutes 2006, section 252.27, subdivision 2a, is amended to read:
171.19    Subd. 2a. Contribution amount. (a) The natural or adoptive parents of a minor
171.20child, including a child determined eligible for medical assistance without consideration of
171.21parental income, must contribute to the cost of services used by making monthly payments
171.22on a sliding scale based on income, unless the child is married or has been married,
171.23parental rights have been terminated, or the child's adoption is subsidized according to
171.24section 259.67 or through title IV-E of the Social Security Act. The parental contribution
171.25is a partial or full payment for medical services provided for diagnostic, therapeutic,
171.26curing, treating, mitigating, rehabilitation, and maintenance and personal care services as
171.27defined in United States Code, title 26, section 213, needed by the child with a chronic
171.28illness or disability.
171.29    (b) For households with adjusted gross income equal to or greater than 100 percent
171.30of federal poverty guidelines, the parental contribution shall be computed by applying the
171.31following schedule of rates to the adjusted gross income of the natural or adoptive parents:
171.32    (1) if the adjusted gross income is equal to or greater than 100 percent of federal
171.33poverty guidelines and less than 175 percent of federal poverty guidelines, the parental
171.34contribution is $4 per month;
172.1    (2) if the adjusted gross income is equal to or greater than 175 percent of federal
172.2poverty guidelines and less than or equal to 545 percent of federal poverty guidelines,
172.3the parental contribution shall be determined using a sliding fee scale established by the
172.4commissioner of human services which begins at one percent of adjusted gross income
172.5at 175 percent of federal poverty guidelines and increases to 7.5 percent of adjusted
172.6gross income for those with adjusted gross income up to 545 percent of federal poverty
172.7guidelines;
172.8    (3) if the adjusted gross income is greater than 545 percent of federal poverty
172.9guidelines and less than 675 percent of federal poverty guidelines, the parental
172.10contribution shall be 7.5 percent of adjusted gross income;
172.11    (4) if the adjusted gross income is equal to or greater than 675 percent of federal
172.12poverty guidelines and less than 975 percent of federal poverty guidelines, the parental
172.13contribution shall be determined using a sliding fee scale established by the commissioner
172.14of human services which begins at 7.5 percent of adjusted gross income at 675 percent of
172.15federal poverty guidelines and increases to ten percent of adjusted gross income for those
172.16with adjusted gross income up to 975 percent of federal poverty guidelines; and
172.17    (5) if the adjusted gross income is equal to or greater than 975 percent of federal
172.18poverty guidelines, the parental contribution shall be 12.5 percent of adjusted gross
172.19income.
172.20    If the child lives with the parent, the annual adjusted gross income parental
172.21contribution is reduced by $2,400 prior to calculating the parental contribution $100
172.22per month. If the child resides in an institution specified in section 256B.35, the parent
172.23is responsible for the personal needs allowance specified under that section in addition
172.24to the parental contribution determined under this section. The parental contribution is
172.25reduced by any amount required to be paid directly to the child pursuant to a court order,
172.26but only if actually paid.
172.27    (c) The household size to be used in determining the amount of contribution under
172.28paragraph (b) includes natural and adoptive parents and their dependents, including the
172.29child receiving services. Adjustments in the contribution amount due to annual changes
172.30in the federal poverty guidelines shall be implemented on the first day of July following
172.31publication of the changes.
172.32    (d) For purposes of paragraph (b), "income" means the adjusted gross income of the
172.33natural or adoptive parents determined according to the previous year's federal tax form,
172.34except, effective retroactive to July 1, 2003, taxable capital gains to the extent the funds
172.35have been used to purchase a home shall not be counted as income.
173.1    (e) The contribution shall be explained in writing to the parents at the time eligibility
173.2for services is being determined. The contribution shall be made on a monthly basis
173.3effective with the first month in which the child receives services. Annually upon
173.4redetermination or at termination of eligibility, if the contribution exceeded the cost of
173.5services provided, the local agency or the state shall reimburse that excess amount to
173.6the parents, either by direct reimbursement if the parent is no longer required to pay
173.7a contribution, or by a reduction in or waiver of parental fees until the excess amount
173.8is exhausted.
173.9    (f) The monthly contribution amount must be reviewed at least every 12 months;
173.10when there is a change in household size; and when there is a loss of or gain in income
173.11from one month to another in excess of ten percent. The local agency shall mail a written
173.12notice 30 days in advance of the effective date of a change in the contribution amount.
173.13A decrease in the contribution amount is effective in the month that the parent verifies a
173.14reduction in income or change in household size.
173.15    (g) Parents of a minor child who do not live with each other shall each pay the
173.16contribution required under paragraph (a). An amount equal to the annual court-ordered
173.17child support payment actually paid on behalf of the child receiving services shall be
173.18deducted from the adjusted gross income of the parent making the payment prior to
173.19calculating the parental contribution under paragraph (b).
173.20    (h) The contribution under paragraph (b) shall be increased by an additional five
173.21percent if the local agency determines that insurance coverage is available but not
173.22obtained for the child. For purposes of this section, "available" means the insurance is a
173.23benefit of employment for a family member at an annual cost of no more than five percent
173.24of the family's annual income. For purposes of this section, "insurance" means health
173.25and accident insurance coverage, enrollment in a nonprofit health service plan, health
173.26maintenance organization, self-insured plan, or preferred provider organization.
173.27    Parents who have more than one child receiving services shall not be required
173.28to pay more than the amount for the child with the highest expenditures. There shall
173.29be no resource contribution from the parents. The parent shall not be required to pay
173.30a contribution in excess of the cost of the services provided to the child, not counting
173.31payments made to school districts for education-related services. Notice of an increase in
173.32fee payment must be given at least 30 days before the increased fee is due.
173.33    (i) The contribution under paragraph (b) shall be reduced by $300 per fiscal year if,
173.34in the 12 months prior to July 1:
173.35    (1) the parent applied for insurance for the child;
173.36    (2) the insurer denied insurance;
174.1    (3) the parents submitted a complaint or appeal, in writing to the insurer, submitted
174.2a complaint or appeal, in writing, to the commissioner of health or the commissioner of
174.3commerce, or litigated the complaint or appeal; and
174.4    (4) as a result of the dispute, the insurer reversed its decision and granted insurance.
174.5    For purposes of this section, "insurance" has the meaning given in paragraph (h).
174.6    A parent who has requested a reduction in the contribution amount under this
174.7paragraph shall submit proof in the form and manner prescribed by the commissioner or
174.8county agency, including, but not limited to, the insurer's denial of insurance, the written
174.9letter or complaint of the parents, court documents, and the written response of the insurer
174.10approving insurance. The determinations of the commissioner or county agency under this
174.11paragraph are not rules subject to chapter 14.

174.12    Sec. 3. Minnesota Statutes 2006, section 252.32, subdivision 3, is amended to read:
174.13    Subd. 3. Amount of support grant; use. Support grant amounts shall be
174.14determined by the county social service agency. Services and items purchased with a
174.15support grant must:
174.16    (1) be over and above the normal costs of caring for the dependent if the dependent
174.17did not have a disability;
174.18    (2) be directly attributable to the dependent's disabling condition; and
174.19    (3) enable the family to delay or prevent the out-of-home placement of the dependent.
174.20    The design and delivery of services and items purchased under this section must
174.21suit the dependent's chronological age and be provided in the least restrictive environment
174.22possible, consistent with the needs identified in the individual service plan.
174.23    Items and services purchased with support grants must be those for which there
174.24are no other public or private funds available to the family. Fees assessed to parents
174.25for health or human services that are funded by federal, state, or county dollars are not
174.26reimbursable through this program.
174.27    In approving or denying applications, the county shall consider the following factors:
174.28    (1) the extent and areas of the functional limitations of the disabled child;
174.29    (2) the degree of need in the home environment for additional support; and
174.30    (3) the potential effectiveness of the grant to maintain and support the person in
174.31the family environment.
174.32    The maximum monthly grant amount shall be $250 per eligible dependent, or
174.33$3,000 per eligible dependent per state fiscal year, within the limits of available funds and
174.34as adjusted by any legislatively authorized cost of living adjustment. The county social
175.1service agency may consider the dependent's supplemental security income in determining
175.2the amount of the support grant.
175.3    Any adjustments to their monthly grant amount must be based on the needs of the
175.4family and funding availability.

175.5    Sec. 4. Minnesota Statutes 2006, section 252.46, is amended by adding a subdivision
175.6to read:
175.7    Subd. 22. Provider rate increase; St. Louis County. A day training and
175.8habilitation provider in St. Louis County licensed to provide services to up to 80
175.9individuals shall receive a per diem rate increase that does not exceed 95 percent of the
175.10greater of 125 percent of the current statewide median or 125 percent of the regional
175.11average per diem rate, whichever is higher.

175.12    Sec. 5. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
175.13to read:
175.14    Subd. 24. Disability linkage line. The commissioner shall establish the disability
175.15linkage line, a statewide consumer information, referral, and assistance system for people
175.16with disabilities and chronic illnesses that:
175.17    (1) provides information about state and federal eligibility requirements, benefits,
175.18and service options;
175.19    (2) makes referrals to appropriate support entities;
175.20    (3) delivers information and assistance based on national and state standards;
175.21    (4) assists people to make well-informed decisions; and
175.22    (5) supports the timely resolution of service access and benefit issues.

175.23    Sec. 6. Minnesota Statutes 2006, section 256.476, subdivision 1, is amended to read:
175.24    Subdivision 1. Purpose and goals. The commissioner of human services shall
175.25establish a consumer support grant program for individuals with functional limitations and
175.26their families who wish to purchase and secure their own supports. The commissioner and
175.27local agencies shall jointly develop an implementation plan which must include a way to
175.28resolve the issues related to county liability. The program shall:
175.29    (1) make support grants available to individuals or families as an effective alternative
175.30to the developmental disability family support program, personal care attendant services,
175.31home health aide services, and private duty nursing services;
175.32    (2) provide consumers more control, flexibility, and responsibility over their services
175.33and supports;
176.1    (3) promote local program management and decision making; and
176.2    (4) encourage the use of informal and typical community supports.

176.3    Sec. 7. Minnesota Statutes 2006, section 256.476, subdivision 2, is amended to read:
176.4    Subd. 2. Definitions. For purposes of this section, the following terms have the
176.5meanings given them:
176.6    (a) "County board" means the county board of commissioners for the county of
176.7financial responsibility as defined in section 256G.02, subdivision 4, or its designated
176.8representative. When a human services board has been established under sections 402.01
176.9to 402.10, it shall be considered the county board for the purposes of this section.
176.10    (b) "Family" means the person's birth parents, adoptive parents or stepparents,
176.11siblings or stepsiblings, children or stepchildren, grandparents, grandchildren, niece,
176.12nephew, aunt, uncle, or spouse. For the purposes of this section, a family member is
176.13at least 18 years of age.
176.14    (c) "Functional limitations" means the long-term inability to perform an activity or
176.15task in one or more areas of major life activity, including self-care, understanding and use
176.16of language, learning, mobility, self-direction, and capacity for independent living. For the
176.17purpose of this section, the inability to perform an activity or task results from a mental,
176.18emotional, psychological, sensory, or physical disability, condition, or illness.
176.19    (d) "Informed choice" means a voluntary decision made by the person or,
176.20the person's legal representative, or other authorized representative after becoming
176.21familiarized with the alternatives to:
176.22    (1) select a preferred alternative from a number of feasible alternatives;
176.23    (2) select an alternative which may be developed in the future; and
176.24    (3) refuse any or all alternatives.
176.25    (e) "Local agency" means the local agency authorized by the county board or,
176.26for counties not participating in the consumer grant program by July 1, 2002, the
176.27commissioner, to carry out the provisions of this section.
176.28    (f) "Person" or "persons" means a person or persons meeting the eligibility criteria in
176.29subdivision 3.
176.30    (g) "Authorized representative" means an individual designated by the person or
176.31their legal representative to act on their behalf. This individual may be a family member,
176.32guardian, representative payee, or other individual designated by the person or their legal
176.33representative, if any, to assist in purchasing and arranging for supports. For the purposes
176.34of this section, an authorized representative is at least 18 years of age.
177.1    (h) "Screening" means the screening of a person's service needs under sections
177.2256B.0911 and 256B.092.
177.3    (i) "Supports" means services, care, aids, environmental modifications, or assistance
177.4purchased by the person or the person's family, the person's legal representative, or other
177.5authorized representative. Examples of supports include respite care, assistance with daily
177.6living, and assistive technology. For the purpose of this section, notwithstanding the
177.7provisions of section 144A.43, supports purchased under the consumer support program
177.8are not considered home care services.
177.9    (j) "Program of origination" means the program the individual transferred from
177.10when approved for the consumer support grant program.

177.11    Sec. 8. Minnesota Statutes 2006, section 256.476, subdivision 3, is amended to read:
177.12    Subd. 3. Eligibility to apply for grants. (a) A person is eligible to apply for a
177.13consumer support grant if the person meets all of the following criteria:
177.14    (1) the person is eligible for and has been approved to receive services under
177.15medical assistance as determined under sections 256B.055 and 256B.056 or the person
177.16has been approved to receive a grant under the developmental disability family support
177.17program under section 252.32;
177.18    (2) the person is able to direct and purchase the person's own care and supports, or
177.19the person has a family member, legal representative, or other authorized representative
177.20who can purchase and arrange supports on the person's behalf;
177.21    (3) the person has functional limitations, requires ongoing supports to live in the
177.22community, and is at risk of or would continue institutionalization without such supports;
177.23and
177.24    (4) the person will live in a home. For the purpose of this section, "home" means the
177.25person's own home or home of a person's family member. These homes are natural home
177.26settings and are not licensed by the Department of Health or Human Services.
177.27    (b) Persons may not concurrently receive a consumer support grant if they are:
177.28    (1) receiving personal care attendant and home health aide services, or private duty
177.29nursing under section 256B.0625; a developmental disability family support grant; or
177.30alternative care services under section 256B.0913; or
177.31    (2) residing in an institutional or congregate care setting.
177.32    (c) A person or person's family receiving a consumer support grant shall not be
177.33charged a fee or premium by a local agency for participating in the program.
177.34    (d) Individuals receiving home and community-based waivers under United States
177.35Code, title 42, section 1396h(c), are not eligible for the consumer support grant, except
178.1for individuals receiving consumer support grants before July 1, 2003, as long as other
178.2eligibility criteria are met.
178.3    (e) The commissioner shall establish a budgeted appropriation each fiscal year
178.4for the consumer support grant program. The number of individuals participating in
178.5the program will be adjusted so the total amount allocated to counties does not exceed
178.6the amount of the budgeted appropriation. The budgeted appropriation will be adjusted
178.7annually to accommodate changes in demand for the consumer support grants.

178.8    Sec. 9. Minnesota Statutes 2006, section 256.476, subdivision 4, is amended to read:
178.9    Subd. 4. Support grants; criteria and limitations. (a) A county board may
178.10choose to participate in the consumer support grant program. If a county has not chosen
178.11to participate by July 1, 2002, the commissioner shall contract with another county or
178.12other entity to provide access to residents of the nonparticipating county who choose
178.13the consumer support grant option. The commissioner shall notify the county board
178.14in a county that has declined to participate of the commissioner's intent to enter into
178.15a contract with another county or other entity at least 30 days in advance of entering
178.16into the contract. The local agency shall establish written procedures and criteria to
178.17determine the amount and use of support grants. These procedures must include, at least,
178.18the availability of respite care, assistance with daily living, and adaptive aids. The local
178.19agency may establish monthly or annual maximum amounts for grants and procedures
178.20where exceptional resources may be required to meet the health and safety needs of the
178.21person on a time-limited basis, however, the total amount awarded to each individual may
178.22not exceed the limits established in subdivision 11.
178.23    (b) Support grants to a person or a person's family, a person's legal representative,
178.24or other authorized representative will be provided through a monthly subsidy payment
178.25and be in the form of cash, voucher, or direct county payment to vendor. Support grant
178.26amounts must be determined by the local agency. Each service and item purchased with a
178.27support grant must meet all of the following criteria:
178.28    (1) it must be over and above the normal cost of caring for the person if the person
178.29did not have functional limitations;
178.30    (2) it must be directly attributable to the person's functional limitations;
178.31    (3) it must enable the person or the person's family, a person's legal representative,
178.32or other authorized representative to delay or prevent out-of-home placement of the
178.33person; and
178.34    (4) it must be consistent with the needs identified in the service agreement, when
178.35applicable.
179.1    (c) Items and services purchased with support grants must be those for which there
179.2are no other public or private funds available to the person or the person's family, a person's
179.3legal representative, or other authorized representative. Fees assessed to the person or the
179.4person's family for health and human services are not reimbursable through the grant.
179.5    (d) In approving or denying applications, the local agency shall consider the
179.6following factors:
179.7    (1) the extent and areas of the person's functional limitations;
179.8    (2) the degree of need in the home environment for additional support; and
179.9    (3) the potential effectiveness of the grant to maintain and support the person in the
179.10family environment or the person's own home.
179.11    (e) At the time of application to the program or screening for other services,
179.12the person or the person's family, a person's legal representative, or other authorized
179.13representative shall be provided sufficient information to ensure an informed choice
179.14of alternatives by the person, the person's legal representative, or other authorized
179.15representative, if any, or the person's family. The application shall be made to the local
179.16agency and shall specify the needs of the person and family, the form and amount of
179.17grant requested, the items and services to be reimbursed, and evidence of eligibility for
179.18medical assistance.
179.19    (f) Upon approval of an application by the local agency and agreement on a support
179.20plan for the person or person's family, the local agency shall make grants to the person or
179.21the person's family. The grant shall be in an amount for the direct costs of the services or
179.22supports outlined in the service agreement.
179.23    (g) Reimbursable costs shall not include costs for resources already available, such as
179.24special education classes, day training and habilitation, case management, other services to
179.25which the person is entitled, medical costs covered by insurance or other health programs,
179.26or other resources usually available at no cost to the person or the person's family.
179.27    (h) The state of Minnesota, the county boards participating in the consumer
179.28support grant program, or the agencies acting on behalf of the county boards in the
179.29implementation and administration of the consumer support grant program shall not be
179.30liable for damages, injuries, or liabilities sustained through the purchase of support by
179.31the individual, the individual's family, or the authorized representative under this section
179.32with funds received through the consumer support grant program. Liabilities include but
179.33are not limited to: workers' compensation liability, the Federal Insurance Contributions
179.34Act (FICA), or the Federal Unemployment Tax Act (FUTA). For purposes of this section,
179.35participating county boards and agencies acting on behalf of county boards are exempt
179.36from the provisions of section 268.04.

180.1    Sec. 10. Minnesota Statutes 2006, section 256.476, subdivision 5, is amended to read:
180.2    Subd. 5. Reimbursement, allocations, and reporting. (a) For the purpose of
180.3transferring persons to the consumer support grant program from the developmental
180.4disability family support program and personal care assistant services, home health
180.5aide services, or private duty nursing services, the amount of funds transferred by the
180.6commissioner between the developmental disability family support program account, the
180.7medical assistance account, or the consumer support grant account shall be based on each
180.8county's participation in transferring persons to the consumer support grant program
180.9from those programs and services.
180.10    (b) At the beginning of each fiscal year, county allocations for consumer support
180.11grants shall be based on:
180.12    (1) the number of persons to whom the county board expects to provide consumer
180.13supports grants;
180.14    (2) their eligibility for current program and services;
180.15    (3) the amount of nonfederal dollars allowed under subdivision 11; and
180.16    (4) projected dates when persons will start receiving grants. County allocations shall
180.17be adjusted periodically by the commissioner based on the actual transfer of persons or
180.18service openings, and the nonfederal dollars associated with those persons or service
180.19openings, to the consumer support grant program.
180.20    (c) The amount of funds transferred by the commissioner from the medical
180.21assistance account for an individual may be changed if it is determined by the county or its
180.22agent that the individual's need for support has changed.
180.23    (d) The authority to utilize funds transferred to the consumer support grant account
180.24for the purposes of implementing and administering the consumer support grant program
180.25will not be limited or constrained by the spending authority provided to the program
180.26of origination.
180.27    (e) The commissioner may use up to five percent of each county's allocation, as
180.28adjusted, for payments for administrative expenses, to be paid as a proportionate addition
180.29to reported direct service expenditures.
180.30    (f) The county allocation for each individual or individual's family cannot exceed
180.31the amount allowed under subdivision 11.
180.32    (g) The commissioner may recover, suspend, or withhold payments if the county
180.33board, local agency, or grantee does not comply with the requirements of this section.
180.34    (h) Grant funds unexpended by consumers shall return to the state once a year. The
180.35annual return of unexpended grant funds shall occur in the quarter following the end of
180.36the state fiscal year.

181.1    Sec. 11. Minnesota Statutes 2006, section 256.476, subdivision 10, is amended to read:
181.2    Subd. 10. Consumer responsibilities. Persons receiving grants under this section
181.3shall:
181.4    (1) spend the grant money in a manner consistent with their agreement with the
181.5local agency;
181.6    (2) notify the local agency of any necessary changes in the grant or the items on
181.7which it is spent;
181.8    (3) notify the local agency of any decision made by the person, the a person's legal
181.9representative, or the person's family or other authorized representative that would change
181.10their eligibility for consumer support grants;
181.11    (4) arrange and pay for supports; and
181.12    (5) inform the local agency of areas where they have experienced difficulty securing
181.13or maintaining supports.

181.14    Sec. 12. Minnesota Statutes 2006, section 256.974, is amended to read:
181.15256.974 OFFICE OF OMBUDSMAN FOR OLDER MINNESOTANS
181.16LONG-TERM CARE; LOCAL PROGRAMS.
181.17    The ombudsman for older Minnesotans long-term care serves in the classified service
181.18under section 256.01, subdivision 7, in an office within the Minnesota Board on Aging that
181.19incorporates the long-term care ombudsman program required by the Older Americans
181.20Act, Public Law 100-75 as amended, United States Code, title 42, section 3027(a)(12)
181.21(9) and 3058g (a), and established within the Minnesota Board on Aging. The Minnesota
181.22Board on Aging may make grants to and designate local programs for the provision of
181.23ombudsman services to clients in county or multicounty areas. The local program may not
181.24be an agency engaged in the provision of nursing home care, hospital care, or home care
181.25services either directly or by contract, or have the responsibility for planning, coordinating,
181.26funding, or administering nursing home care, hospital care, or home care services.

181.27    Sec. 13. Minnesota Statutes 2006, section 256.9741, subdivision 1, is amended to read:
181.28    Subdivision 1. Long-term care facility. "Long-term care facility" means a nursing
181.29home licensed under sections 144A.02 to 144A.10 or; a boarding care home licensed
181.30under sections 144.50 to 144.56; or a licensed or registered residential setting which
181.31provides or arranges for the provision of home care services.

181.32    Sec. 14. Minnesota Statutes 2006, section 256.9741, subdivision 3, is amended to read:
182.1    Subd. 3. Client. "Client" means an individual who requests, or on whose behalf a
182.2request is made for, ombudsman services and is (a) a resident of a long-term care facility
182.3or (b) a Medicare beneficiary who requests assistance relating to access, discharge, or
182.4denial of inpatient or outpatient services, or (c) an individual reserving, receiving, or
182.5requesting a home care service.

182.6    Sec. 15. Minnesota Statutes 2006, section 256.9742, subdivision 3, is amended to read:
182.7    Subd. 3. Posting. Every long-term care facility and acute care facility shall post in a
182.8conspicuous place the address and telephone number of the office. A home care service
182.9provider shall provide all recipients, including those in elderly housing with services
182.10under chapter 144D, with the address and telephone number of the office. Counties shall
182.11provide clients receiving a consumer support grant or a service allowance long-term care
182.12consultation services under section 256B.0911 or home and community-based services
182.13through a state or federally funded program with the name, address, and telephone number
182.14of the office. The posting or notice is subject to approval by the ombudsman.

182.15    Sec. 16. Minnesota Statutes 2006, section 256.9742, subdivision 4, is amended to read:
182.16    Subd. 4. Access to long-term care and acute care facilities and clients. The
182.17ombudsman or designee may:
182.18    (1) enter any long-term care facility without notice at any time;
182.19    (2) enter any acute care facility without notice during normal business hours;
182.20    (3) enter any acute care facility without notice at any time to interview a patient or
182.21observe services being provided to the patient as part of an investigation of a matter that is
182.22within the scope of the ombudsman's authority, but only if the ombudsman's or designee's
182.23presence does not intrude upon the privacy of another patient or interfere with routine
182.24hospital services provided to any patient in the facility;
182.25    (4) communicate privately and without restriction with any client in accordance
182.26with section 144.651, as long as the ombudsman has the client's consent for such
182.27communication;
182.28    (5) inspect records of a long-term care facility, home care service provider, or acute
182.29care facility that pertain to the care of the client according to sections section 144.335 and
182.30144.651; and
182.31    (6) with the consent of a client or client's legal guardian, the ombudsman or
182.32designated staff shall have access to review records pertaining to the care of the client
182.33according to sections section 144.335 and 144.651. If a client cannot consent and has no
182.34legal guardian, access to the records is authorized by this section.
183.1    A person who denies access to the ombudsman or designee in violation of this
183.2subdivision or aids, abets, invites, compels, or coerces another to do so is guilty of a
183.3misdemeanor.

183.4    Sec. 17. Minnesota Statutes 2006, section 256.9742, subdivision 6, is amended to read:
183.5    Subd. 6. Prohibition against discrimination or retaliation. (a) No entity shall take
183.6discriminatory, disciplinary, or retaliatory action against an employee or volunteer, or a
183.7patient, resident, or guardian or family member of a patient, resident, or guardian for filing
183.8in good faith a complaint with or providing information to the ombudsman or designee
183.9including volunteers. A person who violates this subdivision or who aids, abets, invites,
183.10compels, or coerces another to do so is guilty of a misdemeanor.
183.11    (b) There shall be a rebuttable presumption that any adverse action, as defined below,
183.12within 90 days of report, is discriminatory, disciplinary, or retaliatory. For the purpose
183.13of this clause, the term "adverse action" refers to action taken by the entity involved in a
183.14report against the person making the report or the person with respect to whom the report
183.15was made because of the report, and includes, but is not limited to:
183.16    (1) discharge or transfer from a facility;
183.17    (2) termination of service;
183.18    (3) restriction or prohibition of access to the facility or its residents;
183.19    (4) discharge from or termination of employment;
183.20    (5) demotion or reduction in remuneration for services; and
183.21    (6) any restriction of rights set forth in section 144.651 or, 144A.44, or 144A.751.

183.22    Sec. 18. Minnesota Statutes 2006, section 256.9744, subdivision 1, is amended to read:
183.23    Subdivision 1. Classification. Except as provided in this section, data maintained
183.24by the office under sections 256.974 to 256.9744 are private data on individuals or
183.25nonpublic data as defined in section 13.02, subdivision 9 or 12, and must be maintained
183.26in accordance with the requirements of Public Law 100-75 the Older Americans Act, as
183.27amended, United States Code, title 42, section 3027(a)(12)(D) 3058g(d).

183.28    Sec. 19. Minnesota Statutes 2006, section 256.975, subdivision 7, is amended to read:
183.29    Subd. 7. Consumer information and assistance; senior linkage. (a) The
183.30Minnesota Board on Aging shall operate a statewide information and assistance service
183.31to aid older Minnesotans and their families in making informed choices about long-term
183.32care options and health care benefits. Language services to persons with limited English
183.33language skills may be made available. The service, known as Senior LinkAge Line, must
184.1be available during business hours through a statewide toll-free number and must also
184.2be available through the Internet.
184.3    (b) The service must assist older adults, caregivers, and providers in accessing
184.4information about choices in long-term care services that are purchased through private
184.5providers or available through public options. The service must:
184.6    (1) develop a comprehensive database that includes detailed listings in both
184.7consumer- and provider-oriented formats;
184.8    (2) make the database accessible on the Internet and through other telecommunication
184.9and media-related tools;
184.10    (3) link callers to interactive long-term care screening tools and make these tools
184.11available through the Internet by integrating the tools with the database;
184.12    (4) develop community education materials with a focus on planning for long-term
184.13care and evaluating independent living, housing, and service options;
184.14    (5) conduct an outreach campaign to assist older adults and their caregivers in
184.15finding information on the Internet and through other means of communication;
184.16    (6) implement a messaging system for overflow callers and respond to these callers
184.17by the next business day;
184.18    (7) link callers with county human services and other providers to receive more
184.19in-depth assistance and consultation related to long-term care options; and
184.20    (8) link callers with quality profiles for nursing facilities and other providers
184.21developed by the commissioner of health.; and
184.22    (9) incorporate information about housing with services and consumer rights
184.23within the MinnesotaHelp.info network long-term care database to facilitate consumer
184.24comparison of services and costs among housing with services establishments and with
184.25other in-home services and to support financial self-sufficiency as long as possible.
184.26Housing with services establishments and their arranged home care providers shall provide
184.27information to the commissioner of human services that is consistent with information
184.28required by the commissioner of health under section 144G.06, the Uniform Consumer
184.29Information Guide. The commissioner of human services shall provide the data to the
184.30Minnesota Board on Aging for inclusion in the MinnesotaHelp.info network long-term
184.31care database.
184.32    (c) The Minnesota Board on Aging shall conduct an evaluation of the effectiveness
184.33of the statewide information and assistance, and submit this evaluation to the legislature
184.34by December 1, 2002. The evaluation must include an analysis of funding adequacy, gaps
184.35in service delivery, continuity in information between the service and identified linkages,
184.36and potential use of private funding to enhance the service.
185.1EFFECTIVE DATE.This section is effective the day following final enactment.

185.2    Sec. 20. Minnesota Statutes 2006, section 256B.056, subdivision 1a, is amended to
185.3read:
185.4    Subd. 1a. Income and assets generally. Unless specifically required by state law or
185.5rule or federal law or regulation, the methodologies used in counting income and assets
185.6to determine eligibility for medical assistance for persons whose eligibility category is
185.7based on blindness, disability, or age of 65 or more years, the methodologies for the
185.8supplemental security income program shall be used, except as provided under subdivision
185.93, paragraph (f). Increases in benefits under title II of the Social Security Act shall not be
185.10counted as income for purposes of this subdivision until July 1 of each year. Effective
185.11upon federal approval, for children eligible under section 256B.055, subdivision 12, or
185.12for home and community-based waiver services whose eligibility for medical assistance
185.13is determined without regard to parental income, child support payments, including any
185.14payments made by an obligor in satisfaction of or in addition to a temporary or permanent
185.15order for child support, and Social Security payments are not counted as income. For
185.16families and children, which includes all other eligibility categories, the methodologies
185.17under the state's AFDC plan in effect as of July 16, 1996, as required by the Personal
185.18Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public
185.19Law 104-193, shall be used, except that effective October 1, 2003, the earned income
185.20disregards and deductions are limited to those in subdivision 1c. For these purposes, a
185.21"methodology" does not include an asset or income standard, or accounting method,
185.22or method of determining effective dates.

185.23    Sec. 21. Minnesota Statutes 2006, section 256B.056, subdivision 3, is amended to read:
185.24    Subd. 3. Asset limitations for aged, blind, or disabled individuals and families.
185.25    To be eligible for medical assistance, a person whose eligibility is based on blindness,
185.26disability, or age of 65 or more years must not individually own more than $3,000 $6,000
185.27in assets, or if a member of a household with two family members, husband and wife, or
185.28parent and child, the household must not own more than $6,000 $12,000 in assets, plus
185.29$200 $400 for each additional legal dependent. In addition to these maximum amounts,
185.30an eligible individual or family may accrue interest on these amounts, but they must be
185.31reduced to the maximum at the time of an eligibility redetermination. The accumulation
185.32of the clothing and personal needs allowance according to section 256B.35 must also be
185.33reduced to the maximum at the time of the eligibility redetermination. The value of assets
185.34that are not considered in determining eligibility for medical assistance is the value of
186.1those assets excluded under the supplemental security income program for aged, blind,
186.2and disabled persons, with the following exceptions:
186.3    (a) Household goods and personal effects are not considered.
186.4    (b) Capital and operating assets of a trade or business that the local agency
186.5determines are necessary to the person's ability to earn an income are not considered.
186.6    (c) Motor vehicles are excluded to the same extent excluded by the supplemental
186.7security income program.
186.8    (d) Assets designated as burial expenses are excluded to the same extent excluded by
186.9the supplemental security income program. Burial expenses funded by annuity contracts
186.10or life insurance policies must irrevocably designate the individual's estate as contingent
186.11beneficiary to the extent proceeds are not used for payment of selected burial expenses.
186.12    (e) Effective upon federal approval, for a person who no longer qualifies as an
186.13employed person with a disability due to loss of earnings, assets allowed while eligible
186.14for medical assistance under section 256B.057, subdivision 9, are not considered for 12
186.15months, beginning with the first month of ineligibility as an employed person with a
186.16disability, to the extent that the person's total assets remain within the allowed limits of
186.17section 256B.057, subdivision 9, paragraph (b).
186.18    (f) When a person enrolled in medical assistance under section 256B.057,
186.19subdivision 9, reaches age 65 and has been enrolled during each of the 24 consecutive
186.20months before the person's 65th birthday, the assets owned by the person and the person's
186.21spouse must be disregarded, up to the limits of section 256B.057, subdivision 9, paragraph
186.22(b), when determining eligibility for medical assistance under section 256B.055,
186.23subdivision 7. The income of a spouse of a person enrolled in medical assistance under
186.24section 256B.057, subdivision 9, during each of the 24 consecutive months before the
186.25person's 65th birthday must be disregarded when determining eligibility for medical
186.26assistance under section 256B.055, subdivision 7, when the person reaches age 65. This
186.27paragraph does not apply at the time the person or the person's spouse requests medical
186.28assistance payment for long-term care services.
186.29EFFECTIVE DATE.This section is effective July 1, 2007, except that the increase
186.30in the asset standard for persons whose eligibility for medical assistance is based on
186.31blindness, disability, or age of 65 or more years is effective July 1, 2008.

186.32    Sec. 22. Minnesota Statutes 2006, section 256B.056, subdivision 5c, is amended to
186.33read:
186.34    Subd. 5c. Excess income standard. (a) The excess income standard for families
186.35with children is the standard specified in subdivision 4.
187.1    (b) The excess income standard for a person whose eligibility is based on blindness,
187.2disability, or age of 65 or more years is 70 percent of the federal poverty guidelines for the
187.3family size. Effective July 1, 2002, the excess income standard for this paragraph shall
187.4equal 75 percent of the federal poverty guidelines. Effective July 1, 2007, the excess
187.5income standard for this paragraph shall equal 85 percent of the federal poverty guidelines.
187.6The excess income standard for this paragraph shall be increased by five percentage points
187.7on July 1 of each of the next three years, so that the excess income standard shall equal
187.8100 percent of the federal poverty guidelines effective July 1, 2010.
187.9EFFECTIVE DATE.This section is effective July 1, 2007.

187.10    Sec. 23. Minnesota Statutes 2006, section 256B.0621, subdivision 11, is amended to
187.11read:
187.12    Subd. 11. Data use agreement; Notice of relocation assistance. The commissioner
187.13shall execute a data use agreement with the Centers for Medicare and Medicaid Services
187.14to obtain the long-term care minimum data set data to assist residents of nursing facilities
187.15who have establish a process with the Centers for Independent Living that allows a person
187.16residing in a Minnesota nursing facility to receive needed information, consultation, and
187.17assistance from one of the centers about the available community support options that may
187.18enable the person to relocate to the community, if the person: (1) is under the age of 65,
187.19(2) has indicated a desire to live in the community. The commissioner shall in turn enter
187.20into agreements with the Centers for Independent Living to provide information about
187.21assistance for persons who want to move to the community. The commissioner shall work
187.22with the Centers for Independent Living on both the content of the information to be
187.23provided and privacy protections for the individual residents, and (3) has signed a release
187.24of information authorized by the person or the person's appointed legal representative.
187.25The process established under this subdivision shall be coordinated with the long-term
187.26care consultation service activities established in section 256B.0911.

187.27    Sec. 24. Minnesota Statutes 2006, section 256B.0625, subdivision 18a, is amended to
187.28read:
187.29    Subd. 18a. Access to medical services. (a) Medical assistance reimbursement for
187.30meals for persons traveling to receive medical care may not exceed $5.50 for breakfast,
187.31$6.50 for lunch, or $8 for dinner.
187.32    (b) Medical assistance reimbursement for lodging for persons traveling to receive
187.33medical care may not exceed $50 per day unless prior authorized by the local agency.
188.1    (c) Medical assistance direct mileage reimbursement to the eligible person or the
188.2eligible person's driver may not exceed 20 cents per mile.
188.3    (d) Regardless of the number of employees that an enrolled health care provider
188.4may have, medical assistance covers sign and oral language interpreter services when
188.5provided by an enrolled health care provider during the course of providing a direct,
188.6person-to-person covered health care service to an enrolled recipient with limited English
188.7proficiency or who has a hearing loss and uses interpreting services.

188.8    Sec. 25. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
188.9subdivision to read:
188.10    Subd. 49. Self-directed supports option. Upon federal approval, medical
188.11assistance covers the self-directed supports option as defined under section 256B.0657 and
188.12section 6087 of the Federal Deficit Reduction Act of 2005, Public Law 109-171.
188.13EFFECTIVE DATE.This section is effective upon federal approval of the state
188.14Medicaid plan amendment. The commissioner of human services shall inform the Office
188.15of the Revisor of Statutes when approval is obtained.

188.16    Sec. 26. [256B.0657] SELF-DIRECTED SUPPORTS OPTION.
188.17    Subdivision 1. Definition. "Self-directed supports option" means personal
188.18assistance, supports, items, and related services purchased under an approved budget
188.19plan and budget by a recipient.
188.20    Subd. 2. Eligibility. (a) The self-directed supports option is available to a person
188.21who:
188.22    (1) is a recipient of medical assistance as determined under sections 256B.055,
188.23256B.056, and 256B.057, subdivision 9;
188.24    (2) is eligible for personal care assistant services under section 256B.0655;
188.25    (3) lives in the person's own apartment or home, which is not owned, operated, or
188.26controlled by a provider of services not related by blood or marriage;
188.27    (4) has the ability to hire, fire, supervise, establish staff compensation for, and
188.28manage the individuals providing services, and to choose and obtain items, related
188.29services, and supports as described in the participant's plan. If the recipient is not able to
188.30carry out these functions but has a legal guardian or parent to carry them out, the guardian
188.31or parent may fulfill these functions on behalf of the recipient; and
188.32    (5) has not been excluded or disenrolled by the commissioner.
188.33    (b) The commissioner may disenroll or exclude recipients, including guardians and
188.34parents, under the following circumstances:
189.1    (1) recipients who have been restricted by the Primary Care Utilization Review
189.2Committee may be excluded for a specified time period; and
189.3    (2) recipients who exit the self-directed supports option during the recipient's
189.4service plan year shall not access the self-directed supports option for the remainder
189.5of that service plan year.
189.6    Subd. 3. Eligibility for other services. Selection of the self-directed supports
189.7option by a recipient shall not restrict access to other medically necessary care and
189.8services furnished under the state plan medical assistance benefit, including home care
189.9targeted case management, except that a person receiving home and community-based
189.10waiver services, a family support grant or a consumer support grant is not eligible for
189.11funding under the self-directed supports option.
189.12    Subd. 4. Assessment requirements. (a) The self-directed supports option
189.13assessment must meet the following requirements:
189.14    (1) it shall be conducted by the county public health nurse or a certified public
189.15health nurse under contract with the county;
189.16    (2) it shall be conducted face-to-face in the recipient's home initially, and at least
189.17annually thereafter; when there is a significant change in the recipient's condition; and
189.18when there is a change in the need for personal care assistant services. A recipient who is
189.19residing in a facility may be assessed for the self-directed support option for the purpose
189.20of returning to the community using this option; and
189.21    (3) it shall be completed using the format established by the commissioner.
189.22    (b) The results of the assessment and recommendations shall be communicated to
189.23the commissioner and the recipient by the county public health nurse or certified public
189.24health nurse under contract with the county.
189.25    Subd. 5. Self-directed supports option plan requirements. (a) The plan for the
189.26self-directed supports option must meet the following requirements:
189.27    (1) the plan must be completed using a person-centered process that:
189.28    (i) builds upon the recipient's capacity to engage in activities that promote
189.29community life;
189.30    (ii) respects the recipient's preferences, choices, and abilities;
189.31    (iii) involves families, friends, and professionals in the planning or delivery of
189.32services or supports as desired or required by the recipient; and
189.33    (iv) addresses the need for personal care assistant services identified in the recipient's
189.34self-directed supports option assessment;
189.35    (2) the plan shall be developed by the recipient or by the guardian of an adult
189.36recipient or by a parent or guardian of a minor child, with the assistance of an enrolled
190.1medical assistance home care targeted case manager provider who meets the requirements
190.2established for using a person-centered planning process and shall be reviewed at least
190.3annually upon reassessment or when there is a significant change in the recipient's
190.4condition; and
190.5    (3) the plan must include the total budget amount available divided into monthly
190.6amounts that cover the number of months of personal care assistant services authorization
190.7included in the budget. The amount used each month may vary, but additional funds shall
190.8not be provided above the annual personal care assistant services authorized amount
190.9unless a change in condition is documented.
190.10    (b) The commissioner shall:
190.11    (1) establish the format and criteria for the plan as well as the requirements for
190.12providers who assist with plan development;
190.13    (2) review the assessment and plan and, within 30 days after receiving the
190.14assessment and plan, make a decision on approval of the plan;
190.15    (3) notify the recipient, parent, or guardian of approval or denial of the plan and
190.16provide notice of the right to appeal under section 256.045; and
190.17    (4) provide a copy of the plan to the fiscal support entity selected by the recipient.
190.18    Subd. 6. Services covered. (a) Services covered under the self-directed supports
190.19option include:
190.20    (1) personal care assistant services under section 256B.0655; and
190.21    (2) items, related services, and supports, including assistive technology, that increase
190.22independence or substitute for human assistance to the extent expenditures would
190.23otherwise be used for human assistance.
190.24    (b) Items, supports, and related services purchased under this option shall not be
190.25considered home care services for the purposes of section 144A.43.
190.26    Subd. 7. Noncovered services. Services or supports that are not eligible for
190.27payment under the self-directed supports option include:
190.28    (1) services, goods, or supports that do not benefit the recipient;
190.29    (2) any fees incurred by the recipient, such as Minnesota health care program fees
190.30and co-pays, legal fees, or costs related to advocate agencies;
190.31    (3) insurance, except for insurance costs related to employee coverage or fiscal
190.32support entity payments;
190.33    (4) room and board and personal items that are not related to the disability, except
190.34that medically prescribed specialized diet items may be covered if they reduce the need for
190.35human assistance;
190.36    (5) home modifications that add square footage;
191.1    (6) home modifications for a residence other than the primary residence of the
191.2recipient, or in the event of a minor with parents not living together, the primary residences
191.3of the parents;
191.4    (7) expenses for travel, lodging, or meals related to training the recipient, the parent
191.5or guardian of an adult recipient, or the parent or guardian of a minor child, or paid or
191.6unpaid caregivers that exceed $500 in a 12-month period;
191.7    (8) experimental treatment;
191.8    (9) any service or item covered by other medical assistance state plan services,
191.9including prescription and over-the-counter medications, compounds, and solutions and
191.10related fees, including premiums and co-payments;
191.11    (10) membership dues or costs, except when the service is necessary and appropriate
191.12to treat a physical condition or to improve or maintain the recipient's physical condition.
191.13The condition must be identified in the recipient's plan of care and monitored by a
191.14Minnesota health care program enrolled physician;
191.15    (11) vacation expenses other than the cost of direct services;
191.16    (12) vehicle maintenance or modifications not related to the disability;
191.17    (13) tickets and related costs to attend sporting or other recreational events; and
191.18    (14) costs related to Internet access, except when necessary for operation of assistive
191.19technology, to increase independence, or to substitute for human assistance.
191.20    Subd. 8. Self-directed budget requirements. The budget for the provision of the
191.21self-directed service option shall be equal to the greater of either:
191.22    (1) the annual amount of personal care assistant services under section 256B.0655
191.23that the recipient has used in the most recent 12-month period; or
191.24    (2) the amount determined using the consumer support grant methodology under
191.25section 256.476, subdivision 11, except that the budget amount shall include the federal
191.26and nonfederal share of the average service costs.
191.27    Subd. 9. Quality assurance and risk management. (a) The commissioner
191.28shall establish quality assurance and risk management measures for use in developing
191.29and implementing self-directed plans and budgets that (1) recognize the roles and
191.30responsibilities involved in obtaining services in a self-directed manner, and (2) assure
191.31the appropriateness of such plans and budgets based upon a recipient's resources and
191.32capabilities. These measures must include (i) background studies, and (ii) backup and
191.33emergency plans, including disaster planning.
191.34    (b) The commissioner shall provide ongoing technical assistance and resource and
191.35educational materials for families and recipients selecting the self-directed option.
192.1    (c) Performance assessments measures, such as of a recipient's satisfaction with the
192.2services and supports, and ongoing monitoring of health and well-being shall be identified
192.3in consultation with the stakeholder group.
192.4    Subd. 10. Fiscal support entity. (a) Each recipient shall choose a fiscal support
192.5entity provider certified by the commissioner to make payments for services, items,
192.6supports, and administrative costs related to managing a self-directed service plan
192.7authorized for payment in the approved plan and budget. Recipients shall also choose
192.8the payroll, agency with choice, or the fiscal conduit model of financial and service
192.9management.
192.10    (b) The fiscal support entity:
192.11    (1) may not limit or restrict the recipient's choice of service or support providers,
192.12including use of the payroll, agency with choice, or fiscal conduit model of financial
192.13and service management;
192.14    (2) must have a written agreement with the recipient or the recipient's representative
192.15that identifies the duties and responsibilities to be performed and the specific related
192.16charges;
192.17    (3) must provide the recipient and the home care targeted case manager with a
192.18monthly written summary of the self-directed supports option services that were billed,
192.19including charges from the fiscal support entity;
192.20    (4) must be knowledgeable of and comply with Internal Revenue Service
192.21requirements necessary to process employer and employee deductions, provide appropriate
192.22and timely submission of employer tax liabilities, and maintain documentation to support
192.23medical assistance claims;
192.24    (5) must have current and adequate liability insurance and bonding and sufficient
192.25cash flow and have on staff or under contract a certified public accountant or an individual
192.26with a baccalaureate degree in accounting; and
192.27    (6) must maintain records to track all self-directed supports option services
192.28expenditures, including time records of persons paid to provide supports and receipts for
192.29any goods purchased. The records must be maintained for a minimum of five years from
192.30the claim date and be available for audit or review upon request. Claims submitted by
192.31the fiscal support entity must correspond with services, amounts, and time periods as
192.32authorized in the recipient's self-directed supports option plan.
192.33    (c) The commissioner shall have authority to:
192.34    (1) set or negotiate rates with fiscal support entities;
192.35    (2) limit the number of fiscal support entities;
193.1    (3) identify a process to certify and recertify fiscal support entities and assure fiscal
193.2support entities are available to recipients throughout the state; and
193.3    (4) establish a uniform format and protocol to be used by eligible fiscal support
193.4entities.
193.5    Subd. 11. Stakeholder consultation. The commissioner shall consult with a
193.6statewide consumer-directed services stakeholder group, including representatives of
193.7all types of consumer-directed service users, advocacy organizations, counties, and
193.8consumer-directed service providers. The commissioner shall seek recommendations
193.9from this stakeholder group in developing:
193.10    (1) the self-directed plan format;
193.11    (2) requirements and guidelines for the person-centered plan assessment and
193.12planning process;
193.13    (3) implementation of the option and the quality assurance and risk management
193.14techniques; and
193.15    (4) standards and requirements, including rates for the personal support plan
193.16development provider and the fiscal support entity; policies; training; and implementation.
193.17The stakeholder group shall provide recommendations on the repeal of the personal care
193.18assistant choice option, transition issues, and whether the consumer support grant program
193.19under section 256.476 should be modified. The stakeholder group shall meet at least
193.20three times each year to provide advice on policy, implementation, and other aspects of
193.21consumer and self-directed services.
193.22EFFECTIVE DATE.Subdivisions 1 to 10 are effective upon federal approval of
193.23the state Medicaid plan amendment. The commissioner of human services shall inform
193.24the Office of the Revisor of Statutes when federal approval is obtained. Subdivision 11
193.25is effective July 1, 2007.

193.26    Sec. 27. Minnesota Statutes 2006, section 256B.0911, subdivision 3a, is amended to
193.27read:
193.28    Subd. 3a. Assessment and support planning. (a) Persons requesting assessment,
193.29services planning, or other assistance intended to support community-based living,
193.30including persons who need assessment in order to determine waiver or alternative care
193.31program eligibility, must be visited by a long-term care consultation team within ten
193.32working days after the date on which an assessment was requested or recommended.
193.33Assessments must be conducted according to paragraphs (b) to (g) (i).
193.34    (b) The county may utilize a team of either the social worker or public health nurse,
193.35or both, to conduct the assessment in a face-to-face interview. The consultation team
194.1members must confer regarding the most appropriate care for each individual screened or
194.2assessed.
194.3    (c) The long-term care consultation team must assess the health and social needs of
194.4the person, using an assessment form provided by the commissioner.
194.5    (d) The team must conduct the assessment in a face-to-face interview with the
194.6person being assessed and the person's legal representative, if applicable.
194.7    (e) The team must provide the person, or the person's legal representative, with
194.8written recommendations for facility- or community-based services. The team must
194.9document that the most cost-effective alternatives available were offered to the individual.
194.10For purposes of this requirement, "cost-effective alternatives" means community services
194.11and living arrangements that cost the same as or less than nursing facility care.
194.12    (f) If the person chooses to use community-based services, the team must provide
194.13the person or the person's legal representative with a written community support plan,
194.14regardless of whether the individual is eligible for Minnesota health care programs.
194.15The person may request assistance in developing a community support plan without
194.16participating in a complete assessment.
194.17    (g) The person has the right to make the final decision between nursing facility
194.18placement and community placement after the screening team's recommendation, except
194.19as provided in subdivision 4a, paragraph (c).
194.20    (h) The team must give the person receiving assessment or support planning, or
194.21the person's legal representative, materials, and forms supplied by the commissioner
194.22containing the following information:
194.23    (1) the need for and purpose of preadmission screening and assessment if the person
194.24selects nursing facility placement;
194.25    (2) the role of the long-term care consultation assessment and support planning in
194.26waiver and alternative care program eligibility determination;
194.27    (2) (3) information about Minnesota health care programs;
194.28    (3) (4) the person's freedom to accept or reject the recommendations of the team;
194.29    (4) (5) the person's right to confidentiality under the Minnesota Government Data
194.30Practices Act, chapter 13; and
194.31    (6) the long-term care consultant's decision regarding the person's need for nursing
194.32facility level of care;
194.33    (5) (7) the person's right to appeal the decision regarding the need for nursing facility
194.34level of care or the county's final decisions regarding public programs eligibility according
194.35to section 256.045, subdivision 3.
195.1    (i) Face-to-face assessment completed as part of eligibility determination for
195.2the alternative care, elderly waiver, community alternatives for disabled individuals,
195.3community alternative care, and traumatic brain injury waiver programs under sections
195.4256B.0915, 256B.0917, and 256B.49 is valid to establish service eligibility for no more
195.5than 60 calendar days after the date of assessment. The effective eligibility start date
195.6for these programs can never be prior to the date of assessment. If an assessment was
195.7completed more than 60 days before the effective waiver or alternative care program
195.8eligibility start date, assessment and support plan information must be updated in a
195.9face-to-face visit and documented in the department's Medicaid Management Information
195.10System (MMIS). The effective date of program eligibility in this case cannot be prior to
195.11the date the updated assessment is completed.

195.12    Sec. 28. Minnesota Statutes 2006, section 256B.0911, subdivision 3b, is amended to
195.13read:
195.14    Subd. 3b. Transition assistance. (a) A long-term care consultation team shall
195.15provide assistance to persons residing in a nursing facility, hospital, regional treatment
195.16center, or intermediate care facility for persons with developmental disabilities who
195.17request or are referred for assistance. Transition assistance must include assessment,
195.18community support plan development, referrals to Minnesota health care programs,
195.19and referrals to programs that provide assistance with housing. Transition assistance
195.20must also include information about the Centers for Independent Living and about other
195.21organizations that can provide assistance with relocation efforts, and information about
195.22contacting these organizations to obtain their assistance and support.
195.23    (b) The county shall develop transition processes with institutional social workers
195.24and discharge planners to ensure that:
195.25    (1) persons admitted to facilities receive information about transition assistance
195.26that is available;
195.27    (2) the assessment is completed for persons within ten working days of the date of
195.28request or recommendation for assessment; and
195.29    (3) there is a plan for transition and follow-up for the individual's return to the
195.30community. The plan must require notification of other local agencies when a person
195.31who may require assistance is screened by one county for admission to a facility located
195.32in another county.
195.33    (c) If a person who is eligible for a Minnesota health care program is admitted to a
195.34nursing facility, the nursing facility must include a consultation team member or the case
195.35manager in the discharge planning process.

196.1    Sec. 29. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
196.2subdivision to read:
196.3    Subd. 3c. Transition to housing with services. (a) Transitional consultation shall
196.4be offered to all prospective residents 65 years of age or older regardless of income, assets,
196.5or funding sources before housing with services establishments offering or providing
196.6assisted living execute a lease or contract with the prospective resident. The purpose of
196.7transitional long-term care consultation is to support persons with current or anticipated
196.8long-term care needs in making informed choices among options that include the most
196.9cost-effective and least restrictive settings, and to delay spenddown to eligibility for
196.10publicly funded programs by connecting people to alternative services in their homes
196.11before transition to housing with services.
196.12    (b) Transitional consultation services are provided as determined by the
196.13commissioner of human services in partnership with county long-term care consultation
196.14units, and the Area Agencies on Aging, and are a combination of telephone-based
196.15and in-person assistance provided under models developed by the commissioner. The
196.16consultation is to be performed in a manner which provides objective and complete
196.17information. Transitional consultation must be provided within five working days of the
196.18request of the prospective resident as follows:
196.19    (1) the consultation must be provided by a qualified professional as determined by
196.20the commissioner;
196.21    (2) the consultation must include a review of the prospective resident's reasons for
196.22considering assisted living, the prospective resident's personal goals, a discussion of the
196.23prospective resident's immediate and projected long-term care needs, and alternative
196.24community services or assisted living settings that may meet the prospective resident's
196.25needs; and
196.26    (3) the prospective resident will be informed of the availability of long-term care
196.27consultation services described in subdivision 3a that are available at no charge to the
196.28prospective resident to assist the prospective resident in assessment and planning to
196.29meet the prospective resident's long-term care needs. Regardless of the consultation,
196.30prospective residents maintain the right to choose housing with services or assisted living,
196.31if that is their choice.
196.32EFFECTIVE DATE.This section is effective October 1, 2008.

196.33    Sec. 30. Minnesota Statutes 2006, section 256B.0911, subdivision 4b, is amended to
196.34read:
197.1    Subd. 4b. Exemptions and emergency admissions. (a) Exemptions from the
197.2federal screening requirements outlined in subdivision 4a, paragraphs (b) and (c), are
197.3limited to:
197.4    (1) a person who, having entered an acute care facility from a certified nursing
197.5facility, is returning to a certified nursing facility;
197.6    (2) a person transferring from one certified nursing facility in Minnesota to another
197.7certified nursing facility in Minnesota; and
197.8    (3) a person, 21 years of age or older, who satisfies the following criteria, as specified
197.9in Code of Federal Regulations, title 42, section 483.106(b)(2):
197.10    (i) the person is admitted to a nursing facility directly from a hospital after receiving
197.11acute inpatient care at the hospital;
197.12    (ii) the person requires nursing facility services for the same condition for which
197.13care was provided in the hospital; and
197.14    (iii) the attending physician has certified before the nursing facility admission that
197.15the person is likely to receive less than 30 days of nursing facility services.
197.16    (b) Persons who are exempt from preadmission screening for purposes of level of
197.17care determination include:
197.18    (1) persons described in paragraph (a);
197.19    (2) an individual who has a contractual right to have nursing facility care paid for
197.20indefinitely by the veterans' administration;
197.21    (3) an individual enrolled in a demonstration project under section 256B.69,
197.22subdivision 8 , at the time of application to a nursing facility; and
197.23    (4) an individual currently being served under the alternative care program or under
197.24a home and community-based services waiver authorized under section 1915(c) of the
197.25federal Social Security Act; and.
197.26    (5) individuals admitted to a certified nursing facility for a short-term stay, which
197.27is expected to be 14 days or less in duration based upon a physician's certification, and
197.28who have been assessed and approved for nursing facility admission within the previous
197.29six months. This exemption applies only if the consultation team member determines at
197.30the time of the initial assessment of the six-month period that it is appropriate to use the
197.31nursing facility for short-term stays and that there is an adequate plan of care for return to
197.32the home or community-based setting. If a stay exceeds 14 days, the individual must be
197.33referred no later than the first county working day following the 14th resident day for a
197.34screening, which must be completed within five working days of the referral. The payment
197.35limitations in subdivision 7 apply to an individual found at screening to not meet the level
197.36of care criteria for admission to a certified nursing facility.
198.1    (c) Persons admitted to a Medicaid-certified nursing facility from the community
198.2on an emergency basis as described in paragraph (d) or from an acute care facility on a
198.3nonworking day must be screened the first working day after admission.
198.4    (d) Emergency admission to a nursing facility prior to screening is permitted when
198.5all of the following conditions are met:
198.6    (1) a person is admitted from the community to a certified nursing or certified
198.7boarding care facility during county nonworking hours;
198.8    (2) a physician has determined that delaying admission until preadmission screening
198.9is completed would adversely affect the person's health and safety;
198.10    (3) there is a recent precipitating event that precludes the client from living safely in
198.11the community, such as sustaining an injury, sudden onset of acute illness, or a caregiver's
198.12inability to continue to provide care;
198.13    (4) the attending physician has authorized the emergency placement and has
198.14documented the reason that the emergency placement is recommended; and
198.15    (5) the county is contacted on the first working day following the emergency
198.16admission.
198.17Transfer of a patient from an acute care hospital to a nursing facility is not considered
198.18an emergency except for a person who has received hospital services in the following
198.19situations: hospital admission for observation, care in an emergency room without hospital
198.20admission, or following hospital 24-hour bed care.
198.21    (e) A nursing facility must provide a written notice to persons who satisfy the criteria
198.22in paragraph (a), clause (3), information to all persons admitted regarding the person's
198.23right to request and receive long-term care consultation services as defined in subdivision
198.241a. The notice information must be provided prior to the person's discharge from the
198.25facility and in a format specified by the commissioner.

198.26    Sec. 31. Minnesota Statutes 2006, section 256B.0911, subdivision 4c, is amended to
198.27read:
198.28    Subd. 4c. Screening requirements. (a) A person may be screened for nursing
198.29facility admission by telephone or in a face-to-face screening interview. Consultation team
198.30members shall identify each individual's needs using the following categories:
198.31    (1) the person needs no face-to-face screening interview to determine the need
198.32for nursing facility level of care based on information obtained from other health care
198.33professionals;
199.1    (2) the person needs an immediate face-to-face screening interview to determine the
199.2need for nursing facility level of care and complete activities required under subdivision
199.34a; or
199.4    (3) the person may be exempt from screening requirements as outlined in subdivision
199.54b, but will need transitional assistance after admission or in-person follow-along after
199.6a return home.
199.7    (b) Persons admitted on a nonemergency basis to a Medicaid-certified nursing
199.8facility must be screened prior to admission.
199.9    (c) The long-term care consultation team shall recommend a case mix classification
199.10for persons admitted to a certified nursing facility when sufficient information is received
199.11to make that classification. The nursing facility is authorized to conduct all case mix
199.12assessments for persons who have been screened prior to admission for whom the county
199.13did not recommend a case mix classification. The nursing facility is authorized to conduct
199.14all case mix assessments for persons admitted to the facility prior to a preadmission
199.15screening. The county retains the responsibility of distributing appropriate case mix
199.16forms to the nursing facility.
199.17    (d) (c) The county screening or intake activity must include processes to identify
199.18persons who may require transition assistance as described in subdivision 3b.

199.19    Sec. 32. Minnesota Statutes 2006, section 256B.0911, subdivision 6, is amended to
199.20read:
199.21    Subd. 6. Payment for long-term care consultation services. (a) The total payment
199.22for each county must be paid monthly by certified nursing facilities in the county. The
199.23monthly amount to be paid by each nursing facility for each fiscal year must be determined
199.24by dividing the county's annual allocation for long-term care consultation services by 12
199.25to determine the monthly payment and allocating the monthly payment to each nursing
199.26facility based on the number of licensed beds in the nursing facility. Payments to counties
199.27in which there is no certified nursing facility must be made by increasing the payment
199.28rate of the two facilities located nearest to the county seat.
199.29    (b) The commissioner shall include the total annual payment determined under
199.30paragraph (a) for each nursing facility reimbursed under section 256B.431 or 256B.434
199.31according to section 256B.431, subdivision 2b, paragraph (g), or 256B.435.
199.32    (c) In the event of the layaway, delicensure and decertification, or removal from
199.33layaway of 25 percent or more of the beds in a facility, the commissioner may adjust
199.34the per diem payment amount in paragraph (b) and may adjust the monthly payment
199.35amount in paragraph (a). The effective date of an adjustment made under this paragraph
200.1shall be on or after the first day of the month following the effective date of the layaway,
200.2delicensure and decertification, or removal from layaway.
200.3    (d) Payments for long-term care consultation services are available to the county
200.4or counties to cover staff salaries and expenses to provide the services described in
200.5subdivision 1a. The county shall employ, or contract with other agencies to employ, within
200.6the limits of available funding, sufficient personnel to provide long-term care consultation
200.7services while meeting the state's long-term care outcomes and objectives as defined in
200.8section 256B.0917, subdivision 1. The county shall be accountable for meeting local
200.9objectives as approved by the commissioner in the biennial home and community-based
200.10services quality assurance plan on a form provided by the commissioner.
200.11    (e) Notwithstanding section 256B.0641, overpayments attributable to payment of the
200.12screening costs under the medical assistance program may not be recovered from a facility.
200.13    (f) The commissioner of human services shall amend the Minnesota medical
200.14assistance plan to include reimbursement for the local consultation teams.
200.15    (g) The county may bill, as case management services, assessments, support
200.16planning, and follow-along provided to persons determined to be eligible for case
200.17management under Minnesota health care programs. No individual or family member
200.18shall be charged for an initial assessment or initial support plan development provided
200.19under subdivision 3a or 3b.

200.20    Sec. 33. Minnesota Statutes 2006, section 256B.0911, is amended by adding a
200.21subdivision to read:
200.22    Subd. 6a. Withholding. If any provider obligated to pay the long-term care
200.23consultation amount as described in subdivision 6 is more than two months delinquent in
200.24the timely payment of the monthly installment, the commissioner may withhold payments,
200.25penalties, and interest in accordance with the methods outlined in section 256.9657,
200.26subdivision 7a. Any amount withheld under this provision must be returned to the county
200.27to whom the delinquent payments were due.

200.28    Sec. 34. Minnesota Statutes 2006, section 256B.0911, subdivision 7, is amended to
200.29read:
200.30    Subd. 7. Reimbursement for certified nursing facilities. (a) Medical assistance
200.31reimbursement for nursing facilities shall be authorized for a medical assistance recipient
200.32only if a preadmission screening has been conducted prior to admission or the county has
200.33authorized an exemption. Medical assistance reimbursement for nursing facilities shall
200.34not be provided for any recipient who the local screener has determined does not meet the
201.1level of care criteria for nursing facility placement or, if indicated, has not had a level II
201.2OBRA evaluation as required under the federal Omnibus Budget Reconciliation Act of
201.31987 completed unless an admission for a recipient with mental illness is approved by the
201.4local mental health authority or an admission for a recipient with developmental disability
201.5is approved by the state developmental disability authority.
201.6    (b) The nursing facility must not bill a person who is not a medical assistance
201.7recipient for resident days that preceded the date of completion of screening activities as
201.8required under subdivisions 4a, 4b, and 4c. The nursing facility must include unreimbursed
201.9resident days in the nursing facility resident day totals reported to the commissioner.
201.10    (c) The commissioner shall make a request to the Centers for Medicare and Medicaid
201.11Services for a waiver allowing team approval of Medicaid payments for certified nursing
201.12facility care. An individual has a choice and makes the final decision between nursing
201.13facility placement and community placement after the screening team's recommendation,
201.14except as provided in subdivision 4a, paragraph (c).

201.15    Sec. 35. Minnesota Statutes 2006, section 256B.0913, subdivision 4, is amended to
201.16read:
201.17    Subd. 4. Eligibility for funding for services for nonmedical assistance recipients.
201.18    (a) Funding for services under the alternative care program is available to persons who
201.19meet the following criteria:
201.20    (1) the person has been determined by a community assessment under section
201.21256B.0911 to be a person who would require the level of care provided in a nursing
201.22facility, but for the provision of services under the alternative care program;
201.23    (2) the person is age 65 or older;
201.24    (3) the person would be eligible for medical assistance within 135 days of admission
201.25to a nursing facility;
201.26    (4) the person is not ineligible for the payment of long-term care services by the
201.27medical assistance program due to an asset transfer penalty under section 256B.0595 or
201.28equity interest in the home exceeding $500,000 as stated in section 256B.056;
201.29    (5) the person needs long-term care services that are not funded through other state
201.30or federal funding;
201.31    (6) the monthly cost of the alternative care services funded by the program for
201.32this person does not exceed 75 percent of the monthly limit described under section
201.33256B.0915, subdivision 3a . This monthly limit does not prohibit the alternative care client
201.34from payment for additional services, but in no case may the cost of additional services
201.35purchased under this section exceed the difference between the client's monthly service
202.1limit defined under section 256B.0915, subdivision 3, and the alternative care program
202.2monthly service limit defined in this paragraph. If medical care-related supplies and
202.3equipment or environmental modifications and adaptations are or will be purchased for
202.4an alternative care services recipient, the costs may be prorated on a monthly basis for
202.5up to 12 consecutive months beginning with the month of purchase. If the monthly cost
202.6of a recipient's other alternative care services exceeds the monthly limit established in
202.7this paragraph, the annual cost of the alternative care services shall be determined. In this
202.8event, the annual cost of alternative care services shall not exceed 12 times the monthly
202.9limit described in this paragraph; and
202.10    (7) the person is making timely payments of the assessed monthly fee.
202.11A person is ineligible if payment of the fee is over 60 days past due, unless the person
202.12agrees to:
202.13    (i) the appointment of a representative payee;
202.14    (ii) automatic payment from a financial account;
202.15    (iii) the establishment of greater family involvement in the financial management of
202.16payments; or
202.17    (iv) another method acceptable to the county lead agency to ensure prompt fee
202.18payments.
202.19    The county shall lead agency may extend the client's eligibility as necessary while
202.20making arrangements to facilitate payment of past-due amounts and future premium
202.21payments. Following disenrollment due to nonpayment of a monthly fee, eligibility shall
202.22not be reinstated for a period of 30 days.
202.23    (b) Alternative care funding under this subdivision is not available for a person
202.24who is a medical assistance recipient or who would be eligible for medical assistance
202.25without a spenddown or waiver obligation. A person whose initial application for medical
202.26assistance and the elderly waiver program is being processed may be served under the
202.27alternative care program for a period up to 60 days. If the individual is found to be eligible
202.28for medical assistance, medical assistance must be billed for services payable under the
202.29federally approved elderly waiver plan and delivered from the date the individual was
202.30found eligible for the federally approved elderly waiver plan. Notwithstanding this
202.31provision, alternative care funds may not be used to pay for any service the cost of which:
202.32(i) is payable by medical assistance; (ii) is used by a recipient to meet a waiver obligation;
202.33or (iii) is used to pay a medical assistance income spenddown for a person who is eligible
202.34to participate in the federally approved elderly waiver program under the special income
202.35standard provision.
203.1    (c) Alternative care funding is not available for a person who resides in a licensed
203.2nursing home, certified boarding care home, hospital, or intermediate care facility, except
203.3for case management services which are provided in support of the discharge planning
203.4process for a nursing home resident or certified boarding care home resident to assist with
203.5a relocation process to a community-based setting.
203.6    (d) Alternative care funding is not available for a person whose income is greater
203.7than the maintenance needs allowance under section 256B.0915, subdivision 1d, but equal
203.8to or less than 120 percent of the federal poverty guideline effective July 1 in the fiscal
203.9year for which alternative care eligibility is determined, who would be eligible for the
203.10elderly waiver with a waiver obligation.

203.11    Sec. 36. Minnesota Statutes 2006, section 256B.0913, subdivision 5, is amended to
203.12read:
203.13    Subd. 5. Services covered under alternative care. Alternative care funding may
203.14be used for payment of costs of:
203.15    (1) adult day care;
203.16    (2) home health aide;
203.17    (3) homemaker services;
203.18    (4) personal care;
203.19    (5) case management;
203.20    (6) respite care;
203.21    (7) care-related supplies and equipment;
203.22    (8) meals delivered to the home;
203.23    (9) nonmedical transportation;
203.24    (10) nursing services;
203.25    (11) chore services;
203.26    (12) companion services;
203.27    (13) nutrition services;
203.28    (14) training for direct informal caregivers;
203.29    (15) telehome care to provide services in their own homes in conjunction with
203.30in-home visits;
203.31    (16) discretionary services, for which counties may make payment from their
203.32alternative care program allocation or services not otherwise defined in this section
203.33or section 256B.0625, following approval by the commissioner consumer-directed
203.34community services under the alternative care programs which are available statewide and
203.35limited to the average monthly expenditures representative of all alternative care program
204.1participants for the same case mix resident class assigned in the most recent fiscal year for
204.2which complete expenditure data is available;
204.3    (17) environmental modifications and adaptations; and
204.4    (18) direct cash payments for which counties may make payment from their
204.5alternative care program allocation to clients for the purpose of purchasing services,
204.6following approval by the commissioner, and subject to the provisions of subdivision 5h,
204.7until approval and implementation of consumer-directed services through the federally
204.8approved elderly waiver plan. Upon implementation, consumer-directed services under
204.9the alternative care program are available statewide and limited to the average monthly
204.10expenditures representative of all alternative care program participants for the same case
204.11mix resident class assigned in the most recent fiscal year for which complete expenditure
204.12data is available discretionary services, for which lead agencies may make payment from
204.13their alternative care program allocation for services not otherwise defined in this section
204.14or section 256B.0625, following approval by the commissioner.
204.15    Total annual payments for discretionary services and direct cash payments, until
204.16the federally approved consumer-directed service option is implemented statewide, for
204.17all clients within a county may served by a lead agency must not exceed 25 percent of
204.18that county's lead agency's annual alternative care program base allocation. Thereafter,
204.19discretionary services are limited to 25 percent of the county's annual alternative care
204.20program base allocation.

204.21    Sec. 37. Minnesota Statutes 2006, section 256B.0913, subdivision 5a, is amended to
204.22read:
204.23    Subd. 5a. Services; service definitions; service standards. (a) Unless specified in
204.24statute, the services, service definitions, and standards for alternative care services shall
204.25be the same as the services, service definitions, and standards specified in the federally
204.26approved elderly waiver plan, except for alternative care does not cover transitional
204.27support services, assisted living services, adult foster care services, and residential care
204.28services and benefits defined under section 256B.0625 that meet primary and acute
204.29health care needs.
204.30    (b) The county lead agency must ensure that the funds are not used to supplant
204.31or supplement services available through other public assistance or services programs.,
204.32including supplementation of client co-pays, deductibles, premiums, or other cost-sharing
204.33arrangements for health-related benefits and services or entitlement programs and services
204.34that are available to the person, but in which they have elected not to enroll. For a provider
204.35of supplies and equipment when the monthly cost of the supplies and equipment is less
205.1than $250, persons or agencies must be employed by or under a contract with the county
205.2lead agency or the public health nursing agency of the local board of health in order to
205.3receive funding under the alternative care program. Supplies and equipment may be
205.4purchased from a vendor not certified to participate in the Medicaid program if the cost for
205.5the item is less than that of a Medicaid vendor.
205.6    (c) Personal care services must meet the service standards defined in the federally
205.7approved elderly waiver plan, except that a county lead agency may contract with a
205.8client's relative who meets the relative hardship waiver requirements or a relative who
205.9meets the criteria and is also the responsible party under an individual service plan that
205.10ensures the client's health and safety and supervision of the personal care services by a
205.11qualified professional as defined in section 256B.0625, subdivision 19c. Relative hardship
205.12is established by the county lead agency when the client's care causes a relative caregiver
205.13to do any of the following: resign from a paying job, reduce work hours resulting in lost
205.14wages, obtain a leave of absence resulting in lost wages, incur substantial client-related
205.15expenses, provide services to address authorized, unstaffed direct care time, or meet
205.16special needs of the client unmet in the formal service plan.

205.17    Sec. 38. Minnesota Statutes 2006, section 256B.0913, subdivision 8, is amended to
205.18read:
205.19    Subd. 8. Requirements for individual care plan. (a) The case manager shall
205.20implement the plan of care for each alternative care client and ensure that a client's
205.21service needs and eligibility are reassessed at least every 12 months. The plan shall
205.22include any services prescribed by the individual's attending physician as necessary to
205.23allow the individual to remain in a community setting. In developing the individual's care
205.24plan, the case manager should include the use of volunteers from families and neighbors,
205.25religious organizations, social clubs, and civic and service organizations to support the
205.26formal home care services. The county lead agency shall be held harmless for damages or
205.27injuries sustained through the use of volunteers under this subdivision including workers'
205.28compensation liability. The county of service case manager shall provide documentation
205.29in each individual's plan of care and, if requested, to the commissioner that the most
205.30cost-effective alternatives available have been offered to the individual and that the
205.31individual was free to choose among available qualified providers, both public and private,
205.32including qualified case management or service coordination providers other than those
205.33employed by any county; however, the county or tribe maintains responsibility for prior
205.34authorizing services in accordance with statutory and administrative requirements. The
206.1case manager must give the individual a ten-day written notice of any denial, termination,
206.2or reduction of alternative care services.
206.3    (b) The county of service or tribe must provide access to and arrange for case
206.4management services, including assuring implementation of the plan. "County of service"
206.5has the meaning given it in Minnesota Rules, part 9505.0015, subpart 11. The county of
206.6service must notify the county of financial responsibility of the approved care plan and
206.7the amount of encumbered funds.

206.8    Sec. 39. Minnesota Statutes 2006, section 256B.0913, subdivision 9, is amended to
206.9read:
206.10    Subd. 9. Contracting provisions for providers. Alternative care funds paid to
206.11service providers are subject to audit by the commissioner for fiscal and utilization control.
206.12    The lead agency must select providers for contracts or agreements using the
206.13following criteria and other criteria established by the county lead agency:
206.14    (1) the need for the particular services offered by the provider;
206.15    (2) the population to be served, including the number of clients, the length of time
206.16services will be provided, and the medical condition of clients;
206.17    (3) the geographic area to be served;
206.18    (4) quality assurance methods, including appropriate licensure, certification, or
206.19standards, and supervision of employees when needed;
206.20    (5) rates for each service and unit of service exclusive of county lead agency
206.21administrative costs;
206.22    (6) evaluation of services previously delivered by the provider; and
206.23    (7) contract or agreement conditions, including billing requirements, cancellation,
206.24and indemnification.
206.25    The county lead agency must evaluate its own agency services under the criteria
206.26established for other providers.

206.27    Sec. 40. Minnesota Statutes 2006, section 256B.0913, subdivision 10, is amended to
206.28read:
206.29    Subd. 10. Allocation formula. (a) The alternative care appropriation for fiscal
206.30years 1992 and beyond shall cover only alternative care eligible clients. By July 1 15 of
206.31each year, the commissioner shall allocate to county agencies the state funds available for
206.32alternative care for persons eligible under subdivision 2.
206.33    (b) The adjusted base for each county lead agency is the county's lead agency's
206.34current fiscal year base allocation plus any targeted funds approved during the current
207.1fiscal year. Calculations for paragraphs (c) and (d) are to be made as follows: for each
207.2county lead agency, the determination of alternative care program expenditures shall be
207.3based on payments for services rendered from April 1 through March 31 in the base year,
207.4to the extent that claims have been submitted and paid by June 1 of that year.
207.5    (c) If the alternative care program expenditures as defined in paragraph (b) are 95
207.6percent or more of the county's lead agency's adjusted base allocation, the allocation for
207.7the next fiscal year is 100 percent of the adjusted base, plus inflation to the extent that
207.8inflation is included in the state budget.
207.9    (d) If the alternative care program expenditures as defined in paragraph (b) are less
207.10than 95 percent of the county's lead agency's adjusted base allocation, the allocation
207.11for the next fiscal year is the adjusted base allocation less the amount of unspent funds
207.12below the 95 percent level.
207.13    (e) If the annual legislative appropriation for the alternative care program is
207.14inadequate to fund the combined county lead agency allocations for a biennium, the
207.15commissioner shall distribute to each county lead agency the entire annual appropriation
207.16as that county's lead agency's percentage of the computed base as calculated in paragraphs
207.17(c) and (d).
207.18    (f) On agreement between the commissioner and the lead agency, the commissioner
207.19may have discretion to reallocate alternative care base allocations distributed to lead
207.20agencies in which the base amount exceeds program expenditures.

207.21    Sec. 41. Minnesota Statutes 2006, section 256B.0913, subdivision 11, is amended to
207.22read:
207.23    Subd. 11. Targeted funding. (a) The purpose of targeted funding is to make
207.24additional money available to counties lead agencies with the greatest need. Targeted
207.25funds are not intended to be distributed equitably among all counties lead agencies, but
207.26rather, allocated to those with long-term care strategies that meet state goals.
207.27    (b) The funds available for targeted funding shall be the total appropriation for each
207.28fiscal year minus county lead agency allocations determined under subdivision 10 as
207.29adjusted for any inflation increases provided in appropriations for the biennium.
207.30    (c) The commissioner shall allocate targeted funds to counties lead agencies that
207.31demonstrate to the satisfaction of the commissioner that they have developed feasible
207.32plans to increase alternative care spending. In making targeted funding allocations, the
207.33commissioner shall use the following priorities:
208.1    (1) counties lead agencies that received a lower allocation in fiscal year 1991 than in
208.2fiscal year 1990. Counties remain in this priority until they have been restored to their
208.3fiscal year 1990 level plus inflation;
208.4    (2) counties lead agencies that sustain a base allocation reduction for failure to spend
208.595 percent of the allocation if they demonstrate that the base reduction should be restored;
208.6    (3) counties lead agencies that propose projects to divert community residents from
208.7nursing home placement or convert nursing home residents to community living; and
208.8    (4) counties lead agencies that can otherwise justify program growth by
208.9demonstrating the existence of waiting lists, demographically justified needs, or other
208.10unmet needs.
208.11    (d) Counties Lead agencies that would receive targeted funds according to
208.12paragraph (c) must demonstrate to the commissioner's satisfaction that the funds
208.13would be appropriately spent by showing how the funds would be used to further the
208.14state's alternative care goals as described in subdivision 1, and that the county has the
208.15administrative and service delivery capability to use them.
208.16    (e) The commissioner shall request applications make applications available for
208.17targeted funds by November 1 of each year. The counties lead agencies selected for
208.18targeted funds shall be notified of the amount of their additional funding. Targeted funds
208.19allocated to a county lead agency in one year shall be treated as part of the county's lead
208.20agency's base allocation for that year in determining allocations for subsequent years. No
208.21reallocations between counties lead agencies shall be made.

208.22    Sec. 42. Minnesota Statutes 2006, section 256B.0913, subdivision 12, is amended to
208.23read:
208.24    Subd. 12. Client fees. (a) A fee is required for all alternative care eligible clients
208.25to help pay for the cost of participating in the program. The amount of the fee for the
208.26alternative care client shall be determined as follows:
208.27    (1) when the alternative care client's income less recurring and predictable medical
208.28expenses is less than 100 percent of the federal poverty guideline effective on July 1 of
208.29the state fiscal year in which the fee is being computed, and total assets are less than
208.30$10,000, the fee is zero;
208.31    (2) when the alternative care client's income less recurring and predictable medical
208.32expenses is equal to or greater than 100 percent but less than 150 percent of the federal
208.33poverty guideline effective on July 1 of the state fiscal year in which the fee is being
208.34computed, and total assets are less than $10,000, the fee is five percent of the cost of
208.35alternative care services;
209.1    (3) when the alternative care client's income less recurring and predictable medical
209.2expenses is equal to or greater than 150 percent but less than 200 percent of the federal
209.3poverty guidelines effective on July 1 of the state fiscal year in which the fee is being
209.4computed and assets are less than $10,000, the fee is 15 percent of the cost of alternative
209.5care services;
209.6    (4) when the alternative care client's income less recurring and predictable medical
209.7expenses is equal to or greater than 200 percent of the federal poverty guidelines effective
209.8on July 1 of the state fiscal year in which the fee is being computed and assets are less than
209.9$10,000, the fee is 30 percent of the cost of alternative care services; and
209.10    (5) when the alternative care client's assets are equal to or greater than $10,000, the
209.11fee is 30 percent of the cost of alternative care services.
209.12    For married persons, total assets are defined as the total marital assets less the
209.13estimated community spouse asset allowance, under section 256B.059, if applicable. For
209.14married persons, total income is defined as the client's income less the monthly spousal
209.15allotment, under section 256B.058.
209.16    All alternative care services shall be included in the estimated costs for the purpose
209.17of determining the fee.
209.18    Fees are due and payable each month alternative care services are received unless the
209.19actual cost of the services is less than the fee, in which case the fee is the lesser amount.
209.20    (b) The fee shall be waived by the commissioner when:
209.21    (1) a person who is residing in a nursing facility is receiving case management only;
209.22    (2) a married couple is requesting an asset assessment under the spousal
209.23impoverishment provisions;
209.24    (3) a person is found eligible for alternative care, but is not yet receiving alternative
209.25care services including case management services; or
209.26    (4) a person has chosen to participate in a consumer-directed service plan for which
209.27the cost is no greater than the total cost of the person's alternative care service plan less
209.28the monthly fee amount that would otherwise be assessed.
209.29    (c) The county agency must record in the state's receivable system the client's
209.30assessed fee amount or the reason the fee has been waived. The commissioner will bill
209.31and collect the fee from the client. Money collected must be deposited in the general fund
209.32and is appropriated to the commissioner for the alternative care program. The client must
209.33supply the county lead agency with the client's Social Security number at the time of
209.34application. The county lead agency shall supply the commissioner with the client's Social
209.35Security number and other information the commissioner requires to collect the fee from
209.36the client. The commissioner shall collect unpaid fees using the Revenue Recapture Act in
210.1chapter 270A and other methods available to the commissioner. The commissioner may
210.2require counties lead agencies to inform clients of the collection procedures that may be
210.3used by the state if a fee is not paid. This paragraph does not apply to alternative care
210.4pilot projects authorized in Laws 1993, First Special Session chapter 1, article 5, section
210.5133, if a county operating under the pilot project reports the following dollar amounts
210.6to the commissioner quarterly:
210.7    (1) total fees billed to clients;
210.8    (2) total collections of fees billed; and
210.9    (3) balance of fees owed by clients.
210.10If a county lead agency does not adhere to these reporting requirements, the commissioner
210.11may terminate the billing, collecting, and remitting portions of the pilot project and require
210.12the county lead agency involved to operate under the procedures set forth in this paragraph.

210.13    Sec. 43. Minnesota Statutes 2006, section 256B.0913, subdivision 13, is amended to
210.14read:
210.15    Subd. 13. County Lead agency biennial plan. The county lead agency biennial
210.16plan for long-term care consultation services under section 256B.0911, the alternative
210.17care program under this section, and waivers for the elderly under section 256B.0915,
210.18shall be submitted by the lead agency as the home and community-based services quality
210.19assurance plan on a form provided by the commissioner.

210.20    Sec. 44. Minnesota Statutes 2006, section 256B.0913, subdivision 14, is amended to
210.21read:
210.22    Subd. 14. Provider requirements, payment, and rate adjustments. (a) Unless
210.23otherwise specified in statute, providers must be enrolled as Minnesota health care
210.24program providers and abide by the requirements for provider participation according to
210.25Minnesota Rules, part 9505.0195.
210.26    (b) Payment for provided alternative care services as approved by the client's
210.27case manager shall occur through the invoice processing procedures of the department's
210.28Medicaid Management Information System (MMIS). To receive payment, the county lead
210.29agency or vendor must submit invoices within 12 months following the date of service.
210.30The county lead agency and its vendors under contract shall not be reimbursed for services
210.31which exceed the county allocation.
210.32    (c) The county lead agency shall negotiate individual rates with vendors and may
210.33authorize service payment for actual costs up to the county's current approved rate.
210.34Notwithstanding any other rule or statutory provision to the contrary, the commissioner
211.1shall not be authorized to increase rates by an annual inflation factor, unless so authorized
211.2by the legislature. To improve access to community services and eliminate payment
211.3disparities between the alternative care program and the elderly waiver program, the
211.4commissioner shall establish statewide maximum service rate limits and eliminate
211.5county-specific service rate limits.
211.6    (1) Effective July 1, 2001, for service rate limits, except those in subdivision 5,
211.7paragraphs (d) and (i), the rate limit for each service shall be the greater of the alternative
211.8care statewide maximum rate or the elderly waiver statewide maximum rate.
211.9    (2) Counties Lead agencies may negotiate individual service rates with vendors for
211.10actual costs up to the statewide maximum service rate limit.

211.11    Sec. 45. Minnesota Statutes 2006, section 256B.0915, is amended to read:
211.12256B.0915 MEDICAID WAIVER FOR ELDERLY SERVICES.
211.13    Subdivision 1. Authority. The commissioner is authorized to apply for a home
211.14and community-based services waiver for the elderly, authorized under section 1915(c)
211.15of the Social Security Act, in order to obtain federal financial participation to expand
211.16the availability of services for persons who are eligible for medical assistance. The
211.17commissioner may apply for additional waivers or pursue other federal financial
211.18participation which is advantageous to the state for funding home care services for the
211.19frail elderly who are eligible for medical assistance. The provision of waivered services
211.20to elderly and disabled medical assistance recipients must comply with the criteria for
211.21service definitions and provider standards approved in the waiver.
211.22    Subd. 1a. Elderly waiver case management services. (a) Elderly case management
211.23services under the home and community-based services waiver for elderly individuals are
211.24available from providers meeting qualification requirements and the standards specified
211.25in subdivision 1b. Eligible recipients may choose any qualified provider of elderly case
211.26management services.
211.27    Case management services assist individuals who receive waiver services in gaining
211.28access to needed waiver and other state plan services, as well as needed medical, social,
211.29educational, and other services regardless of the funding source for the services to which
211.30access is gained.
211.31    A case aide shall provide assistance to the case manager in carrying out
211.32administrative activities of the case management function. The case aide may not assume
211.33responsibilities that require professional judgment including assessments, reassessments,
211.34and care plan development. The case manager is responsible for providing oversight of
211.35the case aide.
212.1    Case managers shall be responsible for ongoing monitoring of the provision of
212.2services included in the individual's plan of care. Case managers shall initiate and oversee
212.3the process of assessment and reassessment of the individual's care and review plan of
212.4care at intervals specified in the federally approved waiver plan.
212.5    (b) The county of service or tribe must provide access to and arrange for case
212.6management services. County of service has the meaning given it in Minnesota Rules,
212.7part 9505.0015, subpart 11.
212.8    Subd. 1b. Provider qualifications and standards. The commissioner must
212.9enroll qualified providers of elderly case management services under the home
212.10and community-based waiver for the elderly under section 1915(c) of the Social
212.11Security Act. The enrollment process shall ensure the provider's ability to meet the
212.12qualification requirements and standards in this subdivision and other federal and state
212.13requirements of this service. An elderly case management provider is an enrolled medical
212.14assistance provider who is determined by the commissioner to have all of the following
212.15characteristics:
212.16    (1) the demonstrated capacity and experience to provide the components of
212.17case management to coordinate and link community resources needed by the eligible
212.18population;
212.19    (2) administrative capacity and experience in serving the target population for
212.20whom it will provide services and in ensuring quality of services under state and federal
212.21requirements;
212.22    (3) a financial management system that provides accurate documentation of services
212.23and costs under state and federal requirements;
212.24    (4) the capacity to document and maintain individual case records under state and
212.25federal requirements; and
212.26    (5) the county lead agency may allow a case manager employed by the county lead
212.27agency to delegate certain aspects of the case management activity to another individual
212.28employed by the county lead agency provided there is oversight of the individual by
212.29the case manager. The case manager may not delegate those aspects which require
212.30professional judgment including assessments, reassessments, and care plan development.
212.31Lead agencies include counties, health plans, and federally recognized tribes who
212.32authorize services under this section.
212.33    Subd. 1c. Case management activities under the state plan. The commissioner
212.34shall seek an amendment to the home and community-based services waiver for the
212.35elderly to implement the provisions of subdivisions 1a and 1b. If the commissioner
212.36is unable to secure the approval of the secretary of health and human services for the
213.1requested waiver amendment by December 31, 1993, the commissioner shall amend
213.2the medical assistance state plan to provide that case management provided under the
213.3home and community-based services waiver for the elderly is performed by counties
213.4as an administrative function for the proper and effective administration of the state
213.5medical assistance plan. The state shall reimburse counties for the nonfederal share of
213.6costs for case management performed as an administrative function under the home and
213.7community-based services waiver for the elderly.
213.8    Subd. 1d. Posteligibility treatment of income and resources for elderly waiver.
213.9    Notwithstanding the provisions of section 256B.056, the commissioner shall make the
213.10following amendment to the medical assistance elderly waiver program effective July 1,
213.111999, or upon federal approval, whichever is later.
213.12    A recipient's maintenance needs will be an amount equal to the Minnesota
213.13supplemental aid equivalent rate as defined in section 256I.03, subdivision 5, plus the
213.14medical assistance personal needs allowance as defined in section 256B.35, subdivision
213.151 , paragraph (a), when applying posteligibility treatment of income rules to the gross
213.16income of elderly waiver recipients, except for individuals whose income is in excess of
213.17the special income standard according to Code of Federal Regulations, title 42, section
213.18435.236 . Recipient maintenance needs shall be adjusted under this provision each July 1.
213.19    Subd. 2. Spousal impoverishment policies. The commissioner shall seek to amend
213.20the federal waiver and the medical assistance state plan to allow apply:
213.21    (1) the spousal impoverishment criteria as authorized under United States Code, title
213.2242, section 1396r-5, and as implemented in sections 256B.0575, 256B.058, and 256B.059,
213.23except that the amendment shall seek to add to;
213.24    (2) the personal needs allowance permitted in section 256B.0575,; and
213.25    (3) an amount equivalent to the group residential housing rate as set by section
213.26256I.03, subdivision 5 , and according to the approved federal waiver and medical
213.27assistance state plan.
213.28    Subd. 3. Limits of cases. The number of medical assistance waiver recipients that
213.29a county lead agency may serve must be allocated according to the number of medical
213.30assistance waiver cases open on July 1 of each fiscal year. Additional recipients may be
213.31served with the approval of the commissioner.
213.32    Subd. 3a. Elderly waiver cost limits. (a) The monthly limit for the cost of waivered
213.33services to an individual elderly waiver client shall be the weighted average monthly
213.34nursing facility rate of the case mix resident class to which the elderly waiver client would
213.35be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, less the recipient's
213.36maintenance needs allowance as described in subdivision 1d, paragraph (a), until the first
214.1day of the state fiscal year in which the resident assessment system as described in section
214.2256B.437 for nursing home rate determination is implemented. Effective on the first day
214.3of the state fiscal year in which the resident assessment system as described in section
214.4256B.437 for nursing home rate determination is implemented and the first day of each
214.5subsequent state fiscal year, the monthly limit for the cost of waivered services to an
214.6individual elderly waiver client shall be the rate of the case mix resident class to which the
214.7waiver client would be assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,
214.8in effect on the last day of the previous state fiscal year, adjusted by the greater of any
214.9legislatively adopted home and community-based services percentage rate increase or the
214.10average statewide percentage increase in nursing facility payment rates.
214.11    (b) If extended medical supplies and equipment or environmental modifications are
214.12or will be purchased for an elderly waiver client, the costs may be prorated for up to
214.1312 consecutive months beginning with the month of purchase. If the monthly cost of a
214.14recipient's waivered services exceeds the monthly limit established in paragraph (a), the
214.15annual cost of all waivered services shall be determined. In this event, the annual cost of
214.16all waivered services shall not exceed 12 times the monthly limit of waivered services as
214.17described in paragraph (a).
214.18    Subd. 3b. Cost limits for elderly waiver applicants who reside in a nursing
214.19facility. (a) For a person who is a nursing facility resident at the time of requesting a
214.20determination of eligibility for elderly waivered services, a monthly conversion limit for
214.21the cost of elderly waivered services may be requested. The monthly conversion limit for
214.22the cost of elderly waiver services shall be the resident class assigned under Minnesota
214.23Rules, parts 9549.0050 to 9549.0059, for that resident in the nursing facility where
214.24the resident currently resides until July 1 of the state fiscal year in which the resident
214.25assessment system as described in section 256B.437 for nursing home rate determination
214.26is implemented. Effective on July 1 of the state fiscal year in which the resident
214.27assessment system as described in section 256B.437 for nursing home rate determination
214.28is implemented, the monthly conversion limit for the cost of elderly waiver services
214.29shall be the per diem nursing facility rate as determined by the resident assessment
214.30system as described in section 256B.437 for that resident in the nursing facility where
214.31the resident currently resides multiplied by 365 and divided by 12, less the recipient's
214.32maintenance needs allowance as described in subdivision 1d. The initially approved
214.33conversion rate may be adjusted by the greater of any subsequent legislatively adopted
214.34home and community-based services percentage rate increase or the average statewide
214.35percentage increase in nursing facility payment rates. The limit under this subdivision
214.36only applies to persons discharged from a nursing facility after a minimum 30-day stay
215.1and found eligible for waivered services on or after July 1, 1997. For conversions from the
215.2nursing home to the elderly waiver with consumer directed community support services,
215.3the conversion rate limit is equal to the nursing facility rate reduced by a percentage equal
215.4to the percentage difference between the consumer directed services budget limit that
215.5would be assigned according to the federally approved waiver plan and the corresponding
215.6community case mix cap, but not to exceed 50 percent.
215.7    (b) The following costs must be included in determining the total monthly costs
215.8for the waiver client:
215.9    (1) cost of all waivered services, including extended medical supplies and equipment
215.10and environmental modifications and adaptations; and
215.11    (2) cost of skilled nursing, home health aide, and personal care services reimbursable
215.12by medical assistance.
215.13    Subd. 3c. Service approval and contracting provisions. (a) Medical assistance
215.14funding for skilled nursing services, private duty nursing, home health aide, and personal
215.15care services for waiver recipients must be approved by the case manager and included in
215.16the individual care plan.
215.17    (b) A county lead agency is not required to contract with a provider of supplies and
215.18equipment if the monthly cost of the supplies and equipment is less than $250.
215.19    Subd. 3d. Adult foster care rate. The adult foster care rate shall be considered
215.20a difficulty of care payment and shall not include room and board. The adult foster
215.21care service rate shall be negotiated between the county lead agency and the foster care
215.22provider. The elderly waiver payment for the foster care service in combination with
215.23the payment for all other elderly waiver services, including case management, must not
215.24exceed the limit specified in subdivision 3a, paragraph (a).
215.25    Subd. 3e. Assisted living Customized living service rate. (a) Payment for assisted
215.26living service customize living services shall be a monthly rate negotiated and authorized
215.27by the county agency based on an individualized service plan for each resident and may
215.28not cover direct rent or food costs. lead agency within the parameters established by
215.29the commissioner. The payment agreement must delineate the services that have been
215.30customized for each recipient and specify the amount of each service to be provided. The
215.31lead agency shall ensure that there is a documented need for all services authorized.
215.32Customized living services must not include rent or raw food costs. The negotiated
215.33payment rate must be based on services to be provided. Negotiated rates must not exceed
215.34payment rates for comparable elderly waiver or medical assistance services and must
215.35reflect economies of scale.
216.1    (b) The individualized monthly negotiated payment for assisted living customized
216.2living services as described in section 256B.0913, subdivisions 5d to 5f, and residential
216.3care services as described in section 256B.0913, subdivision 5c, shall not exceed the
216.4nonfederal share, in effect on July 1 of the state fiscal year for which the rate limit
216.5is being calculated, of the greater of either the statewide or any of the geographic
216.6groups' weighted average monthly nursing facility rate of the case mix resident class
216.7to which the elderly waiver eligible client would be assigned under Minnesota Rules,
216.8parts 9549.0050 to 9549.0059, less the maintenance needs allowance as described in
216.9subdivision 1d, paragraph (a), until the July 1 of the state fiscal year in which the resident
216.10assessment system as described in section 256B.437 for nursing home rate determination
216.11is implemented. Effective on July 1 of the state fiscal year in which the resident
216.12assessment system as described in section 256B.437 for nursing home rate determination
216.13is implemented and July 1 of each subsequent state fiscal year, the individualized monthly
216.14negotiated payment for the services described in this clause shall not exceed the limit
216.15described in this clause which was in effect on June 30 of the previous state fiscal year
216.16and which has been adjusted by the greater of any legislatively adopted home and
216.17community-based services cost-of-living percentage increase or any legislatively adopted
216.18statewide percent rate increase for nursing facilities.
216.19    (c) The individualized monthly negotiated payment for assisted Customized living
216.20services described in section 144A.4605 and are delivered by a provider licensed by the
216.21Department of Health as a class A or class F home care provider or an assisted living
216.22home care provider and provided in a building that is registered as a housing with services
216.23establishment under chapter 144D and that provides 24-hour supervision in combination
216.24with the payment for other elderly waiver services, including case management, must not
216.25exceed the limit specified in subdivision 3a.
216.26    Subd. 3f. Individual service rates; expenditure forecasts. (a) The county lead
216.27agency shall negotiate individual service rates with vendors and may authorize payment
216.28for actual costs up to the county's lead agency's current approved rate. Persons or agencies
216.29must be employed by or under a contract with the county lead agency or the public health
216.30nursing agency of the local board of health in order to receive funding under the elderly
216.31waiver program, except as a provider of supplies and equipment when the monthly cost of
216.32the supplies and equipment is less than $250.
216.33    (b) Reimbursement for the medical assistance recipients under the approved waiver
216.34shall be made from the medical assistance account through the invoice processing
216.35procedures of the department's Medicaid Management Information System (MMIS),
216.36only with the approval of the client's case manager. The budget for the state share of the
217.1Medicaid expenditures shall be forecasted with the medical assistance budget, and shall
217.2be consistent with the approved waiver.
217.3    Subd. 3g. Service rate limits; state assumption of costs. (a) To improve access
217.4to community services and eliminate payment disparities between the alternative care
217.5program and the elderly waiver, the commissioner shall establish statewide maximum
217.6service rate limits and eliminate county-specific lead agency-specific service rate limits.
217.7    (b) Effective July 1, 2001, for service rate limits, except those described or defined in
217.8subdivisions 3d and 3e, the rate limit for each service shall be the greater of the alternative
217.9care statewide maximum rate or the elderly waiver statewide maximum rate.
217.10    (c) Counties Lead agencies may negotiate individual service rates with vendors for
217.11actual costs up to the statewide maximum service rate limit.
217.12    Subd. 3h. Service rate limits; 24-hour customized living services. The payment
217.13rates for 24-hour customized living services is a monthly rate negotiated and authorized by
217.14the lead agency within the parameters established by the commissioner of human services.
217.15The payment agreement must delineate the services that have been customized for each
217.16recipient and specify the amount of each service to be provided. The lead agency shall
217.17ensure that there is a documented need for all services authorized. The lead agency shall
217.18not authorize 24-hour customized living services unless there is a documented need for
217.1924-hour supervision. For purposes of this section, "24-hour supervision" means that the
217.20recipient requires assistance due to needs related to one or more of the following:
217.21    (1) intermittent assistance with toileting or transferring;
217.22    (2) cognitive or behavioral issues;
217.23    (3) a medical condition that requires clinical monitoring; or
217.24    (4) other conditions or needs as defined by the commissioner of human services.
217.25The lead agency shall ensure that the frequency and mode of supervision of the recipient
217.26and the qualifications of staff providing supervision are described and meet the needs
217.27of the recipient. Customized living services must not include rent or raw food costs.
217.28The negotiated payment rate for 24-hour customized living services must be based on
217.29services to be provided. Negotiated rates must not exceed payment rates for comparable
217.30elderly waiver or medical assistance services and must reflect economies of scale. The
217.31individually negotiated 24-hour customized living payments, in combination with the
217.32payment for other elderly waiver services, including case management, must not exceed
217.33the recipient's community budget cap specified in subdivision 3a.
217.34    Subd. 4. Termination notice. The case manager must give the individual a ten-day
217.35written notice of any denial, reduction, or termination of waivered services.
218.1    Subd. 5. Assessments and reassessments for waiver clients. Each client shall
218.2receive an initial assessment of strengths, informal supports, and need for services in
218.3accordance with section 256B.0911, subdivisions 3, 3a, and 3b. A reassessment of a
218.4client served under the elderly waiver must be conducted at least every 12 months and
218.5at other times when the case manager determines that there has been significant change
218.6in the client's functioning. This may include instances where the client is discharged
218.7from the hospital.
218.8    Subd. 6. Implementation of care plan. Each elderly waiver client shall be provided
218.9a copy of a written care plan that meets the requirements outlined in section 256B.0913,
218.10subdivision 8 . The care plan must be implemented by the county administering waivered
218.11services of service when it is different than the county of financial responsibility. The
218.12county of service administering waivered services must notify the county of financial
218.13responsibility of the approved care plan.
218.14    Subd. 7. Prepaid elderly waiver services. An individual for whom a prepaid health
218.15plan is liable for nursing home services or elderly waiver services according to section
218.16256B.69, subdivision 6a , is not eligible to also receive county-administered elderly waiver
218.17services under this section.
218.18    Subd. 8. Services and supports. (a) Services and supports shall meet the
218.19requirements set out in United States Code, title 42, section 1396n.
218.20    (b) Services and supports shall promote consumer choice and be arranged and
218.21provided consistent with individualized, written care plans.
218.22    (c) The state of Minnesota, county, managed care organization, or tribal government
218.23under contract to administer the elderly waiver shall not be liable for damages, injuries,
218.24or liabilities sustained through the purchase of direct supports or goods by the person,
218.25the person's family, or the authorized representatives with funds received through
218.26consumer-directed community support services under the federally approved waiver plan.
218.27Liabilities include, but are not limited to, workers' compensation liability, the Federal
218.28Insurance Contributions Act (FICA), or the Federal Unemployment Tax Act (FUTA).
218.29    Subd. 9. Tribal management of elderly waiver. Notwithstanding contrary
218.30provisions of this section, or those in other state laws or rules, the commissioner may
218.31develop a model for tribal management of the elderly waiver program and implement this
218.32model through a contract between the state and any of the state's federally recognized tribal
218.33governments. The model shall include the provision of tribal waiver case management,
218.34assessment for personal care assistance, and administrative requirements otherwise carried
218.35out by counties lead agencies but shall not include tribal financial eligibility determination
218.36for medical assistance.
219.1EFFECTIVE DATE.Subdivision 3h is effective the day following final enactment.

219.2    Sec. 46. Minnesota Statutes 2006, section 256B.0917, subdivision 8, is amended to
219.3read:
219.4    Subd. 8. Living-at-home/block nurse program grant. (a) The organization
219.5awarded the contract under subdivision 7, shall develop and administer a grant program
219.6to establish or expand up to 33 51 community-based organizations that will implement
219.7living-at-home/block nurse programs that are designed to enable senior citizens to live as
219.8independently as possible in their homes and in their communities. At least one-half of
219.9the programs must be in counties outside the seven-county metropolitan area. Nonprofit
219.10organizations and units of local government are eligible to apply for grants to establish
219.11the community organizations that will implement living-at-home/block nurse programs.
219.12In awarding grants, the organization awarded the contract under subdivision 7 shall give
219.13preference to nonprofit organizations and units of local government from communities
219.14that:
219.15    (1) have high nursing home occupancy rates;
219.16    (2) have a shortage of health care professionals;
219.17    (3) are located in counties adjacent to, or are located in, counties with existing
219.18living-at-home/block nurse programs; and
219.19    (4) meet other criteria established by LAH/BN, Inc., in consultation with the
219.20commissioner.
219.21    (b) Grant applicants must also meet the following criteria:
219.22    (1) the local community demonstrates a readiness to establish a community model
219.23of care, including the formation of a board of directors, advisory committee, or similar
219.24group, of which at least two-thirds is comprised of community citizens interested in
219.25community-based care for older persons;
219.26    (2) the program has sponsorship by a credible, representative organization within
219.27the community;
219.28    (3) the program has defined specific geographic boundaries and defined its
219.29organization, staffing and coordination/delivery of services;
219.30    (4) the program demonstrates a team approach to coordination and care, ensuring
219.31that the older adult participants, their families, the formal and informal providers are all
219.32part of the effort to plan and provide services; and
219.33    (5) the program provides assurances that all community resources and funding will
219.34be coordinated and that other funding sources will be maximized, including a person's
219.35own resources.
220.1    (c) Grant applicants must provide a minimum of five percent of total estimated
220.2development costs from local community funding. Grants shall be awarded for four-year
220.3periods, and the base amount shall not exceed $80,000 $100,000 per applicant for the grant
220.4period. The organization under contract may increase the grant amount for applicants from
220.5communities that have socioeconomic characteristics that indicate a higher level of need
220.6for assistance. Subject to the availability of funding, grants and grant renewals awarded or
220.7entered into on or after July 1, 1997, shall be renewed by LAH/BN, Inc. every four years,
220.8unless LAH/BN, Inc. determines that the grant recipient has not satisfactorily operated the
220.9living-at-home/block nurse program in compliance with the requirements of paragraphs
220.10(b) and (d). Grants provided to living-at-home/block nurse programs under this paragraph
220.11may be used for both program development and the delivery of services.
220.12    (d) Each living-at-home/block nurse program shall be designed by representatives of
220.13the communities being served to ensure that the program addresses the specific needs of
220.14the community residents. The programs must be designed to:
220.15    (1) incorporate the basic community, organizational, and service delivery principles
220.16of the living-at-home/block nurse program model;
220.17    (2) provide senior citizens with registered nurse directed assessment, provision and
220.18coordination of health and personal care services on a sliding fee basis as an alternative
220.19to expensive nursing home care;
220.20    (3) provide information, support services, homemaking services, counseling, and
220.21training for the client and family caregivers;
220.22    (4) encourage the development and use of respite care, caregiver support, and
220.23in-home support programs, such as adult foster care and in-home adult day care;
220.24    (5) encourage neighborhood residents and local organizations to collaborate in
220.25meeting the needs of senior citizens in their communities;
220.26    (6) recruit, train, and direct the use of volunteers to provide informal services and
220.27other appropriate support to senior citizens and their caregivers; and
220.28    (7) provide coordination and management of formal and informal services to senior
220.29citizens and their families using less expensive alternatives.

220.30    Sec. 47. Minnesota Statutes 2006, section 256B.0919, subdivision 3, is amended to
220.31read:
220.32    Subd. 3. County certification of persons providing adult foster care to related
220.33persons. A person exempt from licensure under section 245A.03, subdivision 2, who
220.34provides adult foster care to a related individual age 65 and older, and who meets the
220.35requirements in Minnesota Rules, parts 9555.5105 to 9555.6265, may be certified by the
221.1county to provide adult foster care. A person certified by the county to provide adult foster
221.2care may be reimbursed for services provided and eligible for funding under sections
221.3256B.0913 and section 256B.0915, if the relative would suffer a financial hardship as
221.4a result of providing care. For purposes of this subdivision, financial hardship refers
221.5to a situation in which a relative incurs a substantial reduction in income as a result of
221.6resigning from a full-time job or taking a leave of absence without pay from a full-time
221.7job to care for the client.

221.8    Sec. 48. Minnesota Statutes 2006, section 256B.095, is amended to read:
221.9256B.095 QUALITY ASSURANCE SYSTEM ESTABLISHED.
221.10    (a) Effective July 1, 1998, a quality assurance system for persons with developmental
221.11disabilities, which includes an alternative quality assurance licensing system for programs,
221.12is established in Dodge, Fillmore, Freeborn, Goodhue, Houston, Mower, Olmsted, Rice,
221.13Steele, Wabasha, and Winona Counties for the purpose of improving the quality of
221.14services provided to persons with developmental disabilities. A county, at its option, may
221.15choose to have all programs for persons with developmental disabilities located within
221.16the county licensed under chapter 245A using standards determined under the alternative
221.17quality assurance licensing system or may continue regulation of these programs under
221.18the licensing system operated by the commissioner. The project expires on June 30,
221.192009 2014.
221.20    (b) Effective July 1, 2003, a county not listed in paragraph (a) may apply to
221.21participate in the quality assurance system established under paragraph (a). The
221.22commission established under section 256B.0951 may, at its option, allow additional
221.23counties to participate in the system.
221.24    (c) Effective July 1, 2003, any county or group of counties not listed in paragraph (a)
221.25may establish a quality assurance system under this section. A new system established
221.26under this section shall have the same rights and duties as the system established
221.27under paragraph (a). A new system shall be governed by a commission under section
221.28256B.0951 . The commissioner shall appoint the initial commission members based
221.29on recommendations from advocates, families, service providers, and counties in the
221.30geographic area included in the new system. Counties that choose to participate in a
221.31new system shall have the duties assigned under section 256B.0952. The new system
221.32shall establish a quality assurance process under section 256B.0953. The provisions of
221.33section 256B.0954 shall apply to a new system established under this paragraph. The
221.34commissioner shall delegate authority to a new system established under this paragraph
221.35according to section 256B.0955.
222.1    (d) Effective July 1, 2007, the quality assurance system may be expanded to include
222.2programs for persons with disabilities and older adults.

222.3    Sec. 49. Minnesota Statutes 2006, section 256B.0951, subdivision 1, is amended to
222.4read:
222.5    Subdivision 1. Membership. The Quality Assurance Commission is established.
222.6The commission consists of at least 14 but not more than 21 members as follows: at
222.7least three but not more than five members representing advocacy organizations; at
222.8least three but not more than five members representing consumers, families, and their
222.9legal representatives; at least three but not more than five members representing service
222.10providers; at least three but not more than five members representing counties; and the
222.11commissioner of human services or the commissioner's designee. The first commission
222.12shall establish membership guidelines for the transition and recruitment of membership for
222.13the commission's ongoing existence. Members of the commission who do not receive a
222.14salary or wages from an employer for time spent on commission duties may receive a per
222.15diem payment when performing commission duties and functions. All members may be
222.16reimbursed for expenses related to commission activities. Notwithstanding the provisions
222.17of section 15.059, subdivision 5, the commission expires on June 30, 2009 2014.

222.18    Sec. 50. [256B.096] QUALITY MANAGEMENT; ASSURANCE; AND
222.19IMPROVEMENT SYSTEM FOR MINNESOTANS RECEIVING DISABILITY
222.20SERVICES.
222.21    Subdivision 1. Scope. In order to improve the quality of services provided to
222.22Minnesotans with disabilities and to meet the requirements of the federally approved home
222.23and community-based waivers under section 1915c of the Social Security Act, a statewide
222.24quality assurance and improvement system for Minnesotans receiving disability services
222.25shall be developed. The disability services included are the home and community-based
222.26services waiver programs for persons with developmental disabilities under section
222.27256B.092, subdivision 4, and persons with disabilities under section 256B.49.
222.28    Subd. 2. Stakeholder advisory group. The commissioner shall consult with a
222.29stakeholder advisory group on the development and implementation of the state quality
222.30management, assurance, and improvement system, including representatives from:
222.31disability service recipients, disability service providers, disability advocacy groups,
222.32county human service agencies, and state agency staff from the Departments of Human
222.33Services and Health and ombudsman for mental health and developmental disabilities on
222.34the development of a statewide quality assurance and improvement system.
223.1    Subd. 3. Annual survey of service recipients. The commissioner, in consultation
223.2with the stakeholder advisory group, shall develop and conduct an annual independent
223.3random statewide survey of between five and ten percent of service recipients to determine
223.4the effectiveness and quality of disability services. The survey shall be consistent with
223.5the system performance expectations of the Centers for Medicare and Medicaid Services
223.6quality management requirements and framework. The survey shall analyze whether
223.7desired outcomes have been achieved for persons with different demographic, diagnostic,
223.8health, and functional needs and receiving different types of services, in different settings,
223.9with different costs. The survey shall be field tested during 2008 and implemented by
223.10February 1, 2009. Annual statewide and regional reports of the results shall be published
223.11for use by regions, counties, and providers to plan and measure the impact of quality
223.12improvement activities.
223.13    Subd. 4. Improvements for incident reporting, investigation, analysis, and
223.14follow-up. In consultation with the stakeholder advisory group, the commissioner shall
223.15identify the information, data sources, and technology needed to improve the system
223.16of incident reporting, including:
223.17    (1) reports made under the Maltreatment of Minors and Vulnerable Adults Acts; and
223.18    (2) investigation, analysis, and follow-up for disability services.
223.19    The commissioner must ensure that the federal home and community-based waiver
223.20requirements are met and that incidents that may have jeopardized safety; health; or
223.21violated service-related assurances, civil and human rights, and other protections designed
223.22to prevent abuse, neglect, and exploitation are reviewed, investigated, and acted upon
223.23in a timely manner.
223.24    Subd. 5. Biennial report. The commissioner shall provide a biennial report to the
223.25chairs of the legislative committees with jurisdiction over health and human services
223.26policy and funding beginning January 15, 2009, on the development and activities of the
223.27quality management, assurance, and improvement system designed to meet the federal
223.28requirements under the home and community-based services waiver programs for persons
223.29with disabilities. By January 15, 2008, the commissioner shall provide a preliminary
223.30report on the priorities for meeting the federal requirements, progress on the annual
223.31survey, recommendations for improvements in the incident reporting system, and a plan
223.32for incorporating the quality assurance efforts under section 256B.095 and other regional
223.33efforts into the statewide system.

223.34    Sec. 51. Minnesota Statutes 2006, section 256B.431, subdivision 1, is amended to read:
224.1    Subdivision 1. In general. The commissioner shall determine prospective
224.2payment rates for resident care costs. For rates established on or after July 1, 1985, the
224.3commissioner shall develop procedures for determining operating cost payment rates that
224.4take into account the mix of resident needs, geographic location, and other factors as
224.5determined by the commissioner. The commissioner shall consider whether the fact that a
224.6facility is attached to a hospital or has an average length of stay of 180 days or less should
224.7be taken into account in determining rates. The commissioner shall consider the use of the
224.8standard metropolitan statistical areas when developing groups by geographic location.
224.9The commissioner shall provide notice to each nursing facility on or before May 1 August
224.1015 of the rates effective for the following rate year except that if legislation is pending on
224.11May 1 August 15 that may affect rates for nursing facilities, the commissioner shall set the
224.12rates after the legislation is enacted and provide notice to each facility as soon as possible.
224.13    Compensation for top management personnel shall continue to be categorized as a
224.14general and administrative cost and is subject to any limits imposed on that cost category.

224.15    Sec. 52. Minnesota Statutes 2006, section 256B.431, subdivision 2e, is amended to
224.16read:
224.17    Subd. 2e. Contracts for services for ventilator-dependent persons. (a)
224.18The commissioner may negotiate with a nursing facility eligible to receive medical
224.19assistance payments to provide services to a ventilator-dependent person identified by the
224.20commissioner according to criteria developed by the commissioner, including:
224.21    (1) nursing facility care has been recommended for the person by a preadmission
224.22screening team;
224.23    (2) the person has been hospitalized and no longer requires inpatient acute care
224.24hospital services; and
224.25    (3) the commissioner has determined that necessary services for the person cannot
224.26be provided under existing nursing facility rates.
224.27    The commissioner may negotiate an adjustment to the operating cost payment
224.28rate for a nursing facility with a resident who is ventilator-dependent, for that resident.
224.29The negotiated adjustment must reflect only the actual additional cost of meeting the
224.30specialized care needs of a ventilator-dependent person identified by the commissioner
224.31for whom necessary services cannot be provided under existing nursing facility rates and
224.32which are not otherwise covered under Minnesota Rules, parts 9549.0010 to 9549.0080 or
224.339505.0170 to 9505.0475. For persons who are initially admitted to a nursing facility before
224.34July 1, 2001, and have their payment rate under this subdivision negotiated after July 1,
224.352001, the negotiated payment rate must not exceed 200 percent of the highest multiple
225.1bedroom payment rate for the facility, as initially established by the commissioner for the
225.2rate year for case mix classification K; or, upon implementation of the RUG's-based case
225.3mix system, 200 percent of the highest RUG's rate. For persons initially admitted to a
225.4nursing facility on or after July 1, 2001, the negotiated payment rate must not exceed 300
225.5percent of the facility's multiple bedroom payment rate for case mix classification K; or,
225.6upon implementation of the RUG's-based case mix system, 300 percent of the highest
225.7RUG's rate. The negotiated adjustment shall not affect the payment rate charged to private
225.8paying residents under the provisions of section 256B.48, subdivision 1.
225.9    (b) Effective July 1, 2007, or upon opening a unit of at least ten beds dedicated to
225.10care of ventilator-dependent persons in partnership with Mayo Health Systems, whichever
225.11is later, the operating payment rates for residents determined eligible under paragraph (a)
225.12of a nursing facility in Waseca County that on February 1, 2007, was licensed for 70 beds
225.13and reimbursed under this section, section 256B.434, or section 256B.441, shall be 300
225.14percent of the facility's highest RUG rate.

225.15    Sec. 53. Minnesota Statutes 2006, section 256B.431, subdivision 3f, is amended to
225.16read:
225.17    Subd. 3f. Property costs after July 1, 1988. (a) Investment per bed limit. For the
225.18rate year beginning July 1, 1988, the replacement-cost-new per bed limit must be $32,571
225.19per licensed bed in multiple bedrooms and $48,857 per licensed bed in a single bedroom.
225.20For the rate year beginning July 1, 1989, the replacement-cost-new per bed limit for a
225.21single bedroom must be $49,907 adjusted according to Minnesota Rules, part 9549.0060,
225.22subpart 4, item A, subitem (1). Beginning January 1, 1990, the replacement-cost-new per
225.23bed limits must be adjusted annually as specified in Minnesota Rules, part 9549.0060,
225.24subpart 4, item A, subitem (1). Beginning January 1, 1991, the replacement-cost-new per
225.25bed limits will be adjusted annually as specified in Minnesota Rules, part 9549.0060,
225.26subpart 4, item A, subitem (1), except that the index utilized will be the Bureau of the
225.27Census: Composite fixed-weighted price index as published in the C30 Report, Value
225.28of New Construction Put in Place Economic Analysis: Price Indexes for Private Fixed
225.29Investments in Structures; Special Care.
225.30    (b) Rental factor. For the rate year beginning July 1, 1988, the commissioner shall
225.31increase the rental factor as established in Minnesota Rules, part 9549.0060, subpart 8,
225.32item A, by 6.2 percent rounded to the nearest 100th percent for the purpose of reimbursing
225.33nursing facilities for soft costs and entrepreneurial profits not included in the cost valuation
225.34services used by the state's contracted appraisers. For rate years beginning on or after July
226.11, 1989, the rental factor is the amount determined under this paragraph for the rate year
226.2beginning July 1, 1988.
226.3    (c) Occupancy factor. For rate years beginning on or after July 1, 1988, in order
226.4to determine property-related payment rates under Minnesota Rules, part 9549.0060,
226.5for all nursing facilities except those whose average length of stay in a skilled level of
226.6care within a nursing facility is 180 days or less, the commissioner shall use 95 percent
226.7of capacity days. For a nursing facility whose average length of stay in a skilled level of
226.8care within a nursing facility is 180 days or less, the commissioner shall use the greater of
226.9resident days or 80 percent of capacity days but in no event shall the divisor exceed 95
226.10percent of capacity days.
226.11    (d) Equipment allowance. For rate years beginning on July 1, 1988, and July 1,
226.121989, the commissioner shall add ten cents per resident per day to each nursing facility's
226.13property-related payment rate. The ten-cent property-related payment rate increase is not
226.14cumulative from rate year to rate year. For the rate year beginning July 1, 1990, the
226.15commissioner shall increase each nursing facility's equipment allowance as established
226.16in Minnesota Rules, part 9549.0060, subpart 10, by ten cents per resident per day. For
226.17rate years beginning on or after July 1, 1991, the adjusted equipment allowance must be
226.18adjusted annually for inflation as in Minnesota Rules, part 9549.0060, subpart 10, item E.
226.19For the rate period beginning October 1, 1992, the equipment allowance for each nursing
226.20facility shall be increased by 28 percent. For rate years beginning after June 30, 1993, the
226.21allowance must be adjusted annually for inflation.
226.22    (e) Post chapter 199 related-organization debts and interest expense. For rate
226.23years beginning on or after July 1, 1990, Minnesota Rules, part 9549.0060, subpart 5, item
226.24E, shall not apply to outstanding related organization debt incurred prior to May 23, 1983,
226.25provided that the debt was an allowable debt under Minnesota Rules, parts 9510.0010
226.26to 9510.0480, the debt is subject to repayment through annual principal payments, and
226.27the nursing facility demonstrates to the commissioner's satisfaction that the interest rate
226.28on the debt was less than market interest rates for similar arm's-length transactions at
226.29the time the debt was incurred. If the debt was incurred due to a sale between family
226.30members, the nursing facility must also demonstrate that the seller no longer participates
226.31in the management or operation of the nursing facility. Debts meeting the conditions of
226.32this paragraph are subject to all other provisions of Minnesota Rules, parts 9549.0010
226.33to 9549.0080.
226.34    (f) Building capital allowance for nursing facilities with operating leases. For
226.35rate years beginning on or after July 1, 1990, a nursing facility with operating lease costs
226.36incurred for the nursing facility's buildings shall receive its building capital allowance
227.1computed in accordance with Minnesota Rules, part 9549.0060, subpart 8. If an operating
227.2lease provides that the lessee's rent is adjusted to recognize improvements made by the
227.3lessor and related debt, the costs for capital improvements and related debt shall be allowed
227.4in the computation of the lessee's building capital allowance, provided that reimbursement
227.5for these costs under an operating lease shall not exceed the rate otherwise paid.

227.6    Sec. 54. Minnesota Statutes 2006, section 256B.431, subdivision 17e, is amended to
227.7read:
227.8    Subd. 17e. Replacement-costs-new per bed limit effective July 1, 2001.
227.9    Notwithstanding Minnesota Rules, part 9549.0060, subpart 11, item C, subitem (2),
227.10for a total replacement, as defined in paragraph (f) subdivision 17d, authorized under
227.11section 144A.071 or 144A.073 after July 1, 1999, or any building project that is a
227.12relocation, renovation, upgrading, or conversion completed on or after July 1, 2001, the
227.13replacement-costs-new per bed limit shall be $74,280 per licensed bed in multiple-bed
227.14rooms, $92,850 per licensed bed in semiprivate rooms with a fixed partition separating
227.15the resident beds, and $111,420 per licensed bed in single rooms. Minnesota Rules, part
227.169549.0060, subpart 11, item C, subitem (2), does not apply. These amounts must be
227.17adjusted annually as specified in subdivision 3f, paragraph (a), beginning January 1, 2000.

227.18    Sec. 55. Minnesota Statutes 2006, section 256B.434, subdivision 4, is amended to read:
227.19    Subd. 4. Alternate rates for nursing facilities. (a) For nursing facilities which
227.20have their payment rates determined under this section rather than section 256B.431, the
227.21commissioner shall establish a rate under this subdivision. The nursing facility must enter
227.22into a written contract with the commissioner.
227.23    (b) A nursing facility's case mix payment rate for the first rate year of a facility's
227.24contract under this section is the payment rate the facility would have received under
227.25section 256B.431.
227.26    (c) A nursing facility's case mix payment rates for the second and subsequent years
227.27of a facility's contract under this section are the previous rate year's contract payment
227.28rates plus an inflation adjustment and, for facilities reimbursed under this section or
227.29section 256B.431, an adjustment to include the cost of any increase in Health Department
227.30licensing fees for the facility taking effect on or after July 1, 2001. The index for the
227.31inflation adjustment must be based on the change in the Consumer Price Index-all items
227.32(United States City average) (CPI-U) forecasted by the commissioner of finance's national
227.33economic consultant, as forecasted in the fourth quarter of the calendar year preceding
227.34the rate year. The inflation adjustment must be based on the 12-month period from the
228.1midpoint of the previous rate year to the midpoint of the rate year for which the rate
228.2is being determined. For the rate years beginning on July 1, 1999, July 1, 2000, July
228.31, 2001, July 1, 2002, July 1, 2003, July 1, 2004, July 1, 2005, July 1, 2006, July 1,
228.42007, and July 1, 2008, July 1, 2009, and July 1, 2010, this paragraph shall apply only
228.5to the property-related payment rate, except that adjustments to include the cost of any
228.6increase in Health Department licensing fees taking effect on or after July 1, 2001, shall
228.7be provided. Beginning in 2005, adjustment to the property payment rate under this
228.8section and section 256B.431 shall be effective on October 1. In determining the amount
228.9of the property-related payment rate adjustment under this paragraph, the commissioner
228.10shall determine the proportion of the facility's rates that are property-related based on the
228.11facility's most recent cost report.
228.12    (d) The commissioner shall develop additional incentive-based payments of up to
228.13five percent above a facility's operating payment rate for achieving outcomes specified
228.14in a contract. The commissioner may solicit contract amendments and implement those
228.15which, on a competitive basis, best meet the state's policy objectives. The commissioner
228.16shall limit the amount of any incentive payment and the number of contract amendments
228.17under this paragraph to operate the incentive payments within funds appropriated for this
228.18purpose. The contract amendments may specify various levels of payment for various
228.19levels of performance. Incentive payments to facilities under this paragraph may be in the
228.20form of time-limited rate adjustments or onetime supplemental payments. In establishing
228.21the specified outcomes and related criteria, the commissioner shall consider the following
228.22state policy objectives:
228.23    (1) successful diversion or discharge of residents to the residents' prior home or other
228.24community-based alternatives;
228.25    (2) adoption of new technology to improve quality or efficiency;
228.26    (3) improved quality as measured in the Nursing Home Report Card;
228.27    (4) reduced acute care costs; and
228.28    (5) any additional outcomes proposed by a nursing facility that the commissioner
228.29finds desirable.
228.30    (e) Notwithstanding the threshold in section 256B.431, subdivision 16, facilities that
228.31take action to come into compliance with existing or pending requirements of the life
228.32safety code provisions or other federal regulations governing sprinkler systems shall
228.33receive reimbursement for the costs associated with compliance if all of the following
228.34conditions are met:
228.35    (1) the expenses associated with compliance occurred on or after January 1, 2005,
228.36and before December 31, 2008;
229.1    (2) the costs were not otherwise reimbursed under section 144A.071, 144A.073,
229.2or 256B.434, subdivision 4f; and
229.3    (3) the total allowable costs reported under this paragraph are less than the minimum
229.4threshold established under section 256B.431, subdivisions 15, paragraph (e), and 16.
229.5The commissioner shall use funds appropriated for this purpose to provide to qualifying
229.6nursing facilities a rate adjustment beginning October 1, 2007, and ending September
229.730, 2008. Nursing facilities that have expended funds or anticipate the need to expend
229.8funds to satisfy the most recent life safety code requirements by (1) installing a sprinkler
229.9system or (2) replacing all or portions of an existing sprinkler system may submit to the
229.10commissioner by June 30, 2007, on a form provided by the commissioner the actual
229.11costs of a completed project or the estimated costs, based on a project bid, of a planned
229.12project. The commissioner shall calculate a rate adjustment equal to the allowable
229.13costs of the project divided by the resident days reported for the report year ending
229.14September 30, 2006. If the costs from all projects exceed the appropriation for this
229.15purpose, the commissioner shall allocate the funds appropriated on a pro rata basis to the
229.16qualifying facilities by reducing the rate adjustment determined for each facility by an
229.17equal percentage. If the rate adjustments under this subdivision are reduced to fit the
229.18appropriation, facilities may include the portion of the costs that are not reimbursed by
229.19the rate adjustment as part of a project that meets the requirements of subdivision 4f.
229.20If the commissioner determines that there are any unexpended funds for the purposes
229.21of this paragraph, the commissioner may allocate the remainder of the funds to the
229.22qualifying facilities on a pro rata basis for other physical plant changes required by the
229.23nursing facility in order to meet the most recent life safety code compliance standards.
229.24Facilities that used estimated costs when requesting the rate adjustment shall report to
229.25the commissioner by January 31, 2009, on the use of these funds on a form provided by
229.26the commissioner. If the nursing facility fails to provide the report, the commissioner
229.27shall recoup the funds appropriated to the facility for this purpose. If the facility reports
229.28expenditures allowable under this subdivision that are less than the amount received in the
229.29facility's annualized rate adjustment, the commissioner shall recoup the difference.

229.30    Sec. 56. Minnesota Statutes 2006, section 256B.434, is amended by adding a
229.31subdivision to read:
229.32    Subd. 4i. Nursing facility rate increase effective October 1, 2007; Hennepin
229.33County. For the rate year beginning October 1, 2007, the commissioner shall provide to
229.34a nursing facility in Hennepin County licensed for 268 beds as of February 1, 2007, an
229.35increase in the property payment rate of $6.52 per resident per day. The increase under
230.1this subdivision must be added following the determination under this chapter of the
230.2payment rate for the rate year beginning October 1, 2007, and must be included in the
230.3facility's total payment rate for purposes of determining future rates under this section or
230.4any other section.

230.5    Sec. 57. Minnesota Statutes 2006, section 256B.434, is amended by adding a
230.6subdivision to read:
230.7    Subd. 4j. Rate increase for facilities in Chisago County. Effective October
230.81, 2007, operating payment rates of all nursing facilities in Chisago County that are
230.9reimbursed under this section or section 256B.441 shall be increased to be equal, for
230.10a RUG's rate with a weight of 1.00, to the geographic group III median rate for the
230.11same RUG's weight. The percentage of the operating payment rate for each facility to
230.12be case-mix adjusted shall be equal to the percentage that is case-mix adjusted in that
230.13facility's September 30, 2007, operating payment rate. This subdivision applies only if it
230.14results in a rate increase. Increases provided by this subdivision shall be added to the rate
230.15determined under any new reimbursement system established under section 256B.441.

230.16    Sec. 58. Minnesota Statutes 2006, section 256B.434, is amended by adding a
230.17subdivision to read:
230.18    Subd. 4k. Nursing facility rate increase effective January 1, 2008; Hennepin
230.19County. Effective January 1, 2008, a nursing facility in Hennepin County licensed for
230.20137 beds as of February 1, 2007, shall receive an increase of $2.81 in each case mix
230.21payment rate to offset property tax payments due as a result of the facility's conversion
230.22from nonprofit to for-profit status. The increase under this subdivision must be added
230.23following the determination under this chapter of the payment rate for the rate year
230.24beginning October 1, 2007, and must be included in the facility's total payment rate for the
230.25purposes of determining future rates under this section or any other section.

230.26    Sec. 59. Minnesota Statutes 2006, section 256B.434, is amended by adding a
230.27subdivision to read:
230.28    Subd. 4l. Property rate adjustment; Kanabec County. The commissioner
230.29shall allow a property rate adjustment for a facility located in Kanabec County that
230.30was approved for a moratorium exception project in 2001, but experienced a delay and
230.31additional costs associated with the project, and completed the project in 2005. The
230.32property payment rate for the rate years beginning October 1, 2007, and ending September
230.3330, 2009, must be $22.73 per resident day. For subsequent years, the property rate of
231.1$22.73 per resident day shall be adjusted as provided in subdivision 4, paragraph (c), as
231.2long as the facility has a contract under this section.

231.3    Sec. 60. Minnesota Statutes 2006, section 256B.434, is amended by adding a
231.4subdivision to read:
231.5    Subd. 4m. Rate increase for facilities in Rice County. Effective July 1, 2007,
231.6operating payment rates of nursing facilities in Rice County located within two miles
231.7of Scott County or Dakota County that are reimbursed under this section or section
231.8256B.441 must be increased to be equal, for a RUG's rate with a weight of 1.00, to the
231.9geographic group III median rate for the same RUG's weight. The percentage of the
231.10operating payment rate for each facility to be case-mix adjusted must be equal to the
231.11percentage that is case-mix adjusted in that facility's June 30, 2006, operating payment
231.12rate. This subdivision applies only if it results in a rate increase.

231.13    Sec. 61. Minnesota Statutes 2006, section 256B.434, is amended by adding a
231.14subdivision to read:
231.15    Subd. 4n. Facility rate increase. For the rate year beginning October 1, 2007, a
231.16nursing facility in Faribault County licensed for 50 beds as of April 19, 2006, shall receive
231.17a rate increase of $2.64 in each case mix payment rate to offset property tax payments
231.18due as a result of the facility's conversion from nonprofit to for-profit status. The increase
231.19under this subdivision shall be added to the payment rates in effect for the facility on
231.20September 30, 2007, and shall be included in the facility's total payment rates for the
231.21purposes of determining future rates under this section or any other section.

231.22    Sec. 62. Minnesota Statutes 2006, section 256B.434, is amended by adding a
231.23subdivision to read:
231.24    Subd. 19. Nursing facility rate increases beginning October 1, 2007, and
231.25October 1, 2008. (a) For the rate year beginning October 1, 2007, the commissioner
231.26shall make available to each nursing facility reimbursed under this section operating
231.27payment rate adjustments equal to three percent of the operating payment rates in effect
231.28on September 30, 2007. For the rate year beginning October 1, 2008, the commissioner
231.29shall make available to each nursing facility reimbursed under this section operating
231.30payment rate adjustments equal to three percent of the operating payment rates in effect
231.31on September 30, 2008.
232.1    (b) Seventy-five percent of the money resulting from the rate adjustments under
232.2paragraph (a) must be used for increases in compensation-related costs of eligible
232.3employees.
232.4    (c) For purposes of this subdivision, eligible employees includes all persons directly
232.5employed by the nursing facility on or after the effective date of the rate adjustments,
232.6except:
232.7    (1) persons employed in the central office of a corporation that has an ownership
232.8interest in the nursing facility or exercises control over the nursing facility; and
232.9    (2) persons paid by the nursing facility under a management contract.
232.10    (d) The commissioner shall allow as compensation-related costs all costs for:
232.11    (1) wages and salaries;
232.12    (2) FICA taxes, Medicare taxes, state and federal unemployment taxes, and workers'
232.13compensation;
232.14    (3) the employer's share of health and dental insurance, life insurance, disability
232.15insurance, long-term care insurance, uniform allowance, and pensions; and
232.16    (4) other benefits provided, subject to the approval of the commissioner.
232.17    (e) The portion of the rate adjustments under paragraph (a) that is not subject to the
232.18requirements in paragraph (b) shall be provided to nursing facilities effective October
232.191 of each year.
232.20    (f) Nursing facilities may apply for the portion of the rate adjustments under
232.21paragraph (a) that is subject to the requirements in paragraph (b). The application
232.22must be submitted to the commissioner within six months of the effective date of the
232.23rate adjustments, and the nursing facility must provide additional information required
232.24by the commissioner within nine months of the effective date of the rate adjustments.
232.25The commissioner must respond to all applications within three weeks of receipt.
232.26The commissioner may waive the deadlines in this paragraph under extraordinary
232.27circumstances, to be determined at the sole discretion of the commissioner. The
232.28application must contain:
232.29    (1) an estimate of the amounts of money that must be used as specified in paragraph
232.30(b);
232.31    (2) a detailed distribution plan specifying the allowable compensation-related
232.32increases the nursing facility will implement to use the funds available in clause (1);
232.33    (3) a description of how the nursing facility will notify eligible employees of
232.34the contents of the approved application, which must provide for giving each eligible
232.35employee a copy of the approved application, excluding the information required in clause
232.36(1), or posting a copy of the approved application, excluding the information required in
233.1clause (1), for a period of at least six weeks in an area of the nursing facility to which all
233.2eligible employees have access; and
233.3    (4) instructions for employees who believe they have not received the
233.4compensation-related increases specified in clause (2), as approved by the commissioner,
233.5and which must include a mailing address, e-mail address, and the telephone number
233.6that may be used by the employee to contact the commissioner or the commissioner's
233.7representative.
233.8    (g) The commissioner shall ensure that cost increases in distribution plans under
233.9paragraph (f), clause (2), that may be included in approved applications, comply with
233.10requirements in clauses (1) to (4):
233.11    (1) costs to be incurred during the applicable rate year resulting from wage and
233.12salary increases implemented prior to the first day of the nursing facility's payroll period
233.13that includes October 1 of each year shall be allowed if they were not used in a prior
233.14year's application;
233.15    (2) a portion of the costs resulting from tenure-related wage or salary increases may
233.16be considered to be allowable compensation-related increases, in accordance with existing
233.17formulas that the commissioner shall provide;
233.18    (3) the annualized amount of increases in costs for the employer's share of health
233.19and dental insurance, life insurance, disability insurance, and workers' compensation shall
233.20be allowable compensation-related increases if they are effective on or after April 1 of
233.21the year in which the rate adjustments are effective and prior to April 1 of the following
233.22year; and
233.23    (4) for nursing facilities in which employees are represented by an exclusive
233.24bargaining representative, an agreement negotiated and agreed to by the employer and
233.25the exclusive bargaining representative constitutes the plan. The commissioner shall not
233.26review and shall not require changes to the portions of the plan covered by collective
233.27bargaining agreements. A negotiated agreement may constitute the plan only if the
233.28agreement is finalized after the date of enactment of all increases for the rate year and
233.29signed by both parties prior to submission to the commissioner.
233.30    (h) The commissioner shall review applications received under paragraph (f) and
233.31shall provide the portion of the rate adjustments under paragraph (b) if the requirements of
233.32this subdivision have been met. The rate adjustments shall be effective October 1 of each
233.33year. Notwithstanding paragraph (a), if the approved application distributes less money
233.34than is available, the amount of the rate adjustment shall be reduced so that the amount of
233.35money made available is equal to the amount to be distributed.

234.1    Sec. 63. Minnesota Statutes 2006, section 256B.434, is amended by adding a
234.2subdivision to read:
234.3    Subd. 20. Payment of Public Employees Retirement Association costs. Nursing
234.4facilities that participate in the Public Employees Retirement Association (PERA) shall
234.5have the component of their payment rate associated with the costs of PERA determined
234.6for each rate year. Effective for rate years beginning on and after October 1, 2007, the
234.7commissioner shall determine the portion of the payment rate in effect on September 30
234.8each year and shall subtract that amount from the payment rate to be effective on the
234.9following October 1. The portion that shall be deemed to be included in the September 30,
234.102007, rate that is associated with PERA costs shall be the allowed costs in the facility's
234.11base for determining rates under this section, divided by the resident days reported for that
234.12year. The commissioner shall add to the payment rate to be effective on October 1 each
234.13year an amount equal to the reported costs associated with PERA, for the year ended on
234.14the most recent September 30 for which data is available, divided by total resident days
234.15for that year, as reported by the facility and audited under section 256B.441.

234.16    Sec. 64. Minnesota Statutes 2006, section 256B.437, is amended by adding a
234.17subdivision to read:
234.18    Subd. 11. Big Stone County rate adjustment. Notwithstanding the time period
234.19specified in subdivision 3, the commissioner shall approve a planned closure rate
234.20adjustment in Big Stone County for an eight-bed facility in Clinton for reassignment to a
234.2150-bed facility in Graceville. The adjustment shall be calculated according to subdivisions
234.223 and 6.

234.23    Sec. 65. Minnesota Statutes 2006, section 256B.438, subdivision 3, is amended to read:
234.24    Subd. 3. Case mix indices. (a) The commissioner of human services shall assign a
234.25case mix index to each resident class based on the Centers for Medicare and Medicaid
234.26Services staff time measurement study and adjusted for Minnesota-specific wage indices.
234.27The case mix indices assigned to each resident class shall be published in the Minnesota
234.28State Register at least 120 days prior to the implementation of the 34 group, RUG-III
234.29resident classification system.
234.30    (b) An index maximization approach shall be used to classify residents.
234.31    (c) After implementation of the revised case mix system, the commissioner of
234.32human services may annually rebase case mix indices and base rates using more current
234.33data on average wage rates and staff time measurement studies. This rebasing shall be
234.34calculated under subdivision 7, paragraph (b). The commissioner shall publish in the
235.1Minnesota State Register adjusted case mix indices at least 45 days prior to the effective
235.2date of the adjusted case mix indices.

235.3    Sec. 66. Minnesota Statutes 2006, section 256B.439, subdivision 1, is amended to read:
235.4    Subdivision 1. Development and implementation of quality profiles. (a) The
235.5commissioner of human services, in cooperation with the commissioner of health, shall
235.6develop and implement a quality profile system for nursing facilities and, beginning not
235.7later than July 1, 2004, other providers of long-term care services, except when the quality
235.8profile system would duplicate requirements under section 256B.5011, 256B.5012, or
235.9256B.5013 . Beginning July 1, 2008, the commissioners shall include quality profiles of
235.10nursing homes that are not medical assistance certified in the Minnesota Nursing Home
235.11Report Card. The nonmedical assistance certified nursing homes may provide to the
235.12commissioners information necessary to conduct consumer satisfaction surveys and to
235.13determine other quality measures. The system must be developed and implemented to the
235.14extent possible without the collection of significant amounts of new data. To the extent
235.15possible, the system must incorporate or be coordinated with information on quality
235.16maintained by area agencies on aging, long-term care trade associations, and other entities.
235.17The system must be designed to provide information on quality to:
235.18    (1) consumers and their families to facilitate informed choices of service providers;
235.19    (2) providers to enable them to measure the results of their quality improvement
235.20efforts and compare quality achievements with other service providers; and
235.21    (3) public and private purchasers of long-term care services to enable them to
235.22purchase high-quality care.
235.23    (b) The system must be developed in consultation with the long-term care task force,
235.24area agencies on aging, and representatives of consumers, providers, and labor unions.
235.25Within the limits of available appropriations, the commissioners may employ consultants
235.26to assist with this project.

235.27    Sec. 67. Minnesota Statutes 2006, section 256B.441, subdivision 1, is amended to read:
235.28    Subdivision 1. Rate determination Rebasing of nursing facility operating cost
235.29payment rates. (a) The commissioner shall establish a value-based nursing facility
235.30reimbursement system which will provide facility-specific, prospective rates for nursing
235.31facilities participating in the medical assistance program. The rates shall be determined
235.32using an annual statistical and cost report filed by each nursing facility. The total payment
235.33rate shall be composed of four rate components: direct care services, support services,
235.34external fixed, and property-related rate components. The payment rate shall be derived
236.1from statistical measures of actual costs incurred in facility operation of nursing facilities.
236.2From this cost basis, the components of the total payment rate shall be adjusted for quality
236.3of services provided, recognition of staffing levels, geographic variation in labor costs, and
236.4resident acuity. The commissioner shall rebase nursing facility operating cost payment
236.5rates to align payments to facilities with the cost of providing care. The rebased operating
236.6cost payment rates shall be calculated using the statistical and cost report filed by each
236.7nursing facility for the report period ending one year prior to the rate year.
236.8    (b) Rates shall be rebased annually. The new operating cost payment rates based on
236.9this section shall take effect beginning with the rate year beginning October 1, 2009, and
236.10shall be phased in over three rate years through October 1, 2011.
236.11    (c) Operating cost payment rates shall be rebased on October 1, 2012, and every
236.12two years after that date.
236.13    (d) Operating cost payment rates for rate years in which rebasing does not occur
236.14shall be increased by the Global Insight SNF Market Basket inflation factor from the
236.15midpoint of the previous rate year to the midpoint of the next rate year.
236.16    (e) Each cost reporting year shall begin on October 1 and end on the following
236.17September 30. Beginning in 2006, a statistical and cost report shall be filed by each
236.18nursing facility by January 15. Notice of rates shall be distributed by August 15 and the
236.19rates shall go into effect on October 1 for one year.
236.20    (c) The commissioner shall begin to phase in the new reimbursement system
236.21beginning October 1, 2007. Full phase-in shall be completed by October 1, 2011.

236.22    Sec. 68. Minnesota Statutes 2006, section 256B.441, subdivision 2, is amended to read:
236.23    Subd. 2. Definitions. For purposes of this section, the terms in subdivisions 3 to
236.2442 42a have the meanings given unless otherwise provided for in this section.

236.25    Sec. 69. Minnesota Statutes 2006, section 256B.441, subdivision 5, is amended to read:
236.26    Subd. 5. Administrative costs. "Administrative costs" means the direct costs for
236.27administering the overall activities of the nursing home. These costs include salaries and
236.28wages of the administrator, assistant administrator, business office employees, security
236.29guards, and associated fringe benefits and payroll taxes, fees, contracts, or purchases
236.30related to business office functions, licenses, and permits except as provided in the
236.31external fixed costs category, employee recognition, travel including meals and lodging,
236.32training, voice and data communication or transmission, office supplies, liability insurance
236.33and other forms of insurance not designated to other areas, personnel recruitment, legal
236.34services, accounting services, management or business consultants, data processing,
237.1information technology, Web site, central or home office costs, business meetings and
237.2seminars, postage, fees for professional organizations, subscriptions, security services,
237.3advertising, board of director's fees, working capital interest expense, and bad debts and
237.4bad debt collection fees.

237.5    Sec. 70. Minnesota Statutes 2006, section 256B.441, subdivision 6, is amended to read:
237.6    Subd. 6. Allowed costs. "Allowed costs" means the amounts reported by the facility
237.7which are necessary for the operation of the facility and the care of residents and which
237.8are reviewed by the department for accuracy, reasonableness, and compliance with this
237.9section and generally accepted accounting principles. All references to costs in this section
237.10shall be assumed to refer to allowed costs.

237.11    Sec. 71. Minnesota Statutes 2006, section 256B.441, subdivision 10, is amended to
237.12read:
237.13    Subd. 10. Dietary costs. "Dietary costs" means the costs for the salaries and wages
237.14of the dietary supervisor, dietitians, chefs, cooks, dishwashers, and other employees
237.15assigned to the kitchen and dining room, and associated fringe benefits and payroll
237.16taxes. Dietary costs also includes the salaries or fees of dietary consultants, direct costs
237.17of raw food (both normal and special diet food), dietary supplies, and food preparation
237.18and serving. Also included are special dietary supplements used for tube feeding or oral
237.19feeding, such as elemental high nitrogen diet, even if written as a prescription item by a
237.20physician.

237.21    Sec. 72. Minnesota Statutes 2006, section 256B.441, subdivision 11, is amended to
237.22read:
237.23    Subd. 11. Direct care costs category. "Direct care costs category" "Direct care
237.24costs" means costs for nursing services, activities, and social services the wages of nursing
237.25administration, staff education, direct care registered nurses, licensed practical nurses,
237.26certified nursing assistants, trained medication aides, and associated fringe benefits and
237.27payroll taxes; services from a supplemental nursing services agency; supplies that are
237.28stocked at nursing stations or on the floor and distributed or used individually, including,
237.29but not limited to: alcohol, applicators, cotton balls, incontinence pads, disposable ice
237.30bags, dressings, bandages, water pitchers, tongue depressors, disposable gloves, enemas,
237.31enema equipment, soap, medication cups, diapers, plastic waste bags, sanitary products,
237.32thermometers, hypodermic needles and syringes, clinical reagents or similar diagnostic
237.33agents, drugs that are not paid for on a separate fee schedule by the medical assistance
238.1program or any other payer, and technology related to the provision of nursing care to
238.2residents, such as electronic charting systems.

238.3    Sec. 73. Minnesota Statutes 2006, section 256B.441, subdivision 13, is amended to
238.4read:
238.5    Subd. 13. External fixed costs category. "External fixed costs category" "External
238.6fixed costs" means costs related to the nursing home surcharge under section 256.9657,
238.7subdivision 1 ; licensure fees under section 144.122; long-term care consultation fees
238.8under section 256B.0911, subdivision 6; family advisory council fee under section
238.9 144A.33 ; scholarships under section 256B.431, subdivision 36; planned closure rate
238.10adjustments under section 256B.436 or 256B.437; or single bed room incentives under
238.11section 256B.431, subdivision 42; property taxes and property insurance; and PERA.

238.12    Sec. 74. Minnesota Statutes 2006, section 256B.441, subdivision 14, is amended to
238.13read:
238.14    Subd. 14. Facility average case mix index. "Facility average case mix index" or
238.15"CMI" means a numerical value score that describes the relative resource use for all
238.16residents within the groups under the resource utilization group (RUG-III) classification
238.17system prescribed by the commissioner based on an assessment of each resident. The
238.18facility average CMI shall be computed as the standardized days divided by total days for
238.19all residents in the facility. The RUG's weights used in this section shall be as follows
238.20for each RUG's class: SE3 1.605; SE2 1.247; SE1 1.081; RAD 1.509; RAC 1.259; RAB
238.211.109; RAA 0.957; SSC 1.453; SSB 1.254; SSA 1.047; CC2 1.292; CC1 1.200; CB2
238.221.086; CB1 1.017; CA2 0.908; CA1 0.834; IB2 0.877; IB1 0.817; IA2 0.720; IA1 0.676;
238.23BB2 0.956; BB1 0.885; BA2 0.716; BA1 0.673; PE2 1.199; PE1 1.104; PD2 1.023;
238.24PD1 0.948; PC2 0.926; PC1 0.860; PB2 0.786; PB1 0.734; PA2 0.691; PA1 0.651; BC1
238.250.651; and DDF 1.000

238.26    Sec. 75. Minnesota Statutes 2006, section 256B.441, is amended by adding a
238.27subdivision to read:
238.28    Subd. 14a. Facility type groups. Facilities shall be classified into two groups,
238.29called "facility type groups," which shall consist of:
238.30    (1) C&NC/R80: facilities that are hospital-attached, or are licensed under Minnesota
238.31Rules, parts 9570.2000 to 9570.3400; and
238.32    (2) freestanding: all other facilities.

239.1    Sec. 76. Minnesota Statutes 2006, section 256B.441, subdivision 17, is amended to
239.2read:
239.3    Subd. 17. Fringe benefit costs. "Fringe benefit costs" means the costs for group
239.4life, health, dental, workers' compensation, and other employee insurances and pension,
239.5profit-sharing, and retirement plans for which the employer pays all or a portion of the
239.6costs and that are available to at least all employees who work at least 20 hours per week.

239.7    Sec. 77. Minnesota Statutes 2006, section 256B.441, subdivision 20, is amended to
239.8read:
239.9    Subd. 20. Housekeeping costs. "Housekeeping costs" means the costs for the
239.10salaries and wages of the housekeeping supervisor, housekeepers, and other cleaning
239.11employees and associated fringe benefits and payroll taxes. It also includes the cost of
239.12housekeeping supplies, including, but not limited to, cleaning and lavatory supplies and
239.13contract services.

239.14    Sec. 78. Minnesota Statutes 2006, section 256B.441, subdivision 24, is amended to
239.15read:
239.16    Subd. 24. Maintenance and plant operations costs. "Maintenance and plant
239.17operations costs" means the costs for the salaries and wages of the maintenance supervisor,
239.18engineers, heating-plant employees, and other maintenance employees and associated
239.19fringe benefits and payroll taxes. It also includes direct costs for maintenance and
239.20operation of the building and grounds, including, but not limited to, fuel, electricity,
239.21medical waste and garbage removal, water, sewer, supplies, tools, and repairs.

239.22    Sec. 79. Minnesota Statutes 2006, section 256B.441, is amended by adding a
239.23subdivision to read:
239.24    Subd. 28a. Other direct care costs. "Other direct care costs" means the costs
239.25for the salaries and wages and associated fringe benefits and payroll taxes of mental
239.26health workers, religious personnel, and other direct care employees not specified in
239.27the definition of direct care costs.

239.28    Sec. 80. Minnesota Statutes 2006, section 256B.441, subdivision 30, is amended to
239.29read:
239.30    Subd. 30. Peer groups. Facilities shall be classified into three groups, called "peer
239.31groups," which by county. The groups shall consist of:
240.1    (1) C&NC/Short Stay/R80 - facilities that have three or more admissions per bed
240.2per year, are hospital-attached, or are licensed under Minnesota Rules, parts 9570.2000
240.3to 9570.3600 group one: facilities in Anoka, Benton, Carlton, Carver, Chisago, Dakota,
240.4Dodge, Goodhue, Hennepin, Isanti, Mille Lacs, Morrison, Olmsted, Ramsey, Rice, Scott,
240.5Sherburne, St. Louis, Stearns, Steele, Wabasha, Washington, Winona, or Wright County;
240.6    (2) boarding care homes - facilities that have more than 50 percent of their beds
240.7licensed as boarding care homes group two: facilities in Aitkin, Beltrami, Blue Earth,
240.8Brown, Cass, Clay, Cook, Crow Wing, Faribault, Fillmore, Freeborn, Houston, Hubbard,
240.9Itasca, Kanabec, Koochiching, Lake, Lake of the Woods, Le Sueur, Martin, McLeod,
240.10Meeker, Mower, Nicollet, Norman, Pine, Roseau, Sibley, Todd, Wadena, Waseca,
240.11Watonwan, or Wilkin County; and
240.12    (3) standard - all other facilities group three: facilities in all other counties.

240.13    Sec. 81. Minnesota Statutes 2006, section 256B.441, subdivision 31, is amended to
240.14read:
240.15    Subd. 31. Prior rate-setting method system operating cost payment rate. "Prior
240.16rate-setting method" "Prior system operating cost payment rate" means the operating cost
240.17payment rate determination process in effect prior to October 1, 2006 on September 30,
240.182009, under Minnesota Rules and Minnesota Statutes, not including planned closure rate
240.19adjustments under section 256B.436 or 256B.437, or single bed room incentives under
240.20section 256B.431, subdivision 42.

240.21    Sec. 82. Minnesota Statutes 2006, section 256B.441, is amended by adding a
240.22subdivision to read:
240.23    Subd. 33a. Raw food costs. "Raw food costs" means the cost of food provided to
240.24nursing facility residents. Also included are special dietary supplements used for tube
240.25feeding or oral feeding, such as elemental high nitrogen diet.

240.26    Sec. 83. Minnesota Statutes 2006, section 256B.441, subdivision 34, is amended to
240.27read:
240.28    Subd. 34. Related organization. "Related organization" means a person that
240.29furnishes goods or services to a nursing facility and that is a close relative of a nursing
240.30facility, an affiliate of a nursing facility, a close relative of an affiliate of a nursing facility,
240.31or an affiliate of a close relative of an affiliate of a nursing facility. As used in this
240.32subdivision, paragraphs (a) to (d) apply:
241.1    (a) "Affiliate" means a person that directly, or indirectly through one or more
241.2intermediaries, controls or is controlled by, or is under common control with another
241.3person.
241.4    (b) "Person" means an individual, a corporation, a partnership, an association, a
241.5trust, an unincorporated organization, or a government or political subdivision.
241.6    (c) "Close relative of an affiliate of a nursing facility" means an individual whose
241.7relationship by blood, marriage, or adoption to an individual who is an affiliate of a
241.8nursing facility is no more remote than first cousin.
241.9    (d) "Control" including the terms "controlling," "controlled by," and "under common
241.10control with" means the possession, direct or indirect, of the power to direct or cause the
241.11direction of the management, operations, or policies of a person, whether through the
241.12ownership of voting securities, by contract, or otherwise, or to influence in any manner
241.13other than through an arms length, legal transaction.

241.14    Sec. 84. Minnesota Statutes 2006, section 256B.441, subdivision 38, is amended to
241.15read:
241.16    Subd. 38. Social services costs. "Social services costs" means the costs for the
241.17salaries and wages of the supervisor and other social work employees, associated fringe
241.18benefits and payroll taxes, supplies, services, and consultants. This category includes the
241.19cost of those employees who manage and process admission to the nursing facility.

241.20    Sec. 85. Minnesota Statutes 2006, section 256B.441, is amended by adding a
241.21subdivision to read:
241.22    Subd. 42a. Therapy costs. "Therapy costs" means any costs related to medical
241.23assistance therapy services provided to residents that are not billed separately from the
241.24daily operating rate.

241.25    Sec. 86. Minnesota Statutes 2006, section 256B.441, is amended by adding a
241.26subdivision to read:
241.27    Subd. 48. Calculation of operating per diems. The direct care per diem for
241.28each facility shall be the facility's direct care costs divided by its standardized days.
241.29The other care-related per diem shall be the sum of the facility's activities costs, other
241.30direct care costs, raw food costs, therapy costs, and social services costs, divided by the
241.31facility's resident days. The other operating per diem shall be the sum of the facility's
241.32administrative costs, dietary costs, housekeeping costs, laundry costs, and maintenance
241.33and plant operations costs divided by the facility's resident days.

242.1    Sec. 87. Minnesota Statutes 2006, section 256B.441, is amended by adding a
242.2subdivision to read:
242.3    Subd. 49. Determination of total care-related per diem. The total care-related
242.4per diem for each facility shall be the sum of the direct care per diem and the other
242.5care-related per diem.

242.6    Sec. 88. Minnesota Statutes 2006, section 256B.441, is amended by adding a
242.7subdivision to read:
242.8    Subd. 50. Determination of total care-related limit. The limit on the total
242.9care-related per diem shall be determined for each peer group and facility type group
242.10combination. A facility's total care-related per diems shall be limited to 120 percent of the
242.11median for the facility's peer and facility type group. The facility-specific direct care costs
242.12used in making this comparison and in the calculation of the median shall be based on a
242.13RUG's weight of 1.00. A facility that is above that limit shall have its total care-related per
242.14diem reduced to the limit. If a reduction of the total care-related per diem is necessary
242.15because of this limit, the reduction shall be made proportionally to both the direct care per
242.16diem and the other care-related per diem.

242.17    Sec. 89. Minnesota Statutes 2006, section 256B.441, is amended by adding a
242.18subdivision to read:
242.19    Subd. 51. Determination of other operating limit. The limit on the other operating
242.20per diem shall be determined for each peer group. A facility's other operating per diem
242.21shall be limited to 105 percent of the median for its peer group. A facility that is above
242.22that limit shall have its other operating per diem reduced to the limit.

242.23    Sec. 90. Minnesota Statutes 2006, section 256B.441, is amended by adding a
242.24subdivision to read:
242.25    Subd. 52. Determination of efficiency incentive. Each facility shall be eligible
242.26for an efficiency incentive based on its other operating per diem. A facility with an other
242.27operating per diem that exceeds the limit in subdivision 51 shall receive no efficiency
242.28incentive. All other facilities shall receive an incentive calculated as 50 percent times the
242.29difference between the facility's other operating per diem and its other operating per diem
242.30limit, up to a maximum incentive of $3.

242.31    Sec. 91. Minnesota Statutes 2006, section 256B.441, is amended by adding a
242.32subdivision to read:
243.1    Subd. 53. Calculation of payment rate for external fixed costs. The commissioner
243.2shall calculate a payment rate for external fixed costs.
243.3    (a) For a facility licensed as a nursing home, the portion related to section 256.9657
243.4shall be equal to $8.86. For a facility licensed as both a nursing home and a boarding care
243.5home, the portion related to section 256.9657 shall be equal to $8.86 multiplied by the
243.6result of its number of nursing home beds divided by its total number of licensed beds.
243.7    (b) The portion related to the licensure fee under section 144.122, paragraph (d),
243.8shall be the amount of the fee divided by actual resident days.
243.9    (c) The portion related to scholarships shall be determined under section 256B.431,
243.10subdivision 36.
243.11    (d) The portion related to long-term care consultation shall be determined according
243.12to section 256B.0911, subdivision 6.
243.13    (e) The portion related to development and education of resident and family advisory
243.14councils under section 144A.33 shall be $5 divided by 365.
243.15    (f) The portion related to planned closure rate adjustments shall be as determined
243.16under sections 256B.436 and 256B.437, subdivision 6.
243.17    (g) The portions related to property insurance, real estate taxes, special assessments,
243.18and payments made in lieu of real estate taxes directly identified or allocated to the nursing
243.19facility shall be the actual amounts divided by actual resident days.
243.20    (h) The portion related to the Public Employees Retirement Association shall be
243.21actual costs divided by resident days.
243.22    (i) The single bed room incentives shall be as determined under section 256B.431,
243.23subdivision 42.
243.24    (j) The payment rate for external fixed costs shall be the sum of the amounts in
243.25paragraphs (a) to (i).

243.26    Sec. 92. Minnesota Statutes 2006, section 256B.441, is amended by adding a
243.27subdivision to read:
243.28    Subd. 54. Adjustment of per diem for inflation. The total care-related per diem
243.29and other operating per diem calculated under this section shall be adjusted for inflation to
243.30adjust for the delay between the reporting year and the rate year. The total care-related
243.31payment rate and other operating payment rate shall be calculated as the per diem
243.32increased by the Global Insight Consumer Price Index urban inflation factor for the period
243.33from the midpoint of the reporting year to the midpoint of the rate year.

244.1    Sec. 93. Minnesota Statutes 2006, section 256B.441, is amended by adding a
244.2subdivision to read:
244.3    Subd. 55. Determination of total payment rates. In rate years when rates are
244.4rebased, the total payment rate for a RUG's weight of 1.00 shall be the sum of the total
244.5care-related payment rate, other operating payment rate, efficiency incentive, external
244.6fixed cost rate, and the property rate determined under section 256B.434. To determine
244.7a total payment rate for each RUG's level, the total care-related payment rate shall be
244.8divided into the direct care payment rate and the other care-related payment rate, and the
244.9direct care payment rate multiplied by the RUG's weight for each RUG's level using the
244.10weights in subdivision 14.

244.11    Sec. 94. Minnesota Statutes 2006, section 256B.441, is amended by adding a
244.12subdivision to read:
244.13    Subd. 56. Phase-in of rebased operating cost payment rates. For the rate years
244.14beginning October 1, 2009, October 1, 2010, and October 1, 2011, the operating cost
244.15payment rate calculated under this section shall be phased in by blending it with the
244.16operating cost payment rate determined under section 256B.434. For the rate year
244.17beginning October 1, 2009, the operating cost payment rate for each facility shall be
244.1825 percent of the operating cost payment rate from this section, and 75 percent of the
244.19operating cost payment rate from section 256B.434. For the rate year beginning October 1,
244.202010, the operating cost payment rate for each facility shall be 35 percent of the operating
244.21cost payment rate from this section, and 65 percent of the operating cost payment rate
244.22from section 256B.434. For the rate year beginning October 1, 2011, the operating cost
244.23payment rate for each facility shall be the operating cost payment rate determined under
244.24this section. The blending of operating cost payment rates under this section shall be
244.25performed separately for each RUG's class.

244.26    Sec. 95. Minnesota Statutes 2006, section 256B.441, is amended by adding a
244.27subdivision to read:
244.28    Subd. 57. Adjustment for inflation during phase-in of rebased operating cost
244.29payment rates. During the phase-in of operating cost payment rates under subdivision
244.3056, both the operating costs per diem under this section and the operating cost payment
244.31rate under section 256B.434 shall be adjusted for inflation. The adjustment for each year
244.32for the operating cost per diems shall be the Global Insight Consumer Price Index urban
244.33inflation factor from the midpoint of the reporting year to the midpoint of the current rate
244.34year. The adjustment for each year for the operating cost payment rate under section
245.1256B.434 shall be the Global Insight Consumer Price Index urban inflation factor from the
245.2midpoint of the October 1, 2007, rate year to the midpoint of the current rate year.

245.3    Sec. 96. Minnesota Statutes 2006, section 256B.441, is amended by adding a
245.4subdivision to read:
245.5    Subd. 58. Hold harmless. For the rate years beginning October 1, 2009, October 1,
245.62010, and October 1, 2011, no nursing facility shall receive an operating cost payment
245.7rate less than its operating cost payment rate under section 256B.434. The comparison
245.8of operating cost payment rates under this section shall be made for each of the RUG's
245.9classes separately, and the operating cost payment rates under section 256B.434 used
245.10under this section shall not include the inflation increases described in subdivision 57.

245.11    Sec. 97. Minnesota Statutes 2006, section 256B.441, is amended by adding a
245.12subdivision to read:
245.13    Subd. 59. Appeals. Nursing facilities may appeal, as defined under section 256B.50,
245.14the determination of a payment rate established under this chapter.

245.15    Sec. 98. Minnesota Statutes 2006, section 256B.49, subdivision 11, is amended to read:
245.16    Subd. 11. Authority. (a) The commissioner is authorized to apply for home and
245.17community-based service waivers, as authorized under section 1915(c) of the Social
245.18Security Act to serve persons under the age of 65 who are determined to require the level
245.19of care provided in a nursing home and persons who require the level of care provided in a
245.20hospital. The commissioner shall apply for the home and community-based waivers in
245.21order to:
245.22    (i) promote the support of persons with disabilities in the most integrated settings;
245.23    (ii) expand the availability of services for persons who are eligible for medical
245.24assistance;
245.25    (iii) promote cost-effective options to institutional care; and
245.26    (iv) obtain federal financial participation.
245.27    (b) The provision of waivered services to medical assistance recipients with
245.28disabilities shall comply with the requirements outlined in the federally approved
245.29applications for home and community-based services and subsequent amendments,
245.30including provision of services according to a service plan designed to meet the needs of
245.31the individual. For purposes of this section, the approved home and community-based
245.32application is considered the necessary federal requirement.
246.1    (c) The commissioner shall provide interested persons serving on agency advisory
246.2committees and, task forces, the Centers for Independent Living, and others upon who
246.3request, with to be on a list to receive, notice of, and an opportunity to comment on,
246.4at least 30 days before any effective dates, (1) any substantive changes to the state's
246.5disability services program manual, or (2) changes or amendments to the federally
246.6approved applications for home and community-based waivers, prior to their submission
246.7to the federal Centers for Medicare and Medicaid Services.
246.8    (d) The commissioner shall seek approval, as authorized under section 1915(c) of
246.9the Social Security Act, to allow medical assistance eligibility under this section for
246.10children under age 21 without deeming of parental income or assets.
246.11    (e) The commissioner shall seek approval, as authorized under section 1915(c) of
246.12the Social Act, to allow medical assistance eligibility under this section for individuals
246.13under age 65 without deeming the spouse's income or assets.

246.14    Sec. 99. Minnesota Statutes 2006, section 256B.49, is amended by adding a
246.15subdivision to read:
246.16    Subd. 16a. Medical assistance reimbursement. (a) The commissioner shall
246.17seek federal approval for medical assistance reimbursement of independent living skills
246.18services, foster care waiver service, supported employment, prevocational service,
246.19structured day service, and adult day care under the home and community-based waiver
246.20for persons with a traumatic brain injury, the community alternatives for disabled
246.21individuals waivers, and the community alternative care waivers.
246.22    (b) Medical reimbursement shall be made only when the provider demonstrates
246.23evidence of its capacity to meet basic health, safety, and protection standards through
246.24one of the methods in paragraphs (c) to (e).
246.25    (c) The provider is licensed to provide services under chapter 245B and agrees to
246.26apply these standards to services funded through the traumatic brain injury, community
246.27alternatives for disabled, or community alternative care home and community-based
246.28waivers.
246.29    (d) The local agency contracting for the services certifies on a form provided by the
246.30commissioner that the provider has the capacity to meet the individual needs as identified
246.31in each person's individual service plan. When certifying that the service provider meets
246.32the necessary provider qualifications, the local agency shall verify that the provider has
246.33policies and procedures governing the following:
246.34    (1) protection of the consumer's rights and privacy;
246.35    (2) risk assessment and planning;
247.1    (3) record keeping and reporting of incidents and emergencies with documentation
247.2of corrective action if needed;
247.3    (4) service outcomes, regular reviews of progress, and periodic reports;
247.4    (5) complaint and grievance procedures;
247.5    (6) service termination or suspension;
247.6    (7) necessary training and supervision of direct care staff that includes:
247.7    (i) documentation in personnel files of 20 hours of orientation training in providing
247.8training related to service provision;
247.9    (ii) training in recognizing the symptoms and effects of certain disabilities, health
247.10conditions, and positive behavioral supports and interventions; and
247.11    (iii) a minimum of five hours of related training annually; and
247.12    (8) when applicable, the local agency shall verify that the provider has policies and
247.13procedures in place governing the following:
247.14    (i) safe medication administration;
247.15    (ii) proper handling of consumer funds; and
247.16    (iii) behavioral interventions that are in compliance with prohibitions and standards
247.17developed by the commissioner to meet federal requirements regarding the use of
247.18restraints and restrictive interventions.
247.19    (e) For foster care waiver services or independent living skills services, the local
247.20agency contracting for the services certifies on a form provided by the commissioner that
247.21the provider meets the following:
247.22    (1) the provider of foster care waiver services is licensed to provide adult foster
247.23care under Minnesota Rules, parts 9555.5105 to 9555.6265, or child foster care under
247.24Minnesota Rules, parts 2960.3000 to 2960.3230;
247.25    (2) the provider of independent living skills services also provides licensed foster
247.26care services and agrees to apply the foster care standards under Minnesota Rules, parts
247.279555.5105; 9555.5705, subpart 2; 9555.6167; 9555.6185; 9555.6195; 9555.6225, subpart
247.288; 9555.6245; 9555.6255; and 9555.6265, or parts 2960.3010; 2960.3080, subparts 10
247.29and 11; 2960.3210; 2960.3220, subparts 5 to 7; and 2960.3230, for the provision of those
247.30services; and
247.31    (3) the provider has policies and procedures applying to the provision of foster
247.32care waiver services or independent living skills services that govern (i) behavioral
247.33interventions that are in compliance with prohibitions and standards developed by the
247.34commissioner to meet federal requirements regarding the use of restraints and restrictive
247.35interventions and (ii) documentation of service needs and outcomes, regular reviews
247.36of progress, and periodic reports.
248.1    (f) The local agency shall review each provider's continued compliance with
248.2the basic health, safety, and protection standards on a regular basis. For the review
248.3of paragraph (e), the local agency shall coordinate the review with the county review
248.4of foster care licensure.
248.5EFFECTIVE DATE.This section is effective the day following final enactment.

248.6    Sec. 100. Minnesota Statutes 2006, section 256B.5012, is amended by adding a
248.7subdivision to read:
248.8    Subd. 7. ICF/MR rate increases October 1, 2007, and October 1, 2008. (a) For
248.9the rate periods beginning October 1, 2007, and October 1, 2008, the commissioner shall
248.10make available to each facility reimbursed under this section an adjustment to the total
248.11operating payment rate of three percent.
248.12    (b) Seventy-five percent of the money resulting from the rate adjustment under
248.13paragraph (a) must be used to increase wages and benefits and pay associated costs for
248.14employees, except for administrative and central office employees. Seventy-five percent
248.15of the money received by a facility as a result of the rate adjustment provided in paragraph
248.16(a) must be used only for wage, benefit, and staff increases implemented on or after
248.17the effective date of the rate increase each year, and must not be used for increases
248.18implemented prior to that date. The wage adjustment eligible employees may receive may
248.19vary based on merit, seniority, or other factors determined by the provider.
248.20    (c) For each facility, the commissioner shall make available an adjustment, based
248.21on occupied beds, using the percentage specified in paragraph (a) multiplied by the total
248.22payment rate, including variable rate but excluding the property-related payment rate, in
248.23effect on the preceding day. The total payment rate must include the adjustment provided
248.24in section 256B.501, subdivision 12.
248.25    (d) A facility whose payment rates are governed by closure agreements, receivership
248.26agreements, or Minnesota Rules, part 9553.0075, is not eligible for an adjustment
248.27otherwise granted under this subdivision.
248.28    (e) A facility may apply for the portion of the payment rate adjustment provided
248.29under paragraph (a) for employee wages and benefits and associated costs. The application
248.30must be made to the commissioner and contain a plan by which the facility will distribute
248.31the funds according to paragraph (b). For facilities in which the employees are represented
248.32by an exclusive bargaining representative, an agreement negotiated and agreed to by
248.33the employer and the exclusive bargaining representative constitutes the plan. The
248.34commissioner shall not review, and shall not require changes, to the portion or portions
248.35of the plan covered by collective bargaining agreements. A negotiated agreement may
249.1constitute the plan only if the agreement is finalized after the date of enactment of all rate
249.2increases for the rate year. The commissioner shall review the plan to ensure that the
249.3payment rate adjustment per diem is used as provided in this subdivision. To be eligible, a
249.4facility must submit its plan by March 31, 2008, and December 31, 2008, respectively.
249.5If a facility's plan is effective for its employees after the first day of the applicable rate
249.6period that the funds are available, the payment rate adjustment per diem is effective
249.7the same date as its plan.
249.8    (f) A copy of the approved distribution plan must be made available to all employees
249.9by giving each employee a copy or by posting it in an area of the facility to which all
249.10employees have access. If an employee does not receive the wage and benefit adjustment
249.11described in the facility's approved plan and is unable to resolve the problem with the
249.12facility's management or through the employee's union representative, the employee
249.13may contact the commissioner at an address or telephone number provided by the
249.14commissioner and included in the approved plan.

249.15    Sec. 101. Minnesota Statutes 2006, section 256B.69, subdivision 23, is amended to
249.16read:
249.17    Subd. 23. Alternative services; elderly and disabled persons. (a) The
249.18commissioner may implement demonstration projects to create alternative integrated
249.19delivery systems for acute and long-term care services to elderly persons and persons
249.20with disabilities as defined in section 256B.77, subdivision 7a, that provide increased
249.21coordination, improve access to quality services, and mitigate future cost increases.
249.22The commissioner may seek federal authority to combine Medicare and Medicaid
249.23capitation payments for the purpose of such demonstrations and may contract with
249.24Medicare-approved special needs plans to provide Medicaid services. Medicare funds and
249.25services shall be administered according to the terms and conditions of the federal contract
249.26and demonstration provisions. For the purpose of administering medical assistance funds,
249.27demonstrations under this subdivision are subject to subdivisions 1 to 22. The provisions
249.28of Minnesota Rules, parts 9500.1450 to 9500.1464, apply to these demonstrations,
249.29with the exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, subpart 1,
249.30items B and C, which do not apply to persons enrolling in demonstrations under this
249.31section. An initial open enrollment period may be provided. Persons who disenroll from
249.32demonstrations under this subdivision remain subject to Minnesota Rules, parts 9500.1450
249.33to 9500.1464. When a person is enrolled in a health plan under these demonstrations and
249.34the health plan's participation is subsequently terminated for any reason, the person shall
249.35be provided an opportunity to select a new health plan and shall have the right to change
250.1health plans within the first 60 days of enrollment in the second health plan. Persons
250.2required to participate in health plans under this section who fail to make a choice of
250.3health plan shall not be randomly assigned to health plans under these demonstrations.
250.4Notwithstanding section 256L.12, subdivision 5, and Minnesota Rules, part 9505.5220,
250.5subpart 1, item A, if adopted, for the purpose of demonstrations under this subdivision,
250.6the commissioner may contract with managed care organizations, including counties, to
250.7serve only elderly persons eligible for medical assistance, elderly and disabled persons, or
250.8disabled persons only. For persons with a primary diagnosis of developmental disability,
250.9serious and persistent mental illness, or serious emotional disturbance, the commissioner
250.10must ensure that the county authority has approved the demonstration and contracting
250.11design. Enrollment in these projects for persons with disabilities shall be voluntary. The
250.12commissioner shall not implement any demonstration project under this subdivision for
250.13persons with a primary diagnosis of developmental disabilities, serious and persistent
250.14mental illness, or serious emotional disturbance, without approval of the county board of
250.15the county in which the demonstration is being implemented.
250.16    (b) Notwithstanding chapter 245B, sections 252.40 to 252.46, 256B.092, 256B.501
250.17to 256B.5015, and Minnesota Rules, parts 9525.0004 to 9525.0036, 9525.1200 to
250.189525.1330 , 9525.1580, and 9525.1800 to 9525.1930, the commissioner may implement
250.19under this section projects for persons with developmental disabilities. The commissioner
250.20may capitate payments for ICF/MR services, waivered services for developmental
250.21disabilities, including case management services, day training and habilitation and
250.22alternative active treatment services, and other services as approved by the state and by
250.23the federal government. Case management and active treatment must be individualized
250.24and developed in accordance with a person-centered plan. Costs under these projects may
250.25not exceed costs that would have been incurred under fee-for-service. Beginning July 1,
250.262003, and until two four years after the pilot project implementation date, subcontractor
250.27participation in the long-term care developmental disability pilot is limited to a nonprofit
250.28long-term care system providing ICF/MR services, home and community-based waiver
250.29services, and in-home services to no more than 120 consumers with developmental
250.30disabilities in Carver, Hennepin, and Scott Counties. The commissioner shall report to the
250.31legislature prior to expansion of the developmental disability pilot project. This paragraph
250.32expires two four years after the implementation date of the pilot project.
250.33    (c) Before implementation of a demonstration project for disabled persons, the
250.34commissioner must provide information to appropriate committees of the house of
250.35representatives and senate and must involve representatives of affected disability groups
250.36in the design of the demonstration projects.
251.1    (d) A nursing facility reimbursed under the alternative reimbursement methodology
251.2in section 256B.434 may, in collaboration with a hospital, clinic, or other health care entity
251.3provide services under paragraph (a). The commissioner shall amend the state plan and
251.4seek any federal waivers necessary to implement this paragraph.
251.5    (e) The commissioner, in consultation with the commissioners of commerce and
251.6health, may approve and implement programs for all-inclusive care for the elderly (PACE)
251.7according to federal laws and regulations governing that program and state laws or rules
251.8applicable to participating providers. The process for approval of these programs shall
251.9begin only after the commissioner receives grant money in an amount sufficient to cover
251.10the state share of the administrative and actuarial costs to implement the programs during
251.11state fiscal years 2006 and 2007. Grant amounts for this purpose shall be deposited in an
251.12account in the special revenue fund and are appropriated to the commissioner to be used
251.13solely for the purpose of PACE administrative and actuarial costs. A PACE provider is
251.14not required to be licensed or certified as a health plan company as defined in section
251.1562Q.01, subdivision 4 . Persons age 55 and older who have been screened by the county
251.16and found to be eligible for services under the elderly waiver or community alternatives
251.17for disabled individuals or who are already eligible for Medicaid but meet level of
251.18care criteria for receipt of waiver services may choose to enroll in the PACE program.
251.19Medicare and Medicaid services will be provided according to this subdivision and
251.20federal Medicare and Medicaid requirements governing PACE providers and programs.
251.21PACE enrollees will receive Medicaid home and community-based services through the
251.22PACE provider as an alternative to services for which they would otherwise be eligible
251.23through home and community-based waiver programs and Medicaid State Plan Services.
251.24The commissioner shall establish Medicaid rates for PACE providers that do not exceed
251.25costs that would have been incurred under fee-for-service or other relevant managed care
251.26programs operated by the state.
251.27    (f) The commissioner shall seek federal approval to expand the Minnesota disability
251.28health options (MnDHO) program established under this subdivision in stages, first to
251.29regional population centers outside the seven-county metro area and then to all areas
251.30of the state. Until January 1, 2008 July 1, 2009, expansion for MnDHO projects that
251.31include home and community-based services is limited to the two projects and service
251.32areas in effect on March 1, 2006. Enrollment in integrated MnDHO programs that
251.33include home and community-based services shall remain voluntary. Costs for home
251.34and community-based services included under MnDHO must not exceed costs that
251.35would have been incurred under the fee-for-service program. In developing program
251.36specifications for expansion of integrated programs, the commissioner shall involve and
252.1consult the state-level stakeholder group established in subdivision 28, paragraph (d),
252.2including consultation on whether and how to include home and community-based waiver
252.3programs. Plans for further expansion of MnDHO projects shall be presented to the chairs
252.4of the house and senate committees with jurisdiction over health and human services
252.5policy and finance by February 1, 2007.
252.6    (g) Notwithstanding section 256B.0261, health plans providing services under this
252.7section are responsible for home care targeted case management and relocation targeted
252.8case management. Services must be provided according to the terms of the waivers and
252.9contracts approved by the federal government.

252.10    Sec. 102. Minnesota Statutes 2006, section 256B.69, subdivision 28, is amended to
252.11read:
252.12    Subd. 28. Medicare special needs plans; medical assistance basic health care.
252.13    (a) The commissioner may contract with qualified Medicare-approved special needs
252.14plans to provide medical assistance basic health care services to persons with disabilities,
252.15including those with developmental disabilities. Basic health care services include:
252.16    (1) those services covered by the medical assistance state plan except for ICF/MR
252.17services, home and community-based waiver services, case management for persons with
252.18developmental disabilities under section 256B.0625, subdivision 20a, and personal care
252.19and certain home care services defined by the commissioner in consultation with the
252.20stakeholder group established under paragraph (d); and
252.21    (2) basic health care services may also include risk for up to 100 days of nursing
252.22facility services for persons who reside in a noninstitutional setting and home health
252.23services related to rehabilitation as defined by the commissioner after consultation with
252.24the stakeholder group.
252.25    The commissioner may exclude other medical assistance services from the basic
252.26health care benefit set. Enrollees in these plans can access any excluded services on the
252.27same basis as other medical assistance recipients who have not enrolled.
252.28    Unless a person is otherwise required to enroll in managed care, enrollment in these
252.29plans for Medicaid services must be voluntary. For purposes of this subdivision, automatic
252.30enrollment with an option to opt out is not voluntary enrollment.
252.31    (b) Beginning January 1, 2007, the commissioner may contract with qualified
252.32Medicare special needs plans to provide basic health care services under medical
252.33assistance to persons who are dually eligible for both Medicare and Medicaid and those
252.34Social Security beneficiaries eligible for Medicaid but in the waiting period for Medicare.
252.35The commissioner shall consult with the stakeholder group under paragraph (d) (e) in
253.1developing program specifications for these services. The commissioner shall report to
253.2the chairs of the house and senate committees with jurisdiction over health and human
253.3services policy and finance by February 1, 2007, on implementation of these programs and
253.4the need for increased funding for the ombudsman for managed care and other consumer
253.5assistance and protections needed due to enrollment in managed care of persons with
253.6disabilities. Payment for Medicaid services provided under this subdivision for the months
253.7of May and June will be made no earlier than July 1 of the same calendar year.
253.8    (c) Beginning January 1, 2008, the commissioner may expand contracting under this
253.9subdivision to all persons with disabilities not otherwise required to enroll in managed
253.10care.
253.11    (d) By February 1, 2009, the commissioner shall report to the chairs of the house and
253.12senate committees with jurisdiction over health and human services policy and finance on
253.13the initial results of implementation of contracts with qualified Medicare special needs
253.14plans to provide basic health care services under medical assistance to persons who are
253.15dually eligible for both Medicare and Medicaid. This report shall include an overall
253.16assessment of the impact on quality of care including actual costs and benefits.
253.17    (e) The commissioner shall establish a state-level stakeholder group to provide
253.18advice on managed care programs for persons with disabilities, including both MnDHO
253.19and contracts with special needs plans that provide basic health care services as described
253.20in paragraphs (a) and (b). The stakeholder group shall include representatives of the
253.21counties and labor organizations representing county social service workers, members,
253.22consumer advocates, and providers, and provide advice on program expansions under this
253.23subdivision and subdivision 23, including:
253.24    (1) implementation efforts;
253.25    (2) consumer protections; and
253.26    (3) program specifications such as quality assurance measures, data collection and
253.27reporting, and evaluation of costs, quality, and results.; and
253.28    (4) county safety net protections for persons with disabilities.
253.29    (e) (f) Each plan under contract to provide medical assistance basic health care
253.30services shall establish a local or regional stakeholder group, including representatives
253.31of the counties covered by the plan and labor organizations representing county social
253.32service workers, members, consumer advocates, and current providers, for advice on
253.33issues that arise in the local or regional area.

253.34    Sec. 103. [256C.261] SERVICES FOR DEAF-BLIND PERSONS.
254.1     (a) The commissioner of human services shall combine the existing biennial base
254.2level funding for deaf-blind services into a single grant program. At least 35 percent
254.3of the total funding is awarded for services and other supports to deaf-blind children
254.4and their families and at least 25 percent is awarded for services and other supports to
254.5deaf-blind adults.
254.6    The commissioner shall award grants for the purposes of:
254.7    (1) providing services and supports to individuals who are deaf-blind; and
254.8    (2) developing and providing training to counties and the network of senior citizen
254.9service providers. The purpose of the training grants is to teach counties how to use
254.10existing programs that capture federal financial participation to meet the needs of eligible
254.11deaf-blind persons and to build capacity of senior service programs to meet the needs of
254.12seniors with a dual sensory hearing and vision loss.
254.13    (b) The commissioner may make grants:
254.14    (1) for services and training provided by organizations; and
254.15    (2) to develop and administer consumer-directed services.
254.16    (c) Any entity that is able to satisfy the grant criteria is eligible to receive a grant
254.17under paragraph (a).
254.18    (d) Deaf-blind service providers are not required to, but may, provide intervenor
254.19services as part of the service package provided with grant funds under this section.

254.20    Sec. 104. Minnesota Statutes 2006, section 256D.44, subdivision 2, is amended to read:
254.21    Subd. 2. Standard of assistance for persons eligible for medical assistance
254.22waivers or at risk of placement in a group residential housing facility. The state
254.23standard of assistance for a person (1) who is eligible for a medical assistance home
254.24and community-based services waiver or a person, (2) who has been determined by the
254.25local agency to meet the plan requirements for placement in a group residential housing
254.26facility under section 256I.04, subdivision 1a, or (3) who is eligible for a shelter needy
254.27payment under subdivision 5, paragraph (f), is the standard established in subdivision 3,
254.28paragraph (a) or (b).

254.29    Sec. 105. Minnesota Statutes 2006, section 256D.44, subdivision 5, is amended to read:
254.30    Subd. 5. Special needs. In addition to the state standards of assistance established in
254.31subdivisions 1 to 4, payments are allowed for the following special needs of recipients of
254.32Minnesota supplemental aid who are not residents of a nursing home, a regional treatment
254.33center, or a group residential housing facility.
255.1    (a) The county agency shall pay a monthly allowance for medically prescribed
255.2diets if the cost of those additional dietary needs cannot be met through some other
255.3maintenance benefit. The need for special diets or dietary items must be prescribed by
255.4a licensed physician. Costs for special diets shall be determined as percentages of the
255.5allotment for a one-person household under the thrifty food plan as defined by the United
255.6States Department of Agriculture. The types of diets and the percentages of the thrifty
255.7food plan that are covered are as follows:
255.8    (1) high protein diet, at least 80 grams daily, 25 percent of thrifty food plan;
255.9    (2) controlled protein diet, 40 to 60 grams and requires special products, 100 percent
255.10of thrifty food plan;
255.11    (3) controlled protein diet, less than 40 grams and requires special products, 125
255.12percent of thrifty food plan;
255.13    (4) low cholesterol diet, 25 percent of thrifty food plan;
255.14    (5) high residue diet, 20 percent of thrifty food plan;
255.15    (6) pregnancy and lactation diet, 35 percent of thrifty food plan;
255.16    (7) gluten-free diet, 25 percent of thrifty food plan;
255.17    (8) lactose-free diet, 25 percent of thrifty food plan;
255.18    (9) antidumping diet, 15 percent of thrifty food plan;
255.19    (10) hypoglycemic diet, 15 percent of thrifty food plan; or
255.20    (11) ketogenic diet, 25 percent of thrifty food plan.
255.21    (b) Payment for nonrecurring special needs must be allowed for necessary home
255.22repairs or necessary repairs or replacement of household furniture and appliances using
255.23the payment standard of the AFDC program in effect on July 16, 1996, for these expenses,
255.24as long as other funding sources are not available.
255.25    (c) A fee for guardian or conservator service is allowed at a reasonable rate
255.26negotiated by the county or approved by the court. This rate shall not exceed five percent
255.27of the assistance unit's gross monthly income up to a maximum of $100 per month. If the
255.28guardian or conservator is a member of the county agency staff, no fee is allowed.
255.29    (d) The county agency shall continue to pay a monthly allowance of $68 for
255.30restaurant meals for a person who was receiving a restaurant meal allowance on June 1,
255.311990, and who eats two or more meals in a restaurant daily. The allowance must continue
255.32until the person has not received Minnesota supplemental aid for one full calendar month
255.33or until the person's living arrangement changes and the person no longer meets the criteria
255.34for the restaurant meal allowance, whichever occurs first.
255.35    (e) A fee of ten percent of the recipient's gross income or $25, whichever is less,
255.36is allowed for representative payee services provided by an agency that meets the
256.1requirements under SSI regulations to charge a fee for representative payee services. This
256.2special need is available to all recipients of Minnesota supplemental aid regardless of
256.3their living arrangement.
256.4    (f) Notwithstanding the language in this subdivision, an amount equal to the
256.5maximum allotment authorized by the federal Food Stamp Program for a single individual
256.6which is in effect on the first day of January July of the previous each year will be added to
256.7the standards of assistance established in subdivisions 1 to 4 for individuals adults under
256.8the age of 65 who qualify as shelter needy and are: (1) relocating from an institution, or
256.9an adult mental health residential treatment program under section 256B.0622, and who
256.10are shelter needy; (2) self-directed supports option participants defined under section
256.11256B.0657 if enacted in the 2007 legislative session; or (3) home and community-based
256.12waiver recipients living in their own rented, leased, or owned apartment or home not
256.13owned, operated, or controlled by a provider of service not related by blood or marriage.
256.14Notwithstanding subdivision 3, paragraph (c), an individual eligible for the shelter needy
256.15benefit under subdivision 5, paragraph (f), is considered a household of one. An eligible
256.16individual who receives this benefit prior to age 65 may continue to receive the benefit
256.17after the age of 65.
256.18    (g)(1) Persons eligible for shelter needy funding under paragraph (f), who are not
256.19receiving medial assistance home and community-based waiver services, are eligible for
256.20a state-funded transitional supports allowance under section 256B.49, subdivision 16,
256.21paragraph (e), to establish their own residence not owned, operated, or controlled by a
256.22provider of service not related by blood or marriage.
256.23    (2) "Shelter needy" means that the assistance unit incurs monthly shelter costs that
256.24exceed 40 percent of the assistance unit's gross income before the application of this
256.25special needs standard. "Gross income" for the purposes of this section is the applicant's or
256.26recipient's income as defined in section 256D.35, subdivision 10, or the standard specified
256.27in subdivision 3, paragraph (a) or (b), whichever is greater. A recipient of a federal or
256.28state housing subsidy, that limits shelter costs to a percentage of gross income, shall not be
256.29considered shelter needy for purposes of this paragraph.

256.30    Sec. 106. Minnesota Statutes 2006, section 256I.04, subdivision 3, is amended to read:
256.31    Subd. 3. Moratorium on the development of group residential housing beds. (a)
256.32County agencies shall not enter into agreements for new group residential housing beds
256.33with total rates in excess of the MSA equivalent rate except: (1) for group residential
256.34housing establishments licensed under Minnesota Rules, parts 9525.0215 to 9525.0355,
256.35provided the facility is needed to meet the census reduction targets for persons with
257.1developmental disabilities at regional treatment centers; (2) to ensure compliance with
257.2the federal Omnibus Budget Reconciliation Act alternative disposition plan requirements
257.3for inappropriately placed persons with developmental disabilities or mental illness;
257.4(3) up to 80 beds in a single, specialized facility located in Hennepin County that will
257.5provide housing for chronic inebriates who are repetitive users of detoxification centers
257.6and are refused placement in emergency shelters because of their state of intoxication,
257.7and planning for the specialized facility must have been initiated before July 1, 1991, in
257.8anticipation of receiving a grant from the Housing Finance Agency under section 462A.05,
257.9subdivision 20a , paragraph (b); (4) notwithstanding the provisions of subdivision 2a, for
257.10up to 190 supportive housing units in Anoka, Dakota, Hennepin, or Ramsey County
257.11for homeless adults with a mental illness, a history of substance abuse, or human
257.12immunodeficiency virus or acquired immunodeficiency syndrome. For purposes of this
257.13section, "homeless adult" means a person who is living on the street or in a shelter or
257.14discharged from a regional treatment center, community hospital, or residential treatment
257.15program and has no appropriate housing available and lacks the resources and support
257.16necessary to access appropriate housing. At least 70 percent of the supportive housing
257.17units must serve homeless adults with mental illness, substance abuse problems, or human
257.18immunodeficiency virus or acquired immunodeficiency syndrome who are about to be
257.19or, within the previous six months, has been discharged from a regional treatment center,
257.20or a state-contracted psychiatric bed in a community hospital, or a residential mental
257.21health or chemical dependency treatment program. If a person meets the requirements of
257.22subdivision 1, paragraph (a), and receives a federal or state housing subsidy, the group
257.23residential housing rate for that person is limited to the supplementary rate under section
257.24256I.05, subdivision 1a , and is determined by subtracting the amount of the person's
257.25countable income that exceeds the MSA equivalent rate from the group residential housing
257.26supplementary rate. A resident in a demonstration project site who no longer participates
257.27in the demonstration program shall retain eligibility for a group residential housing
257.28payment in an amount determined under section 256I.06, subdivision 8, using the MSA
257.29equivalent rate. Service funding under section 256I.05, subdivision 1a, will end June 30,
257.301997, if federal matching funds are available and the services can be provided through a
257.31managed care entity. If federal matching funds are not available, then service funding will
257.32continue under section 256I.05, subdivision 1a; or (6) (5) for group residential housing
257.33beds in settings meeting the requirements of subdivision 2a, clauses (1) and (3), which
257.34are used exclusively for recipients receiving home and community-based waiver services
257.35under sections 256B.0915, 256B.092, subdivision 5, 256B.093, and 256B.49, and who
257.36resided in a nursing facility for the six months immediately prior to the month of entry
258.1into the group residential housing setting. The group residential housing rate for these
258.2beds must be set so that the monthly group residential housing payment for an individual
258.3occupying the bed when combined with the nonfederal share of services delivered under
258.4the waiver for that person does not exceed the nonfederal share of the monthly medical
258.5assistance payment made for the person to the nursing facility in which the person resided
258.6prior to entry into the group residential housing establishment. The rate may not exceed
258.7the MSA equivalent rate plus $426.37 for any case.; or (6) for an additional two beds,
258.8resulting in a total of 32 beds, for a facility located in Hennepin County providing services
258.9for recovering and chemically dependent men that has had a group residential housing
258.10contract with the county and has been licensed as a board and lodge facility with special
258.11services since 1980; (7) for a group residential housing provider located in Stearns County
258.12that operates a 40-bed facility, that received financing through the Minnesota Housing
258.13Finance Agency Ending Long-Term Homelessness Initiative and serves chemically
258.14dependent clientele, providing 24-hour-a-day supervision; (8) for a group residential
258.15housing provider located in Crow Wing County that serves a chemically dependent
258.16clientele, providing 24-hour-a-day supervision and limiting a resident's maximum length
258.17of stay to 13 months out of a consecutive 24-month period; (9) for a 60-bed facility in
258.18St. Louis County which opened in January 2006 that will serve chemically dependent
258.19persons operated by a group residential housing provider that currently operates a 304-bed
258.20facility in Minneapolis; and (10) for a group residential housing provider that operates two
258.21ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
258.22which provide community support and serve the mental health needs of individuals who
258.23have chronically lived unsheltered, providing 24-hour-a-day supervision.
258.24    (b) A county agency may enter into a group residential housing agreement for beds
258.25with rates in excess of the MSA equivalent rate in addition to those currently covered
258.26under a group residential housing agreement if the additional beds are only a replacement
258.27of beds with rates in excess of the MSA equivalent rate which have been made available
258.28due to closure of a setting, a change of licensure or certification which removes the beds
258.29from group residential housing payment, or as a result of the downsizing of a group
258.30residential housing setting. The transfer of available beds from one county to another can
258.31only occur by the agreement of both counties.

258.32    Sec. 107. Minnesota Statutes 2006, section 256I.05, is amended by adding a
258.33subdivision to read:
258.34    Subd. 1h. Supplementary rate for certain facilities serving chemically
258.35dependent males. Notwithstanding subdivisions 1a and 1c, beginning July 1, 2007, a
259.1county agency shall negotiate a supplementary rate in addition to the rate specified in
259.2subdivision 1, not to exceed $737.87 per month, including any legislatively authorized
259.3inflationary adjustments, for a group residential housing provider that:
259.4    (1) is located in Ramsey County and has had a group residential housing contract
259.5with the county since 1982 and has been licensed as a board and lodge facility with special
259.6services since 1979; and
259.7    (2) serves recovering and chemically dependent males, providing 24-hour-a-day
259.8supervision.

259.9    Sec. 108. Minnesota Statutes 2006, section 256I.05, is amended by adding a
259.10subdivision to read:
259.11    Subd. 1i. Supplementary rate for certain facilities; Hennepin County.
259.12    Notwithstanding the provisions of subdivisions 1a and 1c, a county agency shall negotiate
259.13a supplementary rate in addition to the rate specified in subdivision 1, not to exceed $700
259.14per month, including any legislatively authorized inflationary adjustments, for a facility
259.15located in Hennepin County with a capacity of up to 48 beds that has been licensed since
259.161978 as a board and lodging facility and that until August 1, 2007, operated as a licensed
259.17chemical dependency treatment program.
259.18EFFECTIVE DATE.This section is effective the day following final enactment.

259.19    Sec. 109. Minnesota Statutes 2006, section 256I.05, is amended by adding a
259.20subdivision to read:
259.21    Subd. 1j. Supplementary rate for certain facilities; St. Louis County. (a)
259.22Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
259.23county agency shall negotiate a supplementary rate in addition to the rate specified in
259.24subdivision 1, not to exceed $700 per month, including any legislatively authorized
259.25inflationary adjustments, for a 60-bed facility in St. Louis County which opened in
259.26January 2006 that will serve chemically dependent persons operated by a group residential
259.27housing provider that currently operates a 304-bed facility in Minneapolis.
259.28    (b) The supplementary rate in paragraph (a) applies to the 48 beds which do not
259.29already receive a supplementary rate.

259.30    Sec. 110. Minnesota Statutes 2006, section 256I.05, is amended by adding a
259.31subdivision to read:
259.32    Subd. 1k. Supplementary rate for certain facilities; Crow Wing County.
259.33    Notwithstanding the provisions of subdivisions 1a and 1c, beginning July 1, 2007, a
260.1county agency shall negotiate a supplementary rate in addition to the rate specified in
260.2subdivision 1, not to exceed $700 per month, including any legislatively authorized
260.3inflationary adjustments, for a new 65-bed facility in Crow Wing County that will serve
260.4chemically dependent persons operated by a group residential housing provider that
260.5currently operates a 304-bed facility in Minneapolis and a 44-bed facility in Duluth which
260.6opened in January of 2006.

260.7    Sec. 111. Minnesota Statutes 2006, section 256I.05, is amended by adding a
260.8subdivision to read:
260.9    Subd. 1l. Supplementary rate for certain facilities; Stearns County.
260.10    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
260.11shall negotiate a supplementary service rate in addition to the rate specified in subdivision
260.121, not to exceed $700 per month, including any legislatively authorized inflationary
260.13adjustments, for a group residential housing provider located in Stearns County that
260.14operates a 40-bed facility, that received financing through the Minnesota Housing Finance
260.15Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
260.16clientele, providing 24-hour-a-day supervision.

260.17    Sec. 112. Minnesota Statutes 2006, section 256I.05, is amended by adding a
260.18subdivision to read:
260.19    Subd. 1m. Supplementary rate for certain facilities; St. Louis County.
260.20    Notwithstanding the provisions of this section, beginning July 1, 2007, a county agency
260.21shall negotiate a supplementary service rate in addition to the rate specified in subdivision
260.221, not to exceed $700 per month, including any legislatively authorized inflationary
260.23adjustments, for a group residential housing provider located in St. Louis County that
260.24operates a 30-bed facility, that received financing through the Minnesota Housing Finance
260.25Agency Ending Long-Term Homelessness Initiative and serves chemically dependent
260.26clientele, providing 24-hour-a-day supervision.

260.27    Sec. 113. Minnesota Statutes 2006, section 256I.05, is amended by adding a
260.28subdivision to read:
260.29    Subd. 1n. Supplemental rate for certain facilities; Hennepin and Ramsey
260.30Counties. Notwithstanding the provisions of this section, beginning July 1, 2007, a county
260.31agency shall negotiate a supplemental service rate in addition to the rate specified in
260.32subdivision 1, not to exceed $715.78 per month, including any legislatively authorized
260.33inflationary adjustments, for a group residential housing provider that operates two
261.1ten-bed facilities, one located in Hennepin County and one located in Ramsey County,
261.2which provide community support and serve the mental health needs of individuals who
261.3have chronically lived unsheltered, providing 24-hour-a-day supervision.

261.4    Sec. 114. Laws 2000, chapter 340, section 19, is amended to read:
261.5    Sec. 19. ALTERNATIVE CARE PILOT PROJECTS.
261.6    (a) Expenditures for housing with services and adult foster care shall be excluded
261.7when determining average monthly expenditures per client for alternative care pilot
261.8projects authorized in Laws 1993, First Special Session chapter 1, article 5, section 133.
261.9    (b) Alternative care pilot projects shall not expire on June 30, 2001, but shall
261.10continue until June 30, 2005 2007.
261.11EFFECTIVE DATE.This section is effective retroactively from June 29, 2005, for
261.12activities related to discontinuing pilot projects under this section.

261.13    Sec. 115. Laws 2006, chapter 282, article 20, section 37, is amended to read:
261.14    Sec. 37. REPAYMENT DELAY.
261.15    A county that overspent its allowed amounts in calendar year 2004 or 2005 under
261.16the waivered services program for persons with developmental disabilities shall not be
261.17required to pay back the amount of overspending until May 31, 2007.
261.18EFFECTIVE DATE.This section is effective the day following final enactment.

261.19    Sec. 116. LICENSURE; SERVICES FOR YOUTH WITH DISABILITIES.
261.20    (a) Notwithstanding the requirements of Minnesota Statutes, chapter 245A, upon the
261.21recommendation of a county agency, the commissioner of human services shall grant a
261.22license with any necessary variances to a nonresidential program for youth which provides
261.23services to youth with disabilities under age 21 during nonschool hours established
261.24to ensure health and safety, prevent out-of-home placement, and increase community
261.25inclusion of youth with disabilities. The nonresidential youth program is subject to the
261.26conditions of any variances granted and with consumer rights under Minnesota Statutes,
261.27section 245B.04, consumer protection standards under Minnesota Statutes, section
261.28245B.05, service standards under Minnesota Statutes, section 245B.06, management
261.29standards under Minnesota Statutes, section 245B.07, and fire marshal inspections under
261.30Minnesota Statutes, section 245A.151, until the commissioner develops other licensure
261.31requirements for this type of program.
262.1    (b) By February 1, 2008, the commissioner shall recommend amendments to
262.2licensure requirements in Minnesota Statutes, chapter 245A, to allow licensure of
262.3appropriate services for school-age youth with disabilities under age 21 who need
262.4supervision and services to develop skills necessary to maintain personal safety and
262.5increase their independence, productivity, and participation in their communities during
262.6nonschool hours. As part of developing the recommendations, the commissioner shall
262.7survey county agencies to determine how the needs of youth with disabilities under age 21
262.8who require supervision and support services are being met and the funding sources used.
262.9The recommendations must be provided to the house and senate chairs of the committees
262.10with jurisdiction over licensing of programs for youth with disabilities.

262.11    Sec. 117. INDEPENDENT LIVING.
262.12    An individual who has lived in one of the facilities under Minnesota Statutes,
262.13section 256I.05, subdivision 1n, who is being transitioned to independent living as
262.14part of the program plan continues to be eligible for group residential housing and the
262.15supplemental service rate negotiated with the county under Minnesota Statutes, section
262.16256I.05, subdivision 1n.

262.17    Sec. 118. ASSISTIVE TECHNOLOGY RECOMMENDATIONS.
262.18    Subdivision 1. Review. (a) During the biennium ending June 30, 2009, the Council
262.19on Disability shall facilitate a statewide review of the assistive technology needs of people
262.20with disabling conditions, and seniors. The council shall identify community-based
262.21service providers, state agencies, and other entities involved in providing assistive
262.22technology supports.
262.23    (b) The council shall provide oversight and direction to the Minnesota Regions
262.24Assistive Technology Collaborative during the biennium ending June 30, 2009.
262.25    Subd. 2. Recommendations. The council shall present to the chairs of the house
262.26and senate committees having jurisdiction over human services, by January 1, 2009,
262.27recommendations, including proposed legislation creating a statewide comprehensive plan
262.28to meet the assistive technology needs of people with disabling conditions and seniors.
262.29The statewide plan must include steps to coordinate and streamline assistive technology
262.30services.

262.31    Sec. 119. COMMUNITY SERVICES PROVIDER RATE INCREASES.
262.32    (a) The commissioner of human services shall increase allocations, reimbursement
262.33rates, or rate limits, as applicable, by three percent for the rate period beginning October 1,
263.12007, and the rate period beginning October 1, 2008, effective for services rendered on
263.2or after those dates.
263.3    (b) The three percent annual rate increase described in this section must be provided
263.4to:
263.5    (1) home and community-based waivered services for persons with developmental
263.6disabilities or related conditions under Minnesota Statutes, section 256B.501;
263.7    (2) home and community-based waivered services for the elderly under Minnesota
263.8Statutes, section 256B.0915;
263.9    (3) waivered services under community alternatives for disabled individuals under
263.10Minnesota Statutes, section 256B.49;
263.11    (4) community alternative care waivered services under Minnesota Statutes, section
263.12256B.49;
263.13    (5) traumatic brain injury waivered services under Minnesota Statutes, section
263.14256B.49;
263.15    (6) nursing services and home health services under Minnesota Statutes, section
263.16256B.0625, subdivision 6a;
263.17    (7) personal care services and nursing supervision of personal care services under
263.18Minnesota Statutes, section 256B.0625, subdivision 19a;
263.19    (8) private duty nursing services under Minnesota Statutes, section 256B.0625,
263.20subdivision 7;
263.21    (9) day training and habilitation services for adults with developmental disabilities
263.22or related conditions under Minnesota Statutes, sections 252.40 to 252.46, including the
263.23additional cost of rate adjustments on day training and habilitation service, provided as a
263.24social service under Minnesota Statutes, section 256M.60;
263.25    (10) alternative care services under Minnesota Statutes, section 256B.0913;
263.26    (11) adult residential program grants under Minnesota Statutes, section 245.73;
263.27    (12) adult and children's mental health grants under Minnesota Rules, parts
263.289535.1700 to 9535.1760;
263.29    (13) the group residential housing supplementary service rate under Minnesota
263.30Statutes, section 256I.05, subdivision 1a;
263.31    (14) adult mental health integrated fund grants under Minnesota Statutes, section
263.32245.4661;
263.33    (15) semi-independent living services (SILS) under Minnesota Statutes, section
263.34252.275, including SILS funding under county social services grants formerly funded
263.35under Minnesota Statutes, chapter 256I;
264.1    (16) community support services for deaf and hard-of-hearing adults with mental
264.2illness who use or wish to use sign language as their primary means of communication
264.3under Minnesota Statutes, section 256.01, subdivision 2;
264.4    (17) living skills training programs for persons with intractable epilepsy who need
264.5assistance in the transition to independent living under Laws 1988, chapter 689;
264.6    (18) physical therapy services under Minnesota Statutes, sections 256B.0625,
264.7subdivision 8, and 256D.03, subdivision 4;
264.8    (19) occupational therapy services under Minnesota Statutes, sections 256B.0625,
264.9subdivision 8a, and 256D.03, subdivision 4;
264.10    (20) speech-language therapy services under Minnesota Statutes, section 256D.03,
264.11subdivision 4, and Minnesota Rules, part 9505.0390;
264.12    (21) respiratory therapy services under Minnesota Statutes, section 256D.03,
264.13subdivision 4, and Minnesota Rules, part 9505.0295;
264.14    (22) aging grants under Minnesota Statutes, sections 256.975 to 256.977, 256B.0917,
264.15and 256B.0928;
264.16    (23) deaf and hard-of-hearing grants under Minnesota Statutes, sections 256C.233;
264.17256C.25; Laws 1985, chapter 9, article 1; and Laws 1997, First Special Session chapter
264.185, section 20;
264.19    (24) children's therapeutic services and supports under Minnesota Statutes, section
264.20256B.0943;
264.21    (25) tier I chemical health services under Minnesota Statutes, chapter 254B;
264.22    (26) consumer support grants under Minnesota Statutes, section 256.476;
264.23    (27) family support grants under Minnesota Statutes, section 252.32;
264.24    (28) case management services to persons with HIV or AIDS under Minnesota
264.25Statutes, section 256.01, subdivision 19; and
264.26    (29) adult rehabilitative mental health services under Minnesota Statutes, section
264.27256B.0623.
264.28    (c) Providers that receive a rate increase under this section shall use 75 percent of
264.29the additional revenue to increase wages and benefits and pay associated costs for all
264.30employees, except for management fees, the administrator, and central office staff.
264.31    (d) For public employees, the increase for wages and benefits for certain staff is
264.32available and pay rates must be increased only to the extent that they comply with laws
264.33governing public employees' collective bargaining. Money received by a provider for pay
264.34increases under this section may be used only for increases implemented on or after the
264.35first day of the rate period in which the increase is available and must not be used for
264.36increases implemented prior to that date.
265.1    (e) A copy of the provider's plan for complying with paragraph (c) must be made
265.2available to all employees by giving each employee a copy or by posting a copy in an area
265.3of the provider's operation to which all employees have access. If an employee does not
265.4receive the adjustment, if any, described in the plan and is unable to resolve the problem
265.5with the provider, the employee may contact the employee's union representative. If the
265.6employee is not covered by a collective bargaining agreement, the employee may contact
265.7the commissioner at a telephone number provided by the commissioner and included in
265.8the provider's plan.
265.9    (f) The commissioner and each county agency shall take steps necessary to
265.10implement the increases required by this section on the dates specified, and the increases
265.11must be effective on the dates specified, regardless of the client's service authorization date
265.12and notwithstanding the terms of any provider contract, service agreement, or schedule
265.13that limits when a county may increase payment rates.

265.14    Sec. 120. DENTAL ACCESS FOR PERSONS WITH DISABILITIES.
265.15    The commissioner of human services shall study access to dental services for
265.16persons with disabilities, and shall present recommendations for improving access to
265.17dental services to the legislature by January 15, 2008. The study must examine physical
265.18and geographic access, the willingness of dentists to serve persons with disabilities
265.19enrolled in state health care programs, reimbursement rates for dental service providers,
265.20and other factors identified by the commissioner.

265.21    Sec. 121. COMMISSIONER REQUIRED TO SEEK FEDERAL APPROVAL.
265.22    By October 1, 2007, the commissioner shall seek federal approval to allow persons
265.23who have been eligible for medical assistance for employed persons with disabilities
265.24(MA-EPD) under Minnesota Statutes, section 256B.057, subdivision 9, for each of the 24
265.25consecutive months prior to becoming age 65 to continue using the MA-EPD eligibility
265.26rules as long as they qualify.

265.27    Sec. 122. MINNESOTA RULES.
265.28    The Department of Administration shall publish adopted rules in the State Register
265.29making the terminology changes specified in section 92 in Minnesota Rules. Upon
265.30publication in the State Register, the terminology changes for Minnesota Rules are
265.31adopted without further administrative action.

265.32    Sec. 123. REVISOR'S INSTRUCTION.
266.1    The revisor of statutes shall change the terms in column A to the terms in column B
266.2wherever they appear in Minnesota Statutes:

266.3		Column A		Column B
266.4 266.5 266.6 266.7 266.8		"Office of Ombudsman for Older Minnesotans" and "Office of the Ombudsman for Older Minnesotans"		"Office of Ombudsman for Long-Term Care"
266.9 266.10		"ombudsman for older Minnesotans"		"ombudsman for long-term care"

266.11    Sec. 124. REPEALER.
266.12Minnesota Statutes 2006, sections 252.21; 252.22; 252.23; 252.24; 252.25; 252.261;
266.13252.275, subdivision 5; 256.9743; 256B.0913, subdivisions 5b, 5c, 5d, 5e, 5f, 5g, and 5h;
266.14and 256B.441, subdivisions 12, 16, 21, 26, 28, 42, and 45, are repealed.

266.15ARTICLE 5

266.16MENTAL HEALTH

266.17    Section 1. Minnesota Statutes 2006, section 245.462, subdivision 20, is amended to
266.18read:
266.19    Subd. 20. Mental illness. (a) "Mental illness" means an organic disorder of the
266.20brain or a clinically significant disorder of thought, mood, perception, orientation,
266.21memory, or behavior that is listed in the clinical manual of the International Classification
266.22of Diseases (ICD-9-CM), current edition, code range 290.0 to 302.99 or 306.0 to 316.0
266.23or the corresponding code in the American Psychiatric Association's Diagnostic and
266.24Statistical Manual of Mental Disorders (DSM-MD), current edition, Axes I, II, or III, and
266.25that seriously limits a person's capacity to function in primary aspects of daily living such
266.26as personal relations, living arrangements, work, and recreation.
266.27    (b) An "adult with acute mental illness" means an adult who has a mental illness that
266.28is serious enough to require prompt intervention.
266.29    (c) For purposes of case management and community support services, a "person
266.30with serious and persistent mental illness" means an adult who has a mental illness and
266.31meets at least one of the following criteria:
266.32    (1) the adult has undergone two or more episodes of inpatient care for a mental
266.33illness within the preceding 24 months;
266.34    (2) the adult has experienced a continuous psychiatric hospitalization or residential
266.35treatment exceeding six months' duration within the preceding 12 months;
267.1    (3) the adult has been treated by a crisis team two or more times within the preceding
267.224 months;
267.3    (4) the adult:
267.4    (i) has a diagnosis of schizophrenia, bipolar disorder, major depression, or borderline
267.5personality disorder;
267.6    (ii) indicates a significant impairment in functioning; and
267.7    (iii) has a written opinion from a mental health professional, in the last three years,
267.8stating that the adult is reasonably likely to have future episodes requiring inpatient or
267.9residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
267.10management or community support services are provided;
267.11    (4) (5) the adult has, in the last three years, been committed by a court as a person
267.12who is mentally ill under chapter 253B, or the adult's commitment has been stayed or
267.13continued; or
267.14    (5) (6) the adult (i) was eligible under clauses (1) to (4) (5), but the specified time
267.15period has expired or the adult was eligible as a child under section 245.4871, subdivision
267.166 ; and (ii) has a written opinion from a mental health professional, in the last three years,
267.17stating that the adult is reasonably likely to have future episodes requiring inpatient or
267.18residential treatment, of a frequency described in clause (1) or (2), unless ongoing case
267.19management or community support services are provided.

267.20    Sec. 2. Minnesota Statutes 2006, section 245.465, is amended by adding a subdivision
267.21to read:
267.22    Subd. 3. Responsibility not duplicated. For individuals who have health care
267.23coverage, the county board is not responsible for providing mental health services which
267.24are within the limits of the individual's health care coverage.

267.25    Sec. 3. Minnesota Statutes 2006, section 245.4874, is amended to read:
267.26245.4874 DUTIES OF COUNTY BOARD.
267.27    Subdivision 1. Duties of the county board. (a) The county board must:
267.28    (1) develop a system of affordable and locally available children's mental health
267.29services according to sections 245.487 to 245.4887;
267.30    (2) establish a mechanism providing for interagency coordination as specified in
267.31section 245.4875, subdivision 6;
267.32    (3) consider the assessment of unmet needs in the county as reported by the local
267.33children's mental health advisory council under section 245.4875, subdivision 5, paragraph
268.1(b), clause (3). The county shall provide, upon request of the local children's mental health
268.2advisory council, readily available data to assist in the determination of unmet needs;
268.3    (4) assure that parents and providers in the county receive information about how to
268.4gain access to services provided according to sections 245.487 to 245.4887;
268.5    (5) coordinate the delivery of children's mental health services with services
268.6provided by social services, education, corrections, health, and vocational agencies to
268.7improve the availability of mental health services to children and the cost-effectiveness of
268.8their delivery;
268.9    (6) assure that mental health services delivered according to sections 245.487
268.10to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
268.11assessment and individual treatment plan;
268.12    (7) provide the community with information about predictors and symptoms of
268.13emotional disturbances and how to access children's mental health services according to
268.14sections 245.4877 and 245.4878;
268.15    (8) provide for case management services to each child with severe emotional
268.16disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
268.17subdivisions 1, 3, and 5 ;
268.18    (9) provide for screening of each child under section 245.4885 upon admission
268.19to a residential treatment facility, acute care hospital inpatient treatment, or informal
268.20admission to a regional treatment center;
268.21    (10) prudently administer grants and purchase-of-service contracts that the county
268.22board determines are necessary to fulfill its responsibilities under sections 245.487 to
268.23245.4887 ;
268.24    (11) assure that mental health professionals, mental health practitioners, and case
268.25managers employed by or under contract to the county to provide mental health services
268.26are qualified under section 245.4871;
268.27    (12) assure that children's mental health services are coordinated with adult mental
268.28health services specified in sections 245.461 to 245.486 so that a continuum of mental
268.29health services is available to serve persons with mental illness, regardless of the person's
268.30age;
268.31    (13) assure that culturally informed mental health consultants are used as necessary
268.32to assist the county board in assessing and providing appropriate treatment for children of
268.33cultural or racial minority heritage; and
268.34    (14) consistent with section 245.486, arrange for or provide a children's mental
268.35health screening to a child receiving child protective services or a child in out-of-home
268.36placement, a child for whom parental rights have been terminated, a child found to be
269.1delinquent, and a child found to have committed a juvenile petty offense for the third or
269.2subsequent time, unless a screening has been performed within the previous 180 days, or
269.3the child is currently under the care of a mental health professional. The court or county
269.4agency must notify a parent or guardian whose parental rights have not been terminated of
269.5the potential mental health screening and the option to prevent the screening by notifying
269.6the court or county agency in writing. The screening shall be conducted with a screening
269.7instrument approved by the commissioner of human services according to criteria that
269.8are updated and issued annually to ensure that approved screening instruments are valid
269.9and useful for child welfare and juvenile justice populations, and shall be conducted
269.10by a mental health practitioner as defined in section 245.4871, subdivision 26, or a
269.11probation officer or local social services agency staff person who is trained in the use of
269.12the screening instrument. Training in the use of the instrument shall include training in the
269.13administration of the instrument, the interpretation of its validity given the child's current
269.14circumstances, the state and federal data practices laws and confidentiality standards, the
269.15parental consent requirement, and providing respect for families and cultural values.
269.16If the screen indicates a need for assessment, the child's family, or if the family lacks
269.17mental health insurance, the local social services agency, in consultation with the child's
269.18family, shall have conducted a diagnostic assessment, including a functional assessment,
269.19as defined in section 245.4871. The administration of the screening shall safeguard the
269.20privacy of children receiving the screening and their families and shall comply with the
269.21Minnesota Government Data Practices Act, chapter 13, and the federal Health Insurance
269.22Portability and Accountability Act of 1996, Public Law 104-191. Screening results shall be
269.23considered private data and the commissioner shall not collect individual screening results.
269.24    (b) When the county board refers clients to providers of children's therapeutic
269.25services and supports under section 256B.0943, the county board must clearly identify
269.26the desired services components not covered under section 256B.0943 and identify the
269.27reimbursement source for those requested services, the method of payment, and the
269.28payment rate to the provider.
269.29    Subd. 2. Responsibility not duplicated. For individuals who have health care
269.30coverage, the county board is not responsible for providing mental health services which
269.31are within the limits of the individual's health care coverage.

269.32    Sec. 4. Minnesota Statutes 2006, section 245.50, subdivision 5, is amended to read:
269.33    Subd. 5. Special contracts; bordering states. (a) An individual who is detained,
269.34committed, or placed on an involuntary basis under chapter 253B may be confined or
269.35treated in a bordering state pursuant to a contract under this section. An individual who is
270.1detained, committed, or placed on an involuntary basis under the civil law of a bordering
270.2state may be confined or treated in Minnesota pursuant to a contract under this section. A
270.3peace or health officer who is acting under the authority of the sending state may transport
270.4an individual to a receiving agency that provides services pursuant to a contract under
270.5this section and may transport the individual back to the sending state under the laws
270.6of the sending state. Court orders valid under the law of the sending state are granted
270.7recognition and reciprocity in the receiving state for individuals covered by a contract
270.8under this section to the extent that the court orders relate to confinement for treatment
270.9or care of mental illness or chemical dependency. Such treatment or care may address
270.10other conditions that may be co-occurring with the mental illness or chemical dependency.
270.11These court orders are not subject to legal challenge in the courts of the receiving state.
270.12Individuals who are detained, committed, or placed under the law of a sending state and
270.13who are transferred to a receiving state under this section continue to be in the legal
270.14custody of the authority responsible for them under the law of the sending state. Except
270.15in emergencies, those individuals may not be transferred, removed, or furloughed from
270.16a receiving agency without the specific approval of the authority responsible for them
270.17under the law of the sending state.
270.18    (b) While in the receiving state pursuant to a contract under this section, an
270.19individual shall be subject to the sending state's laws and rules relating to length of
270.20confinement, reexaminations, and extensions of confinement. No individual may be sent
270.21to another state pursuant to a contract under this section until the receiving state has
270.22enacted a law recognizing the validity and applicability of this section.
270.23    (c) If an individual receiving services pursuant to a contract under this section leaves
270.24the receiving agency without permission and the individual is subject to involuntary
270.25confinement under the law of the sending state, the receiving agency shall use all
270.26reasonable means to return the individual to the receiving agency. The receiving agency
270.27shall immediately report the absence to the sending agency. The receiving state has the
270.28primary responsibility for, and the authority to direct, the return of these individuals
270.29within its borders and is liable for the cost of the action to the extent that it would be
270.30liable for costs of its own resident.
270.31    (d) Responsibility for payment for the cost of care remains with the sending agency.
270.32    (e) This subdivision also applies to county contracts under subdivision 2 which
270.33include emergency care and treatment provided to a county resident in a bordering state.
270.34    (f) If a Minnesota resident is admitted to a facility in a bordering state under this
270.35chapter, a physician, licensed psychologist who has a doctoral degree in psychology, or
270.36an advance practice registered nurse certified in mental health, who is licensed in the
271.1bordering state, may act as an examiner under sections 253B.07, 253B.08, 253B.092,
271.2253B.12, and 253B.17 subject to the same requirements and limitations in section
271.3253B.02, subdivision 7.

271.4    Sec. 5. Minnesota Statutes 2006, section 245.98, subdivision 2, is amended to read:
271.5    Subd. 2. Program. The commissioner of human services shall establish a program
271.6for the treatment of compulsive gamblers. The commissioner may contract with an
271.7entity with expertise regarding the treatment of compulsive gambling to operate the
271.8program. The program may include the establishment of a statewide toll-free number,
271.9resource library, public education programs; regional in-service training programs and
271.10conferences for health care professionals, educators, treatment providers, employee
271.11assistance programs, and criminal justice representatives; and the establishment of
271.12certification standards for programs and service providers. The commissioner may enter
271.13into agreements with other entities and may employ or contract with consultants to
271.14facilitate the provision of these services or the training of individuals to qualify them to
271.15provide these services. The program may also include inpatient and outpatient treatment
271.16and rehabilitation services and for residents in a temporary or permanent residential
271.17setting for mental health or chemical dependency, and individuals in jails or correctional
271.18facilities. The program may also include research studies. The research studies must
271.19include baseline and prevalence studies for adolescents and adults to identify those at the
271.20highest risk. The program must be approved by the commissioner before it is established.

271.21    Sec. 6. Minnesota Statutes 2006, section 245.98, subdivision 5, is amended to read:
271.22    Subd. 5. Standards. The commissioner shall create standards for treatment and
271.23provider qualifications for the treatment component of the compulsive gambling program.
271.24The commissioner, in coordination with the commissioner of corrections, shall create
271.25standards for the assessment and treatment of compulsive gamblers in programs operated
271.26by the commissioner of corrections.

271.27    Sec. 7. [245A.175] MENTAL HEALTH TRAINING REQUIREMENT.
271.28    Prior to placement of a child in a foster care home, the child foster care provider, if
271.29required to be licensed, must complete two hours of training that addresses the causes,
271.30symptoms, and key warning signs of mental health disorders; cultural considerations; and
271.31effective approaches for dealing with a child's behaviors. At least one hour of the annual
271.3212-hour training requirement for foster parents must be on children's mental health issues
272.1and treatment. Training curriculum shall be approved by the commissioner of human
272.2services.

272.3    Sec. 8. Minnesota Statutes 2006, section 246.54, subdivision 1, is amended to read:
272.4    Subdivision 1. County portion for cost of care. Except for chemical dependency
272.5services provided under sections 254B.01 to 254B.09, the client's county shall pay to the
272.6state of Minnesota a portion of the cost of care provided in a regional treatment center
272.7or a state nursing facility to a client legally settled in that county. A county's payment
272.8shall be made from the county's own sources of revenue and payments shall be paid as
272.9follows: payments to the state from the county shall equal 20 percent a percentage of the
272.10cost of care, as determined by the commissioner, for each day, or the portion thereof, that
272.11the client spends at a regional treatment center or a state nursing facility. according to
272.12the following schedule for each admission:
272.13    (1) for the first 30 days: 20 percent until January 1, 2008, ten percent from January
272.141, 2008, to June 30, 2009, and zero percent thereafter;
272.15    (2) 20 percent for days 31 to 60; and
272.16    (3) for any days over 60: 20 percent until January 1, 2008, 30 percent from January
272.171, 2008, to June 30, 2009, 40 percent from July 1, 2009, to June 30, 2010, and 50 percent
272.18thereafter.
272.19 If payments received by the state under sections 246.50 to 246.53 exceed 80 percent the
272.20noncounty portion of the cost of care, the county shall be responsible for paying the state
272.21only the remaining amount. The county shall not be entitled to reimbursement from
272.22the client, the client's estate, or from the client's relatives, except as provided in section
272.23246.53 . No such payments shall be made for any client who was last committed prior to
272.24July 1, 1947.

272.25    Sec. 9. Minnesota Statutes 2006, section 256B.0625, subdivision 20, is amended to
272.26read:
272.27    Subd. 20. Mental health case management. (a) To the extent authorized by rule
272.28of the state agency, medical assistance covers case management services to persons with
272.29serious and persistent mental illness and children with severe emotional disturbance.
272.30Services provided under this section must meet the relevant standards in sections 245.461
272.31to 245.4887, the Comprehensive Adult and Children's Mental Health Acts, Minnesota
272.32Rules, parts 9520.0900 to 9520.0926, and 9505.0322, excluding subpart 10.
272.33    (b) Entities meeting program standards set out in rules governing family community
272.34support services as defined in section 245.4871, subdivision 17, are eligible for medical
273.1assistance reimbursement for case management services for children with severe
273.2emotional disturbance when these services meet the program standards in Minnesota
273.3Rules, parts 9520.0900 to 9520.0926 and 9505.0322, excluding subparts 6 and 10.
273.4    (c) Medical assistance and MinnesotaCare payment for mental health case
273.5management shall be made on a monthly basis. In order to receive payment for an eligible
273.6child, the provider must document at least a face-to-face contact with the child, the child's
273.7parents, or the child's legal representative. To receive payment for an eligible adult, the
273.8provider must document:
273.9    (1) at least a face-to-face contact with the adult or the adult's legal representative; or
273.10    (2) at least a telephone contact with the adult or the adult's legal representative and
273.11document a face-to-face contact with the adult or the adult's legal representative within
273.12the preceding two months.
273.13    (d) Payment for mental health case management provided by county or state staff
273.14shall be based on the monthly rate methodology under section 256B.094, subdivision 6,
273.15paragraph (b), with separate rates calculated for child welfare and mental health, and
273.16within mental health, separate rates for children and adults.
273.17    (e) Payment for mental health case management provided by Indian health services
273.18or by agencies operated by Indian tribes may be made according to this section or other
273.19relevant federally approved rate setting methodology.
273.20    (f) Payment for mental health case management provided by vendors who contract
273.21with a county or Indian tribe shall be based on a monthly rate negotiated by the host county
273.22or tribe. The negotiated rate must not exceed the rate charged by the vendor for the same
273.23service to other payers. If the service is provided by a team of contracted vendors, the
273.24county or tribe may negotiate a team rate with a vendor who is a member of the team. The
273.25team shall determine how to distribute the rate among its members. No reimbursement
273.26received by contracted vendors shall be returned to the county or tribe, except to reimburse
273.27the county or tribe for advance funding provided by the county or tribe to the vendor.
273.28    (g) If the service is provided by a team which includes contracted vendors, tribal
273.29staff, and county or state staff, the costs for county or state staff participation in the team
273.30shall be included in the rate for county-provided services. In this case, the contracted
273.31vendor, the tribal agency, and the county may each receive separate payment for services
273.32provided by each entity in the same month. In order to prevent duplication of services,
273.33each entity must document, in the recipient's file, the need for team case management and
273.34a description of the roles of the team members.
273.35    (h) The commissioner shall calculate the nonfederal share of actual medical
273.36assistance and general assistance medical care payments for each county, based on the
274.1higher of calendar year 1995 or 1996, by service date, project that amount forward to 1999,
274.2and transfer one-half of the result from medical assistance and general assistance medical
274.3care to each county's mental health grants under section 256E.12 for calendar year 1999.
274.4The annualized minimum amount added to each county's mental health grant shall be
274.5$3,000 per year for children and $5,000 per year for adults. The commissioner may reduce
274.6the statewide growth factor in order to fund these minimums. The annualized total amount
274.7transferred shall become part of the base for future mental health grants for each county.
274.8    (i) Notwithstanding section 256B.19, subdivision 1, the nonfederal share of costs
274.9for mental health case management shall be provided by the recipient's county of
274.10responsibility, as defined in sections 256G.01 to 256G.12, from sources other than federal
274.11funds or funds used to match other federal funds. If the service is provided by a tribal
274.12agency, the nonfederal share, if any, shall be provided by the recipient's tribe. When this
274.13service is paid by the state without a federal share through fee-for-service, 50 percent of
274.14the cost shall be provided by the recipient's county of responsibility.
274.15    (j) Notwithstanding any administrative rule to the contrary, prepaid medical
274.16assistance, general assistance medical care, and MinnesotaCare include mental health case
274.17management. When the service is provided through prepaid capitation, the nonfederal
274.18share is paid by the state and the county pays no share.
274.19    (j) (k) The commissioner may suspend, reduce, or terminate the reimbursement to a
274.20provider that does not meet the reporting or other requirements of this section. The county
274.21of responsibility, as defined in sections 256G.01 to 256G.12, or, if applicable, the tribal
274.22agency, is responsible for any federal disallowances. The county or tribe may share this
274.23responsibility with its contracted vendors.
274.24    (k) (l) The commissioner shall set aside a portion of the federal funds earned for
274.25county expenditures under this section to repay the special revenue maximization account
274.26under section 256.01, subdivision 2, clause (15). The repayment is limited to:
274.27    (1) the costs of developing and implementing this section; and
274.28    (2) programming the information systems.
274.29    (l) (m) Payments to counties and tribal agencies for case management expenditures
274.30under this section shall only be made from federal earnings from services provided
274.31under this section. When this service is paid by the state without a federal share through
274.32fee-for-service, 50 percent of the cost shall be provided by the state. Payments to
274.33county-contracted vendors shall include both the federal earnings, the state share, and the
274.34county share.
274.35    (m) (n) Notwithstanding section 256B.041, county payments for the cost of mental
274.36health case management services provided by county or state staff shall not be made
275.1to the commissioner of finance. For the purposes of mental health case management
275.2services provided by county or state staff under this section, the centralized disbursement
275.3of payments to counties under section 256B.041 consists only of federal earnings from
275.4services provided under this section.
275.5    (n) (o) Case management services under this subdivision do not include therapy,
275.6treatment, legal, or outreach services.
275.7    (o) (p) If the recipient is a resident of a nursing facility, intermediate care facility,
275.8or hospital, and the recipient's institutional care is paid by medical assistance, payment
275.9for case management services under this subdivision is limited to the last 180 days of
275.10the recipient's residency in that facility and may not exceed more than six months in a
275.11calendar year.
275.12    (p) (q) Payment for case management services under this subdivision shall not
275.13duplicate payments made under other program authorities for the same purpose.
275.14    (q) (r) By July 1, 2000, the commissioner shall evaluate the effectiveness of the
275.15changes required by this section, including changes in number of persons receiving
275.16mental health case management, changes in hours of service per person, and changes in
275.17caseload size.
275.18    (r) (s) For each calendar year beginning with the calendar year 2001, the annualized
275.19amount of state funds for each county determined under paragraph (h) shall be adjusted by
275.20the county's percentage change in the average number of clients per month who received
275.21case management under this section during the fiscal year that ended six months prior to
275.22the calendar year in question, in comparison to the prior fiscal year.
275.23    (s) (t) For counties receiving the minimum allocation of $3,000 or $5,000 described
275.24in paragraph (h), the adjustment in paragraph (s) shall be determined so that the county
275.25receives the higher of the following amounts:
275.26    (1) a continuation of the minimum allocation in paragraph (h); or
275.27    (2) an amount based on that county's average number of clients per month who
275.28received case management under this section during the fiscal year that ended six months
275.29prior to the calendar year in question, times the average statewide grant per person per
275.30month for counties not receiving the minimum allocation.
275.31    (t) (u) The adjustments in paragraphs (s) and (t) shall be calculated separately for
275.32children and adults.
275.33EFFECTIVE DATE.This section is effective January 1, 2009, except the
275.34amendment to paragraph (i) is effective January 1, 2008.

276.1    Sec. 10. Minnesota Statutes 2006, section 256B.0625, subdivision 47, is amended to
276.2read:
276.3    Subd. 47. Treatment foster care services. Effective July 1, 2006 2009, and subject
276.4to federal approval, medical assistance covers treatment foster care services according to
276.5section 256B.0946.

276.6    Sec. 11. Minnesota Statutes 2006, section 256B.0945, subdivision 4, is amended to
276.7read:
276.8    Subd. 4. Payment rates. (a) Notwithstanding sections 256B.19 and 256B.041,
276.9payments to counties for residential services provided by a residential facility shall only
276.10be made of federal earnings for services provided under this section, and the nonfederal
276.11share of costs for services provided under this section shall be paid by the county from
276.12sources other than federal funds or funds used to match other federal funds. Payment to
276.13counties for services provided according to this section shall be a proportion of the per
276.14day contract rate that relates to rehabilitative mental health services and shall not include
276.15payment for costs or services that are billed to the IV-E program as room and board.
276.16    (b) Per diem rates paid to providers under this section by prepaid plans shall be the
276.17proportion of the per-day contract rate that relates to rehabilitative mental health services
276.18and shall not include payment for group foster care costs or services that are billed to the
276.19county of financial responsibility.
276.20    (c) The commissioner shall set aside a portion not to exceed five percent of the
276.21federal funds earned for county expenditures under this section to cover the state costs of
276.22administering this section. Any unexpended funds from the set-aside shall be distributed
276.23to the counties in proportion to their earnings under this section.
276.24EFFECTIVE DATE.This section is effective January 1, 2009.

276.25    Sec. 12. Minnesota Statutes 2006, section 256B.69, subdivision 5g, is amended to read:
276.26    Subd. 5g. Payment for covered services. For services rendered on or after January
276.271, 2003, the total payment made to managed care plans for providing covered services
276.28under the medical assistance and general assistance medical care programs is reduced by
276.29.5 percent from their current statutory rates. This provision excludes payments for nursing
276.30home services, home and community-based waivers, and payments to demonstration
276.31projects for persons with disabilities, and mental health services added as covered benefits
276.32after December 31, 2007.

276.33    Sec. 13. Minnesota Statutes 2006, section 256B.69, subdivision 5h, is amended to read:
277.1    Subd. 5h. Payment reduction. In addition to the reduction in subdivision 5g,
277.2the total payment made to managed care plans under the medical assistance program is
277.3reduced 1.0 percent for services provided on or after October 1, 2003, and an additional
277.41.0 percent for services provided on or after January 1, 2004. This provision excludes
277.5payments for nursing home services, home and community-based waivers, and payments
277.6to demonstration projects for persons with disabilities, and mental health services added as
277.7covered benefits after December 1, 2007.

277.8    Sec. 14. Minnesota Statutes 2006, section 256B.763, is amended to read:
277.9256B.763 CRITICAL ACCESS MENTAL HEALTH RATE INCREASE.
277.10    (a) For services defined in paragraph (b) and rendered on or after July 1, 2007,
277.11payment rates shall be increased by 23.7 percent over the rates in effect on January 1,
277.122006, for:
277.13    (1) psychiatrists and advanced practice registered nurses with a psychiatric specialty;
277.14    (2) community mental health centers under section 256B.0625, subdivision 5; and
277.15    (3) mental health clinics and centers certified under Minnesota Rules, parts
277.169520.0750 to 9520.0870, or hospital outpatient psychiatric departments that are designated
277.17as essential community providers under section 62Q.19.
277.18    (b) This increase applies to group skills training when provided as a component of
277.19children's therapeutic services and support, psychotherapy, medication management,
277.20evaluation and management, diagnostic assessment, explanation of findings, psychological
277.21testing, neuropsychological services, direction of behavioral aides, and inpatient
277.22consultation.
277.23    (c) This increase does not apply to rates that are governed by section 256B.0625,
277.24subdivision 30, or 256B.761, paragraph (b), other cost-based rates, rates that are
277.25negotiated with the county, rates that are established by the federal government, or rates
277.26that increased between January 1, 2004, and January 1, 2005.
277.27    (d) The commissioner shall adjust rates paid to prepaid health plans under contract
277.28with the commissioner to reflect the rate increases provided in paragraph (a). The prepaid
277.29health plan must pass this rate increase to the providers identified in paragraph (a)
277.30paragraphs (a), (e), and (f). The prepaid plan must pass this rate increase to the providers
277.31identified in paragraphs (a), (e), and (f).
277.32    (e) For MinnesotaCare only, payment rates shall be increased by 23.7 percent over
277.33the rates in effect on December 31, 2007, for:
277.34    (1) medication education services provided on or after January 1, 2008, by adult
277.35rehabilitative mental health services providers certified under section 256B.0623; and
278.1    (2) mental health behavioral aide services provided on or after January 1, 2008, by
278.2children's therapeutic services and support providers certified under section 256B.0943.
278.3    (f) For services defined in paragraph (b) and rendered on or after January 1, 2008, by
278.4children's therapeutic services and support providers certified under section 256B.0943
278.5and not already included in paragraph (a), payment rates for MinnesotaCare shall be
278.6increased by 23.7 percent over the rates in effect on December 31, 2007.

278.7    Sec. 15. Minnesota Statutes 2006, section 256L.03, subdivision 1, is amended to read:
278.8    Subdivision 1. Covered health services. For individuals under section 256L.04,
278.9subdivision 7 , with income no greater than 75 percent of the federal poverty guidelines
278.10or for families with children under section 256L.04, subdivision 1, all subdivisions of
278.11this section apply. "Covered health services" means the health services reimbursed
278.12under chapter 256B, with the exception of inpatient hospital services, special education
278.13services, private duty nursing services, adult dental care services other than services
278.14covered under section 256B.0625, subdivision 9, orthodontic services, nonemergency
278.15medical transportation services, personal care assistant and case management services,
278.16nursing home or intermediate care facilities services, inpatient mental health services,
278.17and chemical dependency services. Outpatient mental health services covered under the
278.18MinnesotaCare program are limited to diagnostic assessments, psychological testing,
278.19explanation of findings, mental health telemedicine, psychiatric consultation, medication
278.20management by a physician, day treatment, partial hospitalization, and individual, family,
278.21and group psychotherapy.
278.22    "Covered health services" also includes intensive mental health outpatient treatment
278.23for dialectical behavioral therapy for adults.
278.24    No public funds shall be used for coverage of abortion under MinnesotaCare
278.25except where the life of the female would be endangered or substantial and irreversible
278.26impairment of a major bodily function would result if the fetus were carried to term; or
278.27where the pregnancy is the result of rape or incest.
278.28    Covered health services shall be expanded as provided in this section.
278.29EFFECTIVE DATE.This section is effective January 1, 2008, except coverage for
278.30mental health case management is effective January 1, 2009.

278.31    Sec. 16. Minnesota Statutes 2006, section 256L.03, subdivision 5, is amended to read:
278.32    Subd. 5. Co-payments and coinsurance. (a) Except as provided in paragraphs (b)
278.33and (c), the MinnesotaCare benefit plan shall include the following co-payments and
278.34coinsurance requirements for all enrollees:
279.1    (1) ten percent of the paid charges for inpatient hospital services for adult enrollees,
279.2subject to an annual inpatient out-of-pocket maximum of $1,000 per individual and
279.3$3,000 per family;
279.4    (2) $3 per prescription for adult enrollees;
279.5    (3) $25 for eyeglasses for adult enrollees;
279.6    (4) $3 per nonpreventive visit. For purposes of this subdivision, a "visit" means an
279.7episode of service which is required because of a recipient's symptoms, diagnosis, or
279.8established illness, and which is delivered in an ambulatory setting by a physician or
279.9physician ancillary, chiropractor, podiatrist, nurse midwife, advanced practice nurse,
279.10audiologist, optician, or optometrist; and
279.11    (5) $6 for nonemergency visits to a hospital-based emergency room.
279.12    (b) Paragraph (a), clause (1), does not apply to parents and relative caretakers of
279.13children under the age of 21 in households with family income equal to or less than 175
279.14percent of the federal poverty guidelines. Paragraph (a), clause (1), does not apply to
279.15parents and relative caretakers of children under the age of 21 in households with family
279.16income greater than 175 percent of the federal poverty guidelines for inpatient hospital
279.17admissions occurring on or after January 1, 2001.
279.18    (c) Paragraph (a), clauses (1) to (4), do not apply to pregnant women and children
279.19under the age of 21.
279.20    (d) Paragraph (a), clause (4), does not apply to mental health services.
279.21    (e) Adult enrollees with family gross income that exceeds 175 percent of the
279.22federal poverty guidelines and who are not pregnant shall be financially responsible for
279.23the coinsurance amount, if applicable, and amounts which exceed the $10,000 inpatient
279.24hospital benefit limit.
279.25    (e) (f) When a MinnesotaCare enrollee becomes a member of a prepaid health plan,
279.26or changes from one prepaid health plan to another during a calendar year, any charges
279.27submitted towards the $10,000 annual inpatient benefit limit, and any out-of-pocket
279.28expenses incurred by the enrollee for inpatient services, that were submitted or incurred
279.29prior to enrollment, or prior to the change in health plans, shall be disregarded.

279.30    Sec. 17. Minnesota Statutes 2006, section 256L.035, is amended to read:
279.31256L.035 LIMITED BENEFITS COVERAGE FOR CERTAIN SINGLE
279.32ADULTS AND HOUSEHOLDS WITHOUT CHILDREN.
279.33    (a) "Covered health services" for individuals under section 256L.04, subdivision
279.347 , with income above 75 percent, but not exceeding 175 percent, of the federal poverty
279.35guideline means:
280.1    (1) inpatient hospitalization benefits with a ten percent co-payment up to $1,000 and
280.2subject to an annual limitation of $10,000;
280.3    (2) physician services provided during an inpatient stay; and
280.4    (3) physician services not provided during an inpatient stay; outpatient hospital
280.5services; freestanding ambulatory surgical center services; chiropractic services; lab and
280.6diagnostic services; diabetic supplies and equipment; mental health services as covered
280.7under chapter 256B; and prescription drugs; subject to the following co-payments:
280.8    (i) $50 co-pay per emergency room visit;
280.9    (ii) $3 co-pay per prescription drug; and
280.10    (iii) $5 co-pay per nonpreventive visit; except this co-pay does not apply to mental
280.11health services or community mental health services.
280.12The services covered under this section may be provided by a physician, physician
280.13ancillary, chiropractor, psychologist, or licensed independent clinical social worker, or
280.14other mental health providers covered under chapter 256B if the services are within the
280.15scope of practice of that health care professional.
280.16    For purposes of this section, "a visit" means an episode of service which is required
280.17because of a recipient's symptoms, diagnosis, or established illness, and which is delivered
280.18in an ambulatory setting by any health care provider identified in this paragraph.
280.19    Enrollees are responsible for all co-payments in this section.
280.20    (b) Reimbursement to the providers shall be reduced by the amount of the
280.21co-payment, except that reimbursement for prescription drugs shall not be reduced once a
280.22recipient has reached the $20 per month maximum for prescription drug co-payments.
280.23The provider collects the co-payment from the recipient. Providers may not deny services
280.24to recipients who are unable to pay the co-payment, except as provided in paragraph (c).
280.25    (c) If it is the routine business practice of a provider to refuse service to an individual
280.26with uncollected debt, the provider may include uncollected co-payments under this
280.27section. A provider must give advance notice to a recipient with uncollected debt before
280.28services can be denied.
280.29EFFECTIVE DATE.This section is effective January 1, 2008, except coverage
280.30for mental health case management under paragraph (a), clause (3), is effective January
280.311, 2009.

280.32    Sec. 18. Minnesota Statutes 2006, section 256L.12, subdivision 9a, is amended to read:
280.33    Subd. 9a. Rate setting; ratable reduction. For services rendered on or after
280.34October 1, 2003, the total payment made to managed care plans under the MinnesotaCare
281.1program is reduced 1.0 percent. This provision excludes payments for mental health
281.2services added as covered benefits after December 31, 2007.

281.3    Sec. 19. Minnesota Statutes 2006, section 609.115, subdivision 9, is amended to read:
281.4    Subd. 9. Compulsive gambling assessment required. (a) If a person is convicted
281.5of theft under section 609.52, embezzlement of public funds under section 609.54, or
281.6forgery under section 609.625, 609.63, or 609.631, the probation officer shall determine in
281.7the report prepared under subdivision 1 whether or not compulsive gambling contributed
281.8to the commission of the offense. If so, the report shall contain the results of a compulsive
281.9gambling assessment conducted in accordance with this subdivision. The probation officer
281.10shall make an appointment for the offender to undergo the assessment if so indicated.
281.11    (b) The compulsive gambling assessment report must include a recommended level
281.12of treatment for the offender if the assessor concludes that the offender is in need of
281.13compulsive gambling treatment. The assessment must be conducted by an assessor
281.14qualified under section 245.98, subdivision 2a, to perform these assessments or to
281.15provide compulsive gambling treatment. An assessor providing a compulsive gambling
281.16assessment may not have any direct or shared financial interest or referral relationship
281.17resulting in shared financial gain with a treatment provider. If an independent assessor is
281.18not available, the probation officer may use the services of an assessor with a financial
281.19interest or referral relationship as authorized under rules adopted by the commissioner
281.20of human services under section 245.98, subdivision 2a.
281.21    (c) The commissioner of human services shall reimburse the assessor for the
281.22costs associated with a compulsive gambling assessment at a rate established by the
281.23commissioner up to a maximum of $100 for each assessment. To the extent practicable, the
281.24commissioner shall standardize reimbursement rates for assessments. The commissioner
281.25shall reimburse these costs after receiving written verification from the probation officer
281.26that the assessment was performed and found acceptable.

281.27    Sec. 20. REPORT.
281.28    The commissioner shall make a report to the legislature by January 15, 2008,
281.29regarding the transfer of funds to counties for state registered nurses employed in
281.30community mental health pilot projects as part of the assertive community treatment
281.31teams under Minnesota Statutes, section 245.4661. The report shall address the impact
281.32of the nursing shortage on replacing these positions, continuity of patient care if these
281.33positions cannot be filled, and ways to maintain state registered nurses in these positions
282.1until the nurse retires or leaves employment. No funds for state registered nurse positions
282.2may be transferred before the report date.

282.3    Sec. 21. CASE MANAGEMENT; BEST PRACTICES.
282.4    The commissioner of human services, in consultation with consumers, families,
282.5counties, and other interested stakeholders, will develop recommendations for changes in
282.6the adult mental health act related to case management, consistent with evidence-based
282.7and best practices.

282.8    Sec. 22. REGIONAL CHILDREN'S MENTAL HEALTH INITIATIVE.
282.9    Subdivision 1. Pilot project authorized; purpose. A two-year Regional Children's
282.10Mental Health Initiative pilot project is established to improve children's mental health
282.11service coordination, communication, and processes in Blue Earth, Brown, Faribault,
282.12Freeborn, Le Sueur, Martin, Nicollet, Rice, Sibley, Waseca, and Watonwan Counties. The
282.13purpose of the Regional Children's Mental Health Initiative will be to plan and develop
282.14new programs and services related to children's mental health in south central Minnesota.
282.15    Subd. 2. Goals. To accomplish its purpose, the Regional Children's Mental Health
282.16Initiative shall have the following goals:
282.17    (1) work to streamline delivery and regional access to services;
282.18    (2) share strategies and resources for the management of out-of-home placements;
282.19    (3) establish standard protocols and operating procedures for functions that are
282.20performed across all counties;
282.21    (4) share information to improve resource allocation and service delivery across
282.22counties;
282.23    (5) evaluate outcomes of various treatment alternatives;
282.24    (6) create a network for and provide support to service delivery groups;
282.25    (7) establish a regional process to match children in need of out-of-home placement
282.26with foster homes that can meet their needs; and
282.27    (8) recruit and retain foster homes.
282.28    Subd. 3. Director's Council. The Director's Council shall govern the operations of
282.29the Regional Children's Mental Health Initiative. Members of the Director's Council shall
282.30represent each of the 11 counties participating in the pilot project.
282.31    Subd. 4. Regional Children's Mental Health Initiative Team. The members
282.32of the Regional Children's Mental Health Initiative Team shall conduct planning and
282.33development of new and modified children's mental health programs and services in the
282.34region. Members of the team shall reflect the cultural, demographic, and geographic
283.1diversity of the region and shall be composed of representatives from each of the
283.2following:
283.3    (1) the medical community;
283.4    (2) human services;
283.5    (3) corrections;
283.6    (4) education;
283.7    (5) mental health providers and vendors;
283.8    (6) advocacy organizations;
283.9    (7) parents; and
283.10    (8) children and youth.
283.11    Subd. 5. Authority. The regional children's mental health initiative shall have the
283.12authority to develop and implement the following programs:
283.13    (1) Flexible funding payments. This program will make funds available to respond to
283.14the unique and unpredictable needs of children with mental health issues such as the need
283.15for prescription drugs, transportation, clothing, and assessments not otherwise available.
283.16    (2) Transition to self-sufficiency. This program will help youths between the ages of
283.1714 and 21 establish professional relationships, find jobs, build financial foundations, and
283.18learn to fulfill their roles as productive citizens.
283.19    (3) Crisis response. This program will establish public and private partnerships
283.20to offer a range of options to meet the needs of children in crisis. Methods to meet
283.21these needs may include accessible local services, holistic assessments, urgent care and
283.22stabilization services, and telehealth for specialized diagnosis and therapeutic sessions.
283.23    (4) Integrated services for complex conditions. This program will design, develop,
283.24and implement packages of integrated services to meet the needs of children with specific,
283.25complex conditions.
283.26    Subd. 6. Evaluation and report. The regional children's mental health initiative
283.27shall develop a method for evaluating the effectiveness of this pilot project focusing on
283.28identifiable goals and outcomes. An interim report on the pilot project's effectiveness
283.29shall be submitted to the house and senate finance committees having jurisdiction over
283.30mental health, the commissioner of human services, and the Minnesota Association of
283.31County Social Service Administrators no later than December 31, 2008. A final report
283.32is due no later than December 31, 2009.

283.33    Sec. 23. TRAUMA-FOCUSED EVIDENCE-BASED PRACTICES TO
283.34CHILDREN.
284.1    Organizations that are certified to provide children's therapeutic services and
284.2supports under Minnesota Statutes, section 256B.0943, are eligible to apply for a grant.
284.3Grants are to be used to provide trauma-focused evidence-based practices to children
284.4who are living in a battered women's shelter, homeless shelter, transitional housing, or
284.5supported housing. Children served must have been exposed to or witnessed domestic
284.6violence, have been exposed to or witnessed community violence, or be a refugee. Priority
284.7shall be given to organizations that demonstrate collaboration with battered women's
284.8shelters, homeless shelters, or providers of transitional housing or supported housing. The
284.9commissioner shall specify which constitutes evidence-based practice. Organizations shall
284.10use all available funding streams.

284.11    Sec. 24. DUAL DIAGNOSIS; DEMONSTRATION PROJECT.
284.12    (a) The commissioner of human services shall fund demonstration projects for high
284.13risk adults with serious mental illness and co-occurring substance abuse problems. The
284.14projects must include, but not be limited to, the following:
284.15    (1) housing services, including rent or housing subsidies, housing with clinical
284.16staff, or housing support;
284.17    (2) assertive outreach services; and
284.18    (3) intensive direct therapeutic, rehabilitative, and care management services
284.19oriented to harm reduction.
284.20    (b) The commissioner shall work with providers to ensure proper licensure or
284.21certification to meet medical assistance or third-party payor reimbursement requirements.

284.22    Sec. 25. MINNESOTA FAMILY INVESTMENT PROGRAM AND CHILDREN'S
284.23MENTAL HEALTH PILOT PROJECT.
284.24    Subdivision 1. Pilot project authorized. The commissioner of human services
284.25shall fund a three-year pilot project to measure the effect of children's identified mental
284.26health needs, including social and emotional needs, on Minnesota family investment
284.27program (MFIP) participants' ability to obtain and retain employment. The project shall
284.28also measure the effect on work activity of MFIP participants' needs to address their
284.29children's identified mental health needs.
284.30    Subd. 2. Provider and agency proposals. (a) Interested MFIP providers and
284.31agencies shall:
284.32    (1) submit proposals defining how they will identify participants whose children
284.33have mental health needs that hinder the employment process;
285.1    (2) connect families with appropriate developmental, social, and emotional
285.2screenings and services; and
285.3    (3) incorporate those services into the participant's employment plan.
285.4Each proposal under this paragraph must include an evaluation component.
285.5    (b) Interested MFIP providers and agencies shall develop a protocol to inform MFIP
285.6participants of the following:
285.7    (1) the availability of developmental, social, and emotional screening tools for
285.8children and youth;
285.9    (2) the purpose of the screenings;
285.10    (3) how the information will be used to assist the participants in identifying and
285.11addressing potential barriers to employment; and
285.12    (4) that their employment plan may be modified based on the screening results.
285.13    Subd. 3. Program components. (a) MFIP providers shall obtain the participant's
285.14written consent for participation in the pilot project, including consent for developmental,
285.15social, and emotional screening.
285.16    (b) MFIP providers shall coordinate with county social service agencies and health
285.17plans to assist recipients in arranging referrals indicated by the screening results.
285.18    (c) Tools used for developmental, social, and emotional screenings shall be approved
285.19by the commissioner of human services.
285.20    Subd. 4. Program evaluation. The commissioner of human services shall conduct
285.21an evaluation of the pilot project to determine:
285.22    (1) the number of participants who took part in the screening;
285.23    (2) the number of children who were screened and what screening tools were used;
285.24    (3) the number of children who were identified in the screening who needed referral
285.25or follow-up services;
285.26    (4) the number of children who received services, what agency provided the services,
285.27and what type of services were provided;
285.28    (5) the number of employment plans that were adjusted to include the activities
285.29recommended in the screenings;
285.30    (6) the changes in work participation rates;
285.31    (7) the changes in earned income;
285.32    (8) the changes in sanction rates; and
285.33    (9) the participants' report of program effectiveness.
285.34    Subd. 5. Work activity. Participant involvement in screenings and subsequent
285.35referral and follow-up services shall count as work activity under Minnesota Statutes,
285.36section 256J.49, subdivision 13.

286.1    Sec. 26. SOCIAL AND ECONOMIC COSTS OF GAMBLING.
286.2    Subdivision 1. Report. The commissioner of human services, in consultation with
286.3the state affiliate of the National Council on Problem Gambling, stakeholders, and licensed
286.4vendors, shall prepare a report that provides a process and funding mechanism to study the
286.5issues in subdivisions 2 and 3. The commissioner, in consultation with the state affiliate
286.6of the National Council on Problem Gambling, stakeholders, and licensed vendors, shall
286.7include in the report potential financial commitments made by stakeholders and others in
286.8order to fund the study. The report is due to the legislative committees having jurisdiction
286.9over compulsive gambling issues by December 1, 2007.
286.10    Subd. 2. Issues to be addressed. The study must address:
286.11    (1) state, local, and tribal government policies and practices in Minnesota to legalize
286.12or prohibit gambling;
286.13    (2) the relationship between gambling and crime in Minnesota, including: (i) the
286.14relationship between gambling and overall crime rates; (ii) the relationship between
286.15gambling and crimes rates for specific crimes, such as forgery, domestic abuse, child
286.16neglect and abuse, alcohol and drug offenses, and youth crime; and (iii) enforcement
286.17and regulation practices that are intended to address the relationship between gambling
286.18and levels of crime;
286.19    (3) the relationship between expanded gambling and increased rates of problem
286.20gambling in Minnesota, including the impact of pathological or problem gambling on
286.21individuals, families, businesses, social institutions, and the economy;
286.22    (4) the social impact of gambling on individuals, families, businesses, and social
286.23institutions in Minnesota, including an analysis of the relationship between gambling and
286.24depression, abuse, divorce, homelessness, suicide, and bankruptcy;
286.25    (5) the economic impact of gambling on state, local, and tribal economies in
286.26Minnesota; and
286.27    (6) any other issues deemed necessary in assessing the social and economic impact
286.28of gambling in Minnesota.
286.29    Subd. 3. Quantification of social and economic impact. The study shall quantify
286.30the social and economic impact on both (1) state, local, and tribal governments in
286.31Minnesota, and (2) Minnesota's communities and social institutions, including individuals,
286.32families, and businesses within those communities and institutions.

286.33    Sec. 27. REPEALER.
286.34Minnesota Rules, part 9585.0030, is repealed.

287.1ARTICLE 6

287.2DEPARTMENT OF HEALTH

287.3    Section 1. Minnesota Statutes 2006, section 62J.17, subdivision 2, is amended to read:
287.4    Subd. 2. Definitions. For purposes of this section, the terms defined in this
287.5subdivision have the meanings given.
287.6    (a) "Access" means the financial, temporal, and geographic availability of health
287.7care to individuals who need it.
287.8    (b) (a) "Capital expenditure" means an expenditure which, under generally accepted
287.9accounting principles, is not properly chargeable as an expense of operation and
287.10maintenance.
287.11    (c) "Cost" means the amount paid by consumers or third party payers for health
287.12care services or products.
287.13    (d) "Date of the major spending commitment" means the date the provider formally
287.14obligated itself to the major spending commitment. The obligation may be incurred
287.15by entering into a contract, making a down payment, issuing bonds or entering a loan
287.16agreement to provide financing for the major spending commitment, or taking some other
287.17formal, tangible action evidencing the provider's intention to make the major spending
287.18commitment.
287.19    (e) (b) "Health care service" means:
287.20    (1) a service or item that would be covered by the medical assistance program
287.21under chapter 256B if provided in accordance with medical assistance requirements to an
287.22eligible medical assistance recipient; and
287.23    (2) a service or item that would be covered by medical assistance except that it is
287.24characterized as experimental, cosmetic, or voluntary.
287.25    "Health care service" does not include retail, over-the-counter sales of
287.26nonprescription drugs and other retail sales of health-related products that are not generally
287.27paid for by medical assistance and other third-party coverage.
287.28    (f) (c) "Major spending commitment" means an expenditure in excess of $1,000,000
287.29for:
287.30    (1) acquisition of a unit of medical equipment;
287.31    (2) a capital expenditure for a single project for the purposes of providing health
287.32care services, other than for the acquisition of medical equipment;
287.33    (3) offering a new specialized service not offered before;
287.34    (4) planning for an activity that would qualify as a major spending commitment
287.35under this paragraph; or
288.1    (5) a project involving a combination of two or more of the activities in clauses
288.2(1) to (4).
288.3    The cost of acquisition of medical equipment, and the amount of a capital
288.4expenditure, is the total cost to the provider regardless of whether the cost is distributed
288.5over time through a lease arrangement or other financing or payment mechanism.
288.6    (g) (d) "Medical equipment" means fixed and movable equipment that is used by
288.7a provider in the provision of a health care service. "Medical equipment" includes, but
288.8is not limited to, the following:
288.9    (1) an extracorporeal shock wave lithotripter;
288.10    (2) a computerized axial tomography (CAT) scanner;
288.11    (3) a magnetic resonance imaging (MRI) unit;
288.12    (4) a positron emission tomography (PET) scanner; and
288.13    (5) emergency and nonemergency medical transportation equipment and vehicles.
288.14    (h) (e) "New specialized service" means a specialized health care procedure or
288.15treatment regimen offered by a provider that was not previously offered by the provider,
288.16including, but not limited to:
288.17    (1) cardiac catheterization services involving high-risk patients as defined in the
288.18Guidelines for Coronary Angiography established by the American Heart Association
288.19and the American College of Cardiology;
288.20    (2) heart, heart-lung, liver, kidney, bowel, or pancreas transplantation service, or
288.21any other service for transplantation of any other organ;
288.22    (3) megavoltage radiation therapy;
288.23    (4) open heart surgery;
288.24    (5) neonatal intensive care services; and
288.25    (6) any new medical technology for which premarket approval has been granted by
288.26the United States Food and Drug Administration, excluding implantable and wearable
288.27devices.
288.28    (f) "Specialty care" includes but is not limited to cardiac, neurology, orthopedic,
288.29obstetrics, mental health, chemical dependency, and emergency services.

288.30    Sec. 2. Minnesota Statutes 2006, section 62J.17, subdivision 4a, is amended to read:
288.31    Subd. 4a. Expenditure reporting. (a) A provider making a major spending
288.32commitment after April 1, 1992, shall submit notification of the expenditure to the
288.33commissioner and provide the commissioner with any relevant background information.
289.1    (b) Notification must include a report, submitted within 60 days after the date of the
289.2major spending commitment, using terms conforming to the definitions in section 62J.03
289.3and this section. Each report is subject to retrospective review and must contain:
289.4    (1) a detailed description of the major spending commitment, including the specific
289.5dollar amount of each expenditure, and its purpose;
289.6    (2) the date of the major spending commitment;
289.7    (3) a statement of the expected impact that the major spending commitment will
289.8have on charges by the provider to patients and third party payers;
289.9    (4) a statement of the expected impact on the clinical effectiveness or quality of care
289.10received by the patients that the provider expects to serve;
289.11    (5) a statement of the extent to which equivalent services or technology are already
289.12available to the provider's actual and potential patient population;
289.13    (6) a statement of the distance from which the nearest equivalent services or
289.14technology are already available to the provider's actual and potential population;
289.15    (7) a statement describing the pursuit of any lawful collaborative arrangements; and
289.16    (8) a statement of assurance that the provider will not use, purchase, or perform
289.17health care technologies and procedures that are not clinically effective and cost-effective,
289.18unless the technology is used for experimental or research purposes to determine whether
289.19a technology or procedure is clinically effective and cost-effective.
289.20    The provider may submit any additional information that it deems relevant.
289.21    (c) The commissioner may request additional information from a provider for the
289.22purpose of review of a report submitted by that provider, and may consider relevant
289.23information from other sources. A provider shall provide any information requested by
289.24the commissioner within the time period stated in the request, or within 30 days after the
289.25date of the request if the request does not state a time.
289.26    (d) If the provider fails to submit a complete and timely expenditure report, including
289.27any additional information requested by the commissioner, the commissioner may make
289.28the provider's subsequent major spending commitments subject to the procedures of
289.29prospective review and approval under subdivision 6a.
289.30    Each hospital, outpatient surgical center, diagnostic imaging center, and physician
289.31clinic shall report annually to the commissioner on all major spending commitments,
289.32in the form and manner specified by the commissioner. The report shall include the
289.33following information:
289.34    (a) a description of major spending commitments made during the previous year,
289.35including the total dollar amount of major spending commitments and purpose of the
289.36expenditures;
290.1    (b) the cost of land acquisition, construction of new facilities, and renovation of
290.2existing facilities;
290.3    (c) the cost of purchased or leased medical equipment, by type of equipment;
290.4    (d) expenditures by type for specialty care and new specialized services;
290.5    (e) information on the amount and types of added capacity for diagnostic imaging
290.6services, outpatient surgical services, and new specialized services; and
290.7    (f) information on investments in electronic medical records systems.
290.8For hospitals and outpatient surgical centers, this information shall be included in reports
290.9to the commissioner that are required under section 144.698. For diagnostic imaging
290.10centers, this information shall be included in reports to the commissioner that are required
290.11under section 144.565. For physician clinics, this information shall be included in reports
290.12to the commissioner that are required under section 62J.41. For all other health care
290.13providers that are subject to this reporting requirement, reports must be submitted to the
290.14commissioner by March 1 each year for the preceding calendar year.

290.15    Sec. 3. Minnesota Statutes 2006, section 62J.17, subdivision 7, is amended to read:
290.16    Subd. 7. Exceptions. (a) The retrospective review process as described in
290.17subdivision 5a and the prospective review and approval process as described in subdivision
290.186a reporting requirement in subdivision 4a do does not apply to:
290.19    (1) a major spending commitment to replace existing equipment with comparable
290.20equipment used for direct patient care, upgrades of equipment beyond the current model,
290.21or comparable model must be reported;
290.22    (2) (1) a major spending commitment made by a research and teaching institution
290.23for purposes of conducting medical education, medical research supported or sponsored
290.24by a medical school, or by a federal or foundation grant or clinical trials;
290.25    (3) a major spending commitment to repair, remodel, or replace existing buildings or
290.26fixtures if, in the judgment of the commissioner, the project does not involve a substantial
290.27expansion of service capacity or a substantial change in the nature of health care services
290.28provided;
290.29    (4) (2) a major spending commitment for building maintenance including heating,
290.30water, electricity, and other maintenance-related expenditures; and
290.31    (5) (3) a major spending commitment for activities, not directly related to the
290.32delivery of patient care services, including food service, laundry, housekeeping, and
290.33other service-related activities; and.
291.1    (6) a major spending commitment for computer equipment or data systems not
291.2directly related to the delivery of patient care services, including computer equipment or
291.3data systems related to medical record automation.
291.4    (b) In addition to the exceptions listed in paragraph (a), the prospective review and
291.5approval process described in subdivision 6a reporting requirement in subdivision 4a does
291.6not apply to mergers, acquisitions, and other changes in ownership or control that, in the
291.7judgment of the commissioner, do not involve a substantial expansion of service capacity
291.8or a substantial change in the nature of health care services provided.

291.9    Sec. 4. Minnesota Statutes 2006, section 62J.41, subdivision 1, is amended to read:
291.10    Subdivision 1. Cost containment data to be collected from providers. The
291.11commissioner shall require health care providers to collect and provide both patient
291.12specific information and descriptive and financial aggregate data on:
291.13    (1) the total number of patients served;
291.14    (2) the total number of patients served by state of residence and Minnesota county;
291.15    (3) the site or sites where the health care provider provides services;
291.16    (4) the number of individuals employed, by type of employee, by the health care
291.17provider;
291.18    (5) the services and their costs for which no payment was received;
291.19    (6) total revenue by type of payer or by groups of payers, including but not limited
291.20to, revenue from Medicare, medical assistance, MinnesotaCare, nonprofit health service
291.21plan corporations, commercial insurers, health maintenance organizations, and individual
291.22patients;
291.23    (7) revenue from research activities;
291.24    (8) revenue from educational activities;
291.25    (9) revenue from out-of-pocket payments by patients;
291.26    (10) revenue from donations; and
291.27    (11) a report on health care capital expenditures during the previous year, as required
291.28by section 62J.17; and
291.29    (11) (12) any other data required by the commissioner, including data in
291.30unaggregated form, for the purposes of developing spending estimates, setting spending
291.31limits, monitoring actual spending, and monitoring costs.
291.32The commissioner may, by rule, modify the data submission categories listed above if the
291.33commissioner determines that this will reduce the reporting burden on providers without
291.34having a significant negative effect on necessary data collection efforts.

292.1    Sec. 5. Minnesota Statutes 2006, section 62J.52, subdivision 1, is amended to read:
292.2    Subdivision 1. Uniform billing form CMS 1450. (a) On and after January 1,
292.31996, all institutional inpatient hospital services, ancillary services, institutionally owned
292.4or operated outpatient services rendered by providers in Minnesota, and institutional
292.5or noninstitutional home health services that are not being billed using an equivalent
292.6electronic billing format, must be billed using the uniform billing form CMS 1450, except
292.7as provided in subdivision 5.
292.8    (b) The instructions and definitions for the use of the uniform billing form CMS
292.91450 shall be in accordance with the uniform billing form manual specified by the
292.10commissioner. In promulgating these instructions, the commissioner may utilize the
292.11manual developed by the National Uniform Billing Committee, as adopted and finalized
292.12by the Minnesota Uniform Billing Committee.
292.13    (c) Services to be billed using the uniform billing form CMS 1450 include:
292.14institutional inpatient hospital services and distinct units in the hospital such as psychiatric
292.15unit services, physical therapy unit services, swing bed (SNF) services, inpatient state
292.16psychiatric hospital services, inpatient skilled nursing facility services, home health
292.17services (Medicare part A), and hospice services; ancillary services, where benefits are
292.18exhausted or patient has no Medicare part A, from hospitals, state psychiatric hospitals,
292.19skilled nursing facilities, and home health (Medicare part B); institutional owned or
292.20operated outpatient services such as waivered services, hospital outpatient services,
292.21including ambulatory surgical center services, hospital referred laboratory services,
292.22hospital-based ambulance services, and other hospital outpatient services, skilled nursing
292.23facilities, home health, freestanding renal dialysis centers, comprehensive outpatient
292.24rehabilitation facilities (CORF), outpatient rehabilitation facilities (ORF), rural health
292.25clinics, and community mental health centers; home health services such as home health
292.26intravenous therapy providers, waivered services, personal care attendants, and hospice;
292.27and any other health care provider certified by the Medicare program to use this form.
292.28    (d) On and after January 1, 1996, a mother and newborn child must be billed
292.29separately, and must not be combined on one claim form.
292.30    (e) Services provided by Medicare Critical Access Hospitals electing Method
292.31II billing will be allowed an exception to this provision to allow the inclusion of the
292.32professional fees on the CMS 1450.

292.33    Sec. 6. Minnesota Statutes 2006, section 62J.52, subdivision 2, is amended to read:
292.34    Subd. 2. Uniform billing form CMS 1500. (a) On and after January 1, 1996, all
292.35noninstitutional health care services rendered by providers in Minnesota except dental
293.1or pharmacy providers, that are not currently being billed using an equivalent electronic
293.2billing format, must be billed using the health insurance claim form CMS 1500, except as
293.3provided in subdivision 5.
293.4    (b) The instructions and definitions for the use of the uniform billing form CMS
293.51500 shall be in accordance with the manual developed by the Administrative Uniformity
293.6Committee entitled standards for the use of the CMS 1500 form, dated February 1994,
293.7as further defined by the commissioner.
293.8    (c) Services to be billed using the uniform billing form CMS 1500 include physician
293.9services and supplies, durable medical equipment, noninstitutional ambulance services,
293.10independent ancillary services including occupational therapy, physical therapy, speech
293.11therapy and audiology, home infusion therapy, podiatry services, optometry services,
293.12mental health licensed professional services, substance abuse licensed professional
293.13services, nursing practitioner professional services, certified registered nurse anesthetists,
293.14chiropractors, physician assistants, laboratories, medical suppliers, and other health care
293.15providers such as day activity centers and freestanding ambulatory surgical centers.
293.16    (d) Services provided by Medicare Critical Access Hospitals electing Method
293.17II billing will be allowed an exception to this provision to allow the inclusion of the
293.18professional fees on the CMS 1450.

293.19    Sec. 7. Minnesota Statutes 2006, section 62J.60, subdivision 2, is amended to read:
293.20    Subd. 2. General characteristics. (a) The Minnesota uniform health care
293.21identification card must be a preprinted card constructed of plastic, paper, or any other
293.22medium that conforms with ANSI and ISO 7810 physical characteristics standards. The
293.23card dimensions must also conform to ANSI and ISO 7810 physical characteristics
293.24standard. The use of a signature panel is optional. The uniform prescription drug
293.25information contained on the card must conform with the format adopted by the NCPDP
293.26and, except as provided in subdivision 3, paragraph (a), clause (2), must include all of
293.27the fields required to submit a claim in conformance with the most recent pharmacy
293.28identification card implementation guide produced by the NCPDP. All information
293.29required to submit a prescription drug claim, exclusive of information provided on a
293.30prescription that is required by law, must be included on the card in a clear, readable, and
293.31understandable manner. If a health benefit plan requires a conditional or situational field,
293.32as defined by the NCPDP, the conditional or situational field must conform to the most
293.33recent pharmacy information card implementation guide produced by the NCPDP.
293.34    (b) The Minnesota uniform health care identification card must have an essential
293.35information window on the front side with the following data elements: card issuer name,
294.1electronic transaction routing information, card issuer identification number, cardholder
294.2(insured) identification number, and cardholder (insured) identification name. No optional
294.3data may be interspersed between these data elements.
294.4    (c) Standardized labels are required next to human readable data elements and
294.5must come before the human data elements.

294.6    Sec. 8. Minnesota Statutes 2006, section 62J.60, subdivision 3, is amended to read:
294.7    Subd. 3. Human readable data elements. (a) The following are the minimum
294.8human readable data elements that must be present on the front side of the Minnesota
294.9uniform health care identification card:
294.10    (1) card issuer name or logo, which is the name or logo that identifies the card issuer.
294.11The card issuer name or logo may be located at the top of the card. No standard label
294.12is required for this data element;
294.13    (2) complete electronic transaction routing information including, at a minimum,
294.14the international identification number. The standardized label of this data element
294.15is "RxBIN." Processor control numbers and group numbers are required if needed to
294.16electronically process a prescription drug claim. The standardized label for the process
294.17control numbers data element is "RxPCN" and the standardized label for the group
294.18numbers data element is "RxGrp," except that if the group number data element is a
294.19universal element to be used by all health care providers, the standardized label may be
294.20"Grp." To conserve vertical space on the card, the international identification number and
294.21the processor control number may be printed on the same line;
294.22     (3) cardholder (insured) identification number, which is the unique identification
294.23number of the individual card holder established and defined under this section. The
294.24standardized label for the data element is "ID";
294.25    (4) cardholder (insured) identification name, which is the name of the individual
294.26card holder. The identification name must be formatted as follows: first name, space,
294.27optional middle initial, space, last name, optional space and name suffix. The standardized
294.28label for this data element is "Name";
294.29    (5) care type, which is the description of the group purchaser's plan product under
294.30which the beneficiary is covered. The description shall include the health plan company
294.31name and the plan or product name. The standardized label for this data element is
294.32"Care Type";
294.33    (6) service type, which is the description of coverage provided such as hospital,
294.34dental, vision, prescription, or mental health. The standard label for this data element
294.35is "Svc Type"; and
295.1    (7) provider/clinic name, which is the name of the primary care clinic the card
295.2holder is assigned to by the health plan company. The standard label for this field is
295.3"PCP." This information is mandatory only if the health plan company assigns a specific
295.4primary care provider to the card holder.
295.5    (b) The following human readable data elements shall be present on the back side
295.6of the Minnesota uniform health care identification card. These elements must be left
295.7justified, and no optional data elements may be interspersed between them:
295.8    (1) claims submission names and addresses, which are the names and addresses of
295.9the entity or entities to which claims should be submitted. If different destinations are
295.10required for different types of claims, this must be labeled;
295.11    (2) telephone numbers and names that pharmacies and other health care providers
295.12may call for assistance. These telephone numbers and names are required on the back
295.13side of the card only if one of the contacts listed in clause (3) cannot provide pharmacies
295.14or other providers with assistance or with the telephone numbers and names of contacts
295.15for assistance; and
295.16    (3) telephone numbers and names; which are the telephone numbers and names of the
295.17following contacts with a standardized label describing the service function as applicable:
295.18    (i) eligibility and benefit information;
295.19    (ii) utilization review;
295.20    (iii) precertification; or
295.21    (iv) customer services.
295.22    (c) The following human readable data elements are mandatory on the back
295.23side of the Minnesota uniform health care identification card for health maintenance
295.24organizations:
295.25    (1) emergency care authorization telephone number or instruction on how to receive
295.26authorization for emergency care. There is no standard label required for this information;
295.27and
295.28    (2) one of the following:
295.29    (i) telephone number to call to appeal to or file a complaint with the commissioner of
295.30health; or
295.31    (ii) for persons enrolled under section 256B.69, 256D.03, or 256L.12, the telephone
295.32number to call to file a complaint with the ombudsperson designated by the commissioner
295.33of human services under section 256B.69 and the address to appeal to the commissioner of
295.34human services. There is no standard label required for this information.
295.35    (d) All human readable data elements not required under paragraphs (a) to (c) are
295.36optional and may be used at the issuer's discretion.

296.1    Sec. 9. Minnesota Statutes 2006, section 62Q.80, is amended by adding a subdivision
296.2to read:
296.3    Subd. 1a. Demonstration project. The commissioner of health shall award a
296.4demonstration project grant to a community-based health care initiative to develop and
296.5operate a community-based health care coverage program to operate within Carlton,
296.6Cook, Lake, and St. Louis Counties. The demonstration project shall extend for five years
296.7and must comply with all the requirements of this section.

296.8    Sec. 10. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
296.9    Subd. 3. Approval. (a) Prior to the operation of a community-based health care
296.10coverage program, a community-based health initiative shall submit to the commissioner
296.11of health for approval the community-based health care coverage program developed by
296.12the initiative. The commissioner shall only approve a program that has been awarded
296.13a community access program grant from the United States Department of Health and
296.14Human Services. The commissioner shall ensure that the program meets the federal grant
296.15requirements and any requirements described in this section and is actuarially sound based
296.16on a review of appropriate records and methods utilized by the community-based health
296.17initiative in establishing premium rates for the community-based health care coverage
296.18program.
296.19    (b) Prior to approval, the commissioner shall also ensure that:
296.20    (1) the benefits offered comply with subdivision 8 and that there are adequate
296.21numbers of health care providers participating in the community-based health network to
296.22deliver the benefits offered under the program;
296.23    (2) the activities of the program are limited to activities that are exempt under this
296.24section or otherwise from regulation by the commissioner of commerce;
296.25    (3) the complaint resolution process meets the requirements of subdivision 10; and
296.26    (4) the data privacy policies and procedures comply with state and federal law.

296.27    Sec. 11. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
296.28    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval
296.29by the commissioner of health a community-based health care coverage program. The
296.30operational structure established by the initiative shall include, but is not limited to:
296.31    (1) establishing a process for enrolling eligible individuals and their dependents;
296.32    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
296.33    (3) providing payment to participating providers;
297.1    (4) establishing a benefit set according to subdivision 8 and establishing premium
297.2rates and cost-sharing requirements;
297.3    (5) creating incentives to encourage primary care and wellness services; and
297.4    (6) initiating disease management services, as appropriate.
297.5    (b) The payments collected under paragraph (a), clause (2), may be used to capture
297.6available federal funds.

297.7    Sec. 12. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
297.8    Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the
297.9commissioner of health on January 15, April 15, July 15, and October 15 of each year,
297.10with the first report due January 15, 2007 2008. The status report shall include:
297.11    (1) the financial status of the program, including the premium rates, cost per member
297.12per month, claims paid out, premiums received, and administrative expenses;
297.13    (2) a description of the health care benefits offered and the services utilized;
297.14    (3) the number of employers participating, the number of employees and dependents
297.15covered under the program, and the number of health care providers participating;
297.16    (4) a description of the health outcomes to be achieved by the program and a status
297.17report on the performance measurements to be used and collected; and
297.18    (5) any other information requested by the commissioner of health or commerce or
297.19the legislature.
297.20    (b) The initiative shall contract with an independent entity to conduct an evaluation
297.21of the program to be submitted to the commissioners of health and commerce and the
297.22legislature by January 15, 2009 2010. The evaluation shall include:
297.23    (1) an analysis of the health outcomes established by the initiative and the
297.24performance measurements to determine whether the outcomes are being achieved;
297.25    (2) an analysis of the financial status of the program, including the claims to
297.26premiums loss ratio and utilization and cost experience;
297.27    (3) the demographics of the enrollees, including their age, gender, family income,
297.28and the number of dependents;
297.29    (4) the number of employers and employees who have been denied access to the
297.30program and the basis for the denial;
297.31    (5) specific analysis on enrollees who have aggregate medical claims totaling over
297.32$5,000 per year, including data on the enrollee's main diagnosis and whether all the
297.33medical claims were covered by the program;
297.34    (6) number of enrollees referred to state public assistance programs;
298.1    (7) a comparison of employer-subsidized health coverage provided in a comparable
298.2geographic area to the designated community-based geographic area served by the
298.3program, including, to the extent available:
298.4    (i) the difference in the number of employers with 50 or fewer employees offering
298.5employer-subsidized health coverage;
298.6    (ii) the difference in uncompensated care being provided in each area; and
298.7    (iii) a comparison of health care outcomes and measurements established by the
298.8initiative; and
298.9    (8) any other information requested by the commissioner of health or commerce.

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

298.12    Sec. 14. [144.291] MINNESOTA HEALTH RECORDS ACT.
298.13    Subdivision 1. Short title. Sections 144.291 to 144.298 may be cited as the
298.14Minnesota Health Records Act.
298.15    Subd. 2. Definitions. For the purposes of sections 144.291 to 144.298, the following
298.16terms have the meanings given.
298.17    (a) Affiliate. "Affiliate" has the meaning given in section 144.6521, subdivision 3,
298.18paragraph (b).
298.19    (b) Group purchaser. "Group purchaser" has the meaning given in section 62J.03,
298.20subdivision 6.
298.21    (c) Health record. "Health record" means any information, whether oral or recorded
298.22in any form or medium, that relates to the past, present, or future physical or mental health
298.23or condition of a patient; the provision of health care to a patient; or the past, present, or
298.24future payment for the provision of health care to a patient.
298.25    (d) Identifying information. "Identifying information" means the patient's name,
298.26address, date of birth, gender, parent's or guardian's name regardless of the age of the
298.27patient, and other nonclinical data which can be used to uniquely identify a patient.
298.28    (e) Individually identifiable form. "Individually identifiable form" means a form in
298.29which the patient is or can be identified as the subject of the health records.
298.30    (f) Medical emergency. "Medical emergency" means medically necessary care
298.31which is immediately needed to preserve life, prevent serious impairment to bodily
298.32functions, organs, or parts, or prevent placing the physical or mental health of the patient
298.33in serious jeopardy.
299.1    (g) Patient. "Patient" means a natural person who has received health care services
299.2from a provider for treatment or examination of a medical, psychiatric, or mental
299.3condition, the surviving spouse and parents of a deceased patient, or a person the patient
299.4appoints in writing as a representative, including a health care agent acting according to
299.5chapter 145C, unless the authority of the agent has been limited by the principal in the
299.6principal's health care directive. Except for minors who have received health care services
299.7under sections 144.341 to 144.347, in the case of a minor, patient includes a parent or
299.8guardian, or a person acting as a parent or guardian in the absence of a parent or guardian.
299.9    (h) Provider. "Provider" means:
299.10    (1) any person who furnishes health care services and is regulated to furnish the
299.11services under chapter 147, 147A, 147B, 147C, 147D, 148, 148B, 148C, 148D, 150A,
299.12151, 153, or 153A;
299.13    (2) a home care provider licensed under section 144A.46;
299.14    (3) a health care facility licensed under this chapter or chapter 144A;
299.15    (4) a physician assistant registered under chapter 147A; and
299.16    (5) an unlicensed mental health practitioner regulated under sections 148B.60 to
299.17148B.71.
299.18    (i) Record locator service. "Record locator service" means an electronic index of
299.19patient identifying information that directs providers in a health information exchange to
299.20the location of patient health records held by providers and group purchasers.
299.21    (j) Related health care entity. "Related health care entity" means an affiliate of
299.22the provider releasing the health records.

299.23    Sec. 15. [144.292] PATIENT RIGHTS.
299.24    Subdivision 1. Scope. Patients have the rights specified in this section regarding the
299.25treatment the patient receives and the patient's health record.
299.26    Subd. 2. Patient access. Upon request, a provider shall supply to a patient complete
299.27and current information possessed by that provider concerning any diagnosis, treatment,
299.28and prognosis of the patient in terms and language the patient can reasonably be expected
299.29to understand.
299.30    Subd. 3. Additional patient rights. A patient's right specified in this section and
299.31sections 144.293 to 144.298 are in addition to the rights specified in sections 144.651 and
299.32144.652 and any other provision of law relating to the access of a patient to the patient's
299.33health records.
300.1    Subd. 4. Notice of rights; information on release. A provider shall provide to
300.2patients, in a clear and conspicuous manner, a written notice concerning practices and
300.3rights with respect to access to health records. The notice must include an explanation of:
300.4    (1) disclosures of health records that may be made without the written consent of the
300.5patient, including the type of records and to whom the records may be disclosed; and
300.6    (2) the right of the patient to have access to and obtain copies of the patient's health
300.7records and other information about the patient that is maintained by the provider.
300.8    The notice requirements of this subdivision are satisfied if the notice is included with
300.9the notice and copy of the patient and resident bill of rights under section 144.652 or if it
300.10is displayed prominently in the provider's place of business. The commissioner of health
300.11shall develop the notice required in this subdivision and publish it in the State Register.
300.12    Subd. 5. Copies of health records to patients. Except as provided in section
300.13144.296, upon a patient's written request, a provider, at a reasonable cost to the patient,
300.14shall promptly furnish to the patient:
300.15    (1) copies of the patient's health record, including but not limited to laboratory
300.16reports, x-rays, prescriptions, and other technical information used in assessing the
300.17patient's health conditions; or
300.18    (2) the pertinent portion of the record relating to a condition specified by the patient.
300.19    With the consent of the patient, the provider may instead furnish only a summary
300.20of the record. The provider may exclude from the health record written speculations
300.21about the patient's health condition, except that all information necessary for the patient's
300.22informed consent must be provided.
300.23    Subd. 6. Cost. (a) When a patient requests a copy of the patient's record for
300.24purposes of reviewing current medical care, the provider must not charge a fee.
300.25    (b) When a provider or its representative makes copies of patient records upon a
300.26patient's request under this section, the provider or its representative may charge the
300.27patient or the patient's representative no more than 75 cents per page, plus $10 for time
300.28spent retrieving and copying the records, unless other law or a rule or contract provide for
300.29a lower maximum charge. This limitation does not apply to x-rays. The provider may
300.30charge a patient no more than the actual cost of reproducing x-rays, plus no more than
300.31$10 for the time spent retrieving and copying the x-rays.
300.32    (c) The respective maximum charges of 75 cents per page and $10 for time provided
300.33in this subdivision are in effect for calendar year 1992 and may be adjusted annually each
300.34calendar year as provided in this subdivision. The permissible maximum charges shall
300.35change each year by an amount that reflects the change, as compared to the previous year,
301.1in the Consumer Price Index for all Urban Consumers, Minneapolis-St. Paul (CPI-U),
301.2published by the Department of Labor.
301.3    (d) A provider or its representative must not charge a fee to provide copies of records
301.4requested by a patient or the patient's authorized representative if the request for copies
301.5of records is for purposes of appealing a denial of Social Security disability income or
301.6Social Security disability benefits under title II or title XVI of the Social Security Act. For
301.7the purpose of further appeals, a patient may receive no more than two medical record
301.8updates without charge, but only for medical record information previously not provided.
301.9For purposes of this paragraph, a patient's authorized representative does not include units
301.10of state government engaged in the adjudication of Social Security disability claims.
301.11    Subd. 7. Withholding health records from patient. (a) If a provider reasonably
301.12determines that the information is detrimental to the physical or mental health of the
301.13patient, or is likely to cause the patient to inflict self harm, or to harm another, the provider
301.14may withhold the information from the patient and may supply the information to an
301.15appropriate third party or to another provider. The other provider or third party may
301.16release the information to the patient.
301.17    (b) A provider shall release information upon written request unless, prior to the
301.18request, a provider has designated and described a specific basis for withholding the
301.19information as authorized by paragraph (a).

301.20    Sec. 16. [144.293] RELEASE OR DISCLOSURE OF HEALTH RECORDS.
301.21    Subdivision 1. Release or disclosure of health records. Health records can be
301.22released or disclosed as specified in subdivisions 2 to 9 and sections 144.294 and 144.295.
301.23    Subd. 2. Patient consent to release of records. A provider, or a person who
301.24receives health records from a provider, may not release a patient's health records to a
301.25person without:
301.26    (1) a signed and dated consent from the patient or the patient's legally authorized
301.27representative authorizing the release;
301.28    (2) specific authorization in law; or
301.29    (3) a representation from a provider that the provider holds a consent from the
301.30patient.
301.31    Subd. 3. Release from one provider to another. A patient's health record,
301.32including, but not limited to, laboratory reports, x-rays, prescriptions, and other technical
301.33information used in assessing the patient's condition, or the pertinent portion of the record
301.34relating to a specific condition, or a summary of the record, shall promptly be furnished to
301.35another provider upon the written request of the patient. The written request shall specify
302.1the name of the provider to whom the health record is to be furnished. The provider who
302.2furnishes the health record or summary may retain a copy of the materials furnished. The
302.3patient shall be responsible for the reasonable costs of furnishing the information.
302.4    Subd. 4. Duration of consent. Except as provided in this section, a consent is
302.5valid for one year or for a lesser period specified in the consent or for a different period
302.6provided by law.
302.7    Subd. 5. Exceptions to consent requirement. This section does not prohibit the
302.8release of health records:
302.9    (1) for a medical emergency when the provider is unable to obtain the patient's
302.10consent due to the patient's condition or the nature of the medical emergency;
302.11    (2) to other providers within related health care entities when necessary for the
302.12current treatment of the patient; or
302.13    (3) to a health care facility licensed by this chapter, chapter 144A, or to the same
302.14types of health care facilities licensed by this chapter and chapter 144A that are licensed
302.15in another state when a patient:
302.16    (i) is returning to the health care facility and unable to provide consent; or
302.17    (ii) who resides in the health care facility, has services provided by an outside
302.18resource under Code of Federal Regulations, title 42, section 483.75(h), and is unable
302.19to provide consent.
302.20    Subd. 6. Consent does not expire. Notwithstanding subdivision 4, if a patient
302.21explicitly gives informed consent to the release of health records for the purposes and
302.22restrictions in clauses (1) and (2), the consent does not expire after one year for:
302.23    (1) the release of health records to a provider who is being advised or consulted with
302.24in connection with the releasing provider's current treatment of the patient;
302.25    (2) the release of health records to an accident and health insurer, health service plan
302.26corporation, health maintenance organization, or third-party administrator for purposes of
302.27payment of claims, fraud investigation, or quality of care review and studies, provided that:
302.28    (i) the use or release of the records complies with sections 72A.49 to 72A.505;
302.29    (ii) further use or release of the records in individually identifiable form to a person
302.30other than the patient without the patient's consent is prohibited; and
302.31    (iii) the recipient establishes adequate safeguards to protect the records from
302.32unauthorized disclosure, including a procedure for removal or destruction of information
302.33that identifies the patient.
302.34    Subd. 7. Exception to consent. Subdivision 2 does not apply to the release of health
302.35records to the commissioner of health or the Health Data Institute under chapter 62J,
302.36provided that the commissioner encrypts the patient identifier upon receipt of the data.
303.1    Subd. 8. Record locator service. (a) A provider or group purchaser may send
303.2patient identifying information and information about the location of the patient's health
303.3records to a record locator service without consent from the patient. Except in the case of
303.4a medical emergency, a provider participating in a health information exchange using a
303.5record locator service cannot access patient identifying information and information
303.6about the location of the patient's health records until the patient has provided consent.
303.7The Minnesota Department of Health may not access the record locator service or receive
303.8data from the record locator service. Only a provider may access patient identifying
303.9information in a record locator service. The consent does not expire and may be revoked
303.10by the patient at any time by providing written notice of the revocation to the provider.
303.11    (b) A health information exchange maintaining a record locator service or an entity
303.12maintaining a record locator service for a health information exchange must maintain an
303.13audit log of providers accessing information in a record locator service that minimally
303.14contains information on:
303.15    (1) the identity of the provider accessing the information;
303.16    (2) the identity of the patient whose information was accessed by the provider; and
303.17    (3) the date the information was accessed.
303.18    (c) No group purchaser may in any way require a provider to participate in any
303.19record locator service as a condition of payment or participation.
303.20    (d) A record locator service must provide a mechanism for patients to opt out of
303.21including their identifying information and information about the location of their health
303.22records in a record locator service. At a minimum, any consent form that permits a
303.23provider to access a record locator service must include a check-box option that allows a
303.24patient to completely opt out of the record locator service which shall be clearly displayed
303.25to the patient. A provider participating in a health information exchange with a record
303.26locator service who receives a patient's request to completely opt out of the record locator
303.27service or to not have a specific provider contact in the record locator service shall be
303.28responsible for removing the patient's information from the record locator service.
303.29    Subd. 9. Documentation of release. (a) In cases where a provider releases health
303.30records without patient consent as authorized by law, the release must be documented in
303.31the patient's health record. In the case of a release under section 144.294, subdivision 2, the
303.32documentation must include the date and circumstances under which the release was made,
303.33the person or agency to whom the release was made, and the records that were released.
303.34    (b) When a health record is released using a representation from a provider that
303.35holds a consent from the patient, the releasing provider shall document:
303.36    (1) the provider requesting the health records;
304.1    (2) the identity of the patient;
304.2    (3) the health records requested; and
304.3    (4) the date the health records were requested.

304.4    Sec. 17. [144.294] RECORDS RELATING TO MENTAL HEALTH.
304.5    Subdivision 1. Provider inquiry. Upon the written request of a spouse, parent,
304.6child, or sibling of a patient being evaluated for or diagnosed with mental illness, a
304.7provider shall inquire of a patient whether the patient wishes to authorize a specific
304.8individual to receive information regarding the patient's current and proposed course of
304.9treatment. If the patient so authorizes, the provider shall communicate to the designated
304.10individual the patient's current and proposed course of treatment. Section 144.293,
304.11subdivisions 2 and 4, apply to consents given under this subdivision.
304.12    Subd. 2. Disclosure to law enforcement agency. Notwithstanding section 144.293,
304.13subdivisions 2 and 4, a provider must disclose health records relating to a patient's mental
304.14health to a law enforcement agency if the law enforcement agency provides the name
304.15of the patient and communicates that the:
304.16    (1) patient is currently involved in an emergency interaction with the law
304.17enforcement agency; and
304.18    (2) disclosure of the records is necessary to protect the health or safety of the patient
304.19or of another person.
304.20    The scope of disclosure under this subdivision is limited to the minimum necessary
304.21for law enforcement to respond to the emergency. A law enforcement agency that obtains
304.22health records under this subdivision shall maintain a record of the requestor, the provider
304.23of the information, and the patient's name. Health records obtained by a law enforcement
304.24agency under this subdivision are private data on individuals as defined in section 13.02,
304.25subdivision 12, and must not be used by law enforcement for any other purpose.
304.26    Subd. 3. Records release for family and caretaker; mental health care. (a)
304.27Notwithstanding section 144.293, a provider providing mental health care and treatment
304.28may disclose health record information described in paragraph (b) about a patient to a
304.29family member of the patient or other person who requests the information if:
304.30    (1) the request for information is in writing;
304.31    (2) the family member or other person lives with, provides care for, or is directly
304.32involved in monitoring the treatment of the patient;
304.33    (3) the involvement under clause (2) is verified by the patient's mental health care
304.34provider, the patient's attending physician, or a person other than the person requesting the
304.35information, and is documented in the patient's medical record;
305.1    (4) before the disclosure, the patient is informed in writing of the request, the name
305.2of the person requesting the information, the reason for the request, and the specific
305.3information being requested;
305.4    (5) the patient agrees to the disclosure, does not object to the disclosure, or is
305.5unable to consent or object, and the patient's decision or inability to make a decision is
305.6documented in the patient's medical record; and
305.7    (6) the disclosure is necessary to assist in the provision of care or monitoring of the
305.8patient's treatment.
305.9    (b) The information disclosed under this paragraph is limited to diagnosis, admission
305.10to or discharge from treatment, the name and dosage of the medications prescribed, side
305.11effects of the medication, consequences of failure of the patient to take the prescribed
305.12medication, and a summary of the discharge plan.
305.13    (c) If a provider reasonably determines that providing information under this
305.14subdivision would be detrimental to the physical or mental health of the patient or is
305.15likely to cause the patient to inflict self harm or to harm another, the provider must not
305.16disclose the information.
305.17    (d) This subdivision does not apply to disclosures for a medical emergency or
305.18to family members as authorized or required under subdivision 1 or section 144.293,
305.19subdivision 5, clause (1).

305.20    Sec. 18. [144.295] DISCLOSURE OF HEALTH RECORDS FOR EXTERNAL
305.21RESEARCH.
305.22    Subdivision 1. Methods of release. (a) Notwithstanding section 144.293,
305.23subdivisions 2 and 4, health records may be released to an external researcher solely for
305.24purposes of medical or scientific research only as follows:
305.25    (1) health records generated before January 1, 1997, may be released if the patient
305.26has not objected or does not elect to object after that date;
305.27    (2) for health records generated on or after January 1, 1997, the provider must:
305.28    (i) disclose in writing to patients currently being treated by the provider that health
305.29records, regardless of when generated, may be released and that the patient may object, in
305.30which case the records will not be released; and
305.31    (ii) use reasonable efforts to obtain the patient's written general authorization that
305.32describes the release of records in item (i), which does not expire but may be revoked or
305.33limited in writing at any time by the patient or the patient's authorized representative;
305.34    (3) the provider must advise the patient of the rights specified in clause (4); and
306.1    (4) the provider must, at the request of the patient, provide information on how the
306.2patient may contact an external researcher to whom the health record was released and
306.3the date it was released.
306.4    (b) Authorization may be established if an authorization is mailed at least two
306.5times to the patient's last known address with a postage prepaid return envelope and a
306.6conspicuous notice that the patient's medical records may be released if the patient does
306.7not object, and at least 60 days have expired since the second notice was sent.
306.8    Subd. 2. Duties of researcher. In making a release for research purposes, the
306.9provider shall make a reasonable effort to determine that:
306.10    (1) the use or disclosure does not violate any limitations under which the record
306.11was collected;
306.12    (2) the use or disclosure in individually identifiable form is necessary to accomplish
306.13the research or statistical purpose for which the use or disclosure is to be made;
306.14    (3) the recipient has established and maintains adequate safeguards to protect the
306.15records from unauthorized disclosure, including a procedure for removal or destruction of
306.16information that identifies the patient; and
306.17    (4) further use or release of the records in individually identifiable form to a person
306.18other than the patient without the patient's consent is prohibited.

306.19    Sec. 19. [144.296] COPIES OF VIDEOTAPES.
306.20    A provider may not release a copy of a videotape of a child victim or alleged victim
306.21of physical or sexual abuse without a court order under section 13.03, subdivision 6, or
306.22as provided in section 611A.90. This section does not limit the right of a patient to view
306.23the videotape.

306.24    Sec. 20. [144.297] INDEPENDENT MEDICAL EXAMINATION.
306.25    This section applies to the subject and provider of an independent medical
306.26examination requested by or paid for by a third party. Notwithstanding section 144.293, a
306.27provider may release health records created as part of an independent medical examination
306.28to the third party who requested or paid for the examination.

306.29    Sec. 21. [144.298] PENALTIES.
306.30    Subdivision 1. Licensing action. A violation of sections 144.291 to 144.298 may
306.31be grounds for disciplinary action against a provider by the appropriate licensing board
306.32or agency.
307.1    Subd. 2. Allocation of liability. In adjudicating a dispute involving the disclosure
307.2of patient health records, a court shall use the criteria in this subdivision in determining
307.3how liability will be allocated.
307.4    (a) When requesting health records using consent, a person warrants that the consent:
307.5    (1) contains no information known to the person to be false; and
307.6    (2) accurately states the patient's desire to have health records disclosed or that there
307.7is specific authorization in law.
307.8    (b) When requesting health records using consent or the representation authorized in
307.9section 144.293, subdivision 2, a provider warrants that the request:
307.10    (1) contains no information known to the provider to be false;
307.11    (2) accurately states the patient's desire to have health records disclosed or that
307.12there is specific authorization in law; and
307.13    (3) does not exceed any limits imposed by the patient in the consent.
307.14    (c) When disclosing health records, a person releasing health records warrants that
307.15the person:
307.16    (1) has complied with the requirements of this section regarding disclosure of
307.17health records;
307.18    (2) knows of no information related to the request that is false; and
307.19    (3) has complied with the limits set by the patient in the consent or as described
307.20in the representation of consent.
307.21    (d) A court of this state presumes that:
307.22    (1) a request made by a person that complies with the provisions of this section is
307.23valid and represents the wishes of the patient;
307.24    (2) the information listed in a consent or representation of consent is accurate;
307.25    (3) the recipient of a consent or representation of consent has no knowledge or
307.26notice that the person making the request breached a duty to the patient or does not
307.27rightfully have a consent;
307.28    (4) the signature on the consent or representation of consent is not forged;
307.29    (5) the consent or representation of consent was not obtained under false pretenses;
307.30and
307.31    (6) the consent or representation of consent was not altered without the patient's
307.32permission.
307.33    (e) No person or provider may disclaim or contractually limit the application of this
307.34section, or obtain indemnity for its effects, if the disclaimer, limitation, or indemnity
307.35restricts liability for misrepresentation against persons reasonably relying on the consent,
307.36representation of consent, or disclosure.
308.1    (f) A court of this state shall give effect to liability allocations between the parties
308.2provided by contract that does not allocate liability to the detriment of the patient and the
308.3allocation is consistent with the requirements of sections 144.291 to 144.298.
308.4    (g) A patient is eligible to receive compensatory damages plus costs and reasonable
308.5attorney fees if there is a negligent or intentional violation of sections 144.293 to 144.295.
308.6    Subd. 3. Liability for a record locator service. A patient is eligible to receive
308.7compensatory damages plus costs and reasonable attorney fees if a health information
308.8exchange maintaining a record locator service, or an entity maintaining a record locator
308.9service for a health information exchange, negligently or intentionally violates the
308.10provisions of section 144.293, subdivision 8.

308.11    Sec. 22. Minnesota Statutes 2006, section 144.3345, is amended to read:
308.12144.3345 INTERCONNECTED ELECTRONIC HEALTH RECORD
308.13GRANTS.
308.14    Subdivision 1. Definitions. The following definitions are used for the purposes
308.15of this section.
308.16    (a) "Eligible community e-health collaborative" means an existing or newly
308.17established collaborative to support the adoption and use of interoperable electronic
308.18health records. A collaborative must consist of at least three two or more eligible health
308.19care entities in at least two of the categories listed in paragraph (b) and have a focus on
308.20interconnecting the members of the collaborative for secure and interoperable exchange of
308.21health care information.
308.22    (b) "Eligible health care entity" means one of the following:
308.23    (1) community clinics, as defined under section 145.9268;
308.24    (2) hospitals eligible for rural hospital capital improvement grants, as defined
308.25in section 144.148;
308.26    (3) physician clinics located in a community with a population of less than 50,000
308.27according to United States Census Bureau statistics and outside the seven-county
308.28metropolitan area;
308.29    (4) nursing facilities licensed under sections 144A.01 to 144A.27;
308.30    (5) community health boards or boards of health as established under chapter 145A;
308.31    (6) nonprofit entities with a purpose to provide health information exchange
308.32coordination governed by a representative, multi-stakeholder board of directors; and
308.33    (7) other providers of health or health care services approved by the commissioner
308.34for which interoperable electronic health record capability would improve quality of
308.35care, patient safety, or community health.
309.1    Subd. 2. Grants authorized. The commissioner of health shall award grants to:
309.2    (a) eligible community e-health collaborative projects to improve the implementation
309.3and use of interoperable electronic health records including but not limited to the
309.4following projects:
309.5    (1) collaborative efforts to host and support fully functional interoperable electronic
309.6health records in multiple care settings;
309.7    (2) electronic medication history and electronic patient registration medical history
309.8information;
309.9    (3) electronic personal health records for persons with chronic diseases and for
309.10prevention services;
309.11    (4) rural and underserved community models for electronic prescribing; and
309.12    (5) enabling modernize local public health information systems to rapidly and
309.13electronically exchange information needed to participate in community e-health
309.14collaboratives or for public health emergency preparedness and response.; and
309.15    (6) implement regional or community-based health information exchange
309.16organizations;
309.17    (b) community clinics, as defined under section 145.9268, to implement and use
309.18interoperable electronic health records, including but not limited to the following projects:
309.19    (1) efforts to plan for and implement fully functional, standards-based interoperable
309.20electronic health records; and
309.21    (2) purchases and implementation of computer hardware, software, and technology
309.22to fully implement interoperable electronic health records;
309.23    (c) regional or community-based health information exchange organizations to
309.24connect and facilitate the exchange of health information between eligible health care
309.25entities, including but not limited to the development, testing, and implementation of:
309.26    (1) data exchange standards, including data, vocabulary, and messaging standards,
309.27for the exchange of health information, provided that such standards are consistent with
309.28state and national standards;
309.29    (2) security standards necessary to ensure the confidentiality and integrity of health
309.30records;
309.31    (3) computer interfaces and mechanisms for standardizing health information
309.32exchanged between eligible health care entities;
309.33    (4) a record locator service for identifying the location of patient health records; or
309.34    (5) interfaces and mechanisms for implementing patient consent requirements; and
309.35    (d) community health boards and boards of health as established under chapter
309.36145A to modernize local public health information systems to be standards-based and
310.1interoperable with other electronic health records and information systems, or for
310.2enhanced public health emergency preparedness and response.
310.3    Grant funds may not be used for construction of health care or other buildings or
310.4facilities.
310.5    Subd. 3. Allocation of grants. (a) To receive a grant under this section, an eligible
310.6community e-health collaborative, community clinic, regional or community-based health
310.7information exchange, or community health boards and boards of health must submit an
310.8application to the commissioner of health by the deadline established by the commissioner.
310.9A grant may be awarded upon the signing of a grant contract. In awarding grants, the
310.10commissioner shall give preference to projects benefiting providers located in rural and
310.11underserved areas of Minnesota which the commissioner has determined have an unmet
310.12need for the development and funding of electronic health records. Applicants may apply
310.13for and the commissioner may award grants for one-year, two-year, or three-year periods.
310.14    (b) An application must be on a form and contain information as specified by the
310.15commissioner but at a minimum must contain:
310.16    (1) a description of the purpose or project for which grant funds will be used;
310.17    (2) a description of the problem or problems the grant funds will be used to address,
310.18including an assessment of the likelihood of the project occurring absent grant funding;
310.19    (3) a description of achievable objectives, a workplan, budget, budget narrative, a
310.20project communications plan, a timeline for implementation and completion of processes
310.21or projects enabled by the grant, and an assessment of privacy and security issues and a
310.22proposed approach to address these issues;
310.23    (4) a description of the health care entities and other groups participating in the
310.24project, including identification of the lead entity responsible for applying for and
310.25receiving grant funds;
310.26    (5) a plan for how patients and consumers will be involved in development of
310.27policies and procedures related to the access to and interchange of information;
310.28    (6) evidence of consensus and commitment among the health care entities and others
310.29who developed the proposal and are responsible for its implementation; and
310.30    (7) a plan for documenting and evaluating results of the grant. ; and
310.31    (8) a plan for use of data exchange standards, including data and vocabulary.
310.32    (c) The commissioner shall review each application to determine whether the
310.33application is complete and whether the applicant and the project are eligible for a
310.34grant. In evaluating applications, the commissioner shall take into consideration factors,
310.35including but not limited to, the following:
311.1    (1) the degree to which the proposal interconnects the various providers of care with
311.2other health care entities in the applicant's geographic community;
311.3    (2) the degree to which the project provides for the interoperability of electronic
311.4health records or related health information technology between the members of the
311.5collaborative, and presence and scope of a description of how the project intends to
311.6interconnect with other providers not part of the project into the future;
311.7    (3) the degree to which the project addresses current unmet needs pertaining
311.8to interoperable electronic health records in a geographic area of Minnesota and the
311.9likelihood that the needs would not be met absent grant funds;
311.10    (4) the applicant's thoroughness and clarity in describing the project, how the project
311.11will improve patient safety, quality of care, and consumer empowerment, and the role of
311.12the various collaborative members;
311.13    (5) the recommendations of the Health Information and Technology Infrastructure
311.14Advisory Committee; and
311.15    (6) other factors that the commissioner deems relevant.
311.16    (d) Grant funds shall be awarded on a three-to-one match basis. Applicants shall
311.17be required to provide $1 in the form of cash or in-kind staff or services for each $3
311.18provided under the grant program.
311.19    (e) Grants shall not exceed $900,000 per grant. The commissioner has discretion
311.20over the size and number of grants awarded.
311.21    Subd. 4. Evaluation and report. The commissioner of health shall evaluate the
311.22overall effectiveness of the grant program. The commissioner shall collect progress
311.23and expenditure reports to evaluate the grant program from the eligible community
311.24collaboratives receiving grants.

311.25    Sec. 23. Minnesota Statutes 2006, section 144.565, is amended to read:
311.26144.565 DIAGNOSTIC IMAGING FACILITIES.
311.27    Subdivision 1. Utilization and services data; economic and financial interests.
311.28    The commissioner shall require diagnostic imaging facilities and providers of diagnostic
311.29imaging services in Minnesota to annually report by March 1 each year for the preceding
311.30fiscal year to the commissioner, in the form and manner specified by the commissioner:
311.31    (1) utilization data for each health plan company and each public program,
311.32including workers' compensation, as follows: of diagnostic imaging services as defined
311.33in subdivision 4, paragraph (b);
311.34    (i) the number of computerized tomography (CT) procedures performed;
311.35    (ii) the number of magnetic resonance imaging (MRI) procedures performed; and
312.1    (iii) the number of positron emission tomography (PET) procedures performed; and
312.2    (2) the names of all physicians with any financial or economic interest and all other
312.3individuals with a ten percent or greater financial or economic interest in the facility.;
312.4    (3) the location where procedures were performed;
312.5    (4) the number of units of each type of fixed, portable, and mobile scanner used at
312.6each location;
312.7    (5) the average number of hours per month each mobile scanner was operated at
312.8each location;
312.9    (6) the number of hours per month each scanner was leased, if applicable;
312.10    (7) the total number of diagnostic imaging procedures billed for by the provider at
312.11each location, by type of diagnostic imaging service as defined in subdivision 4, paragraph
312.12(b); and
312.13    (8) a report on major health care capital expenditures during the previous year, as
312.14required by section 62J.17.
312.15    Subd. 2. Commissioner's right to inspect records. If the report is not filed or
312.16the commissioner of health has reason to believe the report is incomplete or false, the
312.17commissioner shall have the right to inspect diagnostic imaging facility books, audits,
312.18and records.
312.19    Subd. 3. Separate reports. For a diagnostic imaging facility that is not attached
312.20or not contiguous to a hospital or a hospital affiliate, the commissioner shall require
312.21the information in subdivision 1 be reported separately for each detached diagnostic
312.22imaging facility as part of the report required under section 144.702. If any entity owns
312.23more than one diagnostic imaging facility, that entity must report by individual facility.
312.24Reports must include only services that were billed by the provider of diagnostic imaging
312.25services submitting the report. If a diagnostic imaging facility leases capacity, technical
312.26services, or professional services to one or more other providers of diagnostic imaging
312.27services, each provider must submit a separate annual report to the commissioner for all
312.28diagnostic imaging services that it provided and billed. The owner of the leased capacity
312.29must provide a report listing the names and addresses of providers to whom the diagnostic
312.30imaging services and equipment were leased.
312.31    Subd. 4. Definitions. For purposes of this section, the following terms have the
312.32meanings given:
312.33    (a) "Diagnostic imaging facility" means a health care facility that provides is not
312.34a hospital or location licensed as a hospital which offers diagnostic imaging services
312.35through the use of ionizing radiation or other imaging technique including, but not limited
312.36to magnetic resonance imaging (MRI) or computerized tomography (CT) scan on a
313.1freestanding or mobile basis in Minnesota, regardless of whether the equipment used
313.2to provide the service is owned or leased. For the purposes of this section, diagnostic
313.3imaging facility includes, but is not limited to, facilities such as a physician's office, clinic,
313.4mobile transport vehicle, outpatient imaging center, or surgical center.
313.5    (b) "Diagnostic imaging service" means the use of ionizing radiation or other
313.6imaging technique on a human patient including, but not limited to, magnetic resonance
313.7imaging (MRI) or computerized tomography (CT), positron emission tomography (PET),
313.8or single photon emission computerized tomography (SPECT) scans using fixed, portable,
313.9or mobile equipment.
313.10    (b) (c) "Financial or economic interest" means a direct or indirect:
313.11    (1) equity or debt security issued by an entity, including, but not limited to, shares of
313.12stock in a corporation, membership in a limited liability company, beneficial interest in
313.13a trust, units or other interests in a partnership, bonds, debentures, notes or other equity
313.14interests or debt instruments, or any contractual arrangements;
313.15    (2) membership, proprietary interest, or co-ownership with an individual, group, or
313.16organization to which patients, clients, or customers are referred to; or
313.17    (3) employer-employee or independent contractor relationship, including, but not
313.18limited to, those that may occur in a limited partnership, profit-sharing arrangement, or
313.19other similar arrangement with any facility to which patients are referred, including any
313.20compensation between a facility and a health care provider, the group practice of which
313.21the provider is a member or employee or a related party with respect to any of them.
313.22    (c) (d) "Freestanding Fixed equipment" means a stationary diagnostic imaging
313.23facility that is not located within a: machine installed in a permanent location.
313.24    (1) hospital;
313.25    (2) location licensed as a hospital; or
313.26    (3) physician's office or clinic where the professional practice of medicine by
313.27licensed physicians is the primary purpose and not the provision of ancillary services
313.28such as diagnostic imaging.
313.29    (d) (e) "Mobile equipment" means a diagnostic imaging facility that is transported to
313.30various sites not including movement within a hospital or a physician's office or clinic
313.31machine in a self-contained transport vehicle designed to be brought to a temporary offsite
313.32location to perform diagnostic imaging services.
313.33    (f) "Portable equipment" means a diagnostic imaging machine designed to be
313.34temporarily transported within a permanent location to perform diagnostic imaging
313.35services.
314.1    (g) "Provider of diagnostic imaging services" means a diagnostic imaging facility
314.2or an entity that offers and bills for diagnostic imaging services at a facility owned or
314.3leased by the entity.
314.4    Subd. 5. Reports open to public inspection. All reports filed pursuant to this
314.5section shall be open to public inspection.

314.6    Sec. 24. [144.585] METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS
314.7CONTROL PROGRAMS.
314.8    In order to improve the prevention of hospital-associated bloodstream infections due
314.9to methicillin-resistant Staphylococcus aureus ("MRSA"), every hospital shall establish
314.10an MRSA control program that meets Minnesota Department of Health best practices
314.11standards as published January 15, 2008, including considerations of:
314.12    (1) identification of all MRSA-colonized patients in all intensive care units, and
314.13other at-risk patients identified by the hospital, through active surveillance testing;
314.14    (2) isolation of identified MRSA-colonized or MRSA-infected patients in an
314.15appropriate manner;
314.16    (3) monitoring and strict enforcement of hand hygiene requirements; and
314.17    (4) maintenance of records.

314.18    Sec. 25. Minnesota Statutes 2006, section 144.651, subdivision 26, is amended to read:
314.19    Subd. 26. Right to associate. (a) Residents may meet with and receive visitors
314.20and participate in activities of commercial, religious, political, as defined in section
314.21203B.11 and community groups without interference at their discretion if the activities
314.22do not infringe on the right to privacy of other residents or are not programmatically
314.23contraindicated. This includes:
314.24    (1) the right to join with other individuals within and outside the facility to work for
314.25improvements in long-term care;
314.26    (2) the right to visitation by an individual the patient has appointed as the patient's
314.27health care agent under chapter 145C;
314.28    (3) the right to visitation and health care decision making by an individual designated
314.29by the patient under paragraph (c).
314.30    (b) Upon admission to a facility where federal law prohibits unauthorized disclosure
314.31of patient or resident identifying information to callers and visitors, the patient or
314.32resident, or the legal guardian or conservator of the patient or resident, shall be given the
314.33opportunity to authorize disclosure of the patient's or resident's presence in the facility
314.34to callers and visitors who may seek to communicate with the patient or resident. To the
315.1extent possible, the legal guardian or conservator of a patient or resident shall consider the
315.2opinions of the patient or resident regarding the disclosure of the patient's or resident's
315.3presence in the facility.
315.4    (c) Upon admission to a facility, the patient or resident, or the legal guardian
315.5or conservator of the patient or resident, must be given the opportunity to designate
315.6a person who is not related who will have the status of the patient's next of kin with
315.7respect to visitation and making a health care decision. A designation must be included
315.8in the patient's health record. With respect to making a health care decision, a health
315.9care directive or appointment of a health care agent under chapter 145C prevails over a
315.10designation made under this paragraph. The unrelated person may also be identified as
315.11such by the patient or by the patient's family.

315.12    Sec. 26. Minnesota Statutes 2006, section 144D.03, subdivision 1, is amended to read:
315.13    Subdivision 1. Registration procedures. The commissioner shall establish forms
315.14and procedures for annual registration of housing with services establishments. The
315.15commissioner shall charge an annual registration fee of $35 $155. No fee shall be
315.16refunded. A registered establishment shall notify the commissioner within 30 days of the
315.17date it is no longer required to be registered under this chapter or of any change in the
315.18business name or address of the establishment, the name or mailing address of the owner
315.19or owners, or the name or mailing address of the managing agent. There shall be no
315.20fee for submission of the notice.

315.21    Sec. 27. [145.9269] FEDERALLY QUALIFIED HEALTH CENTERS.
315.22    Subdivision 1. Definitions. For purposes of this section, "federally qualified health
315.23center" means an entity that is receiving a grant under United States Code, title 42,
315.24section 254b, or, based on the recommendation of the Health Resources and Services
315.25Administration within the Public Health Service, is determined by the secretary to meet
315.26the requirements for receiving such a grant.
315.27    Subd. 2. Allocation of subsidies. The commissioner of health shall distribute
315.28subsidies to federally qualified health centers operating in Minnesota to continue, expand,
315.29and improve federally qualified health center services to low-income populations. The
315.30commissioner shall distribute the funds appropriated under this section to federally
315.31qualified health centers operating in Minnesota as of January 1, 2007. The amount of
315.32each subsidy shall be in proportion to each federally qualified health center's amount of
315.33discounts granted to patients during calendar year 2006 as reported on the federal Uniform
315.34Data System report in conformance with the Bureau of Primary Health Care Program
316.1Expectations Policy Information Notice 98-23, except that each eligible federally qualified
316.2health center shall receive at least two percent but no more than 30 percent of the total
316.3amount of money available under this section.

316.4    Sec. 28. Minnesota Statutes 2006, section 145C.05, is amended to read:
316.5145C.05 SUGGESTED FORM; PROVISIONS THAT MAY BE INCLUDED.
316.6    Subdivision 1. Content. A health care directive executed pursuant to this chapter
316.7may, but need not, be in the form contained in section 145C.16.
316.8    Subd. 2. Provisions that may be included. (a) A health care directive may include
316.9provisions consistent with this chapter, including, but not limited to:
316.10    (1) the designation of one or more alternate health care agents to act if the named
316.11health care agent is not reasonably available to serve;
316.12    (2) directions to joint health care agents regarding the process or standards by which
316.13the health care agents are to reach a health care decision for the principal, and a statement
316.14whether joint health care agents may act independently of one another;
316.15    (3) limitations, if any, on the right of the health care agent or any alternate health
316.16care agents to receive, review, obtain copies of, and consent to the disclosure of the
316.17principal's medical records or to visit the principal when the principal is a patient in a
316.18health care facility;
316.19    (4) limitations, if any, on the nomination of the health care agent as guardian for
316.20purposes of sections 524.5-202, 524.5-211, 524.5-302, and 524.5-303;
316.21    (5) a document of gift for the purpose of making an anatomical gift, as set forth in
316.22sections 525.921 to 525.9224, or an amendment to, revocation of, or refusal to make
316.23an anatomical gift;
316.24    (6) a declaration regarding intrusive mental health treatment under section 253B.03,
316.25subdivision 6d , or a statement that the health care agent is authorized to give consent for
316.26the principal under section 253B.04, subdivision 1a;
316.27    (7) a funeral directive as provided in section 149A.80, subdivision 2;
316.28    (8) limitations, if any, to the effect of dissolution or annulment of marriage or
316.29termination of domestic partnership on the appointment of a health care agent under
316.30section 145C.09, subdivision 2;
316.31    (9) specific reasons why a principal wants a health care provider or an employee
316.32of a health care provider attending the principal to be eligible to act as the principal's
316.33health care agent;
316.34    (10) health care instructions by a woman of child bearing age regarding how she
316.35would like her pregnancy, if any, to affect health care decisions made on her behalf; and
317.1    (11) health care instructions regarding artificially administered nutrition or hydration.
317.2    (b) A health care directive may include a statement of the circumstances under
317.3which the directive becomes effective other than upon the judgment of the principal's
317.4attending physician in the following situations:
317.5    (1) a principal who in good faith generally selects and depends upon spiritual means
317.6or prayer for the treatment or care of disease or remedial care and does not have an
317.7attending physician, may include a statement appointing an individual who may determine
317.8the principal's decision-making capacity; and
317.9    (2) a principal who in good faith does not generally select a physician or a health
317.10care facility for the principal's health care needs may include a statement appointing an
317.11individual who may determine the principal's decision-making capacity, provided that if
317.12the need to determine the principal's capacity arises when the principal is receiving care
317.13under the direction of an attending physician in a health care facility, the determination
317.14must be made by an attending physician after consultation with the appointed individual.
317.15    If a person appointed under clause (1) or (2) is not reasonably available and the
317.16principal is receiving care under the direction of an attending physician in a health care
317.17facility, an attending physician shall determine the principal's decision-making capacity.
317.18    (c) A health care directive may authorize a health care agent to make health care
317.19decisions for a principal even though the principal retains decision-making capacity.

317.20    Sec. 29. Minnesota Statutes 2006, section 145C.07, is amended by adding a
317.21subdivision to read:
317.22    Subd. 5. Visitation. A health care agent may visit the principal when the
317.23principal is a patient in a health care facility regardless of whether the principal retains
317.24decision-making capacity, unless:
317.25    (1) the principal has otherwise specified in the health care directive;
317.26    (2) a principal who retains decision-making capacity indicates otherwise; or
317.27    (3) a health care provider reasonably determines that the principal must be isolated
317.28from all visitors or that the presence of the health care agent would endanger the health or
317.29safety of the principal, other patients, or the facility in which the care is being provided.

317.30    Sec. 30. Minnesota Statutes 2006, section 148.6445, subdivision 1, is amended to read:
317.31    Subdivision 1. Initial licensure fee. The initial licensure fee for occupational
317.32therapists is $180 $145. The initial licensure fee for occupational therapy assistants is
317.33$100 $80. The commissioner shall prorate fees based on the number of quarters remaining
317.34in the biennial licensure period.

318.1    Sec. 31. Minnesota Statutes 2006, section 148.6445, subdivision 2, is amended to read:
318.2    Subd. 2. Licensure renewal fee. The biennial licensure renewal fee for
318.3occupational therapists is $180 $145. The biennial licensure renewal fee for occupational
318.4therapy assistants is $100 $80.

318.5    Sec. 32. [148.785] FEES.
318.6    The fees charged by the board are fixed at the following rates:
318.7    (1) application fee for physical therapists and physical therapist assistants, $100;
318.8    (2) annual licensure for physical therapists and physical therapist assistants, $60;
318.9    (3) licensure renewal late fee, $20;
318.10    (4) temporary permit, $25;
318.11    (5) duplicate license or registration, $20;
318.12    (6) certification letter, $25;
318.13    (7) education or training program approval, $100;
318.14    (8) report creation and generation, $60 per hour billed in quarter-hour increments
318.15with a quarter-hour minimum; and
318.16    (9) examination administration:
318.17    (i) half day, $50; and
318.18    (ii) full day, $80.

318.19    Sec. 33. Minnesota Statutes 2006, section 148B.53, subdivision 3, is amended to read:
318.20    Subd. 3. Fee. Nonrefundable fees are as follows:
318.21    (1) initial license application fee for licensed professional counseling (LPC) - $250
318.22$150;
318.23    (2) initial license fee for LPC - $250;
318.24    (3) annual active license renewal fee for LPC - $200 $250 or equivalent;
318.25    (3) (4) annual inactive license renewal fee for LPC - $100 $125;
318.26    (5) initial license application fee for licensed professional clinical counseling
318.27(LPCC) - $150;
318.28    (6) initial license fee for LPCC - $250;
318.29    (7) annual active license renewal fee for LPCC - $250 or equivalent;
318.30    (8) annual inactive license renewal fee for LPCC - $125;
318.31    (4) (9) license renewal late fee - $100 per month or portion thereof;
318.32    (5) (10) copy of board order or stipulation - $10;
318.33    (6) (11) certificate of good standing or license verification - $10 $25;
318.34    (7) (12) duplicate certificate fee - $10 $25;
319.1    (8) (13) professional firm renewal fee - $25;
319.2    (9) (14) sponsor application for approval of a continuing education course - $60;
319.3    (15) initial registration fee - $50; and
319.4    (10) (16) annual registration renewal fee - $25; and
319.5    (17) approved supervisor application processing fee - $30.

319.6    Sec. 34. Minnesota Statutes 2006, section 149A.52, subdivision 3, is amended to read:
319.7    Subd. 3. Application procedure; documentation; initial inspection. An applicant
319.8for a license to operate a crematory shall submit to the commissioner a completed
319.9application. A completed application includes:
319.10    (1) a completed application form, as provided by the commissioner;
319.11    (2) proof of business form and ownership; and
319.12    (3) proof of liability insurance coverage or other financial documentation, as
319.13determined by the commissioner, that demonstrates the applicant's ability to respond in
319.14damages for liability arising from the ownership, maintenance, management, or operation
319.15of a crematory.
319.16    Upon receipt of the application and appropriate fee, the commissioner shall review
319.17and verify all information. Upon completion of the verification process and resolution
319.18of any deficiencies in the application information, the commissioner shall conduct an
319.19initial inspection of the premises to be licensed. After the inspection and resolution of
319.20any deficiencies found and any reinspections as may be necessary, the commissioner shall
319.21make a determination, based on all the information available, to grant or deny licensure. If
319.22the commissioner's determination is to grant the license, the applicant shall be notified and
319.23the license shall issue and remain valid for a period prescribed on the license, but not to
319.24exceed one calendar year from the date of issuance of the license. If the commissioner's
319.25determination is to deny the license, the commissioner must notify the applicant, in
319.26writing, of the denial and provide the specific reason for denial.

319.27    Sec. 35. [149A.65] FEES.
319.28    Subdivision 1. Generally. This section establishes the fees for registrations,
319.29examinations, initial and renewal licenses, and late fees authorized under the provisions
319.30of this chapter.
319.31    Subd. 2. Mortuary science fees. Fees for mortuary science are:
319.32    (1) $50 for the initial and renewal registration of a mortuary science intern;
319.33    (2) $100 for the mortuary science examination;
319.34    (3) $125 for issuance of initial and renewal mortuary science licenses;
320.1    (4) $25 late fee charge for a license renewal; and
320.2    (5) $200 for issuing a mortuary science license by endorsement.
320.3    Subd. 3. Funeral directors. The license renewal fee for funeral directors is $125.
320.4The late fee charge for a license renewal is $25.
320.5    Subd. 4. Funeral establishments. The initial and renewal fee for funeral
320.6establishments is $300. The late fee charge for a license renewal is $25.
320.7    Subd. 5. Crematories. The initial and renewal fee for a crematory is $300. The
320.8late fee charge for a license renewal is $25.

320.9    Sec. 36. Minnesota Statutes 2006, section 149A.97, subdivision 7, is amended to read:
320.10    Subd. 7. Reports to commissioner. Every funeral provider lawfully doing business
320.11in Minnesota that accepts funds under subdivision 2 must make a complete annual report
320.12to the commissioner. The reports may be on forms provided by the commissioner or
320.13substantially similar forms containing, at least, identification and the state of each trust
320.14account, including all transactions involving principal and accrued interest, and must be
320.15filed by March 31 of the calendar year following the reporting year along with a filing
320.16fee of $15 $25 for each report. Fees shall be paid to the commissioner of finance, state of
320.17Minnesota, for deposit in the state government special revenue fund in the state treasury.
320.18Reports must be signed by an authorized representative of the funeral provider and
320.19notarized under oath. All reports to the commissioner shall be reviewed for account
320.20inaccuracies or possible violations of this section. If the commissioner has a reasonable
320.21belief to suspect that there are account irregularities or possible violations of this section,
320.22the commissioner shall report that belief, in a timely manner, to the state auditor. The
320.23commissioner shall also file an annual letter with the state auditor disclosing whether or
320.24not any irregularities or possible violations were detected in review of the annual trust
320.25fund reports filed by the funeral providers. This letter shall be filed with the state auditor
320.26by May 31 of the calendar year following the reporting year.

320.27    Sec. 37. Minnesota Statutes 2006, section 157.16, subdivision 1, is amended to read:
320.28    Subdivision 1. License required annually. A license is required annually for every
320.29person, firm, or corporation engaged in the business of conducting a food and beverage
320.30service establishment, hotel, motel, lodging establishment, or resort. Any person wishing
320.31to operate a place of business licensed in this section shall first make application, pay the
320.32required fee specified in this section, and receive approval for operation, including plan
320.33review approval. Seasonal and temporary food stands and special event food stands are
320.34not required to submit plans. Nonprofit organizations operating a special event food
321.1stand with multiple locations at an annual one-day event shall be issued only one license.
321.2Application shall be made on forms provided by the commissioner and shall require
321.3the applicant to state the full name and address of the owner of the building, structure,
321.4or enclosure, the lessee and manager of the food and beverage service establishment,
321.5hotel, motel, lodging establishment, or resort; the name under which the business is to
321.6be conducted; and any other information as may be required by the commissioner to
321.7complete the application for license.

321.8    Sec. 38. HEALTH PROMOTION PROGRAM.
321.9    The State Community Health Services Advisory Committee established in
321.10Minnesota Statutes, section 145A.10, subdivision 10, shall develop a plan to fund and
321.11implement an ongoing comprehensive health promotion program that can effect change
321.12more effectively and at lower cost at a community level rather than through individual
321.13counseling and change promotion. The program shall use proven public health strategies
321.14to promote healthy lifestyles and behaviors in order to establish a sustainable, long-term
321.15approach to reducing preventable disability, chronic health conditions, and disease. The
321.16focus shall be on community based initiatives that address childhood and adult obesity,
321.17tobacco and substance abuse, improved activity levels among senior citizens, and other
321.18lifestyle issues that impact health and healthcare costs. Because of its population health
321.19focus, funding shall be related to the size of the population to be served. The plan shall be
321.20completed by September 15, 2007, and shared with the Legislative Health Care Access
321.21Commission.

321.22    Sec. 39. INJUNCTIVE RELIEF REPORT.
321.23    The commissioner of health shall present to the 2008 legislature, by December 15,
321.242007, recommendations to fund the cost of bringing actions for injunctive relief under
321.25Minnesota Statutes, section 144G.02, subdivision 2, paragraph (b).

321.26    Sec. 40. DIAGNOSTIC IMAGING SERVICES ADVISORY COMMITTEE;
321.27ESTABLISHMENT.
321.28    (a) The commissioner of health shall establish a Diagnostic Imaging Services
321.29Advisory Committee to perform the following duties:
321.30    (1) gather and analyze data to understand the factors driving utilization of diagnostic
321.31imaging services, including computed tomography (CT), magnetic resonance imaging
321.32(MRI), positron emission tomography (PET), magnetic resonance angiography (MRA),
321.33and nuclear cardiology, in the state relative to evidence-based guidelines; and
322.1    (2) develop recommendations, based on the data collected, on how to improve
322.2the delivery of evidence-based diagnostic imaging services. In developing these
322.3recommendations, the advisory committee shall consider the impacts on patient care,
322.4premium costs, and administrative simplicity.
322.5    (b) The members of the Diagnostic Imaging Services Advisory Committee shall
322.6include the commissioners of health and human services or the commissioners' designees
322.7and the following:
322.8    (1) three physicians representing speciality and geographic diversity, appointed by
322.9the Minnesota Medical Association;
322.10    (2) two hospital representatives, one from a metropolitan hospital and one from a
322.11rural hospital, appointed by the Minnesota Hospital Association;
322.12    (3) three health plan company representatives appointed by the Minnesota Council
322.13of Health Plans;
322.14    (4) two representatives appointed by the Institute for Clinical System Improvement;
322.15and
322.16    (5) one clinic manager appointed by the Minnesota Medical Group Management
322.17Association.
322.18    (c) The Diagnostic Imaging Services Advisory Committee shall convene no later
322.19than September 1, 2007. The commissioner shall report back to the legislature no later
322.20than January 15, 2008. The advisory committee is governed under Minnesota Statutes,
322.21section 15.059, except that members shall not receive a per diem and may only be
322.22reimbursed for expenses.
322.23    (d) A strategy to improve the delivery of evidence-based diagnostic imaging services
322.24may be developed by health plans. The commissioner of health shall report the agreement
322.25to the chairs of the senate and house health care committees immediately.
322.26EFFECTIVE DATE.This section is effective July 1, 2007.

322.27    Sec. 41. HEARING AID DISPENSER FEES.
322.28    Fees relating to hearing aid dispensers, as provided in Minnesota Statutes, section
322.29153A.17, may not be increased until after the Department of Health provides a report to
322.30the legislature regarding the need and reasons for fee increases.

322.31    Sec. 42. REVISOR'S INSTRUCTION.
322.32    In Minnesota Statutes and Minnesota Rules, the revisor shall change the references
322.33in column A with the references in column B.

323.1	Column A	Column B
323.2	section 144.335	sections 144.291 to 144.298
323.3	section 144.335, subdivision 1	section 144.291, subdivision 2
323.4 323.5	section 144.335, subdivision 1, paragraph (b)	section 144.291, subdivision 2, paragraph (h)
323.6 323.7	section 144.335, subdivision 2, paragraphs (a) and (b)	section 144.292, subdivisions 2 and 5
323.8	section 144.335, subdivision 2	section 144.292
323.9	section 144.335, subdivision 3a	section 144.294, subdivision 2
323.10 323.11	section 144.335, subdivision 3a, paragraph (d)	section 144.295
323.12 323.13	section 144.335, subdivision 3a, paragraph (f)	section 144.294
323.14	section 144.335, subdivision 3b	section 144.293, subdivision 7

323.15    Sec. 43. REPEALER.
323.16(a) Minnesota Statutes 2006, section 144.335, is repealed.
323.17(b) Minnesota Statutes 2006, section 62J.17, subdivisions 1, 5a, 6a, and 8, are
323.18repealed.
323.19(c) Minnesota Rules, part 4610.2800, is repealed.

323.20ARTICLE 7

323.21MISCELLANEOUS

323.22    Section 1. Minnesota Statutes 2006, section 16A.10, is amended by adding a
323.23subdivision to read:
323.24    Subd. 2a. Base budget detail. Within one week of the release of the budget forecasts
323.25required in section 16A.102 in November of an even-numbered year and February of an
323.26odd-numbered year, the commissioner, after consulting with the commissioners of human
323.27services and health, must provide to the legislature information at the program, budget
323.28activity and management activity level for the base level budget of the Department of
323.29Human Services and the Department of Health for the next biennium. The information
323.30must be organized in a manner that explains how base level budget appropriations are
323.31projected to be spent. Within one week of the release of the budget forecasts required in
323.32section 16A.102 in November of an even-numbered year, the commissioner must also
323.33provide the legislature with the information submitted by the commissioners of human
323.34services and health under subdivision 2, clauses (3) and (4).

324.1    Sec. 2. Minnesota Statutes 2006, section 43A.316, is amended to read:
324.243A.316 PUBLIC EMPLOYEES INSURANCE PROGRAM.
324.3    Subdivision 1. Intent. The legislature finds that the creation of a statewide program
324.4to provide public employees and other eligible persons with life insurance and hospital,
324.5medical, and dental benefit coverage through provider organizations would result in a
324.6greater utilization more efficient use of government resources and would advance the
324.7health and welfare of the citizens of the state.
324.8    Subd. 2. Definitions. For the purpose of this section, the terms defined in this
324.9subdivision have the meaning given them.
324.10    (a) Commissioner. "Commissioner" means the commissioner of employee relations.
324.11    (b) Employee. "Employee" means:
324.12    (1) a person who is a public employee within the definition of section 179A.03,
324.13subdivision 14 , who is insurance eligible and is employed by an eligible employer;
324.14    (2) an elected public official of an eligible employer who is insurance eligible;
324.15    (3) a person employed by a labor organization or employee association certified as
324.16an exclusive representative of employees of an eligible employer or by another public
324.17employer approved by the commissioner, so long as the plan meets the requirements of a
324.18governmental plan under United States Code, title 29, section 1002(32); or
324.19    (4) a person employed by a county or municipal hospital.
324.20    (c) Eligible employer. "Eligible employer" means:
324.21    (1) a public employer within the definition of section 179A.03, subdivision 15, that
324.22is a town, county, city, school district as defined in section 120A.05, service cooperative
324.23as defined in section 123A.21, intermediate district as defined in section 136D.01,
324.24Cooperative Center for Vocational Education as defined in section 123A.22, regional
324.25management information center as defined in section 123A.23, or an education unit
324.26organized under the joint powers action, section 471.59; or
324.27    (2) an exclusive representative of employees, as defined in paragraph (b);
324.28    (3) a county or municipal hospital; or
324.29    (4) another public employer approved by the commissioner; or
324.30    (5) a nursing home as defined in section 144A.01, subdivision 5, located in this state.
324.31    (d) Exclusive representative. "Exclusive representative" means an exclusive
324.32representative as defined in section 179A.03, subdivision 8.
324.33    (e) Labor-Management Committee. "Labor-Management Committee" means the
324.34committee established by subdivision 4.
324.35    (f) Program. "Program" means the statewide public employees insurance program
324.36created by subdivision 3.
325.1    Subd. 3. Public employee insurance program. The commissioner shall be the
325.2administrator of the public employee insurance program and may determine its funding
325.3arrangements. The commissioner may contract with a qualified entity to perform the
325.4administrative functions. The commissioner shall model the program after the plan
325.5established in section 43A.18, subdivision 2, but may modify adopt variations from that
325.6plan, in consultation with the Labor-Management Committee. The variations may include
325.7different deductibles, coinsurance, co-pays, or other enrollee cost-sharing provisions.
325.8    Subd. 4. Labor-Management Committee. (a) The Labor-Management Committee
325.9consists of ten members appointed by the commissioner. The Labor-Management
325.10Committee must comprise five members who represent employees, including at least
325.11one retired employee, and five members who represent eligible employers. Committee
325.12members are eligible for expense reimbursement in the same manner and amount as
325.13authorized by the commissioner's plan adopted under section 43A.18, subdivision 2. The
325.14commissioner shall consult with the labor-management committee in major decisions
325.15that affect the program. The committee shall study issues and make recommendations
325.16relating to the insurance program including, but not limited to, flexible benefits, utilization
325.17review, quality assessment, and cost efficiency. The committee continues to exist while
325.18the program remains in operation.
325.19    (b) The five members of the Labor-Management Committee who represent
325.20employees must be chosen by the commissioner from among persons nominated as
325.21provided in this paragraph. Exclusive representatives of employees of counties, cities,
325.22school districts, and nursing homes are entitled to nominate two candidates for the
325.23Labor-Management Committee from each of those four categories, and the commissioner
325.24shall appoint one of those two nominees from each category. The commissioner shall
325.25choose the fifth employee to represent retired employees.
325.26    (c) The five members of the Labor-Management Committee who represent employers
325.27must be chosen by the commissioner from among persons nominated as provided in
325.28this paragraph. The Association of Minnesota Counties, Minnesota League of Cities,
325.29Minnesota School Boards Association, and the Minnesota Association of Nursing Homes
325.30are each entitled to nominate two candidates for the committee, and the commissioner
325.31shall appoint one of those from each group. The commissioner shall select the fifth
325.32employer member from an employer participating in the program and not represented
325.33by the other four employer members, if any, or if that is not reasonably possible, the
325.34commissioner may appoint any other person as the fifth employer representative.
325.35    Subd. 5. Public employee participation. (a) Participation in the program is subject
325.36to the conditions in this subdivision.
326.1    (b) Each exclusive representative for an eligible employer determines whether the
326.2employees it represents will participate in the program. The exclusive representative shall
326.3give the employer notice of intent to participate at least 30 60 days before the expiration
326.4date of the collective bargaining agreement preceding the collective bargaining agreement
326.5that covers the date of entry into the program. Either all or none of the employees
326.6represented by an exclusive representative must participate. The exclusive representative
326.7and the eligible employer shall give notice to the commissioner of the determination to
326.8participate in the program at least 30 60 days before entry into the program. Entry into the
326.9program is governed by a schedule established by the commissioner.
326.10    (c) Employees not represented by exclusive representatives may become members
326.11of the program upon a determination of an eligible employer to include these employees
326.12in the program. Either all or none of the employer's unrepresented employees must
326.13participate. The eligible employer shall give at least 30 60 days' notice to the commissioner
326.14before entering the program. Entry into the program is governed by a schedule established
326.15by the commissioner.
326.16    (d) Participation in the program is for a two-year three-year term. Participation is
326.17automatically renewed for an additional two-year three-year term unless the exclusive
326.18representative, or the employer for unrepresented employees, gives the commissioner
326.19notice of withdrawal at least 30 60 days before expiration of the participation period. A
326.20group that withdraws must wait two years before rejoining, except with the approval of
326.21the commissioner. An exclusive representative, or employer for unrepresented employees,
326.22may also withdraw if premiums increase 50 percent by more than 20 percent in excess of
326.23the Consumer Price Index for all urban consumers or more from one insurance year to
326.24the next.
326.25    (e) The exclusive representative shall give the employer notice of intent to withdraw
326.26to the commissioner at least 30 60 days before the expiration date of a collective
326.27bargaining agreement that includes the date on which the term of participation expires.
326.28    (f) Each participating eligible employer shall notify the commissioner of the names
326.29of individuals who will be participating within two weeks of after the commissioner
326.30receiving receives notice of the parties' intent to participate. The employer shall also
326.31submit other information as required by the commissioner for administration of the
326.32program.
326.33    (g) An employer that withdraws from the program under circumstances that do not
326.34permit withdrawal under this subdivision is liable to the board for premiums payable by
326.35the employer until the time that the employer is eligible to withdraw, and the employer
326.36shall pay those premiums voluntarily and no later than their due date. If the premiums are
327.1not paid voluntarily, the board has authority to and shall collect these premiums under any
327.2method permitted by law for a governmental or nongovernmental creditor of the employer.
327.3    Subd. 6. Coverage. (a) By January 1, 1989, The commissioner shall announce the
327.4benefits of the program. The program shall include employee hospital, medical, dental,
327.5and life insurance for employees and hospital and medical benefits for dependents. Health
327.6maintenance organization options and other delivery system options may be provided if
327.7they are available, cost-effective, and capable of servicing the number of people covered
327.8in the program. Participation in optional coverages may be provided by collective
327.9bargaining agreements. For employees not represented by an exclusive representative, the
327.10employer may offer the optional coverages to eligible employees and their dependents
327.11provided in the program. Health coverage must include at least the benefits required of a
327.12health plan company regulated under chapter 62A, 62C, or 62D.
327.13    (b) The commissioner, with the assistance of the Labor-Management Committee,
327.14shall periodically assess whether it is financially feasible for the program to offer or to
327.15continue an individual retiree program that has competitive premium rates and benefits.
327.16If the commissioner determines it to be feasible to offer an individual retiree program,
327.17the commissioner shall announce the applicable benefits, premium rates, and terms of
327.18participation. Eligibility to participate in the individual retiree program is governed by
327.19subdivision 8, but applies to retirees of eligible employers that do not participate in the
327.20program and to those retirees' dependents and surviving spouses.
327.21    Subd. 6a. Chiropractic services Choice of type of provider. All benefits provided
327.22by the program or a successor program relating to expenses incurred for medical treatment
327.23or services of a physician health care provider must also include chiropractic treatment
327.24and services of a chiropractor any other type of licensed, certified, or registered health care
327.25provider to the extent that the chiropractic services and treatment are within the scope of
327.26chiropractic licensure the provider's licensure, certification, or registration.
327.27    This subdivision is intended to provide equal access to benefits for program members
327.28who choose to obtain treatment for illness or injury from a doctor of chiropractic, as long
327.29as the treatment falls within the chiropractor's scope of practice. This subdivision is not
327.30intended to change or add to the benefits provided for in the program.
327.31    Subd. 7. Premiums. (a) The proportion of premium paid by the employer and
327.32employee is subject to collective bargaining or personnel policies. If, at the beginning of
327.33the coverage period, no collective bargaining agreement has been finalized, the increased
327.34dollar costs, if any, from the previous year is the sole responsibility of the individual
327.35participant until a collective bargaining agreement states otherwise. Premiums, including
327.36an administration fee, shall be established by the commissioner. The commissioner may
328.1decide to rate specific employers separately for premium purposes, if the commissioner
328.2determines that doing so is in the best interests of the program. Each employer shall pay
328.3monthly the amounts due for employee benefits including the amounts under subdivision
328.48 to the commissioner no later than the dates established by the commissioner. If an
328.5employer fails to make the payments as required, the commissioner may shall cancel
328.6program benefits and pursue other civil remedies, as provided in subdivision 5, paragraph
328.7(d).
328.8    (b) The premium charged for an employer's first month in the program must be
328.9three times the regular monthly premium charged to that employer, to help establish
328.10and maintain the program's financial resources. The extra two months premium must
328.11be refunded to the employer if the employer leaves the program, if the refund would
328.12not reduce the program's reserves below the level determined to be appropriate by the
328.13commissioner.
328.14    Subd. 8. Continuation of coverage. (a) A former employee of an employer
328.15participating in the program who is receiving a public pension disability benefit or an
328.16annuity or has met the age and service requirements necessary to receive an annuity under
328.17chapter 353, 353C, 354, 354A, 356, 422A, 423, 423A, or 424, and the former employee's
328.18dependents, are eligible to participate in the program. This participation is at the person's
328.19expense unless a collective bargaining agreement or personnel policy provides otherwise.
328.20Premiums for these participants must be established by the commissioner.
328.21    The commissioner may provide policy exclusions for preexisting conditions
328.22only when there is a break in coverage between a participant's coverage under the
328.23employment-based group insurance program and the participant's coverage under this
328.24section. An employer shall notify an employee of the option to participate under this
328.25paragraph no later than the effective date of retirement. The retired employee or the
328.26employer of a participating group on behalf of a current or retired employee shall notify
328.27the commissioner within 30 days of the effective date of retirement of intent to participate
328.28in the program according to the rules established by the commissioner.
328.29    (b) The spouse of a deceased employee or former employee may purchase the
328.30benefits provided at premiums established by the commissioner if the spouse was a
328.31dependent under the employee's or former employee's coverage under this section at the
328.32time of the death. The spouse remains eligible to participate in the program as long as
328.33the group that included the deceased employee or former employee participates in the
328.34program. Coverage under this clause must be coordinated with relevant insurance benefits
328.35provided through the federally sponsored Medicare program.
329.1    (c) The program benefits must continue in the event of strike permitted by section
329.2179A.18 , if the exclusive representative chooses to have coverage continue and the
329.3employee pays the total monthly premiums when due.
329.4    (d) A participant who discontinues coverage may not reenroll.
329.5    (d) Persons participating under these paragraphs this subdivision shall make
329.6appropriate premium payments in the time and manner established by the commissioner.
329.7They are not subject to the payment of the extra payments required under subdivision 7,
329.8paragraph (b).
329.9    Subd. 9. Insurance trust fund. The insurance trust fund in the state treasury
329.10consists of deposits of the premiums received from employers participating in the
329.11program and transfers before July 1, 1994, from the excess contributions holding account
329.12established by section 353.65, subdivision 7. All money in the fund is appropriated to
329.13the commissioner to pay insurance premiums, approved claims, refunds, administrative
329.14costs, and other related service costs. Premiums paid by employers to the fund are exempt
329.15from the taxes imposed by chapter 297I. The commissioner shall reserve an amount of
329.16money to cover the estimated costs of claims incurred but unpaid. The State Board of
329.17Investment shall invest the money according to section 11A.24. Investment income and
329.18losses attributable to the fund must be credited to the fund.
329.19    Subd. 10. Exemption. The public employee insurance program and, where
329.20applicable, the employers participating in it are exempt from chapters 60A, 62A, 62C,
329.2162D, 62E, and 62H, section 471.617, subdivisions 2 and 3, and the bidding requirements
329.22of section 471.6161, except as otherwise provided in subdivision 6, paragraph (a).
329.23    Subd. 11. Reinsurance. The commissioner may, on behalf of the program,
329.24participate in an insured or self-insured reinsurance pool.

329.25    Sec. 3. Minnesota Statutes 2006, section 62H.02, is amended to read:
329.2662H.02 REQUIRED PROVISIONS.
329.27    (a) A joint self-insurance plan must include aggregate excess stop-loss coverage and
329.28individual excess stop-loss coverage provided by an insurance company licensed by the
329.29state of Minnesota.
329.30    (b) Aggregate excess stop-loss coverage must include provisions to cover incurred,
329.31unpaid claim liability in the event of plan termination. In addition,
329.32    (c) The plan of self-insurance must have participating employers fund an amount at
329.33least equal to the point at which the excess or stop-loss insurer has contracted to assume
329.34100 percent of additional liability.
330.1    (d) A joint self-insurance plan must submit its proposed excess or stop-loss insurance
330.2contract to the commissioner of commerce at least 30 days prior to the proposed plan's
330.3effective date and at least 30 days subsequent to any renewal date. The commissioner shall
330.4review the contract to determine if they meet the standards established by sections 62H.01
330.5to 62H.08 and respond within a 30-day period.
330.6    (e) Any excess or stop-loss insurance plan must contain a provision that the excess
330.7or stop-loss insurer will give the plan and the commissioner of commerce a minimum of
330.8180 days' notice of termination or nonrenewal. If the plan fails to secure replacement
330.9coverage within 60 days after receipt of the notice of cancellation or nonrenewal, the
330.10commissioner shall issue an order providing for the orderly termination of the plan.
330.11    (f) The commissioner may waive the requirements of this section and of any rule
330.12relating to the requirements of this section, if the commissioner determines that a joint
330.13self-insurance plan has established alternative arrangements that fully fund the plan's
330.14liability or incurred but unpaid claims. The commissioner may not waive the requirement
330.15that a joint self-insurance plan have excess stop-loss coverage.
330.16EFFECTIVE DATE.This section is effective the day following final enactment.

330.17    Sec. 4. [62Q.40] LANGUAGE INTERPRETER SERVICES.
330.18    (a) A health plan must cover sign language interpreter services provided to deaf and
330.19hard-of-hearing enrollees and language interpreter services provided to enrollees with
330.20limited English proficiency in order to facilitate the provision of health care services by a
330.21provider. For purposes of this section, "provider" has the meaning given in section 62J.03,
330.22subdivision 8, and includes a health care provider facility; and "health plan" includes
330.23coverage excluded under section 62A.011, subdivision 3, clauses (6), (7), (9), and (10).
330.24Interpreter services may be provided in person, by telephone, facsimile, video or audio
330.25streaming, or by video conference. In accordance with paragraphs (b) and (c), a health
330.26plan company shall reimburse either the party providing interpreter services directly
330.27for the costs of language interpreter services provided to the enrollee or the provider
330.28arranging for the provision of interpreter services. Providers that employ or contract
330.29with interpreters may bill and shall be reimbursed directly by health plan companies for
330.30such services in accordance with paragraph (b). A health plan company shall provide to
330.31enrollees, upon request, the policies and procedures for addressing the needs of deaf and
330.32hard-of-hearing enrollees and enrollees with limited English proficiency. All parties
330.33providing interpreter services must disclose their methods for ensuring competency upon
330.34request of any health plan company, provider, or consumer.
331.1    (b) A health plan company shall pay for interpreter services as required in paragraph
331.2(a) by establishing a network of interpreter service providers and requiring use of its own
331.3network of interpreter services providers. The health plan company shall consider, as part
331.4of its interpreter service provider network, entering into an agreement with a provider for
331.5use of an interpreter service provider employed by or under contract with the provider if:
331.6    (1) the provider accepts as reimbursement for services rendered by the provider's
331.7employed or contracted interpreter service provider the lesser of either the health plan
331.8company's reimbursement rate for its in-network interpreter service providers or the
331.9provider's fee for services rendered by the provider's interpreter service provider; and
331.10    (2) the interpreter service provider meets the published quality standards of the
331.11health plan company.
331.12    (c) If a health plan company's or a provider's employed or contracted interpreter
331.13service provider is unavailable to provide interpreter services, the health plan company
331.14shall reimburse the interpreter service provider at the lesser of the health plan company's
331.15median reimbursement rate for its in-network interpreter service providers or the
331.16interpreter service provider's fee. An interpreter service provider not employed or under
331.17contract with a health plan company or provider who fails to meet the quality standards
331.18of a health plan company or as required by law, shall be ineligible for reimbursement
331.19under this section.
331.20    (d) If the health plan company pays the interpreter service provider directly, it has no
331.21obligation to pay the provider under this section.
331.22    (e) Nothing in this section requires a health plan company to establish a network
331.23of interpreter service providers.
331.24EFFECTIVE DATE.This section is effective July 1, 2008, and applies to plans
331.25issued or renewed to provide coverage to Minnesota residents on or after that date unless
331.26the legislature enacts alternative funding sources based on the recommendations of the
331.27commissioner.

331.28    Sec. 5. Minnesota Statutes 2006, section 144.05, is amended by adding a subdivision
331.29to read:
331.30    Subd. 5. Base budget detail. The commissioner shall provide the commissioner
331.31of finance with the information necessary to provide base budget detail to the legislature
331.32under section 16A.10, subdivision 2a.

331.33    Sec. 6. Minnesota Statutes 2006, section 148.235, is amended by adding a subdivision
331.34to read:
332.1    Subd. 11. Dispensing by protocol. A registered nurse in a family planning agency
332.2as defined in Minnesota Rules, part 9505.0280, subpart 3, may dispense oral contraceptives
332.3prescribed by a licensed practitioner as defined in section 151.01, subdivision 23, pursuant
332.4to a dispensing protocol established by the agency's medical director or under the direction
332.5of a physician. The dispensing protocol must address the requirements of sections 151.01,
332.6subdivision 30, and 151.212, subdivision 1.

332.7    Sec. 7. Minnesota Statutes 2006, section 151.37, subdivision 2, is amended to read:
332.8    Subd. 2. Prescribing and filing. (a) A licensed practitioner in the course of
332.9professional practice only, may prescribe, administer, and dispense a legend drug, and may
332.10cause the same to be administered by a nurse, a physician assistant, or medical student or
332.11resident under the practitioner's direction and supervision, and may cause a person who
332.12is an appropriately certified, registered, or licensed health care professional to prescribe,
332.13dispense, and administer the same within the expressed legal scope of the person's practice
332.14as defined in Minnesota Statutes. A licensed practitioner may prescribe a legend drug,
332.15without reference to a specific patient, by directing a nurse, pursuant to section 148.235,
332.16subdivisions 8 and 9 , physician assistant, or medical student or resident to adhere to
332.17a particular practice guideline or protocol when treating patients whose condition falls
332.18within such guideline or protocol, and when such guideline or protocol specifies the
332.19circumstances under which the legend drug is to be prescribed and administered. An
332.20individual who verbally, electronically, or otherwise transmits a written, oral, or electronic
332.21order, as an agent of a prescriber, shall not be deemed to have prescribed the legend drug.
332.22This paragraph applies to a physician assistant only if the physician assistant meets the
332.23requirements of section 147A.18.
332.24    (b) A licensed practitioner that dispenses for profit a legend drug that is to be
332.25administered orally, is ordinarily dispensed by a pharmacist, and is not a vaccine, must
332.26file with the practitioner's licensing board a statement indicating that the practitioner
332.27dispenses legend drugs for profit, the general circumstances under which the practitioner
332.28dispenses for profit, and the types of legend drugs generally dispensed. It is unlawful to
332.29dispense legend drugs for profit after July 31, 1990, unless the statement has been filed
332.30with the appropriate licensing board. For purposes of this paragraph, "profit" means (1)
332.31any amount received by the practitioner in excess of the acquisition cost of a legend drug
332.32for legend drugs that are purchased in prepackaged form, or (2) any amount received
332.33by the practitioner in excess of the acquisition cost of a legend drug plus the cost of
332.34making the drug available if the legend drug requires compounding, packaging, or other
332.35treatment. The statement filed under this paragraph is public data under section 13.03.
333.1This paragraph does not apply to a licensed doctor of veterinary medicine or a registered
333.2pharmacist. Any person other than a licensed practitioner with the authority to prescribe,
333.3dispense, and administer a legend drug under paragraph (a) shall not dispense for profit.
333.4To dispense for profit does not include dispensing by a community health clinic when the
333.5profit from dispensing is used to meet operating expenses.
333.6    (c) A prescription or drug order for a legend drug is not valid unless it is issued
333.7for a legitimate medical purpose arising from a prescriber-patient relationship that
333.8includes a documented patient evaluation adequate to establish diagnoses and identify
333.9underlying conditions and contraindications to the treatment. Treatment, including issuing
333.10a prescription or drug order, based solely on an online questionnaire does not constitute a
333.11legitimate medical purpose.

333.12    Sec. 8. Minnesota Statutes 2006, section 152.11, is amended by adding a subdivision to
333.13read:
333.14    Subd. 2d. Identification requirement for schedule II or III controlled substance.
333.15    No person may dispense a controlled substance included in schedule II or III without
333.16requiring the person purchasing the controlled substance, who need not be the person for
333.17whom the controlled substance prescription is written, to present valid photographic
333.18identification, unless the person purchasing the controlled substance, or if applicable the
333.19person for whom the controlled substance prescription is written, is known to the dispenser.

333.20    Sec. 9. [152.126] SCHEDULE II AND III CONTROLLED SUBSTANCES
333.21PRESCRIPTION ELECTRONIC REPORTING SYSTEM.
333.22    Subdivision 1. Definitions. For purposes of this section, the terms defined in this
333.23subdivision have the meanings given.
333.24    (a) "Board" means the Minnesota State Board of Pharmacy established under
333.25chapter 151.
333.26    (b) "Controlled substances" means those substances listed in section 152.02,
333.27subdivisions 3 and 4, and those substances defined by the board pursuant to section
333.28152.02, subdivisions 8 and 12.
333.29    (c) "Dispense" or "dispensing" has the meaning given in section 151.01, subdivision
333.3030. Dispensing does not include the direct administering of a controlled substance to a
333.31patient by a licensed health care professional.
333.32    (d) "Dispenser" means a person authorized by law to dispense a controlled substance,
333.33pursuant to a valid prescription. A dispenser does not include a licensed hospital pharmacy
333.34that distributes controlled substances for inpatient hospital care.
334.1    (e) "Prescriber" means a licensed health care professional who is authorized to
334.2prescribe a controlled substance under section 152.12, subdivision 1.
334.3    (f) "Prescription" has the meaning given in section 151.01, subdivision 16.
334.4    Subd. 2. Prescription electronic reporting system. (a) By January 1, 2009,
334.5or upon enactment of legislation that implements the recommendations of the Board
334.6of Pharmacy under subdivision 3, paragraph (c), whichever is later, the board shall
334.7establish an electronic system for reporting the information required under subdivision
334.84 for all controlled substances dispensed within the state. Data for controlled substance
334.9prescriptions that are dispensed in a quantity small enough to provide treatment to a
334.10patient for a period of 48 hours or less need not be reported.
334.11    (b) The board may contract with a vendor for the purpose of obtaining technical
334.12assistance in the design, implementation, and maintenance of the electronic reporting
334.13system. The vendor's role shall be limited to providing technical support to the board
334.14concerning the software, databases, and computer systems required to interface with the
334.15existing systems currently used by pharmacies to dispense prescriptions and transmit
334.16prescription data to other third parties.
334.17    (c) The board may issue a waiver to a dispenser that is unable to submit dispensing
334.18information by electronic means. The waiver may permit the dispenser to submit
334.19dispensing information by paper form or other means, provided all information required
334.20by subdivision 4 is submitted in this alternative format.
334.21    Subd. 3. Prescription Electronic Reporting Advisory Committee. (a) The
334.22board shall convene an advisory committee. The committee must include at least one
334.23representative of:
334.24    (1) the Department of Health;
334.25    (2) the Department of Human Services;
334.26    (3) each health-related licensing board that licenses prescribers;
334.27    (4) a professional medical association, which may include an association of pain
334.28management and chemical dependency specialists;
334.29    (5) a professional pharmacy association;
334.30    (6) a consumer privacy or security advocate; and
334.31    (7) a consumer or patient rights organization.
334.32    (b) The advisory committee shall advise the board on the development and operation
334.33of the electronic reporting system, including, but not limited to:
334.34    (1) technical standards for electronic prescription drug reporting;
334.35    (2) proper analysis and interpretation of prescription monitoring data; and
334.36    (3) an evaluation process for the program.
335.1    (c) The Board of Pharmacy, after consultation with the advisory committee, shall
335.2present recommendations and draft legislation on the issues addressed by the advisory
335.3committee under paragraph (b), to the legislature by December 15, 2007.
335.4    Subd. 4. Reporting requirements and notice. (a) Each dispenser must submit the
335.5following data to the board or its designated vendor, subject to the notice required under
335.6paragraph (d):
335.7    (1) prescriber DEA number;
335.8    (2) dispenser DEA number;
335.9    (3) name of the patient for whom the prescription was written;
335.10    (4) date of birth of the patient for whom the prescription was written;
335.11    (5) date the prescription was written;
335.12    (6) date the prescription was filled;
335.13    (7) NDC code for drug dispensed; and
335.14    (8) quantity of controlled substance dispensed.
335.15    (b) The dispenser must submit the required information according to the format and
335.16protocols specified in the "ASAP Telecommunications Format for Controlled Substances,"
335.17May 1995 edition, published by the American Society for Automation in Pharmacy, which
335.18is hereby adopted by reference, by a procedure established by the board.
335.19    (c) A dispenser is not required to submit this data for those controlled substance
335.20prescriptions dispensed for:
335.21    (1) individuals residing in licensed skilled nursing or intermediate care facilities;
335.22    (2) individuals receiving assisted living services under chapter 144G or through a
335.23medical assistance home and community-based waiver;
335.24    (3) individuals receiving medication intravenously;
335.25    (4) individuals receiving hospice and other palliative or end-of-life care; and
335.26    (5) individuals receiving services from a home care provider regulated under chapter
335.27144A.
335.28    (d) A dispenser must not submit data under this subdivision unless a conspicuous
335.29notice of the reporting requirements of this section is given to the patient for whom the
335.30prescription was written.
335.31    Subd. 5. Use of data by board. (a) The board shall develop and maintain a database
335.32of the data reported under subdivision 4. The board shall maintain data that could identify
335.33an individual prescriber or dispenser in encrypted form. The database may be used by
335.34permissible users identified under subdivision 6 for the identification of:
335.35    (1) individuals receiving prescriptions for controlled substances from prescribers
335.36who subsequently obtain controlled substances from dispensers in quantities or with a
336.1frequency inconsistent with generally recognized standards of dosage for those controlled
336.2substances; and
336.3    (2) individuals presenting forged or otherwise false or altered prescriptions for
336.4controlled substances to dispensers.
336.5    (b) No permissible user identified under subdivision 6 may access the database
336.6for the sole purpose of identifying prescribers of controlled substances for unusual or
336.7excessive prescribing patterns without a valid search warrant or court order.
336.8    (c) No personnel of a state or federal occupational licensing board or agency may
336.9access the database for the purpose of obtaining information to be used to initiate or
336.10substantiate a disciplinary action against a prescriber.
336.11    (d) Data reported under subdivision 4 shall be retained by the board in the database
336.12for a six-month period, and shall be removed from the database six months from the
336.13date the data was received.
336.14    Subd. 6. Access to reporting system data. (a) Except as indicated in this
336.15subdivision, the data submitted to the board under subdivision 4 is private data on
336.16individuals as defined in section 13.02, subdivision 12, and not subject to public disclosure.
336.17    (b) Except as specified in subdivision 5, the following persons shall be considered
336.18permissible users and may access the data submitted under subdivision 4 in the same or
336.19similar manner, and for the same or similar purposes, as those persons who are authorized
336.20to access similar private data on individuals under federal and state law:
336.21    (1) a prescriber, to the extent the information relates specifically to a current patient
336.22of the prescriber, to whom the practitioner is prescribing or considering prescribing any
336.23controlled substance;
336.24    (2) a dispenser to the extent the information relates specifically to a current patient to
336.25whom that dispenser is dispensing or considering dispensing any controlled substance;
336.26    (3) an individual who is the recipient of a controlled substance prescription for
336.27which data was submitted under subdivision 4;
336.28    (4) personnel of the board specifically assigned to conduct a bona fide investigation
336.29of a specific board licensee;
336.30    (5) personnel of the board engaged in the collection of controlled substance
336.31prescription information as part of the assigned duties and responsibilities under this
336.32section;
336.33    (6) authorized personnel of a vendor under contract with the board who are engaged
336.34in the design, implementation, and maintenance of the electronic reporting system as part
336.35of the assigned duties and responsibilities of their employment, provided that access to data
336.36is limited to the minimum amount necessary to test and maintain the system databases;
337.1    (7) federal, state, and local law enforcement authorities engaged in a bona fide
337.2investigation of a specific person; and
337.3    (8) personnel of the medical assistance program assigned to use the data collected
337.4under this section to identify recipients whose usage of controlled substances may warrant
337.5restriction to a single primary care physician, a single outpatient pharmacy, or a single
337.6hospital.
337.7    (c) Any permissible user identified in paragraph (b), who directly accesses
337.8the data electronically, shall implement and maintain a comprehensive information
337.9security program that contains administrative, technical, and physical safeguards that
337.10are appropriate to the user's size and complexity, and the sensitivity of the personal
337.11information obtained. The permissible user shall identify reasonably foreseeable internal
337.12and external risks to the security, confidentiality, and integrity of personal information
337.13that could result in the unauthorized disclosure, misuse, or other compromise of the
337.14information and assess the sufficiency of any safeguards in place to control the risks.
337.15    (d) The board shall not release data submitted under this section unless it is provided
337.16with evidence, satisfactory to the board, that the person requesting the information is
337.17entitled to receive the data. Access to the data by law enforcement authorities must be
337.18accompanied by a valid search warrant.
337.19    (e) The board shall not release the name of a prescriber without the written consent
337.20of the prescriber or a valid search warrant or court order. The board shall provide a
337.21mechanism for a prescriber to submit to the board a signed consent authorizing the release
337.22of the prescriber's name when data containing the prescriber's name is requested.
337.23    (f) The board shall maintain a log of all persons who access the data and shall ensure
337.24that any permissible user complies with paragraph (c) prior to attaining direct access to
337.25the data.
337.26    Subd. 7. Disciplinary action. (a) A dispenser who knowingly fails to submit data to
337.27the board as required under this section is subject to disciplinary action by the appropriate
337.28health-related licensing board.
337.29    (b) A prescriber or dispenser authorized to access the data who knowingly discloses
337.30the data in violation of state or federal laws relating to the privacy of health care data
337.31shall be subject to disciplinary action by the appropriate health-related licensing board,
337.32and appropriate civil penalties.
337.33    Subd. 8. Evaluation and reporting. (a) The board shall evaluate the prescription
337.34electronic reporting system to determine if the system is cost-effective and whether it is
337.35negatively impacting appropriate prescribing practices of controlled substances. The
337.36board may contract with a vendor to design and conduct the evaluation.
338.1    (b) The board shall submit the evaluation of the system to the legislature by January
338.215, 2010.
338.3    Subd. 9. Immunity from liability; no requirement to obtain information. (a) A
338.4pharmacist, prescriber, or other dispenser making a report to the program in good faith
338.5under this section is immune from any civil, criminal, or administrative liability, which
338.6might otherwise be incurred or imposed as a result of the report, or on the basis that the
338.7pharmacist or prescriber did or did not seek or obtain or use information from the program.
338.8    (b) Nothing in this section shall require a pharmacist, prescriber, or other dispenser
338.9to obtain information about a patient from the program, and the pharmacist, prescriber,
338.10or other dispenser, if acting in good faith, is immune from any civil, criminal, or
338.11administrative liability that might otherwise be incurred or imposed for requesting,
338.12receiving, or using information from the program.
338.13EFFECTIVE DATE.This section is effective July 1, 2007, or upon receiving
338.14sufficient nonstate funds to implement the prescription electronic reporting program,
338.15whichever is later. In the event that nonstate funds are not secured by the Board of
338.16Pharmacy to adequately fund the implementation of the prescription electronic reporting
338.17program, the board is not required to implement this section without a subsequent
338.18appropriation from the legislature.

338.19    Sec. 10. Minnesota Statutes 2006, section 179A.03, subdivision 7, is amended to read:
338.20    Subd. 7. Essential employee. "Essential employee" means firefighters, peace
338.21officers subject to licensure under sections 626.84 to 626.863, 911 system and police and
338.22fire department public safety dispatchers, guards at correctional facilities, confidential
338.23employees, supervisory employees, assistant county attorneys, assistant city attorneys,
338.24principals, and assistant principals. However, for state employees, "essential employee"
338.25means all employees, except for nonprofessional employees employed by the Department
338.26of Human Services in mental health facilities for the treatment of psychopathic
338.27personalities, sexual predators, and the criminally insane, in law enforcement, public
338.28safety radio communications operators, health care professionals, correctional guards,
338.29professional engineering, and supervisory collective bargaining units, irrespective of
338.30severance, and no other employees. For University of Minnesota employees, "essential
338.31employee" means all employees in law enforcement, nursing professional and supervisory
338.32units, irrespective of severance, and no other employees. "Firefighters" means salaried
338.33employees of a fire department whose duties include, directly or indirectly, controlling,
338.34extinguishing, preventing, detecting, or investigating fires. Employees for whom the state
339.1court administrator is the negotiating employer are not essential employees. For Hennepin
339.2Healthcare System, Inc. employees, "essential employees" means all employees.
339.3EFFECTIVE DATE.This section is effective the day following final enactment.

339.4    Sec. 11. Minnesota Statutes 2006, section 245.4874, is amended to read:
339.5245.4874 DUTIES OF COUNTY BOARD.
339.6    (a) The county board must:
339.7    (1) develop a system of affordable and locally available children's mental health
339.8services according to sections 245.487 to 245.4887;
339.9    (2) establish a mechanism providing for interagency coordination as specified in
339.10section 245.4875, subdivision 6;
339.11    (3) consider the assessment of unmet needs in the county as reported by the local
339.12children's mental health advisory council under section 245.4875, subdivision 5, paragraph
339.13(b), clause (3). The county shall provide, upon request of the local children's mental health
339.14advisory council, readily available data to assist in the determination of unmet needs;
339.15    (4) assure that parents and providers in the county receive information about how to
339.16gain access to services provided according to sections 245.487 to 245.4887;
339.17    (5) coordinate the delivery of children's mental health services with services
339.18provided by social services, education, corrections, health, and vocational agencies to
339.19improve the availability of mental health services to children and the cost-effectiveness of
339.20their delivery;
339.21    (6) assure that mental health services delivered according to sections 245.487
339.22to 245.4887 are delivered expeditiously and are appropriate to the child's diagnostic
339.23assessment and individual treatment plan;
339.24    (7) provide the community with information about predictors and symptoms of
339.25emotional disturbances and how to access children's mental health services according to
339.26sections 245.4877 and 245.4878;
339.27    (8) provide for case management services to each child with severe emotional
339.28disturbance according to sections 245.486; 245.4871, subdivisions 3 and 4; and 245.4881,
339.29subdivisions 1, 3, and 5 ;
339.30    (9) provide for screening of each child under section 245.4885 upon admission
339.31to a residential treatment facility, acute care hospital inpatient treatment, or informal
339.32admission to a regional treatment center;
340.1    (10) prudently administer grants and purchase-of-service contracts that the county
340.2board determines are necessary to fulfill its responsibilities under sections 245.487 to
340.3245.4887 ;
340.4    (11) assure that mental health professionals, mental health practitioners, and case
340.5managers employed by or under contract to the county to provide mental health services
340.6are qualified under section 245.4871;
340.7    (12) assure that children's mental health services are coordinated with adult mental
340.8health services specified in sections 245.461 to 245.486 so that a continuum of mental
340.9health services is available to serve persons with mental illness, regardless of the person's
340.10age;
340.11    (13) assure that culturally informed mental health consultants are used as necessary
340.12to assist the county board in assessing and providing appropriate treatment for children of
340.13cultural or racial minority heritage; and
340.14    (14) consistent with section 245.486, arrange for or provide a children's mental
340.15health screening to a child receiving child protective services or a child in out-of-home
340.16placement, a child for whom parental rights have been terminated, a child found to be
340.17delinquent, and a child found to have committed a juvenile petty offense for the third
340.18or subsequent time, unless a screening or diagnostic assessment has been performed
340.19within the previous 180 days, or the child is currently under the care of a mental health
340.20professional. The court or county agency must notify a parent or guardian whose
340.21parental rights have not been terminated of the potential mental health screening and the
340.22option to prevent the screening by notifying the court or county agency in writing. The
340.23screening shall be conducted with a screening instrument approved by the commissioner
340.24of human services according to criteria that are updated and issued annually to ensure
340.25that approved screening instruments are valid and useful for child welfare and juvenile
340.26justice populations, and shall be conducted by a mental health practitioner as defined in
340.27section 245.4871, subdivision 26, or a probation officer or local social services agency
340.28staff person who is trained in the use of the screening instrument. Training in the use of the
340.29instrument shall include training in the administration of the instrument, the interpretation
340.30of its validity given the child's current circumstances, the state and federal data practices
340.31laws and confidentiality standards, the parental consent requirement, and providing respect
340.32for families and cultural values. If the screen indicates a need for assessment, the child's
340.33family, or if the family lacks mental health insurance, the local social services agency,
340.34in consultation with the child's family, shall have conducted a diagnostic assessment,
340.35including a functional assessment, as defined in section 245.4871. The administration of
340.36the screening shall safeguard the privacy of children receiving the screening and their
341.1families and shall comply with the Minnesota Government Data Practices Act, chapter
341.213, and the federal Health Insurance Portability and Accountability Act of 1996, Public
341.3Law 104-191. Screening results shall be considered private data and the commissioner
341.4shall not collect individual screening results.
341.5    (b) When the county board refers clients to providers of children's therapeutic
341.6services and supports under section 256B.0943, the county board must clearly identify
341.7the desired services components not covered under section 256B.0943 and identify the
341.8reimbursement source for those requested services, the method of payment, and the
341.9payment rate to the provider.

341.10    Sec. 12. Minnesota Statutes 2006, section 253B.185, subdivision 2, is amended to read:
341.11    Subd. 2. Transfer to correctional facility. (a) If a person has been committed
341.12under this section and later is committed to the custody of the commissioner of corrections
341.13for any reason, including but not limited to, being sentenced for a crime or revocation of
341.14the person's supervised release or conditional release under section 244.05, 609.108,
341.15subdivision 6 , or 609.109, subdivision 7, the person shall be transferred to a facility
341.16designated by the commissioner of corrections without regard to the procedures provided
341.17in section 253B.18.
341.18    (b) If a person is committed under this section after a commitment to the
341.19commissioner of corrections, the person shall first serve the sentence in a facility
341.20designated by the commissioner of corrections. After the person has served the sentence,
341.21the person shall be transferred to a treatment program designated by the commissioner
341.22of human services.

341.23    Sec. 13. Minnesota Statutes 2006, section 254A.03, subdivision 3, is amended to read:
341.24    Subd. 3. Rules for chemical dependency care. The commissioner of human
341.25services shall establish by rule criteria to be used in determining the appropriate level
341.26of chemical dependency care, whether outpatient, inpatient or short-term treatment
341.27programs, for each recipient of public assistance seeking treatment for alcohol or other
341.28drug dependency and abuse problems. The criteria shall address, at least, the family
341.29relationship, past treatment history, medical or physical problems, arrest record, and
341.30employment situation.

341.31    Sec. 14. Minnesota Statutes 2006, section 254A.16, subdivision 2, is amended to read:
341.32    Subd. 2. Program and service guidelines. (a) The commissioner shall provide
341.33program and service guidelines and technical assistance to the county boards in carrying
342.1out services authorized under sections section 254A.08, 254A.12, 254A.14, and their
342.2responsibilities under chapter 256E.
342.3    (b) The commissioner shall recommend to the governor means of improving
342.4the efficiency and effectiveness of comprehensive program services in the state and
342.5maximizing the use of nongovernmental funds for providing comprehensive programs.

342.6    Sec. 15. [254A.20] CHEMICAL USE ASSESSMENTS; FINANCIAL CONFLICT
342.7OF INTEREST.
342.8    (a) Except as provided in paragraph (b), an assessor conducting a chemical use
342.9assessment under Minnesota Rules, parts 9530.6600 to 9530.6655, may not have any
342.10direct or shared financial interest or referral relationship resulting in shared financial
342.11interest or referral relationship resulting in shared financial gain with a treatment provider.
342.12    (b) A county may contract with an assessor having a conflict described in paragraph
342.13(a) if the county documents that:
342.14    (1) the assessor is employed by a culturally specific service provider or a service
342.15provider with a program designed to treat individuals of a specific age, sex, or sexual
342.16preference;
342.17    (2) the county does not employ a sufficient number of qualified assessors and the
342.18only qualified assessors available in the county have a direct or shared financial interest or
342.19a referral relationship resulting in shared financial gain with a treatment provider; or
342.20    (3) the county social service agency has an existing relationship with an assessor
342.21or service provider and elects to enter into a contract with that assessor to provide both
342.22assessment and treatment under circumstances specified in the county's contract, provided
342.23the county retains responsibility for making placement decisions.
342.24EFFECTIVE DATE.This section is effective the day following final enactment.

342.25    Sec. 16. Minnesota Statutes 2006, section 254B.02, subdivision 1, is amended to read:
342.26    Subdivision 1. Chemical dependency treatment allocation. The chemical
342.27dependency funds appropriated for allocation shall be placed in a special revenue account.
342.28The commissioner shall annually transfer funds from the chemical dependency fund to pay
342.29for operation of the drug and alcohol abuse normative evaluation system and to pay for all
342.30costs incurred by adding two positions for licensing of chemical dependency treatment
342.31and rehabilitation programs located in hospitals for which funds are not otherwise
342.32appropriated. For each year of the biennium ending June 30, 1999, the commissioner shall
342.33allocate funds to the American Indian chemical dependency tribal account for treatment
342.34of American Indians by eligible vendors under section 254B.05, equal to the amount
343.1allocated in fiscal year 1997. Six percent of the remaining money must be reserved for
343.2tribal allocation under section 254B.09, subdivisions 4 and 5. The commissioner shall
343.3annually divide the money available in the chemical dependency fund that is not held
343.4in reserve by counties from a previous allocation, or allocated to the American Indian
343.5chemical dependency tribal account. Six percent of the remaining money must be
343.6reserved for the nonreservation American Indian chemical dependency allocation for
343.7treatment of American Indians by eligible vendors under section 254B.05, subdivision
343.81 . The remainder of the money must be allocated among the counties according to the
343.9following formula, using state demographer data and other data sources determined by
343.10the commissioner:
343.11    (a) For purposes of this formula, American Indians and children under age 14 are
343.12subtracted from the population of each county to determine the restricted population.
343.13    (b) The amount of chemical dependency fund expenditures for entitled persons for
343.14services not covered by prepaid plans governed by section 256B.69 in the previous year is
343.15divided by the amount of chemical dependency fund expenditures for entitled persons for
343.16all services to determine the proportion of exempt service expenditures for each county.
343.17    (c) The prepaid plan months of eligibility is multiplied by the proportion of exempt
343.18service expenditures to determine the adjusted prepaid plan months of eligibility for
343.19each county.
343.20    (d) The adjusted prepaid plan months of eligibility is added to the number of
343.21restricted population fee for service months of eligibility for the Minnesota family
343.22investment program, general assistance, and medical assistance and divided by the county
343.23restricted population to determine county per capita months of covered service eligibility.
343.24    (e) The number of adjusted prepaid plan months of eligibility for the state is added
343.25to the number of fee for service months of eligibility for the Minnesota family investment
343.26program, general assistance, and medical assistance for the state restricted population and
343.27divided by the state restricted population to determine state per capita months of covered
343.28service eligibility.
343.29    (f) The county per capita months of covered service eligibility is divided by the
343.30state per capita months of covered service eligibility to determine the county welfare
343.31caseload factor.
343.32    (g) The median married couple income for the most recent three-year period
343.33available for the state is divided by the median married couple income for the same period
343.34for each county to determine the income factor for each county.
343.35    (h) The county restricted population is multiplied by the sum of the county welfare
343.36caseload factor and the county income factor to determine the adjusted population.
344.1    (i) $15,000 shall be allocated to each county.
344.2    (j) The remaining funds shall be allocated proportional to the county adjusted
344.3population.

344.4    Sec. 17. Minnesota Statutes 2006, section 254B.02, subdivision 5, is amended to read:
344.5    Subd. 5. Administrative adjustment. The commissioner may make payments to
344.6local agencies from money allocated under this section to support administrative activities
344.7under sections 254B.03 and 254B.04. The administrative payment must not exceed
344.8five percent of the first $50,000, four percent of the next $50,000, and three percent of
344.9the remaining payments for services from the allocation. Twenty-five percent of the
344.10administrative allowance shall be advanced at the beginning of each quarter, based on
344.11the payments for services made in the most recent quarter for which data is available.
344.12Adjustment of any overestimate or underestimate based on actual expenditures shall be
344.13made by the state agency by adjusting the administrative allowance for any succeeding
344.14quarter.

344.15    Sec. 18. Minnesota Statutes 2006, section 254B.03, subdivision 1, is amended to read:
344.16    Subdivision 1. Local agency duties. (a) Every local agency shall provide chemical
344.17dependency services to persons residing within its jurisdiction who meet criteria
344.18established by the commissioner for placement in a chemical dependency residential or
344.19nonresidential treatment service. Chemical dependency money must be administered
344.20by the local agencies according to law and rules adopted by the commissioner under
344.21sections 14.001 to 14.69.
344.22    (b) In order to contain costs, the county board shall, with the approval of the
344.23commissioner of human services, select eligible vendors of chemical dependency services
344.24who can provide economical and appropriate treatment. Unless the local agency is a social
344.25services department directly administered by a county or human services board, the local
344.26agency shall not be an eligible vendor under section 254B.05. The commissioner may
344.27approve proposals from county boards to provide services in an economical manner or to
344.28control utilization, with safeguards to ensure that necessary services are provided. If a
344.29county implements a demonstration or experimental medical services funding plan, the
344.30commissioner shall transfer the money as appropriate. If a county selects a vendor located
344.31in another state, the county shall ensure that the vendor is in compliance with the rules
344.32governing licensure of programs located in the state.
344.33    (c) The calendar year 2002 rate for vendors may not increase more than three
344.34percent above the rate approved in effect on January 1, 2001. The calendar year 2003
345.1rate for vendors may not increase more than three percent above the rate in effect on
345.2January 1, 2002. The calendar years 2004 and 2005 rates may not exceed the rate in
345.3effect on January 1, 2003.
345.4    (d) (c) A culturally specific vendor that provides assessments under a variance under
345.5Minnesota Rules, part 9530.6610, shall be allowed to provide assessment services to
345.6persons not covered by the variance.

345.7    Sec. 19. Minnesota Statutes 2006, section 254B.03, subdivision 3, is amended to read:
345.8    Subd. 3. Local agencies to pay state for county share. Local agencies shall submit
345.9invoices to the state on forms supplied by the commissioner and according to procedures
345.10established by the commissioner. Local agencies shall pay the state for the county share
345.11of the invoiced services authorized by the local agency. Payments shall be made at the
345.12beginning of each month for services provided in the previous month. The commissioner
345.13shall bill the county monthly for services, based on the most recent month for which
345.14expenditure information is available. Adjustment of any overestimate or underestimate
345.15based on actual expenditures shall be made by the state agency by adjusting the estimate
345.16for any succeeding month.

345.17    Sec. 20. Minnesota Statutes 2006, section 254B.06, subdivision 3, is amended to read:
345.18    Subd. 3. Payment; denial. The commissioner shall pay eligible vendors for
345.19placements made by local agencies under section 254B.03, subdivision 1, and placements
345.20by tribal designated agencies according to section 254B.09. The commissioner may
345.21reduce or deny payment of the state share when services are not provided according to the
345.22placement criteria established by the commissioner. The commissioner may pay for all or
345.23a portion of improper county chemical dependency placements and bill the county for the
345.24entire payment made when the placement did not comply with criteria established by the
345.25commissioner. The commissioner may make payments to vendors and charge the county
345.26100 percent of the payments if documentation of a county approved placement is received
345.27more than 30 working days, exclusive of weekends and holidays, after the date services
345.28began; or if the county approved invoice is received by the commissioner more than 120
345.29days after the last date of service provided. The commissioner shall not pay vendors until
345.30private insurance company claims have been settled.

345.31    Sec. 21. Minnesota Statutes 2006, section 256.01, is amended by adding a subdivision
345.32to read:
346.1    Subd. 25. Base budget detail. The commissioner shall provide the commissioner
346.2of finance with the information necessary to provide base budget detail to the legislature
346.3under section 16A.10, subdivision 2a.

346.4    Sec. 22. Minnesota Statutes 2006, section 256B.0625, subdivision 23, is amended to
346.5read:
346.6    Subd. 23. Day treatment services. Medical assistance covers day treatment
346.7services as specified in sections 245.462, subdivision 8, and 245.4871, subdivision 10, that
346.8are provided under contract with the county board. Notwithstanding Minnesota Rules,
346.9part 9505.0323, subpart 15, the commissioner may set authorization thresholds for day
346.10treatment for adults according to section 256B.0625, subdivision 25. Notwithstanding
346.11Minnesota Rules, part 9505.0323, subpart 15, effective July 1, 2004, medical assistance
346.12covers day treatment services for children as specified under section 256B.0943.

346.13    Sec. 23. [256B.0636] PRESCRIBING OF CONTROLLED SUBSTANCES;
346.14ABUSE PREVENTION.
346.15    The commissioner shall develop and implement a plan to:
346.16    (1) monitor the prescribing of controlled substances listed in section 152.02,
346.17subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
346.18section 152.02, subdivisions 8 and 12, by enrolled providers and providers under contract
346.19with participating managed care plans;
346.20    (2) require enrolled providers and providers under contract with participating
346.21managed care plans to report information related to potential patient abuse of the
346.22controlled substances to the commissioner, and the Board of Pharmacy; and
346.23    (3) provide education to Minnesota health care program enrollees on the proper use
346.24of controlled substances.

346.25    Sec. 24. Minnesota Statutes 2006, section 256B.0943, subdivision 6, is amended to
346.26read:
346.27    Subd. 6. Provider entity clinical infrastructure requirements. (a) To be
346.28an eligible provider entity under this section, a provider entity must have a clinical
346.29infrastructure that utilizes diagnostic assessment, an individualized treatment plan,
346.30service delivery, and individual treatment plan review that are culturally competent,
346.31child-centered, and family-driven to achieve maximum benefit for the client. The provider
346.32entity must review and update the clinical policies and procedures every three years and
347.1must distribute the policies and procedures to staff initially and upon each subsequent
347.2update.
347.3    (b) The clinical infrastructure written policies and procedures must include policies
347.4and procedures for:
347.5    (1) providing or obtaining a client's diagnostic assessment that identifies acute and
347.6chronic clinical disorders, co-occurring medical conditions, sources of psychological and
347.7environmental problems, and a functional assessment. The functional assessment must
347.8clearly summarize the client's individual strengths and needs;
347.9    (2) developing an individual treatment plan that is:
347.10    (i) based on the information in the client's diagnostic assessment;
347.11    (ii) developed no later than the end of the first psychotherapy session after the
347.12completion of the client's diagnostic assessment by the mental health professional who
347.13provides the client's psychotherapy;
347.14    (iii) developed through a child-centered, family-driven planning process that
347.15identifies service needs and individualized, planned, and culturally appropriate
347.16interventions that contain specific treatment goals and objectives for the client and the
347.17client's family or foster family;
347.18    (iv) reviewed at least once every 90 days and revised, if necessary; and
347.19    (v) signed by the client or, if appropriate, by the client's parent or other person
347.20authorized by statute to consent to mental health services for the client;
347.21    (3) developing an individual behavior plan that documents services to be provided
347.22by the mental health behavioral aide. The individual behavior plan must include:
347.23    (i) detailed instructions on the service to be provided;
347.24    (ii) time allocated to each service;
347.25    (iii) methods of documenting the child's behavior;
347.26    (iv) methods of monitoring the child's progress in reaching objectives; and
347.27    (v) goals to increase or decrease targeted behavior as identified in the individual
347.28treatment plan;
347.29    (4) clinical supervision of the mental health practitioner and mental health behavioral
347.30aide. A mental health professional must document the clinical supervision the professional
347.31provides by cosigning individual treatment plans and making entries in the client's record
347.32on supervisory activities. Clinical supervision does not include the authority to make or
347.33terminate court-ordered placements of the child. A clinical supervisor must be available
347.34for urgent consultation as required by the individual client's needs or the situation. Clinical
347.35supervision may occur individually or in a small group to discuss treatment and review
347.36progress toward goals. The focus of clinical supervision must be the client's treatment
348.1needs and progress and the mental health practitioner's or behavioral aide's ability to
348.2provide services;
348.3    (4a) CTSS certified provider entities providing day treatment programs must meet
348.4the conditions in items (i) to (iii):
348.5    (i) the provider supervisor must be present and available on the premises more
348.6than 50 percent of the time in a five-working-day period during which the supervisee is
348.7providing a mental health service;
348.8    (ii) the diagnosis and the client's individual treatment plan or a change in the
348.9diagnosis or individual treatment plan must be made by or reviewed, approved, and signed
348.10by the provider supervisor; and
348.11    (iii) every 30 days, the supervisor must review and sign the record of the client's care
348.12for all activities in the preceding 30-day period;
348.13    (4b) for all other services provided under CTSS, clinical supervision standards
348.14provided in items (i) to (iii) must be used:
348.15    (i) medical assistance shall reimburse a mental health practitioner who maintains a
348.16consulting relationship with a mental health professional who accepts full professional
348.17responsibility and is present on site for at least one observation during the first 12 hours
348.18in which the mental health practitioner provides the individual, family, or group skills
348.19training to the child or the child's family;
348.20    (ii) thereafter, the mental health professional is required to be present on site for
348.21observation as clinically appropriate when the mental health practitioner is providing
348.22individual, family, or group skills training to the child or the child's family; and
348.23    (iii) the observation must be a minimum of one clinical unit. The on-site presence of
348.24the mental health professional must be documented in the child's record and signed by the
348.25mental health professional who accepts full professional responsibility;
348.26    (5) providing direction to a mental health behavioral aide. For entities that employ
348.27mental health behavioral aides, the clinical supervisor must be employed by the provider
348.28entity or other certified children's therapeutic supports and services provider entity to
348.29ensure necessary and appropriate oversight for the client's treatment and continuity
348.30of care. The mental health professional or mental health practitioner giving direction
348.31must begin with the goals on the individualized treatment plan, and instruct the mental
348.32health behavioral aide on how to construct therapeutic activities and interventions that
348.33will lead to goal attainment. The professional or practitioner giving direction must also
348.34instruct the mental health behavioral aide about the client's diagnosis, functional status,
348.35and other characteristics that are likely to affect service delivery. Direction must also
348.36include determining that the mental health behavioral aide has the skills to interact with
349.1the client and the client's family in ways that convey personal and cultural respect and
349.2that the aide actively solicits information relevant to treatment from the family. The aide
349.3must be able to clearly explain the activities the aide is doing with the client and the
349.4activities' relationship to treatment goals. Direction is more didactic than is supervision
349.5and requires the professional or practitioner providing it to continuously evaluate the
349.6mental health behavioral aide's ability to carry out the activities of the individualized
349.7treatment plan and the individualized behavior plan. When providing direction, the
349.8professional or practitioner must:
349.9    (i) review progress notes prepared by the mental health behavioral aide for accuracy
349.10and consistency with diagnostic assessment, treatment plan, and behavior goals and the
349.11professional or practitioner must approve and sign the progress notes;
349.12    (ii) identify changes in treatment strategies, revise the individual behavior plan,
349.13and communicate treatment instructions and methodologies as appropriate to ensure
349.14that treatment is implemented correctly;
349.15    (iii) demonstrate family-friendly behaviors that support healthy collaboration among
349.16the child, the child's family, and providers as treatment is planned and implemented;
349.17    (iv) ensure that the mental health behavioral aide is able to effectively communicate
349.18with the child, the child's family, and the provider; and
349.19    (v) record the results of any evaluation and corrective actions taken to modify the
349.20work of the mental health behavioral aide;
349.21    (6) providing service delivery that implements the individual treatment plan and
349.22meets the requirements under subdivision 9; and
349.23    (7) individual treatment plan review. The review must determine the extent to which
349.24the services have met the goals and objectives in the previous treatment plan. The review
349.25must assess the client's progress and ensure that services and treatment goals continue to
349.26be necessary and appropriate to the client and the client's family or foster family. Revision
349.27of the individual treatment plan does not require a new diagnostic assessment unless the
349.28client's mental health status has changed markedly. The updated treatment plan must be
349.29signed by the client, if appropriate, and by the client's parent or other person authorized by
349.30statute to give consent to the mental health services for the child.

349.31    Sec. 25. Minnesota Statutes 2006, section 256B.0943, subdivision 9, is amended to
349.32read:
349.33    Subd. 9. Service delivery criteria. (a) In delivering services under this section, a
349.34certified provider entity must ensure that:
350.1    (1) each individual provider's caseload size permits the provider to deliver services
350.2to both clients with severe, complex needs and clients with less intensive needs. The
350.3provider's caseload size should reasonably enable the provider to play an active role in
350.4service planning, monitoring, and delivering services to meet the client's and client's
350.5family's needs, as specified in each client's individual treatment plan;
350.6    (2) site-based programs, including day treatment and preschool programs, provide
350.7staffing and facilities to ensure the client's health, safety, and protection of rights, and that
350.8the programs are able to implement each client's individual treatment plan;
350.9    (3) a day treatment program is provided to a group of clients by a multidisciplinary
350.10team under the clinical supervision of a mental health professional. The day treatment
350.11program must be provided in and by: (i) an outpatient hospital accredited by the Joint
350.12Commission on Accreditation of Health Organizations and licensed under sections
350.13144.50 to 144.55; (ii) a community mental health center under section 245.62; and (iii)
350.14an entity that is under contract with the county board to operate a program that meets
350.15the requirements of sections 245.4712, subdivision 2, and 245.4884, subdivision 2,
350.16and Minnesota Rules, parts 9505.0170 to 9505.0475. The day treatment program must
350.17stabilize the client's mental health status while developing and improving the client's
350.18independent living and socialization skills. The goal of the day treatment program must be
350.19to reduce or relieve the effects of mental illness and provide training to enable the client
350.20to live in the community. The program must be available at least one day a week for a
350.21minimum three-hour time block. The three-hour time block must include at least one
350.22hour, but no more than two hours, of individual or group psychotherapy. The remainder
350.23of the three-hour time block may include recreation therapy, socialization therapy, or
350.24independent living skills therapy, but only if the therapies are included in the client's
350.25individual treatment plan. Day treatment programs are not part of inpatient or residential
350.26treatment services; and
350.27    (4) a preschool program is a structured treatment program offered to a child who
350.28is at least 33 months old, but who has not yet reached the first day of kindergarten, by a
350.29preschool multidisciplinary team in a day program licensed under Minnesota Rules, parts
350.309503.0005 to 9503.0175. The program must be available at least one day a week for a
350.31minimum two-hour time block. The structured treatment program may include individual
350.32or group psychotherapy and recreation therapy, socialization therapy, or independent
350.33living skills therapy, if included in the client's individual treatment plan.
350.34    (b) A provider entity must deliver the service components of children's therapeutic
350.35services and supports in compliance with the following requirements:
351.1    (1) individual, family, and group psychotherapy must be delivered as specified in
351.2Minnesota Rules, part 9505.0323;
351.3    (2) individual, family, or group skills training must be provided by a mental health
351.4professional or a mental health practitioner who has a consulting relationship with a
351.5mental health professional who accepts full professional responsibility for the training;
351.6    (3) crisis assistance must be time-limited and designed to resolve or stabilize crisis
351.7through arrangements for direct intervention and support services to the child and the
351.8child's family. Crisis assistance must utilize resources designed to address abrupt or
351.9substantial changes in the functioning of the child or the child's family as evidenced by
351.10a sudden change in behavior with negative consequences for well being, a loss of usual
351.11coping mechanisms, or the presentation of danger to self or others;
351.12    (4) medically necessary services that are provided by a mental health behavioral
351.13aide must be designed to improve the functioning of the child and support the family in
351.14activities of daily and community living. A mental health behavioral aide must document
351.15the delivery of services in written progress notes. The mental health behavioral aide
351.16must implement goals in the treatment plan for the child's emotional disturbance that
351.17allow the child to acquire developmentally and therapeutically appropriate daily living
351.18skills, social skills, and leisure and recreational skills through targeted activities. These
351.19activities may include:
351.20    (i) assisting a child as needed with skills development in dressing, eating, and
351.21toileting;
351.22    (ii) assisting, monitoring, and guiding the child to complete tasks, including
351.23facilitating the child's participation in medical appointments;
351.24    (iii) observing the child and intervening to redirect the child's inappropriate behavior;
351.25    (iv) assisting the child in using age-appropriate self-management skills as related
351.26to the child's emotional disorder or mental illness, including problem solving, decision
351.27making, communication, conflict resolution, anger management, social skills, and
351.28recreational skills;
351.29    (v) implementing deescalation techniques as recommended by the mental health
351.30professional;
351.31    (vi) implementing any other mental health service that the mental health professional
351.32has approved as being within the scope of the behavioral aide's duties; or
351.33    (vii) assisting the parents to develop and use parenting skills that help the child
351.34achieve the goals outlined in the child's individual treatment plan or individual behavioral
351.35plan. Parenting skills must be directed exclusively to the child's treatment; and
351.36    (5) direction of a mental health behavioral aide must include the following:
352.1    (i) a total of one hour of on-site observation by a mental health professional during
352.2the first 12 hours of service provided to a child;
352.3    (ii) ongoing on-site observation by a mental health professional or mental health
352.4practitioner for at least a total of one hour during every 40 hours of service provided
352.5to a child; and
352.6    (iii) immediate accessibility of the mental health professional or mental health
352.7practitioner to the mental health behavioral aide during service provision.

352.8    Sec. 26. Minnesota Statutes 2006, section 256B.0943, subdivision 11, is amended to
352.9read:
352.10    Subd. 11. Documentation and billing. (a) A provider entity must document the
352.11services it provides under this section. The provider entity must ensure that the entity's
352.12documentation standards meet the requirements of federal and state laws. Services billed
352.13under this section that are not documented according to this subdivision shall be subject to
352.14monetary recovery by the commissioner. The provider entity may not bill for anything
352.15other than direct service time.
352.16    (b) An individual mental health provider must promptly document the following
352.17in a client's record after providing services to the client:
352.18    (1) each occurrence of the client's mental health service, including the date, type,
352.19length, and scope of the service;
352.20    (2) the name of the person who gave the service;
352.21    (3) contact made with other persons interested in the client, including representatives
352.22of the courts, corrections systems, or schools. The provider must document the name
352.23and date of each contact;
352.24    (4) any contact made with the client's other mental health providers, case manager,
352.25family members, primary caregiver, legal representative, or the reason the provider did
352.26not contact the client's family members, primary caregiver, or legal representative, if
352.27applicable; and
352.28    (5) required clinical supervision, as appropriate.

352.29    Sec. 27. Minnesota Statutes 2006, section 256B.0943, subdivision 12, is amended to
352.30read:
352.31    Subd. 12. Excluded services. The following services are not eligible for medical
352.32assistance payment as children's therapeutic services and supports:
353.1    (1) service components of children's therapeutic services and supports
353.2simultaneously provided by more than one provider entity unless prior authorization is
353.3obtained;
353.4    (2) children's therapeutic services and supports provided in violation of medical
353.5assistance policy in Minnesota Rules, part 9505.0220;
353.6    (3) mental health behavioral aide services provided by a personal care assistant who
353.7is not qualified as a mental health behavioral aide and employed by a certified children's
353.8therapeutic services and supports provider entity;
353.9    (4) service components of CTSS that are the responsibility of a residential or
353.10program license holder, including foster care providers under the terms of a service
353.11agreement or administrative rules governing licensure; and
353.12    (5) adjunctive activities that may be offered by a provider entity but are not
353.13otherwise covered by medical assistance, including:
353.14    (i) a service that is primarily recreation oriented or that is provided in a setting that
353.15is not medically supervised. This includes sports activities, exercise groups, activities
353.16such as craft hours, leisure time, social hours, meal or snack time, trips to community
353.17activities, and tours;
353.18    (ii) a social or educational service that does not have or cannot reasonably be
353.19expected to have a therapeutic outcome related to the client's emotional disturbance;
353.20    (iii) consultation with other providers or service agency staff about the care or
353.21progress of a client;
353.22    (iv) prevention or education programs provided to the community; and
353.23    (v) treatment for clients with primary diagnoses of alcohol or other drug abuse.; and
353.24    (6) activities that are not direct service time.

353.25    Sec. 28. [256B.764] REIMBURSEMENT FOR FAMILY PLANNING SERVICES.
353.26    Effective for services rendered on or after July 1, 2007, payment rates for family
353.27planning services shall be increased by 25 percent over the rates in effect July 30, 2007,
353.28when these services are provided by a community clinic as defined in section 145.9268,
353.29subdivision 1.

353.30    Sec. 29. Minnesota Statutes 2006, section 256E.35, subdivision 2, is amended to read:
353.31    Subd. 2. Definitions. (a) The definitions in this subdivision apply to this section.
353.32    (b) "Family asset account" means a savings account opened by a household
353.33participating in the Minnesota family assets for independence initiative.
353.34    (c) "Fiduciary organization" means:
354.1    (1) a community action agency that has obtained recognition under section 268.53
354.2256E.31 ;
354.3    (2) a federal community development credit union serving the seven-county
354.4metropolitan area; or
354.5    (3) a women-oriented economic development agency serving the seven-county
354.6metropolitan area.
354.7    (d) "Financial institution" means a bank, bank and trust, savings bank, savings
354.8association, or credit union, the deposits of which are insured by the Federal Deposit
354.9Insurance Corporation or the National Credit Union Administration.
354.10    (e) "Permissible use" means:
354.11    (1) postsecondary educational expenses at an accredited public postsecondary
354.12institution including books, supplies, and equipment required for courses of instruction;
354.13    (2) acquisition costs of acquiring, constructing, or reconstructing a residence,
354.14including any usual or reasonable settlement, financing, or other closing costs;
354.15    (3) business capitalization expenses for expenditures on capital, plant, equipment,
354.16working capital, and inventory expenses of a legitimate business pursuant to a business
354.17plan approved by the fiduciary organization; and
354.18    (4) acquisition costs of a principal residence within the meaning of section 1034 of
354.19the Internal Revenue Code of 1986 which do not exceed 100 percent of the average area
354.20purchase price applicable to the residence determined according to section 143(e)(2) and
354.21(3) of the Internal Revenue Code of 1986.
354.22    (f) "Household" means all individuals who share use of a dwelling unit as primary
354.23quarters for living and eating separate from other individuals.

354.24    Sec. 30. [525A.01] SHORT TITLE.
354.25    This chapter may be cited as the "Darlene Luther Revised Uniform Anatomical
354.26Gift Act."

354.27    Sec. 31. [525A.02] DEFINITIONS.
354.28    Subdivision 1. Scope. The definitions in this section apply to this chapter.
354.29    Subd. 2. Adult. "Adult" means an individual who is at least 18 years of age.
354.30    Subd. 3. Agent. "Agent" means an individual who is:
354.31    (1) authorized to make health care decisions on the principal's behalf by a power of
354.32attorney for health care; or
354.33    (2) expressly authorized to make an anatomical gift on the principal's behalf by
354.34any other record signed by the principal.
355.1    Subd. 4. Anatomical gift. "Anatomical gift" means a donation of all or part of
355.2a human body to take effect after the donor's death for the purpose of transplantation,
355.3therapy, research, or education.
355.4    Subd. 5. Decedent. "Decedent" means a deceased individual and includes a stillborn
355.5infant or an embryo or fetus that has died of natural causes in utero.
355.6    Subd. 6. Disinterested witness. "Disinterested witness" means a witness other than
355.7the spouse, child, parent, sibling, grandchild, grandparent, or guardian of the individual
355.8who makes, amends, revokes, or refuses to make an anatomical gift, or another adult who
355.9exhibited special care and concern for the individual. The term does not include a person
355.10to which an anatomical gift could pass under section 525A.11.
355.11    Subd. 7. Document of gift. "Document of gift" means a donor card or other record
355.12used to make an anatomical gift. The term includes a statement or symbol on a driver's
355.13license, identification card, or donor registry.
355.14    Subd. 8. Donor. "Donor" means an individual whose body or part is the subject of
355.15an anatomical gift.
355.16    Subd. 9. Donor registry. "Donor registry" means a database that contains records
355.17of anatomical gifts and amendments to or revocations of anatomical gifts.
355.18    Subd. 10. Driver's license. "Driver's license" means a license or permit issued
355.19under chapter 171 to operate a vehicle, whether or not conditions are attached to the
355.20license or permit.
355.21    Subd. 11. Eye bank. "Eye bank" means a person that is licensed, accredited,
355.22or regulated under federal or state law to engage in the recovery, screening, testing,
355.23processing, storage, or distribution of human eyes or portions of human eyes.
355.24    Subd. 12. Guardian. "Guardian" means a person appointed by a court to make
355.25decisions regarding the support, care, education, health, or welfare of an individual. The
355.26term does not include a guardian ad litem.
355.27    Subd. 13. Hospital. "Hospital" means a facility licensed as a hospital under the
355.28law of any state or a facility operated as a hospital by the United States, a state, or a
355.29subdivision of a state.
355.30    Subd. 14. Identification card. "Identification card" means a Minnesota
355.31identification card issued under chapter 171.
355.32    Subd. 15. Know. "Know" means to have actual knowledge.
355.33    Subd. 16. Medical examiner. "Medical examiner" includes coroner.
355.34    Subd. 17. Minor. "Minor" means an individual who is under 18 years of age.
356.1    Subd. 18. Organ procurement organization. "Organ procurement organization"
356.2means a person designated by the secretary of the United States Department of Health and
356.3Human Services as an organ procurement organization.
356.4    Subd. 19. Parent. "Parent" means a parent whose parental rights have not been
356.5terminated.
356.6    Subd. 20. Part. "Part" means an organ, an eye, or tissue of a human being. The term
356.7does not include the whole body.
356.8    Subd. 21. Person. "Person" means an individual, corporation, business trust, estate,
356.9trust, partnership, limited liability company, association, joint venture, public corporation,
356.10government or governmental subdivision, agency, or instrumentality, or any other legal or
356.11commercial entity.
356.12    Subd. 22. Physician. "Physician" means an individual authorized to practice
356.13medicine or osteopathy under the law of any state.
356.14    Subd. 23. Procurement organization. "Procurement organization" means an eye
356.15bank, organ procurement organization, or tissue bank.
356.16    Subd. 24. Prospective donor. "Prospective donor" means an individual who is dead
356.17or near death and has been determined by a procurement organization to have a part that
356.18could be medically suitable for transplantation, therapy, research, or education. The term
356.19does not include an individual who has made a refusal.
356.20    Subd. 25. Reasonably available. "Reasonably available" means able to be
356.21contacted by a procurement organization without undue effort and willing and able to act
356.22in a timely manner consistent with existing medical criteria necessary for the making of
356.23an anatomical gift.
356.24    Subd. 26. Recipient. "Recipient" means an individual into whose body a decedent's
356.25part has been or is intended to be transplanted.
356.26    Subd. 27. Record. "Record" means information that is inscribed on a tangible
356.27medium or that is stored in an electronic or other medium and is retrievable in perceivable
356.28form.
356.29    Subd. 28. Refusal. "Refusal" means a record created under section 525A.07 that
356.30expressly states an intent to bar other persons from making an anatomical gift of an
356.31individual's body or part.
356.32    Subd. 29. Sign. "Sign" means, with the present intent to authenticate or adopt
356.33a record:
356.34    (1) to execute or adopt a tangible symbol; or
356.35    (2) to attach to or logically associate with the record an electronic symbol, sound,
356.36or process.
357.1    Subd. 30. State. "State" means a state of the United States, the District of Columbia,
357.2Puerto Rico, the United States Virgin Islands, or any territory or insular possession subject
357.3to the jurisdiction of the United States.
357.4    Subd. 31. Technician. "Technician" means an individual determined to be qualified
357.5to remove or process parts by an appropriate organization that is licensed, accredited, or
357.6regulated under federal or state law. The term includes an enucleator.
357.7    Subd. 32. Tissue. "Tissue" means a portion of the human body other than an organ
357.8or an eye. The term does not include blood unless the blood is donated for the purpose
357.9of research or education.
357.10    Subd. 33. Tissue bank. "Tissue bank" means a person that is licensed, accredited,
357.11or regulated under federal or state law to engage in the recovery, screening, testing,
357.12processing, storage, or distribution of tissue.
357.13    Subd. 34. Transplant hospital. "Transplant hospital" means a hospital that
357.14furnishes organ transplants and other medical and surgical specialty services required
357.15for the care of transplant patients.

357.16    Sec. 32. [525A.03] APPLICABILITY.
357.17    This chapter applies to an anatomical gift or amendment to, revocation of, or refusal
357.18to make an anatomical gift, whenever made.

357.19    Sec. 33. [525A.04] WHO MAY MAKE ANATOMICAL GIFT BEFORE
357.20DONOR'S DEATH.
357.21    Subject to section 525A.08, an anatomical gift of a donor's body or part may be
357.22made during the life of the donor for the purpose of transplantation, therapy, research, or
357.23education in the manner provided in section 525A.05 by:
357.24    (1) the donor, if the donor is an adult or if the donor is a minor and is:
357.25    (i) emancipated; or
357.26    (ii) authorized under state law to apply for a driver's license because the donor is
357.27at least 16 years of age;
357.28    (2) an agent of the donor, unless the power of attorney for health care or other record
357.29prohibits the agent from making an anatomical gift;
357.30    (3) a parent of the donor, if the donor is an unemancipated minor; or
357.31    (4) the donor's guardian.

357.32    Sec. 34. [525A.05] MANNER OF MAKING ANATOMICAL GIFT BEFORE
357.33DONOR'S DEATH.
358.1    (a) A donor may make an anatomical gift:
358.2    (1) by authorizing a statement or symbol indicating that the donor has made an
358.3anatomical gift to be imprinted on the donor's driver's license or identification card;
358.4    (2) in a will;
358.5    (3) during a terminal illness or injury of the donor, by any form of communication
358.6addressed to at least two adults, at least one of whom is a disinterested witness; or
358.7    (4) as provided in paragraph (b).
358.8    (b) A donor or other person authorized to make an anatomical gift under section
358.9525A.04 may make a gift by a donor card or other record signed by the donor or other
358.10person making the gift or by authorizing that a statement or symbol indicating that the
358.11donor has made an anatomical gift be included on a donor registry. If the donor or
358.12other person is physically unable to sign a record, the record may be signed by another
358.13individual at the direction of the donor or other person and must:
358.14    (1) be witnessed by at least two adults, at least one of whom is a disinterested
358.15witness, who have signed at the request of the donor or the other person; and
358.16    (2) state that it has been signed and witnessed as provided in clause (1).
358.17    (c) Revocation, suspension, expiration, or cancellation of a driver's license or
358.18identification card upon which an anatomical gift is indicated does not invalidate the gift.
358.19    (d) An anatomical gift made by will takes effect upon the donor's death whether or
358.20not the will is probated. Invalidation of the will after the donor's death does not invalidate
358.21the gift.
358.22    (e) The making of an anatomical gift shall not itself authorize or direct the denial
358.23of health care.

358.24    Sec. 35. [525A.06] AMENDING OR REVOKING ANATOMICAL GIFT
358.25BEFORE DONOR'S DEATH.
358.26    (a) Subject to section 525A.08, a donor or other person authorized to make an
358.27anatomical gift under section 525A.04 may amend or revoke an anatomical gift by:
358.28    (1) a record signed by:
358.29    (i) the donor;
358.30    (ii) the other person; or
358.31    (iii) subject to paragraph (b), another individual acting at the direction of the donor
358.32or the other person if the donor or other person is physically unable to sign; or
358.33    (2) a later-executed document of gift that amends or revokes a previous anatomical
358.34gift or portion of an anatomical gift, either expressly or by inconsistency.
358.35    (b) A record signed pursuant to paragraph (a), clause (1), item (iii), must:
359.1    (1) be witnessed by at least two adults, at least one of whom is a disinterested
359.2witness, who have signed at the request of the donor or the other person; and
359.3    (2) state that it has been signed and witnessed as provided in clause (1).
359.4    (c) Subject to section 525A.08, a donor or other person authorized to make an
359.5anatomical gift under section 525A.04 may revoke an anatomical gift by the destruction or
359.6cancellation of the document of gift, or the portion of the document of gift used to make
359.7the gift, with the intent to revoke the gift.
359.8    (d) A donor may amend or revoke an anatomical gift that was not made in a will
359.9by any form of communication during a terminal illness or injury addressed to at least
359.10two adults, at least one of whom is a disinterested witness.
359.11    (e) A donor who makes an anatomical gift in a will may amend or revoke the gift in
359.12the manner provided for amendment or revocation of wills or as provided in paragraph (a).

359.13    Sec. 36. [525A.07] REFUSAL TO MAKE ANATOMICAL GIFT; EFFECT OF
359.14REFUSAL.
359.15    (a) An individual may refuse to make an anatomical gift of the individual's body
359.16or part by:
359.17    (1) a record signed by:
359.18    (i) the individual; or
359.19    (ii) subject to paragraph (b), another individual acting at the direction of the
359.20individual if the individual is physically unable to sign;
359.21    (2) the individual's will, whether or not the will is admitted to probate or invalidated
359.22after the individual's death; or
359.23    (3) any form of communication made by the individual during the individual's
359.24terminal illness or injury addressed to at least two adults, at least one of whom is a
359.25disinterested witness.
359.26    (b) A record signed pursuant to paragraph (a), clause (1), item (ii), must:
359.27    (1) be witnessed by at least two adults, at least one of whom is a disinterested
359.28witness, who have signed at the request of the individual; and
359.29    (2) state that it has been signed and witnessed as provided in clause (1).
359.30    (c) An individual who has made a refusal may amend or revoke the refusal:
359.31    (1) in the manner provided in paragraph (a) for making a refusal;
359.32    (2) by subsequently making an anatomical gift pursuant to section 525A.05 that is
359.33inconsistent with the refusal; or
359.34    (3) by destroying or canceling the record evidencing the refusal, or the portion of the
359.35record used to make the refusal, with the intent to revoke the refusal.
360.1    (d) Except as otherwise provided in section 525A.08, paragraph (h), in the absence
360.2of an express, contrary indication by the individual set forth in the refusal, an individual's
360.3unrevoked refusal to make an anatomical gift of the individual's body or part bars all other
360.4persons from making an anatomical gift of the individual's body or part.

360.5    Sec. 37. [525A.08] PRECLUSIVE EFFECT OF ANATOMICAL GIFT,
360.6AMENDMENT, OR REVOCATION.
360.7    (a) Except as otherwise provided in paragraph (g) and subject to paragraph (f), in the
360.8absence of an express, contrary indication by the donor, a person other than the donor is
360.9barred from making, amending, or revoking an anatomical gift of a donor's body or part if
360.10the donor made an anatomical gift of the donor's body or part under section 525A.05 or an
360.11amendment to an anatomical gift of the donor's body or part under section 525A.06. An
360.12anatomical gift made in a will, a designation on a driver's license or identification card, or
360.13a health care directive under chapter 145C, and not revoked, establishes the intent of the
360.14person making the designation and may not be overridden by any other person.
360.15    (b) A donor's revocation of an anatomical gift of the donor's body or part under
360.16section 525A.06 is not a refusal and does not bar another person specified in section
360.17525A.04 or 525A.09 from making an anatomical gift of the donor's body or part under
360.18section 525A.05 or 525A.10.
360.19    (c) If a person other than the donor makes an unrevoked anatomical gift of the
360.20donor's body or part under section 525A.05 or an amendment to an anatomical gift of the
360.21donor's body or part under section 525A.06, another person may not make, amend, or
360.22revoke the gift of the donor's body or part under section 525A.10.
360.23    (d) A revocation of an anatomical gift of a donor's body or part under section
360.24525A.06 by a person other than the donor does not bar another person from making an
360.25anatomical gift of the body or part under section 525A.05 or 525A.10.
360.26    (e) In the absence of an express, contrary indication by the donor or other person
360.27authorized to make an anatomical gift under section 525A.04, an anatomical gift of a part
360.28is neither a refusal to give another part nor a limitation on the making of an anatomical gift
360.29of another part at a later time by the donor or another person.
360.30    (f) In the absence of an express, contrary indication by the donor or other person
360.31authorized to make an anatomical gift under section 525A.04, an anatomical gift of a
360.32part for one or more of the purposes set forth in section 525A.04 is not a limitation on
360.33the making of an anatomical gift of the part for any of the other purposes by the donor
360.34or any other person under section 525A.05 or 525A.10.
361.1    (g) If a donor who is an unemancipated minor dies, a parent of the donor who is
361.2reasonably available may revoke or amend an anatomical gift of the donor's body or part.
361.3    (h) If an unemancipated minor who signed a refusal dies, a parent of the minor who
361.4is reasonably available may revoke the minor's refusal.

361.5    Sec. 38. [525A.09] WHO MAY MAKE ANATOMICAL GIFT OF DECEDENT'S
361.6BODY OR PART.
361.7    (a) Subject to paragraphs (b) and (c) and unless barred by section 525A.07 or
361.8525A.08, an anatomical gift of a decedent's body or part for the purpose of transplantation,
361.9therapy, research, or education may be made by any member of the following classes of
361.10persons who is reasonably available, in the order of priority listed:
361.11    (1) an agent of the decedent at the time of death who could have made an anatomical
361.12gift under section 525A.04, clause (2), immediately before the decedent's death;
361.13    (2) the spouse of the decedent;
361.14    (3) adult children of the decedent;
361.15    (4) parents of the decedent;
361.16    (5) adult siblings of the decedent;
361.17    (6) adult grandchildren of the decedent;
361.18    (7) grandparents of the decedent;
361.19    (8) an adult who exhibited special care and concern for the decedent;
361.20    (9) the persons who were acting as the guardians of the person of the decedent
361.21at the time of death; and
361.22    (10) any other person having the authority to dispose of the decedent's body.
361.23    (b) If there is more than one member of a class listed in paragraph (a), clause (1),
361.24(3), (4), (5), (6), (7), or (9), entitled to make an anatomical gift, an anatomical gift may
361.25be made by a member of the class unless that member or a person to which the gift may
361.26pass under section 525A.11 knows of an objection by another member of the class. If
361.27an objection is known, the gift may be made only by a majority of the members of the
361.28class who are reasonably available.
361.29    (c) A person may not make an anatomical gift if, at the time of the decedent's death,
361.30a person in a prior class under paragraph (a) is reasonably available to make or to object to
361.31the making of an anatomical gift.

361.32    Sec. 39. [525A.10] MANNER OF MAKING, AMENDING, OR REVOKING
361.33ANATOMICAL GIFT OF DECEDENT'S BODY OR PART.
362.1    (a) A person authorized to make an anatomical gift under section 525A.09 may
362.2make an anatomical gift by a document of gift signed by the person making the gift or by
362.3that person's oral communication that is electronically recorded or is contemporaneously
362.4reduced to a record and signed by the individual receiving the oral communication.
362.5    (b) Subject to paragraph (c), an anatomical gift by a person authorized under section
362.6525A.09 may be amended or revoked orally or in a record by any member of a prior class
362.7who is reasonably available. If more than one member of the prior class is reasonably
362.8available, the gift made by a person authorized under section 525A.09 may be:
362.9    (1) amended only if a majority of the reasonably available members agree to the
362.10amending of the gift; or
362.11    (2) revoked only if a majority of the reasonably available members agree to the
362.12revoking of the gift or if they are equally divided as to whether to revoke the gift.
362.13    (c) A revocation under paragraph (b) is effective only if, before an incision has been
362.14made to remove a part from the donor's body or before invasive procedures have begun to
362.15prepare the recipient, the procurement organization, transplant hospital, or physician or
362.16technician knows of the revocation.

362.17    Sec. 40. [525A.11] PERSONS THAT MAY RECEIVE ANATOMICAL GIFT;
362.18PURPOSE OF ANATOMICAL GIFT.
362.19    (a) An anatomical gift may be made to the following persons named in the document
362.20of gift:
362.21    (1) a hospital; accredited medical school, dental school, college, or university; organ
362.22procurement organization; or nonprofit organization in medical education or research,
362.23for research or education;
362.24    (2) subject to paragraph (b), an individual designated by the person making the
362.25anatomical gift if the individual is the recipient of the part; and
362.26    (3) an eye bank or tissue bank.
362.27    (b) If an anatomical gift to an individual under paragraph (a), clause (2), cannot be
362.28transplanted into the individual, the part passes in accordance with paragraph (g) in the
362.29absence of an express, contrary indication by the person making the anatomical gift.
362.30    (c) If an anatomical gift of one or more specific parts or of all parts is made in a
362.31document of gift that does not name a person described in paragraph (a) but identifies the
362.32purpose for which an anatomical gift may be used, the following rules apply:
362.33    (1) if the part is an eye and the gift is for the purpose of transplantation or therapy,
362.34the gift passes to the appropriate eye bank;
363.1    (2) if the part is tissue and the gift is for the purpose of transplantation or therapy, the
363.2gift passes to the appropriate tissue bank;
363.3    (3) if the part is an organ and the gift is for the purpose of transplantation or therapy,
363.4the gift passes to the appropriate organ procurement organization as custodian of the
363.5organ; and
363.6    (4) if the part is an organ, an eye, or tissue and the gift is for the purpose of research
363.7or education, the gift passes to the appropriate procurement organization.
363.8    (d) For the purpose of paragraph (c), if there is more than one purpose of an
363.9anatomical gift set forth in the document of gift but the purposes are not set forth in any
363.10priority, the gift must be used for transplantation or therapy, if suitable. If the gift cannot
363.11be used for transplantation or therapy, the gift may be used for research or education.
363.12    (e) If an anatomical gift of one or more specific parts is made in a document of gift
363.13that does not name a person described in paragraph (a) and does not identify the purpose
363.14of the gift, the gift may be used only for transplantation or therapy, and the gift passes in
363.15accordance with paragraph (g).
363.16    (f) If a document of gift specifies only a general intent to make an anatomical gift
363.17by words such as "donor," "organ donor," or "body donor," or by a symbol or statement
363.18of similar import, the gift may be used only for transplantation or therapy, and the gift
363.19passes in accordance with paragraph (g).
363.20    (g) For purposes of paragraphs (b), (e), and (f), the following rules apply:
363.21    (1) if the part is an eye, the gift passes to the appropriate eye bank;
363.22    (2) if the part is tissue, the gift passes to the appropriate tissue bank; and
363.23    (3) if the part is an organ, the gift passes to the appropriate organ procurement
363.24organization as custodian of the organ.
363.25    (h) An anatomical gift of an organ for transplantation or therapy, other than
363.26an anatomical gift under paragraph (a), clause (2), passes to the organ procurement
363.27organization as custodian of the organ.
363.28    (i) If an anatomical gift does not pass pursuant to paragraphs (a) to (h) or the
363.29decedent's body or part is not used for transplantation, therapy, research, or education,
363.30custody of the body or part passes to the person under obligation to dispose of the body or
363.31part.
363.32    (j) A person may not accept an anatomical gift if the person knows that the gift was
363.33not effectively made under section 525A.05 or 525A.10 or if the person knows that the
363.34decedent made a refusal under section 525A.07 that was not revoked. For purposes of
363.35this paragraph, if a person knows that an anatomical gift was made on a document of gift,
364.1the person is deemed to know of any amendment or revocation of the gift or any refusal
364.2to make an anatomical gift on the same document of gift.
364.3    (k) Except as otherwise provided in paragraph (a), clause (2), nothing in this chapter
364.4affects the allocation of organs for transplantation or therapy.

364.5    Sec. 41. [525A.12] SEARCH AND NOTIFICATION.
364.6    (a) The following persons shall make a reasonable search of an individual who
364.7the person reasonably believes is dead or near death for a document of gift or other
364.8information identifying the individual as a donor or as an individual who made a refusal:
364.9    (1) a law enforcement officer, firefighter, paramedic, or other emergency rescuer
364.10finding the individual; and
364.11    (2) if no other source of the information is immediately available, a hospital, as soon
364.12as practical after the individual's arrival at the hospital.
364.13    (b) If a document of gift or a refusal to make an anatomical gift is located by the
364.14search required by paragraph (a), clause (1), and the individual or deceased individual to
364.15whom it relates is taken to a hospital, the person responsible for conducting the search
364.16shall send the document of gift or refusal to the hospital. If a body is transferred to
364.17the custody of the medical examiner, the person who discovered the body must notify
364.18the person's dispatcher. A dispatcher notified under this section must notify the state's
364.19federally designated organ procurement organization and inform the organization of the
364.20deceased's name, donor status, and location.
364.21    (c) A person is not subject to criminal or civil liability for failing to discharge the
364.22duties imposed by this section but may be subject to administrative sanctions.

364.23    Sec. 42. [525A.13] DELIVERY OF DOCUMENT OF GIFT NOT REQUIRED;
364.24RIGHT TO EXAMINE.
364.25    (a) A document of gift need not be delivered during the donor's lifetime to be
364.26effective.
364.27    (b) Upon or after an individual's death, a person in possession of a document of
364.28gift or a refusal to make an anatomical gift with respect to the individual shall allow
364.29examination and copying of the document of gift or refusal by a person authorized to
364.30make or object to the making of an anatomical gift with respect to the individual or by a
364.31person to which the gift could pass under section 525A.11.

364.32    Sec. 43. [525A.14] RIGHTS AND DUTIES OF PROCUREMENT
364.33ORGANIZATION AND OTHERS.
365.1    (a) When a hospital refers an individual at or near death to a procurement
365.2organization, the organization shall make a reasonable search of the records of the
365.3Department of Public Safety and any donor registry that it knows exists for the
365.4geographical area in which the individual resides to ascertain whether the individual has
365.5made an anatomical gift.
365.6    (b) A procurement organization must be allowed reasonable access to information
365.7in the records of the Department of Public Safety to ascertain whether an individual at
365.8or near death is a donor.
365.9    (c) When a hospital refers an individual at or near death to a procurement
365.10organization, the organization may conduct any reasonable examination necessary to
365.11ensure the medical suitability of a part that is or could be the subject of an anatomical gift
365.12for transplantation, therapy, research, or education from a donor or a prospective donor.
365.13During the examination period, measures necessary to ensure the medical suitability of the
365.14part may not be withdrawn unless the hospital or procurement organization knows that
365.15the individual expressed a contrary intent.
365.16    (d) Unless prohibited by law other than this chapter, at any time after a donor's death,
365.17the person to which a part passes under section 525A.11 may conduct any reasonable
365.18examination necessary to ensure the medical suitability of the body or part for its intended
365.19purpose.
365.20    (e) Unless prohibited by law other than this chapter, an examination under paragraph
365.21(c) or (d) may include an examination of all medical and dental records of the donor or
365.22prospective donor.
365.23    (f) Upon the death of a minor who was a donor or had signed a refusal, unless a
365.24procurement organization knows the minor is emancipated, the procurement organization
365.25shall conduct a reasonable search for the parents of the minor and provide the parents with
365.26an opportunity to revoke or amend the anatomical gift or revoke the refusal.
365.27    (g) Upon referral by a hospital under paragraph (a), a procurement organization shall
365.28make a reasonable search for any person listed in section 525A.09 having priority to make
365.29an anatomical gift on behalf of a prospective donor. If a procurement organization receives
365.30information that an anatomical gift to any other person was made, amended, or revoked, it
365.31shall promptly advise the other person of all relevant information.
365.32    (h) Subject to sections 525A.11, paragraph (i), and 525A.23, the rights of the person
365.33to which a part passes under section 525A.11 are superior to the rights of all others with
365.34respect to the part. The person may accept or reject an anatomical gift in whole or in part.
365.35Subject to the terms of the document of gift and this chapter, a person that accepts an
365.36anatomical gift of an entire body may allow embalming, burial, or cremation, and use of
366.1remains in a funeral service. If the gift is of a part, the person to which the part passes
366.2under section 525A.11, upon the death of the donor and before embalming, burial, or
366.3cremation, shall cause the part to be removed without unnecessary mutilation.
366.4    (i) Neither the physician who attends the decedent at death nor the physician who
366.5determines the time of the decedent's death may participate in the procedures for removing
366.6or transplanting a part from the decedent.
366.7    (j) A physician or technician may remove a donated part from the body of a donor
366.8that the physician or technician is qualified to remove.

366.9    Sec. 44. [525A.15] COORDINATION OF PROCUREMENT AND USE.
366.10    Each hospital in this state shall enter into agreements or affiliations with procurement
366.11organizations for coordination of procurement and use of anatomical gifts.

366.12    Sec. 45. [525A.16] SALE OR PURCHASE OF PARTS PROHIBITED; FELONY.
366.13    (a) Except as otherwise provided in paragraph (b), a person that, for valuable
366.14consideration, knowingly purchases or sells a part for transplantation or therapy if removal
366.15of a part from an individual is intended to occur after the individual's death, commits a
366.16felony and upon conviction is subject to a fine not exceeding $10,000 or imprisonment
366.17not exceeding five years, or both.
366.18    (b) A person may charge a reasonable amount for the removal, processing,
366.19preservation, quality control, storage, transportation, implantation, or disposal of a part.

366.20    Sec. 46. [525A.17] PROHIBITED ACTS; FELONY.
366.21    A person that, in order to obtain a financial gain, intentionally falsifies, forges,
366.22conceals, defaces, or obliterates a document of gift, an amendment or revocation of a
366.23document of gift, or a refusal commits a felony and upon conviction is subject to a fine not
366.24exceeding $10,000 or imprisonment not exceeding five years, or both.

366.25    Sec. 47. [525A.18] IMMUNITY.
366.26    (a) A person that acts in accordance with this chapter or with the applicable
366.27anatomical gift law of another state, or attempts in good faith to do so, is not liable for the
366.28act in a civil action, criminal prosecution, or administrative proceeding.
366.29    (b) Neither the person making an anatomical gift nor the donor's estate is liable for
366.30any injury or damage that results from the making or use of the gift.
366.31    (c) In determining whether an anatomical gift has been made, amended, or revoked
366.32under this chapter, a person may rely upon representations of an individual listed in
367.1section 525A.09, paragraph (a), clause (2), (3), (4), (5), (6), (7), or (8), relating to the
367.2individual's relationship to the donor or prospective donor unless the person knows that
367.3the representation is untrue.
367.4    (d) An anatomical gift under this chapter is not a sale of goods as that term is defined
367.5in section 336.2-105, paragraph (1), or the sale of a product.

367.6    Sec. 48. [525A.19] LAW GOVERNING VALIDITY; CHOICE OF LAW AS TO
367.7EXECUTION OF DOCUMENT OF GIFT; PRESUMPTION OF VALIDITY.
367.8    (a) A document of gift is valid if executed in accordance with:
367.9    (1) this chapter;
367.10    (2) the laws of the state or country where it was executed; or
367.11    (3) the laws of the state or country where the person making the anatomical gift
367.12was domiciled, has a place of residence, or was a national at the time the document of
367.13gift was executed.
367.14    (b) If a document of gift is valid under this section, the law of this state governs
367.15the interpretation of the document of gift.
367.16    (c) A person may presume that a document of gift or amendment of an anatomical
367.17gift is valid unless that person knows that it was not validly executed or was revoked.

367.18    Sec. 49. [525A.20] DONOR REGISTRY.
367.19    (a) The Department of Health may establish or contract for the establishment of a
367.20donor registry.
367.21    (b) The Department of Public Safety shall cooperate with a person that administers
367.22any donor registry that this state establishes, contracts for, or recognizes for the purpose
367.23of transferring to the donor registry all relevant information regarding a donor's making,
367.24amendment to, or revocation of an anatomical gift.
367.25    (c) A donor registry must:
367.26    (1) allow a donor or other person authorized under section 525A.04 to include on
367.27the donor registry a statement or symbol that the donor has made, amended, or revoked
367.28an anatomical gift;
367.29    (2) be accessible to a procurement organization to allow it to obtain relevant
367.30information on the donor registry to determine, at or near death of the donor or a
367.31prospective donor, whether the donor or prospective donor has made, amended, or revoked
367.32an anatomical gift; and
367.33    (3) be accessible, for purposes of clauses (1) and (2), seven days a week on a
367.3424-hour basis.
368.1    (d) Personally identifiable information on a donor registry about a donor or
368.2prospective donor may not be used or disclosed without the express consent of the donor,
368.3prospective donor, or person that made the anatomical gift for any purpose other than
368.4to determine, at or near death of the donor or prospective donor, whether the donor or
368.5prospective donor has made, amended, or revoked an anatomical gift.
368.6    (e) This section does not prohibit any person from creating or maintaining a donor
368.7registry that is not established by or under contract with the state. Any such registry
368.8must comply with paragraphs (c) and (d).

368.9    Sec. 50. [525A.21] EFFECT OF ANATOMICAL GIFT ON ADVANCE HEALTH
368.10CARE DIRECTIVE.
368.11    (a) In this section:
368.12    (1) "advance health care directive" means a power of attorney for health care
368.13or a record signed by a prospective donor containing the prospective donor's direction
368.14concerning a health care decision for the prospective donor;
368.15    (2) "declaration" means a record signed by a prospective donor specifying the
368.16circumstances under which a life support system may be withheld or withdrawn from
368.17the prospective donor; and
368.18    (3) "health care decision" means any decision made regarding the health care of the
368.19prospective donor.
368.20    (b) If a prospective donor has a declaration or advance health care directive,
368.21measures necessary to ensure the medical suitability of an organ for transplantation
368.22or therapy may not be withheld or withdrawn from the prospective donor, unless the
368.23declaration expressly provides to the contrary.

368.24    Sec. 51. [525A.22] COOPERATION BETWEEN MEDICAL EXAMINER AND
368.25PROCUREMENT ORGANIZATION.
368.26    (a) A medical examiner shall cooperate with procurement organizations to maximize
368.27the opportunity to recover anatomical gifts for the purpose of transplantation, therapy,
368.28research, or education.
368.29    (b) If a medical examiner receives notice from a procurement organization that an
368.30anatomical gift might be available or was made with respect to a decedent whose body is
368.31under the jurisdiction of the medical examiner and a postmortem examination is going to
368.32be performed, unless the medical examiner denies recovery in accordance with section
368.33525A.23, the medical examiner or designee shall conduct a postmortem examination of
369.1the body or the part in a manner and within a period compatible with its preservation for
369.2the purposes of the gift.
369.3    (c) A part may not be removed from the body of a decedent under the jurisdiction
369.4of a medical examiner for transplantation, therapy, research, or education unless the part
369.5is the subject of an anatomical gift. The body of a decedent under the jurisdiction of the
369.6medical examiner may not be delivered to a person for research or education unless the
369.7body is the subject of an anatomical gift. This paragraph does not preclude a medical
369.8examiner from performing the medicolegal investigation upon the body or parts of a
369.9decedent under the jurisdiction of the medical examiner.

369.10    Sec. 52. [525A.23] FACILITATION OF ANATOMICAL GIFT FROM
369.11DECEDENT WHOSE BODY IS UNDER JURISDICTION OF MEDICAL
369.12EXAMINER.
369.13    (a) Upon request of a procurement organization, a medical examiner shall release to
369.14the procurement organization the name, contact information, and available medical and
369.15social history of a decedent whose body is under the jurisdiction of the medical examiner.
369.16If the decedent's body or part is medically suitable for transplantation, therapy, research,
369.17or education, the medical examiner shall release postmortem examination results to
369.18the procurement organization. The procurement organization may make a subsequent
369.19disclosure of the postmortem examination results or other information received from the
369.20medical examiner only if relevant to transplantation or therapy.
369.21    (b) The medical examiner may conduct a medicolegal examination by reviewing
369.22all medical records, laboratory test results, x-rays, other diagnostic results, and other
369.23information that any person possesses about a donor or prospective donor whose body is
369.24under the jurisdiction of the medical examiner which the medical examiner determines
369.25may be relevant to the investigation.
369.26    (c) A person that has any information requested by a medical examiner pursuant
369.27to paragraph (b) shall provide that information as expeditiously as possible to allow the
369.28medical examiner to conduct the medicolegal investigation within a period compatible
369.29with the preservation of parts for the purpose of transplantation, therapy, research, or
369.30education.
369.31    (d) If an anatomical gift has been or might be made of a part of a decedent whose
369.32body is under the jurisdiction of the medical examiner and a postmortem examination
369.33is not required, or the medical examiner determines that a postmortem examination is
369.34required but that the recovery of the part that is the subject of an anatomical gift will
369.35not interfere with the examination, the medical examiner and procurement organization
370.1shall cooperate in the timely removal of the part from the decedent for the purpose of
370.2transplantation, therapy, research, or education.
370.3    (e) If an anatomical gift of a part from the decedent under the jurisdiction of
370.4the medical examiner has been or might be made, but the medical examiner initially
370.5believes that the recovery of the part could interfere with the postmortem investigation
370.6into the decedent's cause or manner of death, the medical examiner shall consult with
370.7the procurement organization or physician or technician designated by the procurement
370.8organization about the proposed recovery. After consultation, the medical examiner may
370.9allow the recovery.
370.10    (f) Following the consultation under paragraph (e), in the absence of mutually
370.11agreed-upon protocols to resolve conflict between the medical examiner and the
370.12procurement organization, if the medical examiner intends to deny recovery of an organ
370.13for transplantation, the medical examiner or designee, at the request of the procurement
370.14organization, shall attend the removal procedure for the part before making a final
370.15determination not to allow the procurement organization to recover the part. During
370.16the removal procedure, the medical examiner or designee may allow recovery by the
370.17procurement organization to proceed, or, if the medical examiner or designee reasonably
370.18believes that the part may be involved in determining the decedent's cause or manner of
370.19death, deny recovery by the procurement organization.
370.20    (g) If the medical examiner or designee denies recovery under paragraph (f), the
370.21medical examiner or designee shall:
370.22    (1) explain in a record the specific reasons for not allowing recovery of the part;
370.23    (2) include the specific reasons in the records of the medical examiner; and
370.24    (3) provide a record with the specific reasons to the procurement organization.
370.25    (h) If the medical examiner or designee allows recovery of a part under paragraph
370.26(d), (e), or (f), the procurement organization, upon request, shall cause the physician
370.27or technician who removes the part to provide the medical examiner with a record
370.28describing the condition of the part, a biopsy, a photograph, and any other information and
370.29observations that would assist in the postmortem examination.
370.30    (i) If a medical examiner or designee is required to be present at a removal procedure
370.31under paragraph (f), upon request the procurement organization requesting the recovery
370.32of the part shall reimburse the medical examiner or designee for the additional costs
370.33incurred in complying with paragraph (f).

370.34    Sec. 53. [525A.24] RELATION TO ELECTRONIC SIGNATURES IN GLOBAL
370.35AND NATIONAL COMMERCE ACT.
371.1    This chapter modifies, limits, and supersedes the Electronic Signatures in Global and
371.2National Commerce Act, United States Code, title 15, section 7001 et seq., but does not
371.3modify, limit, or supersede section 101(a) of that act, United States Code, title 15, section
371.47001, or authorize electronic delivery of any of the notices described in section 103(b)
371.5of that act, United States Code, title 15, section 7003(b).

371.6    Sec. 54. Laws 2005, chapter 98, article 3, section 25, is amended to read:
371.7    Sec. 25. REPEALER.
371.8    Minnesota Statutes 2004, sections 245.713, subdivisions 2 and subdivision 4;
371.9245.716 ; and 626.5551, subdivision 4, are repealed.
371.10EFFECTIVE DATE.This section is effective retroactively from August 1, 2005.

371.11    Sec. 55. SOBER HOUSES.
371.12    Subdivision 1. Sober house defined. For purposes of this section, a "sober house"
371.13means a cooperative living residence that:
371.14    (1) provides temporary housing to persons with alcohol or other drug dependency
371.15and abuse problems in exchange for compensation;
371.16    (2) stipulates residents must abstain from using alcohol or drugs and meet other
371.17requirements as a condition of living in the residence; and
371.18    (3) does not provide counseling or treatment services to those residents within the
371.19meaning of Minnesota Statutes, chapter 148C or 254A.
371.20    Subd. 2. Work group creation; membership. The commissioner of human services
371.21shall convene a sober house work group which is comprised of the following members:
371.22    (1) sober house landlords;
371.23    (2) sober house residents;
371.24    (3) community members with knowledge of sober housing;
371.25    (4) representatives of cities and counties;
371.26    (5) a representative from the Department of Human Services, Chemical Health
371.27Division;
371.28    (6) a representative from the Department of Human Services, Licensing Division;
371.29    (7) a representative of chemical dependency treatment providers; and
371.30    (8) a representative from the Department of Health.
371.31    Subd. 3. Report. The work group created in subdivision 2 is directed to study the
371.32issue of sober houses in the state and determine whether state licensing or other regulation
371.33of sober houses is appropriate. Based on findings of the work group, the commissioner of
372.1human services shall submit a report of recommendations to the legislature by January
372.21, 2008.

372.3    Sec. 56. INTERPRETER SERVICES WORK GROUP.
372.4    (a) The commissioner of health shall, in consultation with the commissioners of
372.5commerce, human services, and employee relations, convene a work group to study the
372.6provision of interpreter services to patients in medical and dental care settings. The work
372.7group shall include one representative from each of the following groups:
372.8    (1) consumers;
372.9    (2) interpreters;
372.10    (3) interpreter service providers or agencies;
372.11    (4) health plan companies;
372.12    (5) self-insured purchasers;
372.13    (6) hospitals;
372.14    (7) health care providers;
372.15    (8) dental providers;
372.16    (9) clinic administrators;
372.17    (10) state agency staff from the Departments of Health, Human Services, and
372.18Employee Relations;
372.19    (11) Minnesota Registry of Interpreters for the Deaf;
372.20    (12) local county social services agencies;
372.21    (13) local public health agencies;
372.22    (14) interpreting stakeholders group;
372.23    (15) one interpreter trainer; and
372.24    (16) one interpreter certification examiner.
372.25    (b) The work group shall develop findings and recommendations on the following:
372.26    (1) assuring access to interpreter services;
372.27    (2) compliance with requirements of federal law and guidance;
372.28    (3) developing a quality assurance program to ensure the quality of health care
372.29interpreting services, including requirements for training and establishing a certification
372.30process; and
372.31    (4) identifying broad-based funding mechanisms for interpreter services.
372.32    (c) Based on the discussions of the work group, the commissioner shall make
372.33recommendations to the chairs of the health policy and finance committees in the house
372.34and senate by January 15, 2008, on how to ensure high quality interpreter services for
373.1patients in medical and dental settings, and for a broad-based funding mechanism for
373.2delivering these services.
373.3EFFECTIVE DATE.This section is effective the day following final enactment.

373.4    Sec. 57. FEDERAL GRANTS.
373.5    The Board of Pharmacy shall apply for any applicable federal grants or other nonstate
373.6funds to establish and fully implement the prescription electronic reporting system.
373.7EFFECTIVE DATE.This section is effective the day following final enactment.

373.8    Sec. 58. BOARD OF PHARMACY.
373.9    The Board of Pharmacy shall not increase the license fees of pharmacists or
373.10pharmacies in order to adequately fund the prescription electronic reporting system under
373.11Minnesota Statutes, section 152.126, without specific authority from the legislature.
373.12EFFECTIVE DATE.This section is effective the day following final enactment.

373.13    Sec. 59. BOARD OF MEDICAL PRACTICE.
373.14    The Board of Medical Practice shall convene a work group to discuss the appropriate
373.15prescribing of controlled substances listed in Minnesota Statutes, section 152.02,
373.16subdivisions 3 and 4, and those substances defined by the Board of Pharmacy under
373.17Minnesota Statutes, section 152.02, subdivisions 7, 8, and 12, for pain management, and
373.18shall report to the legislature by December 15, 2007.

373.19    Sec. 60. AGRICULTURAL COOPERATIVE HEALTH PLAN FOR FARMERS.
373.20    Subdivision 1. Pilot project requirements. The commissioner of commerce shall
373.21authorize a joint self-insurance pilot project administered by a trust sponsored by one
373.22or more agricultural cooperatives organized under Minnesota Statutes, chapter 308A,
373.23or under a federal charter for the purpose of offering health coverage to members of
373.24the cooperatives and their families, provided the project satisfies the requirements of
373.25Minnesota Statutes, chapter 62H, except as follows:
373.26    (1) Minnesota Statutes, section 62H.02, paragraph (b), does not apply;
373.27    (2) the notice period required under Minnesota Statutes, section 62H.02, paragraph
373.28(e), is 90 days;
373.29    (3) the commissioner shall grant necessary waivers and approve an alternative
373.30arrangement that fully funds the plan's liability or incurred but unpaid claims under
373.31Minnesota Statutes, section 62H.02, paragraph (f), unless the commissioner provides
374.1evidence demonstrating that the insolvency protection proposed is substantially less than
374.2that typically provided by self-insured group plans of a similar size in Minnesota;
374.3    (4) notwithstanding Minnesota Statutes, section 62H.04, paragraph (a), the joint
374.4self-insurance plan shall be considered a large group and not subject to the small group
374.5insurance requirements in Minnesota Statutes, chapter 62L, even if some employer
374.6groups enrolled in the plan would be defined as small employers, except that the joint
374.7self-insurance plan may elect to treat the sale of a health plan to or for an employer that
374.8has only one eligible employee who has not waived coverage as the sale of an individual
374.9health plan as allowed under Minnesota Statutes, section 62L.02, subdivision 26;
374.10    (5) Minnesota Statutes, section 297I.05, subdivision 12, paragraph (c), does not
374.11apply; and
374.12    (6) the trust must pay the assessment for the Minnesota comprehensive health
374.13association as provided under Minnesota Statutes, section 62E.11.
374.14    Subd. 2. Evaluation and renewal. The pilot project authorized under this section
374.15is for a period of four years from the date of initial enrollment. The commissioner shall
374.16grant an extension of four additional years if the trust provides evidence that it remains in
374.17compliance with the requirements of this section and other applicable laws and rules. If the
374.18commissioner determines that the operation of the trust has not improved access, expanded
374.19health plan choices, or improved affordability of health coverage for farm families, or
374.20that it has significantly damaged access, choice, or affordability for other consumers not
374.21enrolled in the trust, the commissioner shall provide at least 180 days' advance written
374.22notice to the trust and to the chairs of the senate and house finance and policy committees
374.23with jurisdiction over health and insurance matters of the commissioner's intention not to
374.24renew the pilot project at the expiration of a four-year period.
374.25EFFECTIVE DATE.This section is effective the day following final enactment.

374.26    Sec. 61. HEALTH PLAN PURCHASING POOL STUDY GROUP.
374.27    Subdivision 1. Creation; membership. A health care purchasing pool study group
374.28is created to study and make recommendations regarding the creation of a voluntary,
374.29statewide health care purchasing pool that would contract directly with providers to
374.30provide affordable health coverage to eligible Minnesota residents. The study group is
374.31composed of:
374.32    (1) the chief house and senate authors of this act;
374.33    (2) the chairs of the senate Committee on Health, Housing, and Family Security and
374.34the Health and Human Services Budget Division;
375.1    (3) the chairs of the house Health Care and Human Services Committee and the
375.2Health Care and Human Services Division;
375.3    (4) the attorney general or the attorney general's designated representative;
375.4    (5) three representatives of health care providers appointed as follows:
375.5    (i) one member appointed by the governor;
375.6    (ii) one member appointed by the speaker of the house; and
375.7    (iii) one member appointed by the Subcommittee on Committees of the senate
375.8Committee on Rules and Administration; and
375.9    (6) two consumers of health care appointed by the governor.
375.10    All appointments to be made under this subdivision must be made within 30 days
375.11of the effective date of this act.
375.12    Subd. 2. Study; report. The study group shall study and make recommendations
375.13on the following issues related to the creation, maintenance, and funding of a voluntary,
375.14statewide health plan purchasing pool to provide comprehensive, cost-effective, and
375.15medically appropriate health coverage to all public and private employees in Minnesota
375.16and all Minnesota residents:
375.17    (1) the creation of an independent public entity to administer the pool;
375.18    (2) eligibility and participation requirements for existing public and private health
375.19care purchasing pools, public and private employers, and residents of this state;
375.20    (3) how to contract directly with providers to provide comprehensive coverage for
375.21preventive, mental health, dental and other medical services, and comprehensive drug
375.22benefits to enrollees and maximize the cost savings and other efficiencies that a large
375.23purchasing pool would be expected to generate without the need for a public subsidy;
375.24    (4) provisions that allow the pool to contract directly with health care providers
375.25to provide coverage to enrollees;
375.26    (5) incentives designed to attract and retain the maximum number of enrollees;
375.27    (6) recommendations for the administration of the pool and the plans that will be
375.28available to enrollees including, but not limited to, recommendations to keep the pool
375.29solvent and profitable so that public subsidies are not necessary; and
375.30    (7) other elements the study group concludes are necessary or desirable for the
375.31pool to possess.
375.32    The study group shall submit its report and the draft legislation necessary to
375.33implement its recommendations to the chairs of the legislative committees and divisions
375.34with jurisdiction over health care policy and finance, the Health Care Access Commission,
375.35and the governor by February 1, 2008.
376.1    Subd. 3. Staffing. State agencies shall assist the study group with any requests for
376.2information the study group considers necessary to complete the study and report under
376.3subdivision 2.
376.4    Subd. 4. Removal; vacancies; expenses. Removal of members, vacancies, and
376.5expenses for members shall be as provided in Minnesota Statutes, section 15.059.
376.6    Subd. 5. Expiration. This section expires after the submission of the report as
376.7required in subdivision 2.
376.8EFFECTIVE DATE.This section is effective the day following final enactment.

376.9    Sec. 62. REPEALER.
376.10(a) Minnesota Statutes 2006, sections 254A.02, subdivisions 7, 9, 12, 14, 15, and 16;
376.11254A.085; 254A.086; 254A.12; 254A.14; 254A.15; 254A.16, subdivision 5; 254A.175;
376.12254A.18; 256J.561, subdivision 1; 256J.62, subdivision 9; and 256J.65, are repealed.
376.13(b) Minnesota Rules, part 9503.0035, subpart 2, is repealed.
376.14(c) Minnesota Statutes 2006, sections 525.921; 525.9211; 525.9212; 525.9213;
376.15525.9214; 525.9215; 525.9216; 525.9217; 525.9218; 525.9219; 525.9221; 525.9222;
376.16525.9223; and 525.9224, are repealed.

376.17ARTICLE 8

376.18CHILDREN'S HEALTH SECURITY PROGRAM

376.19    Section 1. [16A.726] CHILDREN'S HEALTH SECURITY ACCOUNT.
376.20    A children's health security account is created in a special revenue fund in the
376.21state treasury. The commissioner shall deposit to the credit of the account money made
376.22available to the account. Notwithstanding section 11A.20, any investment income
376.23attributable to the investment of the children's health security account not currently needed
376.24shall be credited to the children's health security account.

376.25    Sec. 2. Minnesota Statutes 2006, section 256B.057, subdivision 8, is amended to read:
376.26    Subd. 8. Children under age two. Medical assistance may be paid for a child under
376.27two years of age whose countable family income is above 275 300 percent of the federal
376.28poverty guidelines for the same size family but less than or equal to 280 305 percent of the
376.29federal poverty guidelines for the same size family.
376.30EFFECTIVE DATE.This section is effective January 1, 2011, or upon federal
376.31approval, whichever is later.

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

377.3    Sec. 4. [256N.02] DEFINITIONS.
377.4    Subdivision 1. Applicability. The terms used in this chapter have the following
377.5meanings unless otherwise provided for by text.
377.6    Subd. 2. Child. "Child" means an individual under age 21.
377.7    Subd. 3. Commissioner. "Commissioner" means the commissioner of human
377.8services.
377.9    Subd. 4. Dependent child. "Dependent child" means an unmarried child under
377.10age 25 who is claimed as a dependent for federal income tax purposes by a parent,
377.11grandparent, foster parent, relative caretaker, or legal guardian.

377.12    Sec. 5. [256N.03] ESTABLISHMENT.
377.13    The commissioner shall establish the children's health security program. The
377.14commissioner shall begin implementation of the program on October 1, 2008, or upon
377.15federal approval, whichever is later. The children's health security program must comply
377.16with title XIX of the federal Social Security Act, and waivers granted under title XIX.

377.17    Sec. 6. [256N.05] ELIGIBILITY.
377.18    Subdivision 1. General requirements. Children meeting the eligibility
377.19requirements of this section are eligible for the children's health security program.
377.20    Subd. 2. Income limit. (a) Effective October 1, 2008, children in families with
377.21gross household incomes equal to or less than 225 percent of the federal poverty
377.22guidelines are eligible for the children's health security program. In determining gross
377.23income, the commissioner shall use the income methodology applied to children under the
377.24MinnesotaCare program.
377.25    (b) Effective October 1, 2008, a dependent child who meets the program income
377.26limits under paragraph (a) and all other program eligibility requirements is eligible for
377.27state-funded benefits under this section.
377.28    (c) Effective January 1, 2011, or upon federal approval, whichever is later, children
377.29in families with household incomes equal to or less than 300 percent of the federal poverty
377.30guidelines must be included in the children's health security program.
377.31    (d) The Legislative Task Force On Children's Health Care Coverage established
377.32under section 19 shall develop recommendations on options for extending health insurance
378.1coverage to children in families with household incomes in excess of 300 percent of the
378.2federal poverty guidelines.
378.3    Subd. 3. Residency. Program participants must meet the residency requirements of
378.4section 256B.056, subdivision 1.
378.5    Subd. 4. Enrollment voluntary. Enrollment in the children's health security
378.6program is voluntary. Parents or guardians may retain private sector or Medicare coverage
378.7for a child as the sole source of coverage. Parents or guardians who have private sector or
378.8Medicare coverage for children may also enroll children in the children's health security
378.9program. If private sector or Medicare coverage is available, coverage under the children's
378.10health security program is secondary to the private sector or Medicare coverage.
378.11    Subd. 5. Emergency services. Payment must be made for care and services that
378.12are furnished to noncitizens, regardless of immigration status, who otherwise meet the
378.13eligibility requirements of this chapter, if the care and services are necessary for the
378.14treatment of an emergency medical condition, except for organ transplants and related
378.15care and services and routine prenatal care. For purposes of this subdivision, "emergency
378.16medical condition" means a medical condition that meets the requirements of United
378.17States Code, title 42, section 1396b(v).
378.18    Subd. 6. Medical assistance standards and procedures. (a) Unless otherwise
378.19specified in this chapter, the commissioner shall use medical assistance procedures and
378.20methodology when determining initial eligibility and redetermining eligibility for the
378.21children's health security program.
378.22    (b) The procedures and income standard specified in section 256B.056, subdivisions
378.235 and 5c, paragraph (a), apply to children who would be eligible for the children's health
378.24security program, except for excess income.
378.25    (c) Retroactive coverage for the children's health security program must be provided
378.26as specified in section 256B.056, subdivision 7.

378.27    Sec. 7. [256N.07] COVERED SERVICES.
378.28    Covered services under the children's health security program must consist of all
378.29covered services under chapter 256B.

378.30    Sec. 8. [256N.09] NO ENROLLEE PREMIUMS OR COST SHARING.
378.31    In order to ensure broad access to coverage, the children's health security program
378.32has no enrollee premium or cost-sharing requirements.

379.1    Sec. 9. [256N.11] APPLICATION PROCEDURES; ELIGIBILITY
379.2DETERMINATION.
379.3    Subdivision 1. Application procedure. The application form for the program
379.4must be easily understandable and must not exceed two pages in length. Applications for
379.5the program must be made available to provider offices, local human services agencies,
379.6school districts, schools, community health offices, and other sites willing to cooperate in
379.7program outreach. These sites may accept applications and forward applications to the
379.8commissioner, and counties where applicable. Applications may also be made directly to
379.9the commissioner and to counties that determine eligibility.
379.10    Subd. 2. Eligibility determination. Counties that determine eligibility for
379.11MinnesotaCare as of March 1, 2007, shall determine eligibility for the children's health
379.12security program. The commissioner, and counties where applicable, shall determine an
379.13applicant's eligibility for the program within 30 days of the date the application is received,
379.14according to the procedures in Code of Federal Regulations, title 42, section 435.911.
379.15    Subd. 3. Presumptive eligibility. Coverage under the program is available during a
379.16presumptive eligibility period for children under age 19 whose family income does not
379.17exceed the applicable income standard. The presumptive eligibility period begins on the
379.18date on which a health care provider enrolled in the program, or other entity designated by
379.19the commissioner, determines, based on preliminary information, that the child's family
379.20income does not exceed the applicable income standard. The presumptive eligibility period
379.21ends the earlier of the day on which a determination is made of eligibility under this section
379.22or the last day of the month following the month presumptive eligibility was determined.
379.23    Subd. 4. Renewal of eligibility. The commissioner shall require enrollees to renew
379.24eligibility every 12 months.
379.25    Subd. 5. Continuous eligibility. Children under the age of 19 who are eligible
379.26under this section shall be continuously eligible until the earlier of the next renewal period,
379.27or the time that a child exceeds age 19.

379.28    Sec. 10. [256N.12] COUNTY ROLE.
379.29    Counties not required to determine eligibility under section 256N.11, subdivision
379.302, may choose to determine eligibility under that section. Counties may also choose
379.31to provide assistance to applicants under section 256N.17, subdivision 1, and provide
379.32ombudsperson services under section 256N.17, subdivision 2. This must not limit the
379.33ability of the commissioner to establish reasonable staffing standards that relate to the
379.34number of persons served, and that provide a county option to hire part-time staff or pursue
379.35multicounty implementation models. If a county chooses not to deliver these services, they
380.1must be delivered by the commissioner. State and federal funding to support these services
380.2must be the same, whether delivered by the state or by a county or group of counties.

380.3    Sec. 11. [256N.13] SERVICE DELIVERY.
380.4    Subdivision 1. Contracts for service delivery. The commissioner, within each
380.5county, may contract with managed care organizations, including health maintenance
380.6organizations licensed under chapter 62D, community integrated service networks licensed
380.7under chapter 62N, accountable provider networks licensed under chapter 62T, and
380.8county-based purchasing plans established under section 256B.692, to provide covered
380.9health care services to program enrollees under a managed care system, and may contract
380.10with health care and social service providers to provide services on a fee-for-service basis.
380.11Section 256B.69, subdivision 26, applies to contracts with managed care organizations. In
380.12determining the method for service delivery, the commissioner shall consider the cost and
380.13quality of health care services; the breadth of services offered, including medical, dental
380.14and mental health services; the breadth of choice of medical providers for enrollees; the
380.15ease of access to quality medical care for enrollees; the efficiency and cost-effectiveness of
380.16service delivery; and the integration of best medical practice standards into the children's
380.17health security program.
380.18    Subd. 2. Managed care organization requirements. (a) Managed care
380.19organizations under contract are responsible for coordinating covered health care services
380.20provided to eligible individuals. Managed care organizations under contract:
380.21    (1) shall authorize and arrange for the provision of all needed covered health
380.22services under chapter 256B, with the exception of services available only under a medical
380.23assistance home and community-based waiver, in order to ensure appropriate health care
380.24is delivered to enrollees;
380.25    (2) shall comply with the requirements of section 256B.69, subdivision 26;
380.26    (3) shall accept the prospective, per capita payment from the commissioner in return
380.27for the provision of comprehensive and coordinated health care services for enrollees;
380.28    (4) may contract with health care and social service providers to provide covered
380.29services to enrollees; and
380.30    (5) shall institute enrollee grievance procedures according to the method established
380.31by the commissioner, utilizing applicable requirements of chapter 62D and Code of
380.32Federal Regulations, title 42, section 438, subpart F. Disputes may also be appealed to
380.33the commissioner using the procedures in section 256.045.
380.34    (b) Upon implementation of the children's health security program, the commissioner
380.35shall withhold five percent of managed care organization payments pending completion
381.1of performance targets, including lead screening, well child services, immunizations,
381.2vision screening, and customer service performance targets. Effective January 1, 2011,
381.3the commissioner shall add treatment of asthma and screening for mental health as new
381.4performance targets. Each performance target must apply uniformly to all managed care
381.5organizations, and be qualitative, objective, measurable, and reasonably attainable, except
381.6in the case of a performance target based on federal or state law or rule. Criteria for
381.7assessment of each performance target must be outlined in writing prior to the contract
381.8effective date. The withhold funds must be returned no sooner than July of the following
381.9year if performance targets in the contract are achieved. The success of each managed care
381.10organization in reaching performance targets must be reported to the legislature annually.
381.11    Subd. 3. Fee-for-service delivery. Disputes related to services provided under
381.12the fee-for-service system may be appealed to the commissioner using the procedures
381.13in section 256.045.
381.14    Subd. 4. Contracts for waiver services. The commissioner, when services
381.15are delivered through managed care, may contract with health care and social service
381.16providers on a fee-for-service basis to provide program enrollees with covered services
381.17available only under a medical assistance home and community-based waiver. The
381.18commissioner shall determine eligibility for home and community-based waiver services
381.19using the criteria and procedures in chapter 256B. Disputes related to services provided
381.20on a fee-for-service basis may be appealed to the commissioner using the procedures
381.21in section 256.045.
381.22    Subd. 5. Service delivery for Minnesota disabilities health option recipient.
381.23    Individuals who voluntarily enroll in the Minnesota Disability Health Option (MnDHO),
381.24established under section 256B.69, subdivision 23, shall continue to receive their home
381.25and community-based waiver services through MnDHO.
381.26    Subd. 6. Disabled or blind children. Children eligible for medical assistance due
381.27to blindness or disability as determined by the Social Security Administration or the state
381.28medical review team are exempt from enrolling in a managed care organization and shall
381.29be provided health benefits on a fee-for-service basis.

381.30    Sec. 12. [256N.15] PAYMENT RATES.
381.31    Subdivision 1. Establishment. The commissioner, in consultation with a health
381.32care actuary, shall establish the method and amount of payments for services. The
381.33commissioner shall annually contract with eligible entities to provide services to program
381.34enrollees. The commissioner, in consultation with the Risk Adjustment Association
382.1established under section 62Q.03, subdivision 6, shall develop and implement a risk
382.2adjustment system for the program.
382.3    Subd. 2. Provider rates. In establishing the payment amount under subdivision
382.41, the commissioner shall ensure that fee-for-service payment rates for preventative
382.5care services provided on or after October 1, 2008, are at least five percent above the
382.6medical assistance rates for preventative services in effect on September 30, 2008, and
382.7shall ensure that fee-for-service payment rates for all other services provided on or after
382.8October 1, 2008, are at least three percent above the medical assistance rates for those
382.9services in effect on September 30, 2008. The commissioner shall adjust managed care
382.10capitation rates to reflect these increases, and shall require managed care organizations, as
382.11a condition of contract, to pass these increases on to providers under contract.

382.12    Sec. 13. [256N.17] CONSUMER ASSISTANCE.
382.13    Subdivision 1. Assistance to applicants. The commissioner shall assist applicants
382.14in choosing a managed care organization or fee-for-service provider by:
382.15    (1) establishing a Web site to provide information about managed care organizations
382.16and fee-for-service providers and to allow online enrollment;
382.17    (2) make information on managed care organizations and fee-for-service providers
382.18available at the sites specified in section 256N.11, subdivision 1;
382.19    (3) make applications and information on managed care organizations and
382.20fee-for-service providers available to applicants and enrollees according to Title VI of the
382.21Civil Rights Act and federal regulations adopted under that law or any guidance from the
382.22United States Department of Health and Human Services; and
382.23    (4) make benefit educators available to assist applicants in choosing a managed care
382.24organization or fee-for-service provider.
382.25    Subd. 2. Ombudsperson. The commissioner shall designate an ombudsperson
382.26to advocate for children enrolled in the children's health security program. The
382.27ombudsperson shall assist enrollees in understanding and making use of complaint and
382.28appeal procedures and ensure that necessary medical services are provided to enrollees. At
382.29the time of enrollment, the commissioner shall inform enrollees about the ombudsperson
382.30program, the right to a resolution of the enrollee's complaint by the managed care
382.31organization if the enrollee experiences a problem with the managed care organization
382.32or its providers, and appeal rights under section 256.045.

382.33    Sec. 14. [256N.19] MONITORING AND EVALUATION OF QUALITY AND
382.34COSTS.
383.1    (a) The commissioner, as a condition of contract, shall require each participating
383.2managed care organization and participating provider to submit, in the form and manner
383.3specified by the commissioner, data required for assessing enrollee satisfaction, quality
383.4of care, cost, and utilization of services. The commissioner shall evaluate this data, in
383.5order to:
383.6    (1) make summary information on the quality of care across managed care
383.7organizations, medical clinics, and providers available to consumers;
383.8    (2) require managed care organizations and providers, as a condition of contract, to
383.9implement quality improvement plans; and
383.10    (3) compare the cost and quality of services under the program to the cost and
383.11quality of services provided to private sector enrollees.
383.12    (b) The commissioner shall implement this section to the extent allowed by federal
383.13and state laws on data privacy.

383.14    Sec. 15. [256N.21] FEDERAL APPROVAL.
383.15    The commissioner shall seek all federal waivers and approvals necessary to
383.16implement this chapter including, but not limited to, waivers and approvals necessary to:
383.17    (1) coordinate medical assistance and MinnesotaCare coverage for children with the
383.18children's health security program;
383.19    (2) use federal medical assistance and MinnesotaCare dollars to pay for health care
383.20services under the children's health security program;
383.21    (3) maximize receipt of the federal medical assistance match for covered children,
383.22by increasing income standards through the use of more liberal income methodologies as
383.23provided under United States Code, title 42, sections 1396a and 1396u-1;
383.24    (4) extend presumptive eligibility and continuous eligibility to children under age
383.2521; and
383.26    (5) use federal medical assistance and MinnesotaCare dollars to provide benefits to
383.27dependent children.

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

383.30    Sec. 17. [256N.25] CHILDREN'S HEALTH SECURITY PROGRAM
383.31OUTREACH.
383.32    Subdivision 1. Grant awards. The commissioner shall award grants to public or
383.33private organizations to:
384.1    (1) provide information, in areas of the state with high uninsured populations, on the
384.2importance of maintaining insurance coverage and on how to obtain coverage through
384.3the children's health security program; and
384.4    (2) monitor and provide ongoing support to ensure enrolled children remain covered.
384.5    Subd. 2. Criteria. In awarding the grants, the commissioner shall consider the
384.6following:
384.7    (1) geographic areas and populations with high uninsured rates;
384.8    (2) the ability to raise matching funds;
384.9    (3) the ability to contact, effectively communicate with, or serve eligible populations;
384.10and
384.11    (4) the applicant's plan to monitor and provide support to ensure enrolled children
384.12remain covered.
384.13    Subd. 3. Monitoring and termination. The commissioner shall monitor the grants
384.14and may terminate a grant if the outreach effort does not increase enrollment in the
384.15children's health security program.

384.16    Sec. 18. IMPLEMENTATION PLAN.
384.17    The commissioner of human services shall develop an implementation plan for the
384.18children's health security program, which includes a health delivery plan based on the
384.19criteria specified in Minnesota Statutes, section 256N.13, subdivision 1. The commissioner
384.20shall present this plan, any necessary draft legislation, and a draft of proposed rules
384.21to the legislature by December 15, 2007. The plan must include recommendations
384.22for any additional legislative changes necessary to coordinate medical assistance and
384.23MinnesotaCare coverage for children with the children's health security program. The
384.24commissioner shall evaluate the provision of services under the program to children with
384.25disabilities and shall present recommendations to the legislature by December 15, 2009,
384.26for any program changes necessary to ensure the quality and continuity of care.

384.27    Sec. 19. LEGISLATIVE TASK FORCE ON CHILDREN'S HEALTH CARE
384.28COVERAGE.
384.29    Subdivision 1. Establishment; membership. (a) The Legislative Task Force on
384.30Children's Health Care Coverage is established. The task force is made up of 12 voting
384.31members and six nonvoting members.
384.32    (b) The voting members are:
384.33    (1) six members of the house of representatives appointed by the speaker, three from
384.34the majority party and three from the minority party; and
385.1    (2) six members of the senate appointed by the Subcommittee on Committees of the
385.2senate Committee on Rules and Administration, three from the majority party and three
385.3from the minority party.
385.4    (c) The nonvoting members are one representative selected by each of the following
385.5organizations:
385.6    (1) the American Academy of Pediatrics, Minnesota chapter;
385.7    (2) the Minnesota Nurses Association;
385.8    (3) the Minnesota Council of Health Plans;
385.9    (4) the Minnesota Children's Platform Coalition;
385.10    (5) the Minnesota Universal Health Care Coalition; and
385.11    (6) the Minnesota Business Partnership.
385.12    (d) The task force members must be appointed by September 1, 2007. The majority
385.13leader of the senate and the speaker of the house of representatives must each designate
385.14a chair from their appointments. The chair appointed by the speaker of the house of
385.15representatives shall convene and chair the first meeting of the task force. The chair
385.16appointed by the majority leader of the senate shall chair the next meeting of the task
385.17force. The chairs shall then alternate for the duration of the task force.
385.18    Subd. 2. Study; staff support. (a) The task force shall study viable options to extend
385.19coverage to all children as provided in Minnesota Statutes, section 256N.05, subdivision
385.202, paragraph (d), and provide recommendations to the legislature. The study must:
385.21    (1) evaluate methods to achieve universal coverage for children, including, but not
385.22limited to, changes to the employer-based coverage system and an expansion of eligibility
385.23for the children's health security program established under Minnesota Statutes, chapter
385.24256N;
385.25    (2) examine health care reform and cost containment methods that will contain costs
385.26and increase access and improve health outcomes;
385.27    (3) examine how to increase access to preventive care and health care services; and
385.28    (4) examine how to reduce health disparities among minority populations.
385.29    (b) The task force, through the Legislative Coordinating Commission, may hire staff
385.30or contract for staff support for the study.
385.31    (c) The task force, in developing recommendations, shall hold meetings to hear
385.32public testimony at locations throughout the state, including locations outside of the
385.33seven-county metropolitan area.
385.34    Subd. 3. Recommendations. The task force shall report its recommendations to
385.35the legislature by December 15, 2009. Recommendations must be consistent with the
385.36following criteria:
386.1    (1) health care coverage must include preventive care and all other medically
386.2necessary services;
386.3    (2) health care coverage must be affordable for families, with the family share of
386.4premium costs and cost-sharing in total not exceeding five percent of family income;
386.5    (3) the system of coverage must give priority to ensuring access to and the quality
386.6and continuity of care; and
386.7    (4) enrollment must be simple and seamless for families.
386.8    Subd. 4. Expiration. This section expires December 16, 2009.

386.9ARTICLE 9

386.10HEALTH CARE REFORM

386.11    Section 1. Minnesota Statutes 2006, section 62A.65, subdivision 3, is amended to read:
386.12    Subd. 3. Premium rate restrictions. No individual health plan may be offered,
386.13sold, issued, or renewed to a Minnesota resident unless the premium rate charged is
386.14determined in accordance with the following requirements:
386.15    (a) Premium rates must be no more than 25 percent above and no more than 25
386.16percent below the index rate charged to individuals for the same or similar coverage,
386.17adjusted pro rata for rating periods of less than one year. The premium variations
386.18permitted by this paragraph must be based only upon health status, claims experience,
386.19and occupation. For purposes of this paragraph, health status includes refraining from
386.20tobacco use or other actuarially valid lifestyle factors associated with good health,
386.21provided that the lifestyle factor and its effect upon premium rates have been determined
386.22by the commissioner to be actuarially valid and have been approved by the commissioner.
386.23Variations permitted under this paragraph must not be based upon age or applied
386.24differently at different ages. This paragraph does not prohibit use of a constant percentage
386.25adjustment for factors permitted to be used under this paragraph.
386.26    (b) Premium rates may vary based upon the ages of covered persons only as
386.27provided in this paragraph. In addition to the variation permitted under paragraph (a),
386.28each health carrier may use an additional premium variation based upon age for adults
386.29aged 19 and above of up to plus or minus 50 percent of the index rate. Premium rates for
386.30children under the age of 19 may not vary based on age, regardless of whether the child is
386.31covered as a dependent or as a primary insured.
386.32    (c) A health carrier may request approval by the commissioner to establish separate
386.33geographic regions determined by the health carrier and to establish separate index rates
386.34for each such region. The commissioner shall grant approval if the following conditions
386.35are met:
387.1    (1) the geographic regions must be applied uniformly by the health carrier;
387.2    (2) each geographic region must be composed of no fewer than seven counties that
387.3create a contiguous region; and
387.4    (3) the health carrier provides actuarial justification acceptable to the commissioner
387.5for the proposed geographic variations in index rates, establishing that the variations are
387.6based upon differences in the cost to the health carrier of providing coverage.
387.7    (d) Health carriers may use rate cells and must file with the commissioner the rate
387.8cells they use. Rate cells must be based upon the number of adults or children covered
387.9under the policy and may reflect the availability of Medicare coverage. The rates for
387.10different rate cells must not in any way reflect generalized differences in expected costs
387.11between principal insureds and their spouses.
387.12    (e) In developing its index rates and premiums for a health plan, a health carrier shall
387.13take into account only the following factors:
387.14    (1) actuarially valid differences in rating factors permitted under paragraphs (a)
387.15and (b); and
387.16    (2) actuarially valid geographic variations if approved by the commissioner as
387.17provided in paragraph (c).
387.18    (f) All premium variations must be justified in initial rate filings and upon request of
387.19the commissioner in rate revision filings. All rate variations are subject to approval by
387.20the commissioner.
387.21    (g) The loss ratio must comply with the section 62A.021 requirements for individual
387.22health plans.
387.23    (h) The rates must not be approved, unless the commissioner has determined that the
387.24rates are reasonable. In determining reasonableness, the commissioner shall consider the
387.25growth rates applied under section 62J.04, subdivision 1, paragraph (b), to the calendar
387.26year or years that the proposed premium rate would be in effect, actuarially valid changes
387.27in risks associated with the enrollee populations, and actuarially valid changes as a result
387.28of statutory changes in Laws 1992, chapter 549.
387.29    (i) An insurer may, as part of a minimum lifetime loss ratio guarantee filing under
387.30section 62A.02, subdivision 3a, include a rating practices guarantee as provided in this
387.31paragraph. The rating practices guarantee must be in writing and must guarantee that
387.32the policy form will be offered, sold, issued, and renewed only with premium rates and
387.33premium rating practices that comply with subdivisions 2, 3, 4, and 5. The rating practices
387.34guarantee must be accompanied by an actuarial memorandum that demonstrates that the
387.35premium rates and premium rating system used in connection with the policy form will
387.36satisfy the guarantee. The guarantee must guarantee refunds of any excess premiums to
388.1policyholders charged premiums that exceed those permitted under subdivision 2, 3, 4,
388.2or 5. An insurer that complies with this paragraph in connection with a policy form is
388.3exempt from the requirement of prior approval by the commissioner under paragraphs
388.4(c), (f), and (h).

388.5    Sec. 2. [62A.67] MINNESOTA HEALTH INSURANCE EXCHANGE.
388.6    Subdivision 1. Title; citation. This section may be cited as the "Minnesota Health
388.7Insurance Exchange."
388.8    Subd. 2. Creation; tax exemption. The Minnesota Health Insurance Exchange
388.9is created for the limited purpose of providing individuals with greater access, choice,
388.10portability, and affordability of health insurance products. The Minnesota Health
388.11Insurance Exchange is a not-for-profit corporation under chapter 317A and section 501(c)
388.12of the Internal Revenue Code.
388.13    Subd. 3. Definitions. The following terms have the meanings given them unless
388.14otherwise provided in text.
388.15    (a) "Board" means the board of directors of the Minnesota Health Insurance
388.16Exchange under subdivision 13.
388.17    (b) "Commissioner" means:
388.18    (1) the commissioner of commerce for health insurers subject to the jurisdiction
388.19of the Department of Commerce;
388.20    (2) the commissioner of health for health insurers subject to the jurisdiction of the
388.21Department of Health; or
388.22    (3) either commissioner's designated representative.
388.23    (c) "Exchange" means the Minnesota Health Insurance Exchange.
388.24    (d) "HIPAA" means the Health Insurance Portability and Accountability Act of 1996.
388.25    (e) "Individual market health plans," unless otherwise specified, means individual
388.26market health plans defined in section 62A.011.
388.27    (f) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125 of
388.28the Internal Revenue Code that allows employees to pay for health insurance premiums
388.29with pretax dollars.
388.30    Subd. 4. Insurer and health plan participation. All health plans as defined in
388.31section 62A.011, subdivision 3, issued or renewed in the individual market shall participate
388.32in the exchange. No health plans in the individual market may be issued or renewed
388.33outside of the exchange. Group health plans as defined in section 62A.10 shall not be
388.34offered through the exchange. Health plans offered through the Minnesota Comprehensive
388.35Health Association as defined in section 62E.10 are offered through the exchange to
389.1eligible enrollees as determined by the Minnesota Comprehensive Health Association.
389.2Health plans offered through MinnesotaCare under chapter 256L are offered through the
389.3exchange to eligible enrollees as determined by the commissioner of human services.
389.4    Subd. 5. Approval of health plans. No health plan may be offered through the
389.5exchange unless the commissioner has first certified that:
389.6    (1) the insurer seeking to offer the health plan is licensed to issue health insurance in
389.7the state; and
389.8    (2) the health plan meets the requirements of this section, and the health plan and the
389.9insurer are in compliance with all other applicable health insurance laws.
389.10    Subd. 6. Individual market health plans. Individual market health plans offered
389.11through the exchange continue to be regulated by the commissioner as specified in
389.12chapters 62A, 62C, 62D, 62E, 62Q, and 72A, and must include the following provisions
389.13that apply to all health plans issued or renewed through the exchange:
389.14    (1) premiums for children under the age of 19 shall not vary by age in the exchange;
389.15and
389.16    (2) premiums for children under the age of 19 must be excluded from rating factors
389.17under section 62A.65, subdivision 3, paragraph (b).
389.18    Subd. 7. Individual participation and eligibility. Individuals are eligible to
389.19purchase health plans directly through the exchange or through an employer Section
389.20125 Plan under section 62A.68. Nothing in this section requires guaranteed issue of
389.21individual market health plans offered through the exchange. Individuals are eligible to
389.22purchase individual market health plans through the exchange by meeting one or more
389.23of the following qualifications:
389.24    (1) the individual is a Minnesota resident, meaning the individual is physically
389.25residing on a permanent basis in a place that is the person's principal residence and from
389.26which the person is absent only for temporary purposes;
389.27    (2) the individual is a student attending an institution outside of Minnesota and
389.28maintains Minnesota residency;
389.29    (3) the individual is not a Minnesota resident but is employed by an employer
389.30physically located within the state and the individual's employer is required to offer a
389.31Section 125 Plan under section 62A.68;
389.32    (4) the individual is not a Minnesota resident but is self-employed and the
389.33individual's principal place of business is in the state; or
389.34    (5) the individual is a dependent as defined in section 62L.02, of another individual
389.35who is eligible to participate in the exchange.
390.1    Subd. 8. Continuation of coverage. Enrollment in a health plan may be canceled
390.2for nonpayment of premiums, fraud, or changes in eligibility for MinnesotaCare under
390.3chapter 256L. Enrollment in an individual market health plan may not be canceled or
390.4nonrenewed because of any change in employer or employment status, marital status,
390.5health status, age, residence, or any other change that does not affect eligibility as defined
390.6in this section.
390.7    Subd. 9. Responsibilities of the exchange. The exchange shall serve as the sole
390.8entity for enrollment and collection and transfer of premium payments for health plans
390.9sold to individuals through the exchange. The exchange shall be responsible for the
390.10following functions:
390.11    (1) publicize the exchange, including but not limited to its functions, eligibility
390.12rules, and enrollment procedures;
390.13    (2) provide assistance to employers to establish Section 125 Plans under section
390.1462A.68;
390.15    (3) provide education and assistance to employers to help them understand the
390.16requirements of Section 125 Plans and compliance with applicable regulations;
390.17    (4) create a system to allow individuals to compare and enroll in health plans offered
390.18through the exchange;
390.19    (5) create a system to collect and transmit to the applicable plans all premium
390.20payments made by individuals, including developing mechanisms to receive and process
390.21automatic payroll deductions for individuals who purchase coverage through employer
390.22Section 125 Plans;
390.23    (6) not accept premium payments for individual market health plans from an
390.24employer Section 125 Plan if the employer offers a group health plan as defined in section
390.2562A.10, or if the employer is a self-insurer as defined in section 62E.02;
390.26    (7) provide jointly with health insurers a cancellation notice directly to the primary
390.27insured at least ten days prior to termination of coverage for nonpayment of premium;
390.28    (8) bill the employer for the premiums payable by an employee, provided that the
390.29employer is not liable for payment except from payroll deductions for that purpose;
390.30    (9) refer individuals interested in MinnesotaCare under chapter 256L to the
390.31Department of Human Services to determine eligibility;
390.32    (10) establish a mechanism with the Department of Human Services to transfer
390.33premiums and subsidies for MinnesotaCare to qualify for federal matching payments;
390.34    (11) upon request, issue certificates of previous coverage according to the provisions
390.35of HIPAA and as referenced in section 62Q.181 to all such individuals who cease to be
390.36covered by a participating health plan through the exchange;
391.1    (12) establish procedures to account for all funds received and disbursed by the
391.2exchange for individual participants of the exchange;
391.3    (13) make available to the public, at the end of each calendar year, a report of an
391.4independent audit of the exchange's accounts; and
391.5    (14) provide copies of written and signed statements from employers stating that
391.6the employer is not contributing to the employee's premiums for health plans purchased
391.7by an employee through the exchange to all health insurers with enrolled employees of
391.8the employer.
391.9    Health insurers may rely on the employer's statement in clause (4) provided by the
391.10Minnesota Health Insurance Exchange and are not required to guarantee-issue individual
391.11health plans to the employer's employees.
391.12    Subd. 10. State not liable. The state of Minnesota shall not be liable for the actions
391.13of the Minnesota Health Insurance Exchange.
391.14    Subd. 11. Powers of the exchange. The exchange shall have the power to:
391.15    (1) contract with insurance producers licensed in accident and health insurance
391.16under chapter 60K and vendors to perform one or more of the functions specified in
391.17subdivision 10;
391.18    (2) contract with employers to collect premiums through a Section 125 Plan for
391.19eligible individuals who purchase an individual market health plan through the exchange;
391.20    (3) establish and assess fees on health plan premiums of health plans purchased
391.21through the exchange to fund the cost of administering the exchange;
391.22    (4) seek and directly receive grant funding from government agencies or private
391.23philanthropic organizations to defray the costs of operating the exchange;
391.24    (5) establish and administer rules and procedures governing the operations of the
391.25exchange;
391.26    (6) establish one or more service centers within Minnesota;
391.27    (7) sue or be sued or otherwise take any necessary or proper legal action;
391.28    (8) establish bank accounts and borrow money; and
391.29    (9) enter into agreements with the commissioners of commerce, health, human
391.30services, revenue, employment and economic development, and other state agencies as
391.31necessary for the exchange to implement the provisions of this section.
391.32    Subd. 12. Dispute resolution. The exchange shall establish procedures for
391.33resolving disputes with respect to the eligibility of an individual to participate in the
391.34exchange. The exchange does not have the authority or responsibility to intervene in or
391.35resolve disputes between an individual and a health plan or health insurer. The exchange
392.1shall refer complaints from individuals participating in the exchange to the commissioner
392.2to be resolved according to sections 62Q.68 to 62Q.73.
392.3    Subd. 13. Governance. The exchange shall be governed by a board of directors
392.4with 11 members. The board shall convene on or before July 1, 2007, after the initial board
392.5members have been selected. The initial board membership consists of the following:
392.6    (1) the commissioner of commerce;
392.7    (2) the commissioner of human services;
392.8    (3) the commissioner of health;
392.9    (4) four members appointed by a joint committee of the Minnesota senate and the
392.10Minnesota house of representatives to serve three-year terms; and
392.11    (5) four members appointed by the governor to serve three-year terms.
392.12    Subd. 14. Subsequent board membership. Ongoing membership of the exchange
392.13consists of the following effective July 1, 2010:
392.14    (1) the commissioner of commerce;
392.15    (2) the commissioner of human services;
392.16    (3) the commissioner of health;
392.17    (4) two members appointed by the governor with the approval of a joint committee
392.18of the senate and house of representatives to serve two-year terms; and
392.19    (5) six members elected by the membership of the exchange of which three
392.20are elected to serve a two-year term and three are elected to serve a three-year term.
392.21Appointed and elected members may serve more than one term.
392.22    Subd. 15. Operations of the board. Officers of the board of directors are elected by
392.23members of the board and serve one-year terms. Six members of the board constitutes a
392.24quorum, and the affirmative vote of six members of the board is necessary and sufficient
392.25for any action taken by the board. Board members serve without pay, but are reimbursed
392.26for actual expenses incurred in the performance of their duties.
392.27    Subd. 16. Operations of the exchange. The board of directors shall appoint an
392.28exchange director who shall:
392.29    (1) be a full-time employee of the exchange;
392.30    (2) administer all of the activities and contracts of the exchange; and
392.31    (3) hire and supervise the staff of the exchange.
392.32    Subd. 17. Insurance producers. An individual has the right to choose any
392.33insurance producer licensed in accident and health insurance under chapter 60K to assist
392.34them in purchasing an individual market health plan through the exchange. When a
392.35producer licensed in accident and health insurance under chapter 60K enrolls an eligible
393.1individual in the exchange, the health plan chosen by an individual may pay the producer
393.2a commission.
393.3    Subd. 18. Implementation. Health plan coverage through the exchange begins on
393.4January 1, 2009. The exchange must be operational to assist employers and individuals
393.5by September 1, 2008, and be prepared for enrollment by December 1, 2008. Enrollees
393.6of individual market health plans, MinnesotaCare, and the Minnesota Comprehensive
393.7Health Association as of December 2, 2008, are automatically enrolled in the exchange
393.8on January 1, 2009, in the same health plan and at the same premium that they were
393.9enrolled as of December 2, 2008, subject to the provisions of this section. As of January 1,
393.102009, all enrollees of individual market health plans, MinnesotaCare, and the Minnesota
393.11Comprehensive Health Association shall make premium payments to the exchange.

393.12    Sec. 3. [62A.68] SECTION 125 PLANS.
393.13    Subdivision 1. Definitions. The following terms have the meanings given unless
393.14otherwise provided in text:
393.15    (a) "Current employee" means an employee currently on an employer's payroll other
393.16than a retiree or disabled former employee.
393.17    (b) "Employer" means a person, firm, corporation, partnership, association, business
393.18trust, or other entity employing one or more persons, including a political subdivision of
393.19the state, filing payroll tax information on such employed person or persons.
393.20    (c) "Section 125 Plan" means a cafeteria or Premium Only Plan under section 125
393.21of the Internal Revenue Code that allows employees to purchase health insurance with
393.22pretax dollars.
393.23    (d) "Exchange" means the Minnesota Health Insurance Exchange under section
393.2462A.67.
393.25    (e) "Exchange director" means the appointed director under section 62A.67,
393.26subdivision 16.
393.27    Subd. 2. Section 125 Plan requirement. (a) Effective January 1, 2009, all
393.28employers with 11 or more current employees shall establish a Section 125 Plan to
393.29allow their employees to purchase individual market health plan coverage with pretax
393.30dollars. Nothing in this section requires or mandates employers to offer or purchase
393.31health insurance coverage for their employees. The following employers are exempt
393.32from the Section 125 Plan requirement:
393.33    (1) employers that offer a group health insurance plan as defined in 62A.10;
393.34    (2) employers that are self-insurers as defined in section 62E.02; and
394.1    (3) employers with fewer than 11 current employees, except that employers under
394.2this clause may voluntarily offer a Section 125 Plan.
394.3    (b) Employers that offer a Section 125 Plan may enter into an agreement with the
394.4exchange to administer the employer's Section 125 Plan.
394.5    Subd. 3. Tracking compliance. By July 1, 2008, the exchange, in consultation with
394.6the commissioners of commerce, health, employment and economic development, and
394.7revenue shall establish a method for tracking employer compliance with the Section 125
394.8Plan requirement.
394.9    Subd. 4. Employer requirements. Employers that are required to offer or choose
394.10to offer a Section 125 Plan shall:
394.11    (1) allow employees to purchase any individual market health plan for themselves
394.12and their dependents through the exchange;
394.13    (2) allow employees to choose any insurance producer licensed in accident and
394.14health insurance under chapter 60K to assist them in purchasing an individual market
394.15health plan through the exchange;
394.16    (3) provide a written and signed statement to the exchange stating that the employer
394.17is not contributing to the employee's premiums for health plans purchased by an employee
394.18through the exchange;
394.19    (4) upon an employee's request, deduct premium amounts on a pretax basis in an
394.20amount not to exceed an employee's wages, and remit these employee payments to the
394.21exchange; and
394.22    (5) provide notice to employees that individual market health plans purchased
394.23through the exchange are not employer-sponsored or administered. Employers shall be
394.24held harmless from any and all liability claims related to the individual market health
394.25plans purchased through the exchange by employees under a Section 125 Plan.
394.26    Subd. 5. Section 125 eligible health plans. Individuals who are eligible to use
394.27an employer Section 125 Plan to pay for health insurance coverage purchased through
394.28the exchange may enroll in any health plan offered through the exchange for which the
394.29individual is eligible including individual market health plans, MinnesotaCare, and the
394.30Minnesota Comprehensive Health Association.

394.31    Sec. 4. Minnesota Statutes 2006, section 62E.141, is amended to read:
394.3262E.141 INCLUSION IN EMPLOYER-SPONSORED PLAN.
394.33    No employee of an employer that offers a group health plan, under which the
394.34employee is eligible for coverage, is eligible to enroll, or continue to be enrolled, in
394.35the comprehensive health association, except for enrollment or continued enrollment
395.1necessary to cover conditions that are subject to an unexpired preexisting condition
395.2limitation, preexisting condition exclusion, or exclusionary rider under the employer's
395.3health plan. This section does not apply to persons enrolled in the Comprehensive Health
395.4Association as of June 30, 1993. With respect to persons eligible to enroll in the health
395.5plan of an employer that has more than 29 current employees, as defined in section
395.662L.02 , this section does not apply to persons enrolled in the Comprehensive Health
395.7Association as of December 31, 1994.

395.8    Sec. 5. Minnesota Statutes 2006, section 62J.04, subdivision 3, is amended to read:
395.9    Subd. 3. Cost containment duties. The commissioner shall:
395.10    (1) establish statewide and regional cost containment goals for total health care
395.11spending under this section and, collect data as described in sections 62J.38 to 62J.41 to
395.12monitor statewide achievement of the cost containment goals, and annually report to the
395.13legislature on whether the goals were achieved and, if not, what action should be taken to
395.14ensure that goals are achieved in the future;
395.15    (2) divide the state into no fewer than four regions, with one of those regions being
395.16the Minneapolis/St. Paul metropolitan statistical area but excluding Chisago, Isanti,
395.17Wright, and Sherburne Counties, for purposes of fostering the development of regional
395.18health planning and coordination of health care delivery among regional health care
395.19systems and working to achieve the cost containment goals;
395.20    (3) monitor the quality of health care throughout the state and take action as
395.21necessary to ensure an appropriate level of quality;
395.22    (4) issue recommendations regarding uniform billing forms, uniform electronic
395.23billing procedures and data interchanges, patient identification cards, and other uniform
395.24claims and administrative procedures for health care providers and private and public
395.25sector payers. In developing the recommendations, the commissioner shall review the
395.26work of the work group on electronic data interchange (WEDI) and the American National
395.27Standards Institute (ANSI) at the national level, and the work being done at the state and
395.28local level. The commissioner may adopt rules requiring the use of the Uniform Bill
395.2982/92 form, the National Council of Prescription Drug Providers (NCPDP) 3.2 electronic
395.30version, the Centers for Medicare and Medicaid Services 1500 form, or other standardized
395.31forms or procedures;
395.32    (5) undertake health planning responsibilities;
395.33    (6) authorize, fund, or promote research and experimentation on new technologies
395.34and health care procedures;
396.1    (7) within the limits of appropriations for these purposes, administer or contract for
396.2statewide consumer education and wellness programs that will improve the health of
396.3Minnesotans and increase individual responsibility relating to personal health and the
396.4delivery of health care services, undertake prevention programs including initiatives to
396.5improve birth outcomes, expand childhood immunization efforts, and provide start-up
396.6grants for worksite wellness programs;
396.7    (8) undertake other activities to monitor and oversee the delivery of health care
396.8services in Minnesota with the goal of improving affordability, quality, and accessibility of
396.9health care for all Minnesotans; and
396.10    (9) make the cost containment goal data available to the public in a
396.11consumer-oriented manner.
396.12EFFECTIVE DATE.This section is effective July 1, 2007.

396.13    Sec. 6. Minnesota Statutes 2006, section 62J.495, is amended to read:
396.1462J.495 HEALTH INFORMATION TECHNOLOGY AND
396.15INFRASTRUCTURE ADVISORY COMMITTEE.
396.16    Subdivision 1. Establishment; members; duties Implementation. By January
396.171, 2012, all hospitals and health care providers must have in place an interoperable
396.18electronic health records system within their hospital system or clinical practice setting.
396.19The commissioner of health, in consultation with the Health Information Technology and
396.20Infrastructure Advisory Committee, shall develop a statewide plan to meet this goal,
396.21including the adoption of uniform standards to be used for the interoperable system for
396.22sharing and synchronizing patient data across systems. The standards must be compatible
396.23with federal efforts. The uniform standards must be refined and adopted for use when
396.24a standard development organization accredited by the American National Standards
396.25Institute completes the development of a standard for sharing and synchronizing patient
396.26data across systems.
396.27    Subd. 2. Health Information Technology and Infrastructure Advisory
396.28Committee. (a) The commissioner shall establish a Health Information Technology
396.29and Infrastructure Advisory Committee governed by section 15.059 to advise the
396.30commissioner on the following matters:
396.31    (1) assessment of the use of health information technology by the state, licensed
396.32health care providers and facilities, and local public health agencies;
396.33    (2) recommendations for implementing a statewide interoperable health information
396.34infrastructure, to include estimates of necessary resources, and for determining standards
397.1for administrative data exchange, clinical support programs, patient privacy requirements,
397.2and maintenance of the security and confidentiality of individual patient data; and
397.3    (3) recommendations for encouraging use of innovative health care applications
397.4using information technology and systems to improve patient care and reduce the cost
397.5of care, including applications relating to disease management and personal health
397.6management that enable remote monitoring of patients' conditions, especially those with
397.7chronic conditions; and
397.8    (3) (4) other related issues as requested by the commissioner.
397.9    (b) The members of the Health Information Technology and Infrastructure Advisory
397.10Committee shall include the commissioners, or commissioners' designees, of health,
397.11human services, administration, and commerce and additional members to be appointed
397.12by the commissioner to include persons representing Minnesota's local public health
397.13agencies, licensed hospitals and other licensed facilities and providers, private purchasers,
397.14the medical and nursing professions, health insurers and health plans, the state quality
397.15improvement organization, academic and research institutions, consumer advisory
397.16organizations with an interest and expertise in health information technology, and other
397.17stakeholders as identified by the Health Information Technology and Infrastructure
397.18Advisory Committee.
397.19    Subd. 2. Annual report. (c) The commissioner shall prepare and issue an annual
397.20report not later than January 30 of each year outlining progress to date in implementing a
397.21statewide health information infrastructure and recommending future projects.
397.22    Subd. 3. Expiration. (d) Notwithstanding section 15.059, this section subdivision
397.23expires June 30, 2009 2012.

397.24    Sec. 7. [62J.496] ELECTRONIC HEALTH RECORD SYSTEM REVOLVING
397.25ACCOUNT AND LOAN PROGRAM.
397.26    Subdivision 1. Account establishment. The commissioner of finance shall establish
397.27and implement a revolving account in the state government special revenue fund to
397.28provide loans to eligible borrowers to assist in financing the installation or support of
397.29an interoperable health record system. The system must provide for the interoperable
397.30exchange of health care information between the applicant and, at a minimum, a hospital
397.31system, pharmacy, and a health care clinic or other physician group.
397.32    Subd. 2. Eligibility. (a) "Eligible borrower" means one of the following:
397.33    (1) community clinics, as defined under section 145.9268;
397.34    (2) hospitals eligible for rural hospital capital improvement grants, as defined
397.35in section 144.148;
398.1    (3) physician clinics located in a community with a population of less than 50,000
398.2according to United States Census Bureau statistics and outside the seven-county
398.3metropolitan area;
398.4    (4) nursing facilities licensed under sections 144A.01 to 144A.27; and
398.5    (5) other providers of health or health care services approved by the commissioner
398.6for which interoperable electronic health record capability would improve quality of
398.7care, patient safety, or community health.
398.8    (b) To be eligible for a loan under this section, the applicant must submit a loan
398.9application to the commissioner of health on forms prescribed by the commissioner. The
398.10application must include, at a minimum:
398.11    (1) the amount of the loan requested and a description of the purpose or project
398.12for which the loan proceeds will be used;
398.13    (2) a quote from a vendor;
398.14    (3) a description of the health care entities and other groups participating in the
398.15project;
398.16    (4) evidence of financial stability and a demonstrated ability to repay the loan; and
398.17    (5) a description of how the system to be financed interconnects or plans in the
398.18future to interconnect with other health care entities and provider groups located in the
398.19same geographical area.
398.20    Subd. 3. Loans. (a) The commissioner of health may make a no interest loan
398.21to a provider or provider group who is eligible under subdivision 2 on a first-come,
398.22first-served basis provided that the applicant is able to comply with this section. The total
398.23accumulative loan principal must not exceed $1,500,000 per loan. The commissioner of
398.24health has discretion over the size and number of loans made.
398.25    (b) The commissioner of health may prescribe forms and establish an application
398.26process and, notwithstanding section 16A.1283, may impose a reasonable nonrefundable
398.27application fee to cover the cost of administering the loan program.
398.28    (c) The borrower must begin repaying the principal no later than two years from the
398.29date of the loan. Loans must be amortized no later than six years from the date of the loan.
398.30    (d) Repayments must be credited to the account.
398.31    Subd. 4. Data classification. Data collected by the commissioner of health on the
398.32application to determine eligibility under subdivision 2 and to monitor borrowers' default
398.33risk or collect payments owed under subdivision 3 are (1) private data on individuals as
398.34defined in section 13.02, subdivision 12; and (2) nonpublic data as defined in section
398.3513.02, subdivision 9. The names of borrowers and the amounts of the loans granted are
398.36public data.

399.1    Sec. 8. [62J.536] UNIFORM ELECTRONIC TRANSACTIONS AND
399.2IMPLEMENTATION GUIDE STANDARDS.
399.3    Subdivision 1. Electronic claims and eligibility transactions required. (a)
399.4Beginning January 15, 2009, all group purchasers must accept from health care providers
399.5the eligibility for a health plan transaction described under Code of Federal Regulations,
399.6title 45, part 162, subpart L. Beginning July 15, 2009, all group purchasers must accept
399.7from health care providers the health care claims or equivalent encounter information
399.8transaction described under Code of Federal Regulations, title 45, part 162, subpart K.
399.9    (b) Beginning January 15, 2009, all group purchasers must transmit to providers the
399.10eligibility for a health plan transaction described under Code of Federal Regulations, title
399.1145, part 162, subpart L. Beginning December 1, 2009, all group purchasers must transmit
399.12to providers the health care payment and remittance advice transaction described under
399.13Code of Federal Regulations, title 45, part 162, subpart P.
399.14    (c) Beginning January 15, 2009, all health care providers must submit to group
399.15purchasers the eligibility for a health plan transaction described under Code of Federal
399.16Regulations, title 45, part 162, subpart L. Beginning July 15, 2009, all health care
399.17providers must submit to group purchasers the health care claims or equivalent encounter
399.18information transaction described under Code of Federal Regulations, title 45, part 162,
399.19subpart K.
399.20    (d) Beginning January 15, 2009, all health care providers must accept from group
399.21purchasers the eligibility for a health plan transaction described under Code of Federal
399.22Regulations, title 45, part 162, subpart L. Beginning December 15, 2009, all health care
399.23providers must accept from group purchasers the health care payment and remittance
399.24advice transaction described under Code of Federal Regulations, title 45, part 162, subpart
399.25P.
399.26    (e) Each of the transactions described in paragraphs (a) to (d) shall require the use
399.27of a single, uniform companion guide to the implementation guides described under
399.28Code of Federal Regulations, title 45, part 162. The companion guides will be developed
399.29pursuant to subdivision 2.
399.30    (f) Notwithstanding any other provisions in sections 62J.50 to 62J.61, all group
399.31purchasers and health care providers must exchange claims and eligibility information
399.32electronically using the transactions, companion guides, implementation guides, and
399.33timelines required under this subdivision. Group purchasers may not impose any fee on
399.34providers for the use of the transactions prescribed in this subdivision.
399.35    (g) Nothing in this subdivision shall prohibit group purchasers and health care
399.36providers from using a direct data entry, Web-based methodology for complying with
400.1the requirements of this subdivision. Any direct data entry method for conducting
400.2the transactions specified in this subdivision must be consistent with the data content
400.3component of the single, uniform companion guides required in paragraph (e) and the
400.4implementation guides described under Code of Federal Regulations, title 45, part 162.
400.5    Subd. 2. Establishing uniform, standard companion guides. (a) At least 12
400.6months prior to the timelines required in subdivision 1, the commissioner of health shall
400.7promulgate rules pursuant to section 62J.61 establishing and requiring group purchasers
400.8and health care providers to use the transactions and the uniform, standard companion
400.9guides required under subdivision 1, paragraph (e).
400.10    (b) The commissioner of health must consult with the Minnesota Administrative
400.11Uniformity Committee on the development of the single, uniform companion guides
400.12required under subdivision 1, paragraph (e), for each of the transactions in subdivision 1.
400.13The single uniform companion guides required under subdivision 1, paragraph (e), must
400.14specify uniform billing and coding standards. The commissioner of health shall base the
400.15companion guides required under subdivision 1, paragraph (e), billing and coding rules,
400.16and standards on the Medicare program, with modifications that the commissioner deems
400.17appropriate after consulting the Minnesota Administrative Uniformity Committee.
400.18    (c) No group purchaser or health care provider may add to or modify the single,
400.19uniform companion guides defined in subdivision 1, paragraph (e), through additional
400.20companion guides or other requirements.
400.21    (d) In promulgating the rules in paragraph (a), the commissioner shall not require
400.22data content that is not essential to accomplish the purpose of the transactions in
400.23subdivision 1.

400.24    Sec. 9. Minnesota Statutes 2006, section 62J.692, subdivision 1, is amended to read:
400.25    Subdivision 1. Definitions. For purposes of this section, the following definitions
400.26apply:
400.27    (a) "Accredited clinical training" means the clinical training provided by a
400.28medical education program that is accredited through an organization recognized by the
400.29Department of Education, the Centers for Medicare and Medicaid Services, or another
400.30national body who reviews the accrediting organizations for multiple disciplines and
400.31whose standards for recognizing accrediting organizations are reviewed and approved by
400.32the commissioner of health in consultation with the Medical Education and Research
400.33Advisory Committee.
400.34    (b) "Commissioner" means the commissioner of health.
401.1    (c) "Clinical medical education program" means the accredited clinical training of
401.2physicians (medical students and residents), doctor of pharmacy practitioners, doctors
401.3of chiropractic, dentists, advanced practice nurses (clinical nurse specialists, certified
401.4registered nurse anesthetists, nurse practitioners, and certified nurse midwives), and
401.5physician assistants.
401.6    (d) "Sponsoring institution" means a hospital, school, or consortium located in
401.7Minnesota that sponsors and maintains primary organizational and financial responsibility
401.8for a clinical medical education program in Minnesota and which is accountable to the
401.9accrediting body.
401.10    (e) "Teaching institution" means a hospital, medical center, clinic, or other
401.11organization that conducts a clinical medical education program in Minnesota.
401.12    (f) "Trainee" means a student or resident involved in a clinical medical education
401.13program.
401.14    (g) "Eligible trainee FTEs" means the number of trainees, as measured by full-time
401.15equivalent counts, that are at training sites located in Minnesota with a currently
401.16active medical assistance provider number enrollment status and a National Provider
401.17Identification (NPI) number where training occurs in either an inpatient or ambulatory
401.18patient care setting and where the training is funded, in part, by patient care revenues.

401.19    Sec. 10. Minnesota Statutes 2006, section 62J.692, subdivision 4, is amended to read:
401.20    Subd. 4. Distribution of funds. (a) The commissioner shall annually distribute
401.2190 percent of available medical education funds transferred according to section
401.22256B.69, subdivision 5c, paragraph (a), clause (1), to all qualifying applicants based on a
401.23distribution formula that reflects a summation of two factors:
401.24    (1) an education factor, which is determined by the total number of eligible trainee
401.25FTEs and the total statewide average costs per trainee, by type of trainee, in each clinical
401.26medical education program; and
401.27    (2) a public program volume factor, which is determined by the total volume of
401.28public program revenue received by each training site as a percentage of all public
401.29program revenue received by all training sites in the fund pool.
401.30    In this formula, the education factor is weighted at 67 percent and the public program
401.31volume factor is weighted at 33 percent.
401.32    Public program revenue for the distribution formula includes revenue from medical
401.33assistance, prepaid medical assistance, general assistance medical care, and prepaid
401.34general assistance medical care. Training sites that receive no public program revenue
401.35are ineligible for funds available under this paragraph. Total statewide average costs per
402.1trainee for medical residents is based on audited clinical training costs per trainee in
402.2primary care clinical medical education programs for medical residents. Total statewide
402.3average costs per trainee for dental residents is based on audited clinical training costs
402.4per trainee in clinical medical education programs for dental students. Total statewide
402.5average costs per trainee for pharmacy residents is based on audited clinical training costs
402.6per trainee in clinical medical education programs for pharmacy students.
402.7    (b) The commissioner shall annually distribute ten percent of total available medical
402.8education funds transferred according to section 256B.69, subdivision 5c, paragraph (a),
402.9clause (1), to all qualifying applicants based on the percentage received by each applicant
402.10under paragraph (a). These funds are to be used to offset clinical education costs at
402.11eligible clinical training sites based on criteria developed by the clinical medical education
402.12program. Applicants may choose to distribute funds allocated under this paragraph based
402.13on the distribution formula described in paragraph (a).
402.14    (c) The commissioner shall annually distribute $5,000,000 of the funds dedicated
402.15to the commissioner under section 297F.10, subdivision 1, clause (2), plus any federal
402.16financial participation on these funds and on funds transferred under subdivision 10, to all
402.17qualifying applicants based on a distribution formula that gives 100 percent weight to a
402.18public program volume factor, which is determined by the total volume of public program
402.19revenue received by each training site as a percentage of all public program revenue
402.20received by all training sites in the fund pool. If federal approval is not obtained for
402.21federal financial participation on any portion of funds distributed under this paragraph,
402.2290 percent of the unmatched funds shall be distributed by the commissioner based on
402.23the formula described in paragraph (a) and ten percent of the unmatched funds shall be
402.24distributed by the commissioner based on the formula described in paragraph (b).
402.25    (d) The commissioner shall annually distribute $3,060,000 of funds dedicated to the
402.26commissioner under section 297F.10, subdivision 1, clause (2), through a formula giving
402.27100 percent weight to an education factor, which is determined by the total number of
402.28eligible trainee full-time equivalents and the total statewide average costs per trainee, by
402.29type of trainee, in each clinical medical education program. If no matching funds are
402.30received on funds distributed under paragraph (c), funds distributed under this paragraph
402.31shall be distributed by the commissioner based on the formula described in paragraph (a).
402.32    (e) The commissioner shall annually distribute $340,000 of funds dedicated to the
402.33commissioner under section 297F.10, subdivision 1, clause (2), to all qualifying applicants
402.34based on the percentage received by each applicant under paragraph (a). These funds are
402.35to be used to offset clinical education costs at eligible clinical training sites based on
402.36criteria developed by the clinical medical education program. Applicants may choose to
403.1distribute funds allocated under this paragraph based on the distribution formula described
403.2in paragraph (a). If no matching funds are received on funds distributed under paragraph
403.3(c), funds distributed under this paragraph shall be distributed by the commissioner based
403.4on the formula described in paragraph (b).
403.5    (c) (f) Funds distributed shall not be used to displace current funding appropriations
403.6from federal or state sources.
403.7    (d) (g) Funds shall be distributed to the sponsoring institutions indicating the amount
403.8to be distributed to each of the sponsor's clinical medical education programs based on
403.9the criteria in this subdivision and in accordance with the commissioner's approval letter.
403.10Each clinical medical education program must distribute funds allocated under paragraph
403.11(a) to the training sites as specified in the commissioner's approval letter. Sponsoring
403.12institutions, which are accredited through an organization recognized by the Department
403.13of Education or the Centers for Medicare and Medicaid Services, may contract directly
403.14with training sites to provide clinical training. To ensure the quality of clinical training,
403.15those accredited sponsoring institutions must:
403.16    (1) develop contracts specifying the terms, expectations, and outcomes of the clinical
403.17training conducted at sites; and
403.18    (2) take necessary action if the contract requirements are not met. Action may
403.19include the withholding of payments under this section or the removal of students from
403.20the site.
403.21    (e) (h) Any funds not distributed in accordance with the commissioner's approval
403.22letter must be returned to the medical education and research fund within 30 days of
403.23receiving notice from the commissioner. The commissioner shall distribute returned funds
403.24to the appropriate training sites in accordance with the commissioner's approval letter.
403.25    (f) (i) The commissioner shall distribute by June 30 of each year an amount equal to
403.26the funds transferred under subdivision 10, plus five percent interest to the University of
403.27Minnesota Board of Regents for the instructional costs of health professional programs
403.28at the Academic Health Center and for interdisciplinary academic initiatives within the
403.29Academic Health Center.
403.30    (g) (j) A maximum of $150,000 of the funds dedicated to the commissioner
403.31under section 297F.10, subdivision 1, paragraph (b), clause (2), may be used by the
403.32commissioner for administrative expenses associated with implementing this section.

403.33    Sec. 11. Minnesota Statutes 2006, section 62J.692, subdivision 7a, is amended to read:
403.34    Subd. 7a. Clinical medical education innovations grants. (a) The commissioner
403.35shall award grants to teaching institutions and clinical training sites for projects that
404.1increase dental access for underserved populations and promote innovative clinical
404.2training of dental professionals.
404.3    (b) The commissioner shall award grants to teaching institutions and clinical training
404.4sites for projects that increase mental health access for underserved populations, promote
404.5innovative clinical training of mental health professionals, increase the number of mental
404.6health providers in rural or underserved areas, and promote the incorporation of patient
404.7safety principles into clinical medical education programs.
404.8    (c) In awarding the grants, the commissioner, in consultation with the commissioner
404.9of human services, shall consider the following:
404.10    (1) potential to successfully increase access to an underserved population;
404.11    (2) the long-term viability of the project to improve access beyond the period
404.12of initial funding;
404.13    (3) evidence of collaboration between the applicant and local communities;
404.14    (4) the efficiency in the use of the funding; and
404.15    (5) the priority level of the project in relation to state clinical education, access,
404.16patient safety, and workforce goals.; and
404.17    (6) the potential of the project to impact the number or distribution of the health
404.18care workforce.
404.19    (b) (d) The commissioner shall periodically evaluate the priorities in awarding the
404.20innovations grants in order to ensure that the priorities meet the changing workforce
404.21needs of the state.

404.22    Sec. 12. Minnesota Statutes 2006, section 62J.692, subdivision 8, is amended to read:
404.23    Subd. 8. Federal financial participation. (a) The commissioner of human
404.24services shall seek to maximize federal financial participation in payments for medical
404.25education and research costs. If the commissioner of human services determines that
404.26federal financial participation is available for the medical education and research, the
404.27commissioner of health shall transfer to the commissioner of human services the amount
404.28of state funds necessary to maximize the federal funds available. The amount transferred
404.29to the commissioner of human services, plus the amount of federal financial participation,
404.30shall be distributed to medical assistance providers in accordance with the distribution
404.31methodology described in subdivision 4.
404.32    (b) For the purposes of paragraph (a), the commissioner shall use physician clinic
404.33rates where possible to maximize federal financial participation.

404.34    Sec. 13. Minnesota Statutes 2006, section 62J.692, subdivision 10, is amended to read:
405.1    Subd. 10. Transfers from University of Minnesota. Of the funds dedicated to the
405.2Academic Health Center under section 297F.10, subdivision 1, clause (1), $4,850,000
405.3shall be transferred annually to the commissioner of health no later than April 15 of each
405.4year for distribution under subdivision 4, paragraph (f) (i).

405.5    Sec. 14. Minnesota Statutes 2006, section 62J.81, subdivision 1, is amended to read:
405.6    Subdivision 1. Required disclosure of estimated payment. (a) A health care
405.7provider, as defined in section 62J.03, subdivision 8, or the provider's designee as agreed
405.8to by that designee, shall, at the request of a consumer, provide that consumer with a good
405.9faith estimate of the reimbursement allowable payment the provider expects to receive
405.10from the health plan company in which the consumer is enrolled has agreed to accept from
405.11the consumer's health plan company for the services specified by the consumer, specifying
405.12the amount of the allowable payment due from the health plan company. Health plan
405.13companies must allow contracted providers, or their designee, to release this information.
405.14A good faith estimate must also be made available at the request of a consumer who
405.15is not enrolled in a health plan company. If a consumer has no applicable public or
405.16private coverage, the health care provider must give the consumer a good faith estimate
405.17of the average allowable reimbursement the provider accepts as payment from private
405.18third-party payers for the services specified by the consumer and the estimated amount
405.19the noncovered consumer will be required to pay. Payment information provided by a
405.20provider, or by the provider's designee as agreed to by that designee, to a patient pursuant
405.21to this subdivision does not constitute a legally binding estimate of the allowable charge
405.22for or cost to the consumer of services.
405.23    (b) A health plan company, as defined in section 62J.03, subdivision 10, shall, at
405.24the request of an enrollee or the enrollee's designee, provide that enrollee with a good
405.25faith estimate of the reimbursement allowable amount the health plan company would
405.26expect to pay to has contracted for with a specified provider within the network as total
405.27payment for a health care service specified by the enrollee and the portion of the allowable
405.28amount due from the enrollee and the enrollee's out-of-pocket costs. If requested by the
405.29enrollee, the health plan company shall also provide to the enrollee a good faith estimate
405.30of the enrollee's out-of-pocket cost for the health care service. An estimate provided to
405.31an enrollee under this paragraph is not a legally binding estimate of the reimbursement
405.32allowable amount or enrollee's out-of-pocket cost.
405.33EFFECTIVE DATE.This section is effective August 1, 2007.

406.1    Sec. 15. Minnesota Statutes 2006, section 62J.82, is amended to read:
406.262J.82 HOSPITAL CHARGE INFORMATION REPORTING DISCLOSURE.
406.3    Subdivision 1. Required information. The Minnesota Hospital Association shall
406.4develop a Web-based system, available to the public free of charge, for reporting charge
406.5information the following, for Minnesota residents,:
406.6    (1) hospital-specific performance on the measures of care developed under section
406.7256B.072 for acute myocardial infarction, heart failure, and pneumonia;
406.8    (2) by January 1, 2009, hospital-specific performance on the public reporting
406.9measures for hospital-acquired infections as published by the National Quality Forum
406.10and collected by the Minnesota Hospital Association and Stratis Health in collaboration
406.11with infection control practitioners; and
406.12    (3) charge information, including, but not limited to, number of discharges, average
406.13length of stay, average charge, average charge per day, and median charge, for each of the
406.1450 most common inpatient diagnosis-related groups and the 25 most common outpatient
406.15surgical procedures as specified by the Minnesota Hospital Association.
406.16    Subd. 2. Web site. The Web site must provide information that compares
406.17hospital-specific data to hospital statewide data. The Web site must be established by
406.18October 1, 2006, and must be updated annually. The commissioner shall provide a link to
406.19this reporting information on the department's Web site.
406.20    Subd. 3. Enforcement. The commissioner shall provide a link to this information
406.21on the department's Web site. If a hospital does not provide this information to the
406.22Minnesota Hospital Association, the commissioner of health may require the hospital to
406.23do so in accordance with section 144.55, subdivision 6. The commissioner shall provide a
406.24link to this information on the department's Web site.

406.25    Sec. 16. [62J.84] HEALTH CARE TRANSFORMATION TASK FORCE.
406.26    Subdivision 1. Task force. The governor shall convene a health care transformation
406.27task force to advise and assist the governor and the Minnesota legislature. The task force
406.28shall consist of:
406.29    (1) four legislators from the house of representatives appointed by the speaker, two
406.30from the majority party and two from the minority party, and four legislators from the
406.31senate appointed by the Subcommittee on Committees of the senate Committee on Rules
406.32and Administration, two from the majority party and two from the minority party;
406.33    (2) four representatives of the governor and state agencies appointed by the governor;
407.1    (3) at least four persons appointed by the governor who have demonstrated
407.2leadership in health care organizations, health improvement initiatives, health care trade or
407.3professional associations, or other collaborative health system improvement activities; and
407.4    (4) at least two persons appointed by the governor who have demonstrated leadership
407.5in employer and group purchaser activities related to health system improvement, at least
407.6one of which must be from a labor organization.
407.7    Subd. 2. Public input. The commissioner of health shall review available research,
407.8and conduct statewide, regional, and local surveys, focus groups, and other activities as
407.9needed to fill gaps in existing research, to determine Minnesotans' values, preferences,
407.10opinions, and perceptions related to health care and to the issues confronting the task
407.11force, and shall report the findings to the task force.
407.12    Subd. 3. Inventory and assessment of existing activities; action plan. The task
407.13force shall complete an inventory and assessment of all public and private organized
407.14activities, coalitions, and collaboratives working on tasks relating to health system
407.15improvement including, but not limited to, patient safety, quality measurement and
407.16reporting, evidence-based practice, adoption of health information technology, disease
407.17management and chronic care coordination, medical homes, access to health care,
407.18cultural competence, prevention and public health, consumer incentives, price and cost
407.19transparency, nonprofit organization community benefits, education, research, and health
407.20care workforce.
407.21    Subd. 4. Action plan. By December 15, 2007, the governor, with the advice
407.22and assistance of the task force, shall develop and present to the legislature a statewide
407.23action plan for transforming the health care system to improve affordability, quality,
407.24and access. The plan shall include draft legislation needed to implement the plan. The
407.25plan may consist of legislative actions, administrative actions of governmental entities,
407.26collaborative actions, and actions of individuals and individual organizations. Among
407.27other things, the action plan must include the following, with specific and measurable
407.28goals and deadlines for each:
407.29    (1) proposed actions that will slow the rate of increase in health care costs to a rate
407.30that does not exceed the increase in the Consumer Price Index for urban consumers for the
407.31preceding calendar year plus two percentage points, plus an additional percentage based
407.32on the added costs necessary to implement legislation enacted in 2007;
407.33    (2) actions that will increase the affordable health coverage options for uninsured
407.34and underinsured Minnesotans and other strategies that will ensure that all Minnesotans
407.35will have health coverage by January 2011;
408.1    (3) actions to improve the quality and safety of health care and reduce racial and
408.2ethnic disparities in access and quality;
408.3    (4) actions that will reduce the rate of preventable chronic illness through prevention
408.4and public health and wellness initiatives; and
408.5    (5) proposed changes to state health care purchasing and payment strategies used for
408.6state health care programs and state employees that will promote higher quality, lower
408.7cost health care through incentives that reward prevention and early intervention, use
408.8of cost-effective primary care, effective care coordination, and management of chronic
408.9disease;
408.10    (6) actions that will promote the appropriate and cost-effective investment in new
408.11facilities, technologies, and drugs;
408.12    (7) actions to reduce administrative costs; and
408.13    (8) the results of the inventory completed under subdivision 3 and recommendations
408.14for how these activities can be coordinated and improved.
408.15    Subd. 5. Options for small employers. The task force shall study and report back
408.16to the legislature by December 15, 2007, on options for serving small employers and their
408.17employees, and self-employed individuals.

408.18    Sec. 17. Minnesota Statutes 2006, section 62L.12, subdivision 2, is amended to read:
408.19    Subd. 2. Exceptions. (a) A health carrier may sell, issue, or renew individual
408.20conversion policies to eligible employees otherwise eligible for conversion coverage under
408.21section 62D.104 as a result of leaving a health maintenance organization's service area.
408.22    (b) A health carrier may sell, issue, or renew individual conversion policies to
408.23eligible employees otherwise eligible for conversion coverage as a result of the expiration
408.24of any continuation of group coverage required under sections 62A.146, 62A.17, 62A.21,
408.2562C.142 , 62D.101, and 62D.105.
408.26    (c) A health carrier may sell, issue, or renew conversion policies under section
408.2762E.16 to eligible employees.
408.28    (d) A health carrier may sell, issue, or renew individual continuation policies to
408.29eligible employees as required.
408.30    (e) A health carrier may sell, issue, or renew individual health plans if the coverage
408.31is appropriate due to an unexpired preexisting condition limitation or exclusion applicable
408.32to the person under the employer's group health plan or due to the person's need for health
408.33care services not covered under the employer's group health plan.
408.34    (f) A health carrier may sell, issue, or renew an individual health plan, if the
408.35individual has elected to buy the individual health plan not as part of a general plan to
409.1substitute individual health plans for a group health plan nor as a result of any violation of
409.2subdivision 3 or 4.
409.3    (g) Nothing in this subdivision relieves a health carrier of any obligation to provide
409.4continuation or conversion coverage otherwise required under federal or state law.
409.5    (h) Nothing in this chapter restricts the offer, sale, issuance, or renewal of coverage
409.6issued as a supplement to Medicare under sections 62A.3099 to 62A.44, or policies or
409.7contracts that supplement Medicare issued by health maintenance organizations, or those
409.8contracts governed by sections 1833, 1851 to 1859, 1860D, or 1876 of the federal Social
409.9Security Act, United States Code, title 42, section 1395 et seq., as amended.
409.10    (i) Nothing in this chapter restricts the offer, sale, issuance, or renewal of individual
409.11health plans necessary to comply with a court order.
409.12    (j) A health carrier may offer, issue, sell, or renew an individual health plan to
409.13persons eligible for an employer group health plan, if the individual health plan is a high
409.14deductible health plan for use in connection with an existing health savings account, in
409.15compliance with the Internal Revenue Code, section 223. In that situation, the same or
409.16a different health carrier may offer, issue, sell, or renew a group health plan to cover
409.17the other eligible employees in the group.
409.18    (k) A health carrier may offer, sell, issue, or renew an individual health plan to one
409.19or more employees of a small employer if the individual health plan is marketed directly
409.20through the Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 to
409.21all employees of the small employer and the small employer does not contribute directly
409.22or indirectly to the premiums or facilitate the administration of the individual health
409.23plan. The requirement to market an individual health plan to all employees through the
409.24Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 does not require
409.25the health carrier to offer or issue an individual health plan to any employee. For purposes
409.26of this paragraph, an employer is not contributing to the premiums or facilitating the
409.27administration of the individual health plan if the employer does not contribute to the
409.28premium and merely collects the premiums from an employee's wages or salary through
409.29payroll deductions and submits payment for the premiums of one or more employees in a
409.30lump sum to the health carrier to the Minnesota Health Insurance Exchange under section
409.3162A.67 or 62A.68. Except for coverage under section 62A.65, subdivision 5, paragraph
409.32(b), or 62E.16, at the request of an employee, the health carrier Minnesota Health Insurance
409.33Exchange under section 62A.67 or 62A.68 may bill the employer for the premiums
409.34payable by the employee, provided that the employer is not liable for payment except
409.35from payroll deductions for that purpose. If an employer is submitting payments under
409.36this paragraph, the health carrier and the Minnesota Health Insurance Exchange under
410.1section 62A.67 or 62A.68 shall jointly provide a cancellation notice directly to the primary
410.2insured at least ten days prior to termination of coverage for nonpayment of premium.
410.3Individual coverage under this paragraph may be offered only if the small employer has
410.4not provided coverage under section 62L.03 to the employees within the past 12 months.
410.5    The employer must provide a written and signed statement to the health carrier
410.6Minnesota Health Insurance Exchange under section 62A.67 or 62A.68 that the employer
410.7is not contributing directly or indirectly to the employee's premiums. The Minnesota
410.8Health Insurance Exchange under section 62A.67 or 62A.68 shall provide all health
410.9carriers with enrolled employees of the employer with a copy of the employer's statement.
410.10The health carrier may rely on the employer's statement provided by the Minnesota Health
410.11Insurance Exchange under section 62A.67 or 62A.68 and is not required to guarantee-issue
410.12individual health plans to the employer's other current or future employees.

410.13    Sec. 18. Minnesota Statutes 2006, section 62L.12, subdivision 4, is amended to read:
410.14    Subd. 4. Employer prohibition. A small employer offering a health benefit plan
410.15shall not encourage or direct an employee or applicant to:
410.16    (1) refrain from filing an application for health coverage when other similarly
410.17situated employees may file an application for health coverage;
410.18    (2) file an application for health coverage during initial eligibility for coverage,
410.19the acceptance of which is contingent on health status, when other similarly situated
410.20employees may apply for health coverage, the acceptance of which is not contingent on
410.21health status;
410.22    (3) seek coverage from another health carrier, including, but not limited to, MCHA;
410.23or
410.24    (4) cause coverage to be issued on different terms because of the health status or
410.25claims experience of that person or the person's dependents.

410.26    Sec. 19. Minnesota Statutes 2006, section 62Q.165, subdivision 1, is amended to read:
410.27    Subdivision 1. Definition. It is the commitment of the state to achieve universal
410.28health coverage for all Minnesotans by the year 2011. Universal coverage is achieved
410.29when:
410.30    (1) every Minnesotan has access to a full range of quality health care services;
410.31    (2) every Minnesotan is able to obtain affordable health coverage which pays for the
410.32full range of services, including preventive and primary care; and
410.33    (3) every Minnesotan pays into the health care system according to that person's
410.34ability.
411.1EFFECTIVE DATE.This section is effective July 1, 2007.

411.2    Sec. 20. Minnesota Statutes 2006, section 62Q.165, subdivision 2, is amended to read:
411.3    Subd. 2. Goal. It is the goal of the state to make continuous progress toward
411.4reducing the number of Minnesotans who do not have health coverage so that by January
411.51, 2000, fewer than four percent of the state's population will be without health coverage
411.62011, all Minnesota residents have access to affordable health care. The goal will be
411.7achieved by improving access to private health coverage through insurance reforms and
411.8market reforms, by making health coverage more affordable for low-income Minnesotans
411.9through purchasing pools and state subsidies, and by reducing the cost of health coverage
411.10through cost containment programs and methods of ensuring that all Minnesotans are
411.11paying into the system according to their ability.
411.12EFFECTIVE DATE.This section is effective July 1, 2007.

411.13    Sec. 21. Minnesota Statutes 2006, section 62Q.80, subdivision 3, is amended to read:
411.14    Subd. 3. Approval. (a) Prior to the operation of a community-based health care
411.15coverage program, a community-based health initiative shall submit to the commissioner
411.16of health for approval the community-based health care coverage program developed by
411.17the initiative. The commissioner shall only approve a program that has been awarded
411.18a community access program grant from the United States Department of Health and
411.19Human Services. The commissioner shall ensure that the program meets the federal grant
411.20requirements and any requirements described in this section and is actuarially sound based
411.21on a review of appropriate records and methods utilized by the community-based health
411.22initiative in establishing premium rates for the community-based health care coverage
411.23program.
411.24    (b) Prior to approval, the commissioner shall also ensure that:
411.25    (1) the benefits offered comply with subdivision 8 and that there are adequate
411.26numbers of health care providers participating in the community-based health network to
411.27deliver the benefits offered under the program;
411.28    (2) the activities of the program are limited to activities that are exempt under this
411.29section or otherwise from regulation by the commissioner of commerce;
411.30    (3) the complaint resolution process meets the requirements of subdivision 10; and
411.31    (4) the data privacy policies and procedures comply with state and federal law.

411.32    Sec. 22. Minnesota Statutes 2006, section 62Q.80, subdivision 4, is amended to read:
412.1    Subd. 4. Establishment. (a) The initiative shall establish and operate upon approval
412.2by the commissioner of health a community-based health care coverage program. The
412.3operational structure established by the initiative shall include, but is not limited to:
412.4    (1) establishing a process for enrolling eligible individuals and their dependents;
412.5    (2) collecting and coordinating premiums from enrollees and employers of enrollees;
412.6    (3) providing payment to participating providers;
412.7    (4) establishing a benefit set according to subdivision 8 and establishing premium
412.8rates and cost-sharing requirements;
412.9    (5) creating incentives to encourage primary care and wellness services; and
412.10    (6) initiating disease management services, as appropriate.
412.11    (b) The payments collected under paragraph (a), clause (2), may be used to capture
412.12available federal funds.

412.13    Sec. 23. Minnesota Statutes 2006, section 62Q.80, subdivision 13, is amended to read:
412.14    Subd. 13. Report. (a) The initiative shall submit quarterly status reports to the
412.15commissioner of health on January 15, April 15, July 15, and October 15 of each year,
412.16with the first report due January 15, 2007 2008. The status report shall include:
412.17    (1) the financial status of the program, including the premium rates, cost per member
412.18per month, claims paid out, premiums received, and administrative expenses;
412.19    (2) a description of the health care benefits offered and the services utilized;
412.20    (3) the number of employers participating, the number of employees and dependents
412.21covered under the program, and the number of health care providers participating;
412.22    (4) a description of the health outcomes to be achieved by the program and a status
412.23report on the performance measurements to be used and collected; and
412.24    (5) any other information requested by the commissioner of health or commerce or
412.25the legislature.
412.26    (b) The initiative shall contract with an independent entity to conduct an evaluation
412.27of the program to be submitted to the commissioners of health and commerce and the
412.28legislature by January 15, 2009 2010. The evaluation shall include:
412.29    (1) an analysis of the health outcomes established by the initiative and the
412.30performance measurements to determine whether the outcomes are being achieved;
412.31    (2) an analysis of the financial status of the program, including the claims to
412.32premiums loss ratio and utilization and cost experience;
412.33    (3) the demographics of the enrollees, including their age, gender, family income,
412.34and the number of dependents;
413.1    (4) the number of employers and employees who have been denied access to the
413.2program and the basis for the denial;
413.3    (5) specific analysis on enrollees who have aggregate medical claims totaling over
413.4$5,000 per year, including data on the enrollee's main diagnosis and whether all the
413.5medical claims were covered by the program;
413.6    (6) number of enrollees referred to state public assistance programs;
413.7    (7) a comparison of employer-subsidized health coverage provided in a comparable
413.8geographic area to the designated community-based geographic area served by the
413.9program, including, to the extent available:
413.10    (i) the difference in the number of employers with 50 or fewer employees offering
413.11employer-subsidized health coverage;
413.12    (ii) the difference in uncompensated care being provided in each area; and
413.13    (iii) a comparison of health care outcomes and measurements established by the
413.14initiative; and
413.15    (8) any other information requested by the commissioner of health or commerce.

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

413.18    Sec. 25. Minnesota Statutes 2006, section 144.698, subdivision 1, is amended to read:
413.19    Subdivision 1. Yearly reports. (a) Each hospital and each outpatient surgical center,
413.20which has not filed the financial information required by this section with a voluntary,
413.21nonprofit reporting organization pursuant to section 144.702, shall file annually with the
413.22commissioner of health after the close of the fiscal year:
413.23    (1) a balance sheet detailing the assets, liabilities, and net worth of the hospital or
413.24outpatient surgical center;
413.25    (2) a detailed statement of income and expenses;
413.26    (3) a copy of its most recent cost report, if any, filed pursuant to requirements of
413.27Title XVIII of the United States Social Security Act;
413.28    (4) a copy of all changes to articles of incorporation or bylaws;
413.29    (5) information on services provided to benefit the community, including services
413.30provided at no cost or for a reduced fee to patients unable to pay, teaching and research
413.31activities, or other community or charitable activities;
413.32    (6) information required on the revenue and expense report form set in effect on
413.33July 1, 1989, or as amended by the commissioner in rule;
413.34    (7) information on changes in ownership or control; and
414.1    (8) other information required by the commissioner in rule.;
414.2    (9) information on the number of available hospital beds that are dedicated to certain
414.3specialized services, as designated by the commissioner, and annual occupancy rates for
414.4those beds, separately for adult and pediatric care;
414.5    (10) from outpatient surgical centers, the total number of surgeries; and
414.6    (11) a report on health care capital expenditures during the previous year, as required
414.7by section 62J.17.
414.8    (b) Beginning with hospital fiscal year 2009, each nonprofit hospital shall report on
414.9community benefits under paragraph (a), clause (5). "Community benefit" means the costs
414.10of community care, underpayment for services provided under state health care programs,
414.11research costs, community health services costs, financial and in-kind contributions, costs
414.12of community building activities, costs of community benefit operations, education, and
414.13the cost of operating subsidized services. The cost of bad debts and underpayment for
414.14Medicare services are not included in the calculation of community benefit.

414.15    Sec. 26. Minnesota Statutes 2006, section 144.699, is amended by adding a subdivision
414.16to read:
414.17    Subd. 5. Annual reports on community benefit, community care amounts,
414.18and state program underfunding. (a) For each hospital reporting health care cost
414.19information under section 144.698 or 144.702, the commissioner shall report annually
414.20on the hospital's community benefit, community care, and underpayment for state public
414.21health care programs.
414.22    (b) For purposes of this subdivision, "community benefits" has the definition given
414.23in section 144.698, paragraph (b).
414.24    (c) For purposes of this subdivision, "community care" means the costs for medical
414.25care for which a hospital has determined is charity care, as defined under Minnesota Rules,
414.26part 4650.0115, or for which the hospital determines after billing for the services that there
414.27is a demonstrated inability to pay. Any costs forgiven under a hospital's community care
414.28plan or under section 62J.83 may be counted in the hospital's calculation of community
414.29care. Bad debt expenses and discounted charges available to the uninsured shall not be
414.30included in the calculation of community care. The amount of community care is the value
414.31of costs incurred and not the charges made for services.
414.32    (d) For purposes of this subdivision, underpayment for services provided by state
414.33public health care programs is the difference between hospital costs and public program
414.34payments. The information shall be reported in terms of total dollars and as a percentage
414.35of total operating costs for each hospital.

415.1    Sec. 27. Minnesota Statutes 2006, section 256.01, subdivision 2b, is amended to read:
415.2    Subd. 2b. Performance payments. (a) The commissioner shall develop and
415.3implement a pay-for-performance system to provide performance payments to:
415.4    (1) eligible medical groups and clinics that demonstrate optimum care in serving
415.5individuals with chronic diseases who are enrolled in health care programs administered
415.6by the commissioner under chapters 256B, 256D, and 256L.;
415.7    (2) medical groups that implement effective medical home models of patient care
415.8that improve quality and reduce costs through effective primary and preventive care, care
415.9coordination, and management of chronic conditions; and
415.10    (3) eligible medical groups and clinics that evaluate medical provider usage patterns
415.11and provide feedback to individual medical providers on that provider's practice patterns
415.12relative to peer medical providers.
415.13    (b) The commissioner shall also develop and implement a patient incentive health
415.14program to provide incentives and rewards to patients who are enrolled in health care
415.15programs administered by the commissioner under chapters 256B, 256D, and 256L, and
415.16who have agreed to and meet personal health goals established with their primary care
415.17provider to manage a chronic disease or condition including, but not limited to, diabetes,
415.18high blood pressure, and coronary artery disease.
415.19    (c) The commissioner may receive any federal matching money that is made
415.20available through the medical assistance program for managed care oversight contracted
415.21through vendors including consumer surveys, studies, and external quality reviews as
415.22required by the Federal Balanced Budget Act of 1997, Code of Federal Regulations,
415.23title 42, part 438, subpart E. Any federal money received for managed care oversight is
415.24appropriated to the commissioner for this purpose. The commissioner may expend the
415.25federal money received in either year of the biennium.
415.26EFFECTIVE DATE.This section is effective July 1, 2007.

415.27    Sec. 28. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
415.28subdivision to read:
415.29    Subd. 49. Provider-directed care coordination services. The commissioner
415.30shall develop and implement a provider-directed care coordination program for medical
415.31assistance recipients who are not enrolled in the prepaid medical assistance program and
415.32who are receiving services on a fee-for-service basis. This program provides payment
415.33to primary care clinics for care coordination for people who have complex and chronic
415.34medical conditions. Clinics must meet certain criteria such as the capacity to develop care
415.35plans; have a dedicated care coordinator; and have an adequate number of fee-for-service
416.1clients, evaluation mechanisms, and quality improvement processes to qualify for
416.2reimbursement. For purposes of this subdivision, a primary care clinic is a medical clinic
416.3designated as the patient's first point of contact for medical care, available 24 hours a
416.4day, seven days a week, that provides or arranges for the patient's comprehensive health
416.5care needs, and provides overall integration, coordination and continuity over time and
416.6referrals for specialty care.

416.7    Sec. 29. HEALTH CARE PAYMENT SYSTEM REFORM.
416.8    Subdivision 1. Payment reform plan. The commissioners of employee relations,
416.9human services, commerce, and health shall develop a plan for promoting and facilitating
416.10changes in payment rates and methods for paying for health care services, drugs, devices,
416.11supplies, and equipment in order to:
416.12    (1) reward the provision of cost-effective primary and preventive care;
416.13    (2) reward the use of evidence-based care;
416.14    (3) discourage underutilization, overuse, and misuse;
416.15    (4) reward the use of the most cost-effective settings, drugs, devices, providers,
416.16and treatments; and
416.17    (5) encourage consumers to maintain good health and use the health care system
416.18appropriately.
416.19    In developing the plan, the commissioners shall analyze existing data to determine
416.20specific services and health conditions for which changes in payment rates and methods
416.21would lead to significant improvements in quality of care.
416.22    Subd. 2. Report. The commissioners shall submit a report to the legislature by
416.23December 15, 2007, describing the payment reform plan. The report must include
416.24proposed legislation for implementing those components of the plan requiring legislative
416.25action or appropriations of money.
416.26EFFECTIVE DATE.This section is effective July 1, 2007.

416.27    Sec. 30. COMMUNITY COLLABORATIVE PILOT PROJECTS TO COVER
416.28THE UNINSURED.
416.29    Subdivision 1. Community collaboratives. The commissioner of human services
416.30shall provide grants to and authorization for up to three community collaboratives that
416.31satisfy the requirements in this section. To be eligible to receive a grant and authorization
416.32under this section, a community collaborative must include:
416.33    (1) one or more counties;
416.34    (2) one or more local hospitals;
417.1    (3) one or more local employers who collectively provide at least 300 jobs in the
417.2community;
417.3    (4) one or more health care clinics or physician groups; and
417.4    (5) a third-party payer, which may be a county-based purchasing plan operating
417.5under Minnesota Statutes, section 256B.692, a self-insured employer, or a health plan
417.6company as defined in Minnesota Statutes, section 62Q.01, subdivision 4.
417.7    Subd. 2. Pilot project requirements. (a) Community collaborative pilot projects
417.8must:
417.9    (1) identify and enroll persons in the community who are uninsured, and who have,
417.10or are at risk of developing, one of the following chronic conditions: mental illness,
417.11diabetes, asthma, hypertension, or other chronic condition designated by the project;
417.12    (2) assist uninsured persons to obtain private-sector health insurance coverage if
417.13possible or to enroll in any public health care programs for which they are eligible. If the
417.14uninsured individual is unable to obtain health coverage, the community collaborative
417.15must enroll the individual in a local health care assistance program that provides specified
417.16services to prevent or effectively manage the chronic condition;
417.17    (3) include components to help uninsured persons retain employment or to become
417.18employable, if currently unemployed;
417.19    (4) ensure that each uninsured person enrolled in the program has a medical home
417.20responsible for providing, or arranging for, health care services and assisting in the
417.21effective management of the chronic condition;
417.22    (5) coordinate services between all providers and agencies serving an enrolled
417.23individual; and
417.24    (6) be coordinated with the state's Q-Care initiative and improve the use of
417.25evidence-based treatments and effective disease management programs in the broader
417.26community, beyond those individuals enrolled in the project.
417.27    (b) Projects established under this section are not insurance and are not subject to
417.28state-mandated benefit requirements or insurance regulations.
417.29    Subd. 3. Criteria. Proposals must be evaluated by actuarial, financial, and clinical
417.30experts based on the likelihood that the project would produce a positive return on
417.31investment for the community. In awarding grants, the commissioner of human services
417.32shall give preference to proposals that:
417.33    (1) have broad community support from local businesses, provider counties, and
417.34other public and private organizations;
417.35    (2) would provide services to uninsured persons who have, or are at risk of
417.36developing, multiple, co-occurring chronic conditions;
418.1    (3) integrate or coordinate resources from multiple sources, such as employer
418.2contributions, county funds, social service programs, and provider financial or in-kind
418.3support;
418.4    (4) provide continuity of treatment and services when uninsured individuals in
418.5the program become eligible for public or private health insurance or when insured
418.6individuals lose their coverage;
418.7    (5) demonstrate how administrative costs for health plan companies and providers
418.8can be reduced through greater simplification, coordination, consolidation, standardization,
418.9reducing billing errors, or other methods; and
418.10    (6) involve local contributions to the cost of the pilot projects.
418.11    Subd. 4. Grants. The commissioner of human services shall provide
418.12implementation grants of up to one-half of the community collaborative's costs for
418.13planning, administration, and evaluation. The commissioner shall also provide grants to
418.14community collaboratives to develop a fund to pay up to 50 percent of the cost of the
418.15services provided to uninsured individuals. The remaining costs must be paid for through
418.16other sources or by agreement of a health care provider to contribute the cost as charity
418.17care.
418.18    Subd. 5. Evaluation. The commissioner of human services shall evaluate the
418.19effectiveness of each community collaborative project awarded a grant, by comparing
418.20actual costs for serving the identified uninsured persons to the predicted costs that would
418.21have been incurred in the absence of early intervention and consistent treatment to manage
418.22the chronic condition, including the costs to medical assistance, MinnesotaCare, and
418.23general assistance medical care. The commissioner shall require community collaborative
418.24projects, as a condition of receipt of a grant award, to provide the commissioner with all
418.25information necessary for this evaluation.
418.26EFFECTIVE DATE.This section is effective July 1, 2007.

418.27    Sec. 31. HEALTH CARE PAYMENT REFORM PILOT PROJECTS.
418.28    Subdivision 1. Pilot projects. (a) The commissioners of health, human services,
418.29and employee relations shall develop and administer payment reform pilot projects for
418.30state employees and persons enrolled in medical assistance, MinnesotaCare, or general
418.31assistance medical care, to the extent permitted by federal requirements. The purpose of
418.32the projects is to promote and facilitate changes in payment rates and methods for paying
418.33for health care services, drugs, devices, supplies, and equipment in order to:
418.34    (1) reward the provision of cost-effective primary and preventive care;
418.35    (2) reward the use of evidence-based care;
419.1    (3) reward coordination of care for patients with chronic conditions;
419.2    (4) discourage overuse and misuse;
419.3    (5) reward the use of the most cost-effective settings, drugs, devices, providers,
419.4and treatments;
419.5    (6) encourage consumers to maintain good health and use the health care system
419.6appropriately.
419.7    (b) The pilot projects must involve the use of designated care professionals or
419.8clinics to serve as a patient's medical home and be responsible for coordinating health
419.9care services across the continuum of care. The pilot projects must evaluate different
419.10payment reform models and must be coordinated with the Minnesota senior health options
419.11program and the Minnesota disability health options program. To the extent possible, the
419.12commissioners shall coordinate state purchasing activities with other public employers
419.13and with private purchasers, self-insured groups, and health plan companies to promote
419.14the use of pilot projects encompassing both public and private purchasers and markets.
419.15    Subd. 2. Payment methods and incentives. The commissioners shall modify
419.16existing payment methods and rates for those enrollees and health care providers
419.17participating in the pilot project in order to provide incentives for care management,
419.18team-based care, and practice redesign, and increase resources for primary care, chronic
419.19condition care, and care provided to complex patients. The commissioners may create
419.20financial incentives for patients to select a medical home under the pilot project by
419.21reducing, modifying, or eliminating deductibles and co-payments for certain services, or
419.22through other incentives. The commissioners may require patients to remain with their
419.23designated medical home for a specified period of time. Alternative payment methods
419.24may include complete or partial capitation, fee-for-service payments, or other payment
419.25methodologies. The payment methods may provide for the payment of bonuses to medical
419.26home providers or other providers, or to patients, for the achievement of performance
419.27goals. The payment methods may include allocating a portion of the payment that
419.28would otherwise be paid to health plans under state prepaid health care programs to the
419.29designated medical home for specified services.
419.30    Subd. 3. Requirements. In order to be designated a medical home under the pilot
419.31project, health care professionals or clinics must demonstrate their ability to:
419.32    (1) be the patient's first point of contact by telephone or other means, 24 hours a
419.33day, seven days a week;
419.34    (2) provide or arrange for patients' comprehensive health care needs, including the
419.35ability to structure planned chronic disease visits and to manage chronic disease through
419.36the use of disease registries;
420.1    (3) coordinate patients' care when care must be provided outside the medical home;
420.2    (4) provide longitudinal care, not just episodic care, including meeting long-term
420.3and unique personal needs;
420.4    (5) utilize an electronic health record and incorporate a plan to develop and make
420.5available to patients that choose a medical home an electronic personal health record that
420.6is prepopulated with the patient's data, consumer-directed, connected to the provider,
420.724-hour accessible, and owned and controlled by the patient;
420.8    (6) systematically improve quality of care using, among other inputs, patient
420.9feedback; and
420.10    (7) create a provider network that provides for increased reimbursement for a
420.11medical home in a cost-neutral manner.
420.12    Subd. 4. Evaluation. Pilot projects must be evaluated based on patient satisfaction,
420.13provider satisfaction, clinical process and outcome measures, program costs and savings,
420.14and economic impact on health care providers. Pilot projects must be evaluated based
420.15on the extent to which the medical home:
420.16    (1) coordinated health care services across the continuum of care and thereby
420.17reduced duplication of services and enhanced communication across providers;
420.18    (2) provided safe and high-quality care by increasing utilization of effective
420.19treatments, reduced use of ineffective treatments, reduced barriers to essential care and
420.20services, and eliminated barriers to access;
420.21    (3) reduced unnecessary hospitalizations and emergency room visits and increased
420.22use of cost-effective care and settings;
420.23    (4) encouraged long-term patient and provider relationships by shifting from
420.24episodic care to consistent, coordinated communication and care with a specified team of
420.25providers or individual providers;
420.26    (5) engaged and educated consumers by encouraging shared patient and provider
420.27responsibility and accountability for disease prevention, health promotion, chronic
420.28disease management, acute care, and overall well-being, encouraging informed medical
420.29decision-making, ensuring the availability of accurate medical information, and facilitated
420.30the transfer of accurate medical information;
420.31    (6) encouraged innovation in payment methodologies by using patient and provider
420.32incentives to coordinate care and utilize medical home services and fostering the
420.33expansion of a technology infrastructure that supports collaboration; and
420.34    (7) reduced overall health care costs as compared to conventional payment methods
420.35for similar patient populations.
421.1    Subd. 5. Rulemaking. The commissioners are exempt from administrative
421.2rulemaking under chapter 14 for purposes of developing, administering, contracting
421.3for, and evaluating pilot projects under this section. The commissioner shall publish a
421.4proposed request for proposals in the State Register and allow 30 days for comment
421.5before issuing the final request for proposals.
421.6    Subd. 6. Regulatory and payment barriers. The commissioners shall study state
421.7and federal statutory and regulatory barriers to the creation of medical homes and provide
421.8a report and recommendations to the legislature by December 15, 2007.

421.9    Sec. 32. HEALTH CARE SYSTEM CONSOLIDATION.
421.10    (a) The commissioner of health shall study the effect of health care provider and
421.11health plan company consolidation in the four metropolitan statistical areas in Minnesota
421.12on: health care costs, including provider payment rates; quality of care; and access to care.
421.13The commissioner shall separately consider hospitals, specialty groups, and primary care
421.14groups. The commissioner shall present findings and recommendations to the legislature
421.15by December 15, 2007.
421.16    (b) For purposes of this study, health carriers, provider networks, and other health
421.17care providers shall provide data on network participation, contracted payment rates,
421.18charges, costs, payments received, patient referrals, and other information requested by
421.19the commissioner, in the form and manner specified by the commissioner. Provider-level
421.20information on contracted payment rates and payments from health plans provided to the
421.21commissioner of health for the purposes of this study are (1) private data on individuals as
421.22defined in Minnesota Statutes, section 13.02, subdivision 12, and (2) nonpublic data as
421.23defined in Minnesota Statutes, section 13.02, subdivision 9. The commissioner may not
421.24collect patient-identified data for purposes of this study. Data collected for purposes of
421.25this study may not be used for any other purposes.

421.26    Sec. 33. REPEALER.
421.27Minnesota Statutes 2006, section 62J.052, subdivision 1, is repealed effective
421.28August 1, 2007.

421.29ARTICLE 10

421.30PUBLIC HEALTH

421.31    Section 1. Minnesota Statutes 2006, section 13.3806, is amended by adding a
421.32subdivision to read:
422.1    Subd. 21. Birth defects registry system. Data on individuals collected by the
422.2birth defects registry system are private data on individuals and classified pursuant to
422.3section 144.2215.

422.4    Sec. 2. Minnesota Statutes 2006, section 16B.61, is amended by adding a subdivision
422.5to read:
422.6    Subd. 3b. Window fall prevention device code. The commissioner of labor and
422.7industry shall adopt rules for window fall prevention devices as part of the state Building
422.8Code. Window fall prevention devices include, but are not limited to, safety screens,
422.9hardware, guards, and other devices that comply with the standards established by the
422.10commissioner of labor and industry. The rules must require compliance with standards
422.11for window fall prevention devices developed by ASTM International, contained in the
422.12International Building Code as the model language with amendments deemed necessary to
422.13coordinate with the other adopted building codes in Minnesota. The rules must establish a
422.14scope that includes the applicable building occupancies, and the types, locations, and sizes
422.15of windows that will require the installation of fall devices. The rules will be effective July
422.161, 2009. The commissioner shall report to the legislature on the status of the rulemaking
422.17on or before February 15, 2008.

422.18    Sec. 3. Minnesota Statutes 2006, section 103I.101, subdivision 6, is amended to read:
422.19    Subd. 6. Fees for variances. The commissioner shall charge a nonrefundable
422.20application fee of $175 $215 to cover the administrative cost of processing a request for a
422.21variance or modification of rules adopted by the commissioner under this chapter.
422.22EFFECTIVE DATE.This section is effective July 1, 2008.

422.23    Sec. 4. Minnesota Statutes 2006, section 103I.208, subdivision 1, is amended to read:
422.24    Subdivision 1. Well notification fee. The well notification fee to be paid by a
422.25property owner is:
422.26    (1) for a new water supply well, $175 $215, which includes the state core function
422.27fee;
422.28    (2) for a well sealing, $35 $50 for each well, which includes the state core function
422.29fee, except that for monitoring wells constructed on a single property, having depths
422.30within a 25 foot range, and sealed within 48 hours of start of construction, a single fee of
422.31$35 $50; and
422.32    (3) for construction of a dewatering well, $175 $215, which includes the state core
422.33function fee, for each dewatering well except a dewatering project comprising five or
423.1more dewatering wells shall be assessed a single fee of $875 $1,075 for the dewatering
423.2wells recorded on the notification.
423.3EFFECTIVE DATE.This section is effective July 1, 2008.

423.4    Sec. 5. Minnesota Statutes 2006, section 103I.208, subdivision 2, is amended to read:
423.5    Subd. 2. Permit fee. The permit fee to be paid by a property owner is:
423.6    (1) for a water supply well that is not in use under a maintenance permit, $150 $175
423.7annually;
423.8    (2) for construction of a monitoring well, $175 $215, which includes the state
423.9core function fee;
423.10    (3) for a monitoring well that is unsealed under a maintenance permit, $150 $175
423.11annually;
423.12    (4) for monitoring wells used as a leak detection device at a single motor fuel retail
423.13outlet, a single petroleum bulk storage site excluding tank farms, or a single agricultural
423.14chemical facility site, the construction permit fee is $175 $215, which includes the state
423.15core function fee, per site regardless of the number of wells constructed on the site, and
423.16the annual fee for a maintenance permit for unsealed monitoring wells is $150 $175 per
423.17site regardless of the number of monitoring wells located on site;
423.18    (5) for a groundwater thermal exchange device, in addition to the notification fee for
423.19water supply wells, $175 $215, which includes the state core function fee;
423.20    (6) for a vertical heat exchanger, $175 $215;
423.21    (7) for a dewatering well that is unsealed under a maintenance permit, $150 $175
423.22annually for each dewatering well, except a dewatering project comprising more than five
423.23dewatering wells shall be issued a single permit for $750 $875 annually for dewatering
423.24wells recorded on the permit; and
423.25    (8) for an elevator boring, $175 $215 for each boring.
423.26EFFECTIVE DATE.This section is effective July 1, 2008.

423.27    Sec. 6. Minnesota Statutes 2006, section 103I.235, subdivision 1, is amended to read:
423.28    Subdivision 1. Disclosure of wells to buyer. (a) Before signing an agreement to
423.29sell or transfer real property, the seller must disclose in writing to the buyer information
423.30about the status and location of all known wells on the property, by delivering to the buyer
423.31either a statement by the seller that the seller does not know of any wells on the property,
423.32or a disclosure statement indicating the legal description and county, and a map drawn
423.33from available information showing the location of each well to the extent practicable.
424.1In the disclosure statement, the seller must indicate, for each well, whether the well is in
424.2use, not in use, or sealed.
424.3    (b) At the time of closing of the sale, the disclosure statement information, name and
424.4mailing address of the buyer, and the quartile, section, township, and range in which each
424.5well is located must be provided on a well disclosure certificate signed by the seller or a
424.6person authorized to act on behalf of the seller.
424.7    (c) A well disclosure certificate need not be provided if the seller does not know
424.8of any wells on the property and the deed or other instrument of conveyance contains
424.9the statement: "The Seller certifies that the Seller does not know of any wells on the
424.10described real property."
424.11    (d) If a deed is given pursuant to a contract for deed, the well disclosure certificate
424.12required by this subdivision shall be signed by the buyer or a person authorized to act on
424.13behalf of the buyer. If the buyer knows of no wells on the property, a well disclosure
424.14certificate is not required if the following statement appears on the deed followed by the
424.15signature of the grantee or, if there is more than one grantee, the signature of at least one
424.16of the grantees: "The Grantee certifies that the Grantee does not know of any wells on the
424.17described real property." The statement and signature of the grantee may be on the front
424.18or back of the deed or on an attached sheet and an acknowledgment of the statement by
424.19the grantee is not required for the deed to be recordable.
424.20    (e) This subdivision does not apply to the sale, exchange, or transfer of real property:
424.21    (1) that consists solely of a sale or transfer of severed mineral interests; or
424.22    (2) that consists of an individual condominium unit as described in chapters 515
424.23and 515B.
424.24    (f) For an area owned in common under chapter 515 or 515B the association or other
424.25responsible person must report to the commissioner by July 1, 1992, the location and
424.26status of all wells in the common area. The association or other responsible person must
424.27notify the commissioner within 30 days of any change in the reported status of wells.
424.28    (g) For real property sold by the state under section 92.67, the lessee at the time of
424.29the sale is responsible for compliance with this subdivision.
424.30    (h) If the seller fails to provide a required well disclosure certificate, the buyer, or
424.31a person authorized to act on behalf of the buyer, may sign a well disclosure certificate
424.32based on the information provided on the disclosure statement required by this section
424.33or based on other available information.
424.34    (i) A county recorder or registrar of titles may not record a deed or other instrument
424.35of conveyance dated after October 31, 1990, for which a certificate of value is required
424.36under section 272.115, or any deed or other instrument of conveyance dated after October
425.131, 1990, from a governmental body exempt from the payment of state deed tax, unless
425.2the deed or other instrument of conveyance contains the statement made in accordance
425.3with paragraph (c) or (d) or is accompanied by the well disclosure certificate containing all
425.4the information required by paragraph (b) or (d). The county recorder or registrar of titles
425.5must not accept a certificate unless it contains all the required information. The county
425.6recorder or registrar of titles shall note on each deed or other instrument of conveyance
425.7accompanied by a well disclosure certificate that the well disclosure certificate was
425.8received. The notation must include the statement "No wells on property" if the disclosure
425.9certificate states there are no wells on the property. The well disclosure certificate shall not
425.10be filed or recorded in the records maintained by the county recorder or registrar of titles.
425.11After noting "No wells on property" on the deed or other instrument of conveyance, the
425.12county recorder or registrar of titles shall destroy or return to the buyer the well disclosure
425.13certificate. The county recorder or registrar of titles shall collect from the buyer or the
425.14person seeking to record a deed or other instrument of conveyance, a fee of $40 $45
425.15for receipt of a completed well disclosure certificate. By the tenth day of each month,
425.16the county recorder or registrar of titles shall transmit the well disclosure certificates
425.17to the commissioner of health. By the tenth day after the end of each calendar quarter,
425.18the county recorder or registrar of titles shall transmit to the commissioner of health
425.19$32.50 $37.50 of the fee for each well disclosure certificate received during the quarter.
425.20The commissioner shall maintain the well disclosure certificate for at least six years. The
425.21commissioner may store the certificate as an electronic image. A copy of that image
425.22shall be as valid as the original.
425.23    (j) No new well disclosure certificate is required under this subdivision if the buyer
425.24or seller, or a person authorized to act on behalf of the buyer or seller, certifies on the deed
425.25or other instrument of conveyance that the status and number of wells on the property
425.26have not changed since the last previously filed well disclosure certificate. The following
425.27statement, if followed by the signature of the person making the statement, is sufficient
425.28to comply with the certification requirement of this paragraph: "I am familiar with the
425.29property described in this instrument and I certify that the status and number of wells on
425.30the described real property have not changed since the last previously filed well disclosure
425.31certificate." The certification and signature may be on the front or back of the deed or on
425.32an attached sheet and an acknowledgment of the statement is not required for the deed or
425.33other instrument of conveyance to be recordable.
425.34    (k) The commissioner in consultation with county recorders shall prescribe the form
425.35for a well disclosure certificate and provide well disclosure certificate forms to county
425.36recorders and registrars of titles and other interested persons.
426.1    (l) Failure to comply with a requirement of this subdivision does not impair:
426.2    (1) the validity of a deed or other instrument of conveyance as between the parties
426.3to the deed or instrument or as to any other person who otherwise would be bound by
426.4the deed or instrument; or
426.5    (2) the record, as notice, of any deed or other instrument of conveyance accepted for
426.6filing or recording contrary to the provisions of this subdivision.
426.7EFFECTIVE DATE.This section is effective July 1, 2008.

426.8    Sec. 7. Minnesota Statutes 2006, section 144.123, is amended to read:
426.9144.123 FEES FOR DIAGNOSTIC LABORATORY SERVICES;
426.10EXCEPTIONS.
426.11    Subdivision 1. Who must pay. Except for the limitation contained in this section,
426.12the commissioner of health shall charge a handling fee for each specimen submitted to
426.13the Department of Health for analysis for diagnostic purposes by any hospital, private
426.14laboratory, private clinic, or physician. No fee shall be charged to any entity which
426.15receives direct or indirect financial assistance from state or federal funds administered by
426.16the Department of Health, including any public health department, nonprofit community
426.17clinic, venereal sexually transmitted disease clinic, family planning clinic, or similar
426.18entity. No fee will be charged for any biological materials submitted to the Department
426.19of Health as a requirement of Minnesota Rules, part 4605.7040, or for those biological
426.20materials requested by the department to gather information for disease prevention or
426.21control purposes. The commissioner of health may establish by rule other exceptions to
426.22the handling fee as may be necessary to gather information for epidemiologic purposes
426.23protect the public's health. All fees collected pursuant to this section shall be deposited in
426.24the state treasury and credited to the state government special revenue fund.
426.25    Subd. 2. Rules for Fee amounts. The commissioner of health shall promulgate
426.26rules, in accordance with chapter 14, which shall specify the amount of the charge a
426.27handling fee prescribed in subdivision 1. The fee shall approximate the costs to the
426.28department of handling specimens including reporting, postage, specimen kit preparation,
426.29and overhead costs. The fee prescribed in subdivision 1 shall be $15 $25 per specimen
426.30until the commissioner promulgates rules pursuant to this subdivision.

426.31    Sec. 8. Minnesota Statutes 2006, section 144.125, is amended to read:
426.32144.125 TESTS OF INFANTS FOR HERITABLE AND CONGENITAL
426.33DISORDERS.
427.1    Subdivision 1. Duty to perform testing. It is the duty of (1) the administrative
427.2officer or other person in charge of each institution caring for infants 28 days or less
427.3of age, (2) the person required in pursuance of the provisions of section 144.215, to
427.4register the birth of a child, or (3) the nurse midwife or midwife in attendance at the
427.5birth, to arrange to have administered to every infant or child in its care tests for heritable
427.6and congenital disorders according to subdivision 2 and rules prescribed by the state
427.7commissioner of health. Testing and the recording and reporting of test results shall be
427.8performed at the times and in the manner prescribed by the commissioner of health. The
427.9commissioner shall charge laboratory service fees a fee so that the total of fees collected
427.10will approximate the costs of conducting the tests and implementing and maintaining
427.11a system to follow-up infants with heritable or congenital disorders. The laboratory
427.12service fee is $61 $101 per specimen. Costs associated with capital expenditures and
427.13the development of new procedures may be prorated over a three-year period when
427.14calculating the amount of the fees.
427.15    Subd. 2. Determination of tests to be administered. The commissioner shall
427.16periodically revise the list of tests to be administered for determining the presence of a
427.17heritable or congenital disorder. Revisions to the list shall reflect advances in medical
427.18science, new and improved testing methods, or other factors that will improve the public
427.19health. In determining whether a test must be administered, the commissioner shall take
427.20into consideration the adequacy of laboratory analytical methods to detect the heritable
427.21or congenital disorder, the ability to treat or prevent medical conditions caused by the
427.22heritable or congenital disorder, and the severity of the medical conditions caused by the
427.23heritable or congenital disorder. The list of tests to be performed may be revised if the
427.24changes are recommended by the advisory committee established under section 144.1255,
427.25approved by the commissioner, and published in the State Register. The revision is
427.26exempt from the rulemaking requirements in chapter 14, and sections 14.385 and 14.386
427.27do not apply.
427.28    Subd. 3. Objection of parents to test. Persons with a duty to perform testing under
427.29subdivision 1 shall advise parents of infants (1) that the blood or tissue samples used to
427.30perform testing thereunder as well as the results of such testing may be retained by the
427.31Department of Health, (2) the benefit of retaining the blood or tissue sample, and (3) that
427.32the following options are available to them with respect to the testing: (i) to decline to
427.33have the tests, or (ii) to elect to have the tests but to require that all blood samples and
427.34records of test results be destroyed within 24 months of the testing. If the parents of
427.35an infant object in writing to testing for heritable and congenital disorders or elect to
427.36require that blood samples and test results be destroyed, the objection or election shall
428.1be recorded on a form that is signed by a parent or legal guardian and made part of the
428.2infant's medical record. A written objection exempts an infant from the requirements of
428.3this section and section 144.128.

428.4    Sec. 9. Minnesota Statutes 2006, section 144.2215, subdivision 1, is amended to read:
428.5    Subdivision 1. Establishment. Within the limits of available appropriations, the
428.6commissioner of health shall establish and maintain an information system containing data
428.7on the cause, treatment, prevention, and cure of major birth defects. The commissioner
428.8shall consult with representatives and experts in epidemiology, medicine, insurance,
428.9health maintenance organizations, genetics, consumers, and voluntary organizations in
428.10developing the system and may phase in the implementation of the system. After the
428.11parents have provided informed consent under section 144.2216, subdivision 4, the
428.12commissioner shall offer the parents with their informed consent a visit by a trained health
428.13care worker to interview the parents about:
428.14    (1) all previous home addresses, occupations, and places of work including from
428.15childhood;
428.16    (2) the time and place of any military service; and
428.17    (3) known occasions or sites of toxic exposures.

428.18    Sec. 10. Minnesota Statutes 2006, section 144.672, subdivision 1, is amended to read:
428.19    Subdivision 1. Rule authority. The commissioner of health shall collect cancer
428.20incidence information, analyze the information, and conduct special studies designed to
428.21determine the potential public health significance of an increase in cancer incidence.
428.22    The commissioner shall adopt rules to administer the system, collect information,
428.23and distribute data. The rules must include, but not be limited to, the following:
428.24    (1) the type of data to be reported, which must include current and previous
428.25occupational data;
428.26    (2) standards for reporting specific types of data;
428.27    (3) payments allowed to hospitals, pathologists, and registry systems to defray their
428.28costs in providing information to the system;
428.29    (4) criteria relating to contracts made with outside entities to conduct studies using
428.30data collected by the system. The criteria may include requirements for a written protocol
428.31outlining the purpose and public benefit of the study, the description, methods, and
428.32projected results of the study, peer review by other scientists, the methods and facilities
428.33to protect the privacy of the data, and the qualifications of the researcher proposing to
428.34undertake the study; and
429.1    (5) specification of fees to be charged under section 13.03, subdivision 3, for all
429.2out-of-pocket expenses for data summaries or specific analyses of data requested by
429.3public and private agencies, organizations, and individuals, and which are not otherwise
429.4included in the commissioner's annual summary reports. Fees collected are appropriated
429.5to the commissioner to offset the cost of providing the data.

429.6    Sec. 11. Minnesota Statutes 2006, section 144.9502, subdivision 3, is amended to read:
429.7    Subd. 3. Reports of blood lead analysis required. (a) Every hospital, medical
429.8clinic, medical laboratory, other facility, or individual performing blood lead analysis
429.9shall report the results after the analysis of each specimen analyzed, for both capillary
429.10and venous specimens, and epidemiologic information required in this section to the
429.11commissioner of health, within the time frames set forth in clauses (1) and (2):
429.12    (1) within two working days by telephone, fax, or electronic transmission, with
429.13written or electronic confirmation within one month, for a venous blood lead level equal to
429.14or greater than 15 ten micrograms of lead per deciliter of whole blood; or
429.15    (2) within one month in writing or by electronic transmission, for any capillary
429.16result or for a venous blood lead level less than 15 ten micrograms of lead per deciliter of
429.17whole blood.
429.18    (b) If a blood lead analysis is performed outside of Minnesota and the facility
429.19performing the analysis does not report the blood lead analysis results and epidemiological
429.20information required in this section to the commissioner, the provider who collected the
429.21blood specimen must satisfy the reporting requirements of this section. For purposes of
429.22this section, "provider" has the meaning given in section 62D.02, subdivision 9.
429.23    (c) The commissioner shall coordinate with hospitals, medical clinics, medical
429.24laboratories, and other facilities performing blood lead analysis to develop a universal
429.25reporting form and mechanism.

429.26    Sec. 12. Minnesota Statutes 2006, section 144.9504, subdivision 2, is amended to read:
429.27    Subd. 2. Lead risk assessment. (a) An assessing agency shall conduct a lead risk
429.28assessment of a residence according to the venous blood lead level and time frame set
429.29forth in clauses (1) to (4) for purposes of secondary prevention:
429.30    (1) within 48 hours of a child or pregnant female in the residence being identified to
429.31the agency as having a venous blood lead level equal to or greater than 60 45 micrograms
429.32of lead per deciliter of whole blood;
430.1    (2) within five working days of a child or pregnant female in the residence being
430.2identified to the agency as having a venous blood lead level equal to or greater than 45 15
430.3micrograms of lead per deciliter of whole blood;
430.4    (3) within ten working days of a child in the residence being identified to the agency
430.5as having a venous blood lead level equal to or greater than 15 ten micrograms of lead
430.6per deciliter of whole blood; or
430.7    (4) within ten working days of a pregnant female in the residence being identified to
430.8the agency as having a venous blood lead level equal to or greater than ten micrograms of
430.9lead per deciliter of whole blood.
430.10    (b) Within the limits of available local, state, and federal appropriations, an assessing
430.11agency may also conduct a lead risk assessment for children with any elevated blood
430.12lead level.
430.13    (c) In a building with two or more dwelling units, an assessing agency shall assess
430.14the individual unit in which the conditions of this section are met and shall inspect all
430.15common areas accessible to a child. If a child visits one or more other sites such as another
430.16residence, or a residential or commercial child care facility, playground, or school, the
430.17assessing agency shall also inspect the other sites. The assessing agency shall have one
430.18additional day added to the time frame set forth in this subdivision to complete the lead
430.19risk assessment for each additional site.
430.20    (d) Within the limits of appropriations, the assessing agency shall identify the
430.21known addresses for the previous 12 months of the child or pregnant female with venous
430.22blood lead levels of at least 15 ten micrograms per deciliter for the child or at least ten
430.23micrograms per deciliter for the pregnant female; notify the property owners, landlords,
430.24and tenants at those addresses that an elevated blood lead level was found in a person
430.25who resided at the property; and give them primary prevention information. Within the
430.26limits of appropriations, the assessing agency may perform a risk assessment and issue
430.27corrective orders in the properties, if it is likely that the previous address contributed to
430.28the child's or pregnant female's blood lead level. The assessing agency shall provide the
430.29notice required by this subdivision without identifying the child or pregnant female with
430.30the elevated blood lead level. The assessing agency is not required to obtain the consent of
430.31the child's parent or guardian or the consent of the pregnant female for purposes of this
430.32subdivision. This information shall be classified as private data on individuals as defined
430.33under section 13.02, subdivision 12.
430.34    (e) The assessing agency shall conduct the lead risk assessment according to rules
430.35adopted by the commissioner under section 144.9508. An assessing agency shall have
430.36lead risk assessments performed by lead risk assessors licensed by the commissioner
431.1according to rules adopted under section 144.9508. If a property owner refuses to allow
431.2a lead risk assessment, the assessing agency shall begin legal proceedings to gain entry
431.3to the property and the time frame for conducting a lead risk assessment set forth in this
431.4subdivision no longer applies. A lead risk assessor or assessing agency may observe the
431.5performance of lead hazard reduction in progress and shall enforce the provisions of this
431.6section under section 144.9509. Deteriorated painted surfaces, bare soil, and dust must be
431.7tested with appropriate analytical equipment to determine the lead content, except that
431.8deteriorated painted surfaces or bare soil need not be tested if the property owner agrees to
431.9engage in lead hazard reduction on those surfaces. The lead content of drinking water
431.10must be measured if another probable source of lead exposure is not identified. Within a
431.11standard metropolitan statistical area, an assessing agency may order lead hazard reduction
431.12of bare soil without measuring the lead content of the bare soil if the property is in a
431.13census tract in which soil sampling has been performed according to rules established by
431.14the commissioner and at least 25 percent of the soil samples contain lead concentrations
431.15above the standard in section 144.9508.
431.16    (f) Each assessing agency shall establish an administrative appeal procedure which
431.17allows a property owner to contest the nature and conditions of any lead order issued by
431.18the assessing agency. Assessing agencies must consider appeals that propose lower cost
431.19methods that make the residence lead safe. The commissioner shall use the authority and
431.20appeal procedure granted under sections 144.989 to 144.993.
431.21    (g) Sections 144.9501 to 144.9509 neither authorize nor prohibit an assessing agency
431.22from charging a property owner for the cost of a lead risk assessment.

431.23    Sec. 13. Minnesota Statutes 2006, section 144.9507, is amended by adding a
431.24subdivision to read:
431.25    Subd. 6. Medical assistance. Medical assistance reimbursement for lead risk
431.26assessment services under section 256B.0625, subdivision 49, shall not be used to replace
431.27or decrease existing state or local funding for lead services and lead-related activities.

431.28    Sec. 14. Minnesota Statutes 2006, section 144.9512, is amended to read:
431.29144.9512 LEAD ABATEMENT PROGRAM.
431.30    Subdivision 1. Definitions. (a) The definitions in section 144.9501 and in this
431.31subdivision apply to this section.
431.32    (b) "Eligible organization" means a lead contractor, city, board of health, community
431.33health department, community action agency as defined in section 256E.30, or community
431.34development corporation.
432.1    (c) "Commissioner" means the commissioner of health, or the commissioner of the
432.2Minnesota Housing Finance Agency as authorized by section 462A.05, subdivision 15c.
432.3    Subd. 2. Grants; administration. Within the limits of the available appropriation,
432.4the commissioner must develop a swab team services program which may shall make
432.5demonstration and training grants to eligible organizations a nonprofit organization
432.6currently operating the CLEARCorps lead hazard reduction project to train workers to
432.7provide swab team services and swab team services for residential property. Grants may
432.8be awarded to nonprofit organizations to provide technical assistance and training to
432.9ensure quality and consistency within the statewide program. Grants must be awarded to
432.10help ensure full-time employment to workers providing swab team services and must be
432.11awarded for a two-year period.
432.12    Grants awarded under this section must be made in consultation with the
432.13commissioner of the Housing Finance Agency and representatives of neighborhood
432.14groups from areas at high risk for toxic lead exposure, a labor organization, the lead
432.15coalition, community action agencies, and the legal aid society. The consulting team must
432.16review grant applications and recommend awards to eligible organizations that meet
432.17requirements for receiving a grant under this section.
432.18    Subd. 3. Applicants. (a) Interested eligible organizations may apply to the
432.19commissioner for grants under this section. Two or more eligible organizations may
432.20jointly apply for a grant. Priority shall be given to community action agencies in greater
432.21Minnesota and to either community action agencies or neighborhood based nonprofit
432.22organizations in cities of the first class. Of the total annual appropriation, 12.5 percent may
432.23be used for administrative purposes. The commissioner may deviate from this percentage
432.24if a grantee can justify the need for a larger administrative allowance. Of this amount,
432.25up to five percent may be used by the commissioner for state administrative purposes.
432.26Applications must provide information requested by the commissioner, including at least
432.27the information required to assess the factors listed in paragraph (d).
432.28    (b) The commissioner must consult with boards of health to provide swab team
432.29services for purposes of secondary prevention. The priority for swab teams created
432.30by grants to eligible organizations under this section must be work assigned by the
432.31commissioner of health, or by a board of health if so designated by the commissioner of
432.32health, to provide secondary prevention swab team services to fulfill the requirements
432.33of section 144.9504, subdivision 6, in response to a lead order. Swab teams assigned
432.34work under this section by the commissioner, that are not engaged daily in fulfilling the
432.35requirements of section 144.9504, subdivision 6, must deliver swab team services in
432.36response to elevated blood lead levels as defined in section 144.9501, subdivision 9,
433.1where lead orders were not issued, and for purposes of primary prevention in census
433.2tracts known to be in areas at high risk for toxic lead exposure as described in section
433.3144.9503, subdivision 2.
433.4    (c) Any additional money must be used for grants to establish swab teams for
433.5primary prevention under section 144.9503, in census tracts in areas at high risk for toxic
433.6lead exposure as determined under section 144.9503, subdivision 2.
433.7    (d) In evaluating grant applications, the commissioner must consider the following
433.8criteria:
433.9    (1) the use of lead contractors and lead workers for residential swab team services;
433.10    (2) the participation of neighborhood groups and individuals, as swab team workers,
433.11in areas at high risk for toxic lead exposure;
433.12    (3) plans for the provision of swab team services for primary and secondary
433.13prevention as required under subdivision 4;
433.14    (4) plans for supervision, training, career development, and postprogram placement
433.15of swab team members;
433.16    (5) plans for resident and property owner education on lead safety;
433.17    (6) plans for distributing cleaning supplies to area residents and educating residents
433.18and property owners on cleaning techniques;
433.19    (7) sources of other funding and cost estimates for training, lead inspections, swab
433.20team services, equipment, monitoring, testing, and administration;
433.21    (8) measures of program effectiveness;
433.22    (9) coordination of program activities with other federal, state, and local public
433.23health, job training, apprenticeship, and housing renovation programs including programs
433.24under sections 116L.86 to 116L.881; and
433.25    (10) prior experience in providing swab team services.
433.26    Subd. 4. Lead supervisor or certified firm Eligible grant activities. (a) Eligible
433.27organizations and lead supervisors or certified firms may participate in the swab team
433.28program. An eligible organization The nonprofit receiving a grant under this section
433.29must assure ensure that all participating lead supervisors or certified firms are licensed
433.30and that all swab team workers are certified by the Department of Health under section
433.31144.9505 . Eligible organizations and lead supervisors or certified firms may distinguish
433.32between interior and exterior services in assigning duties and The nonprofit organization
433.33may participate in the program by:
433.34    (1) providing on-the-job training for swab team workers;
433.35    (2) providing swab team services to meet the requirements of sections 144.9503,
433.36subdivision 4 , and 144.9504, subdivision 6;
434.1    (3) providing a removal and replacement component using skilled craft workers
434.2under subdivision 7 lead hazard reduction to meet the requirements of section 144.9501,
434.3subdivision 17;
434.4    (4) providing lead testing according to subdivision 8;
434.5    (5) (4) providing lead dust cleaning supplies cleanup equipment and materials, as
434.6described in section 144.9507 144.9503, subdivision 4, paragraph (c) 1, to residents; or
434.7    (6) (5) having a swab team worker instruct residents and property owners on
434.8appropriate lead control techniques, including the lead-safe directives developed by the
434.9commissioner of health.;
434.10    (6) conducting blood lead testing events including screening children and pregnant
434.11women according to Department of Health screening guidelines;
434.12    (7) performing case management services according to Department of Health case
434.13management guidelines; or
434.14    (8) conducting mandated risk assessments under Minnesota Statutes, section
434.15144.9504, subdivision 2.
434.16    (b) Participating lead supervisors or certified firms must:
434.17    (1) demonstrate proof of workers' compensation and general liability insurance
434.18coverage;
434.19    (2) be knowledgeable about lead abatement requirements established by the
434.20Department of Housing and Urban Development and the Occupational Safety and Health
434.21Administration and lead hazard reduction requirements and lead-safe directives of the
434.22commissioner of health;
434.23    (3) demonstrate experience with on-the-job training programs;
434.24    (4) demonstrate an ability to recruit employees from areas at high risk for toxic
434.25lead exposure; and
434.26    (5) demonstrate experience in working with low-income clients.
434.27    Subd. 5. Swab team workers. Each worker engaged in swab team services
434.28established under this section must have blood lead concentrations below 15 micrograms
434.29of lead per deciliter of whole blood as determined by a baseline blood lead screening.
434.30Any The nonprofit organization receiving a grant under this section is responsible for lead
434.31screening and must assure ensure that all swab team workers meet the standards established
434.32in this subdivision. Grantees The nonprofit organization must use appropriate workplace
434.33procedures including following the lead-safe directives developed by the commissioner of
434.34health to reduce risk of elevated blood lead levels. Grantees The nonprofit organization
434.35and participating contractors must report all employee blood lead levels that exceed 15
434.36micrograms of lead per deciliter of whole blood to the commissioner of health.
435.1    Subd. 6. On-the-job training component. (a) Programs established under this
435.2section must provide on-the-job training for swab team workers.
435.3    (b) Swab team workers must receive monetary compensation equal to the prevailing
435.4wage as defined in section 177.42, subdivision 6, for comparable jobs in the licensed
435.5contractor's principal business.
435.6    Subd. 7. Removal and replacement component. (a) Within the limits of the
435.7available appropriation and if a need is identified by a lead inspector, the commissioner
435.8may establish a component for removal and replacement of deteriorated paint in residential
435.9properties according to the following criteria:
435.10    (1) components within a residence must have both deteriorated lead-based paint and
435.11substrate damage beyond repair or rotting wooden framework to be eligible for removal
435.12and replacement;
435.13    (2) all removal and replacement must be done using least-cost methods and
435.14following lead-safe directives;
435.15    (3) whenever windows and doors or other components covered with deteriorated
435.16lead-based paint have sound substrate or are not rotting, those components should be
435.17repaired, sent out for stripping, planed down to remove deteriorated lead-based paint, or
435.18covered with protective guards instead of being replaced, provided that such an activity is
435.19the least-cost method of providing the swab team service;
435.20    (4) removal and replacement or repair must be done by lead contractors using skilled
435.21craft workers or trained swab team members; and
435.22    (5) all craft work that requires a state license must be supervised by a person with
435.23a state license in the craft work being supervised. The grant recipient may contract for
435.24this supervision.
435.25    (b) The program design must:
435.26    (1) identify the need for on-the-job training of swab team workers to be removal and
435.27replacement workers; and
435.28    (2) describe plans to involve appropriate groups in designing methods to meet the
435.29need for training swab team workers.
435.30    Subd. 8. Testing and evaluation. (a) Testing of the environment is not necessary
435.31by swab teams whose work is assigned by the commissioner of health or a designated
435.32board of health under section 144.9504. The commissioner of health or designated board
435.33of health must share the analytical testing data collected on each residence for purposes
435.34of secondary prevention under section 144.9504 with the swab team workers in order to
435.35provide constructive feedback on their work and to the commissioner for the purposes
435.36set forth in paragraph (c).
436.1    (b) For purposes of primary prevention evaluation, the following samples must be
436.2collected: pretesting and posttesting of one noncarpeted floor dust lead sample and a
436.3notation of the extent and location of bare soil and of deteriorated lead-based paint. The
436.4analytical testing data collected on each residence for purposes of primary prevention
436.5under section 144.9503 must be shared with the swab team workers in order to provide
436.6constructive feedback on their work and to the commissioner for the purposes set forth in
436.7paragraph (c).
436.8    (c) The commissioner of health must establish a program to collect appropriate data
436.9as required under paragraphs (a) and (b), in order to conduct an ongoing evaluation of
436.10swab team services for primary and secondary prevention. Within the limits of available
436.11appropriations, the commissioner of health must conduct on up to 1,000 residences which
436.12have received primary or secondary prevention swab team services, a postremediation
436.13evaluation, on at least a quarterly basis for a period of at least two years for each residence.
436.14The evaluation must note the condition of the paint within the residence, the extent of bare
436.15soil on the grounds, and collect and analyze one noncarpeted floor dust lead sample.
436.16The data collected must be evaluated to determine the efficacy of providing swab team
436.17services as a method of reducing lead exposure in young children. In evaluating this data,
436.18the commissioner of health must consider city size, community location, historic traffic
436.19flow, soil lead level of the property by area or census tract, distance to industrial point
436.20sources that emit lead, season of the year, age of the housing, age and number of children
436.21living at the residence, the presence of pets that move in and out of the residence, and
436.22other relevant factors as the commissioner of health may determine.
436.23    Subd. 9. Program benefits. As a condition of providing swab team services under
436.24this section, an the nonprofit organization may require a property owner to not increase
436.25rents on a property solely as a result of a substantial improvement made with public
436.26funds under the programs in this section.
436.27    Subd. 10. Requirements of organizations receiving grants the nonprofit
436.28organization. An eligible The nonprofit organization that is awarded a training and
436.29demonstration grant under this section must prepare and submit a quarterly progress report
436.30to the commissioner beginning three months after receipt of the grant.

436.31    Sec. 15. [144.966] EARLY HEARING DETECTION AND INTERVENTION
436.32ACT.
436.33    Subdivision 1. Definitions. (a) "Child" means a person 18 years of age or younger.
437.1    (b) "False positive rate" means the proportion of infants identified as having a
437.2significant hearing loss by the screening process who are ultimately found to not have a
437.3significant hearing loss.
437.4    (c) "False negative rate" means the proportion of infants not identified as having
437.5a significant hearing loss by the screening process who are ultimately found to have a
437.6significant hearing loss.
437.7    (d) "Hearing screening test" means automated auditory brain stem response,
437.8otoacoustic emissions, or another appropriate screening test approved by the Department
437.9of Health.
437.10    (e) "Hospital" means a birthing health care facility or birthing center licensed in
437.11this state that provides obstetrical services.
437.12    (f) "Infant" means a child who is not a newborn and has not attained the age of
437.13one year.
437.14    (g) "Newborn" means an infant 28 days old or younger.
437.15    (h) "Parent" means a natural parent, stepparent, adoptive parent, guardian, or
437.16custodian of a newborn or infant.
437.17    Subd. 2. Newborn Hearing Screening Advisory Committee. (a) The
437.18commissioner of health shall appoint a Newborn Hearing Screening Advisory Committee
437.19to advise and assist the Department of Health and the Department of Education in:
437.20    (1) developing protocols and timelines for screening, rescreening, and diagnostic
437.21audiological assessment and early medical, audiological, and educational intervention
437.22services for children who are deaf or hard-of-hearing;
437.23    (2) designing protocols for tracking children from birth through age three that may
437.24have passed newborn screening but are at risk for delayed or late onset of permanent
437.25hearing loss;
437.26    (3) designing a technical assistance program to support facilities implementing the
437.27screening program and facilities conducting rescreening and diagnostic audiological
437.28assessment;
437.29    (4) designing implementation and evaluation of a system of follow-up and tracking;
437.30and
437.31    (5) evaluating program outcomes to increase effectiveness and efficiency and ensure
437.32culturally appropriate services for children with a confirmed hearing loss and their families.
437.33    (b) Membership of the committee shall include at least one member from each of the
437.34following groups with no less than two of the members being deaf or hard-of-hearing:
437.35    (1) a representative from a consumer organization representing culturally deaf
437.36persons;
438.1    (2) a parent with a child with hearing loss representing a parent organization;
438.2    (3) a consumer from an organization representing oral communication options;
438.3    (4) a consumer from an organization representing cued speech communication
438.4options;
438.5    (5) an audiologist who has experience in evaluation and intervention of infants
438.6and young children;
438.7    (6) a speech-language pathologist who has experience in evaluation and intervention
438.8of infants and young children;
438.9    (7) two primary care providers who have experience in the care of infants and young
438.10children, one of which shall be a pediatrician;
438.11    (8) a representative from the early hearing detection intervention teams;
438.12    (9) a representative from the Department of Education resource center for the deaf
438.13and hard-of-hearing or their designee;
438.14    (10) a representative of the Minnesota Commission Serving Deaf and Hard of
438.15Hearing People;
438.16    (11) a representative from the Department of Human Services Deaf and Hard of
438.17Hearing Services Division;
438.18    (12) one or more of the Part C coordinators from the Department of Education, the
438.19Department of Health, or the Department of Human Services or their designee;
438.20    (13) the Department of Health early hearing detection and intervention coordinator;
438.21    (14) two birth hospital representatives from one rural and one urban hospital;
438.22    (15) a pediatric geneticist;
438.23    (16) an otolaryngologist;
438.24    (17) a representative from the Newborn Screening Advisory Committee under
438.25this subdivision; and
438.26    (18) a representative of the Department of Education regional low-incidence
438.27facilitators.
438.28    The Department of Health member shall chair the first meeting of the committee.
438.29At the first meeting, the committee shall elect a chairperson from its membership. The
438.30committee shall meet at the call of the chairperson, at least four times a year. The
438.31committee shall adopt written bylaws to govern its activities. The Department of Health
438.32shall provide technical and administrative support services as required by the committee.
438.33These services shall include technical support from individuals qualified to administer
438.34infant hearing screening, rescreening, and diagnostic audiological assessments.
439.1    Members of the committee shall receive no compensation for their service, but
439.2shall be reimbursed for expenses incurred as a result of their duties as members of the
439.3committee.
439.4    Subd. 3. Newborn and infant hearing screening programs. All hospitals shall
439.5establish a Universal Newborn Hearing and Infant Screening (UNHS) program. Each
439.6UNHS program shall:
439.7    (1) in advance of any hearing screening testing, provide to the newborn's or infant's
439.8parents information concerning the nature of the screening procedure, applicable costs of
439.9the screening procedure, the potential risks and effects of hearing loss, and the benefits of
439.10early detection and intervention;
439.11    (2) comply with parental consent under section 144.125, subdivision 3;
439.12    (3) develop policies and procedures for screening and rescreening based on
439.13Department of Health recommendations;
439.14    (4) provide appropriate training and monitoring of individuals responsible for
439.15performing hearing screening tests as recommended by the Department of Health;
439.16    (5) test the newborn's hearing prior to discharge, or, if the newborn is expected to
439.17remain in the hospital for a prolonged period, testing shall be performed prior to three
439.18months of age, or when medically feasible;
439.19    (6) develop and implement procedures for documenting the results of all hearing
439.20screening tests;
439.21    (7) inform the baby's parents or parent, primary care physician, and the Department
439.22of Health according to recommendations of the Department of Health of the results of the
439.23hearing screening test or rescreening if conducted, or if the newborn or infant was not
439.24successfully tested. The hospital that discharges the baby to home is responsible for
439.25the screening; and
439.26    (8) collect performance data specified by the Department of Health.
439.27    Subd. 4. Notification and information. (a) Notification to the parents, primary
439.28care provider, and Department of Health shall occur prior to discharge or no later than ten
439.29days following the date of testing. Notification shall include information recommended by
439.30the Department of Health.
439.31    (b) A physician, nurse, midwife, or other health professional attending a birth outside
439.32a hospital or institution shall provide information, orally and in writing, as established by
439.33the Department of Health, to parents regarding places where the parents may have their
439.34infants' hearing screened and the importance of such screening.
440.1    (c) The professional conducting the diagnostic procedure to confirm the hearing loss
440.2must report the results to the parents, primary care provider, and Department of Health
440.3according to the Department of Health recommendations.
440.4    Subd. 5. Oversight responsibility. The Department of Health shall exercise
440.5oversight responsibility for UNHS programs, including establishing a performance data
440.6set and reviewing performance data collected by each hospital.
440.7    Subd. 6. Civil and criminal immunity and penalties. (a) No physician or hospital
440.8shall be civilly or criminally liable for failure to conduct hearing screening testing.
440.9    (b) No physician, midwife, nurse, other health professional, or hospital acting in
440.10compliance with this section shall be civilly or criminally liable for any acts conforming
440.11with this section, including furnishing information required according to this section.
440.12    Subd. 7. Laboratory service fees. The commissioner shall charge laboratory
440.13service fees according to section 16A.1285 so that the total of fees collected will
440.14approximate the costs of implementing and maintaining a system to follow up infants,
440.15provide technical assistance, a tracking system, data management, and evaluation.
440.16EFFECTIVE DATE.This section is effective the day following final enactment.

440.17    Sec. 16. [144.967] ARSENIC HEALTH RISK STANDARD.
440.18    Subdivision 1. Arsenic health risk standard established. The commissioner of
440.19health in cooperation with the commissioners of agriculture and the Pollution Control
440.20Agency responsible for monitoring land and water cleanup and soil contamination
440.21information shall determine a health risk standard for human exposure to arsenic. The
440.22commissioner of health shall ensure that the established arsenic health risk standard is
440.23included in all information provided to the public.
440.24    Subd. 2. Information. The commissioner of health, in consultation with the
440.25commissioners of agriculture and the Pollution Control Agency with jurisdiction over
440.26soil and water contamination, shall establish a central information source available to
440.27the public to provide accurate information on arsenic soil and water contamination in
440.28residential areas.
440.29    Subd. 3. Testing for arsenic. (a) The commissioner of health shall ensure access
440.30to medical testing for arsenical pesticide exposure to persons living within one mile of
440.31the CMC Heartland Lite Yard Superfund site who are not covered by health insurance or
440.32medical assistance.
440.33    (b) Through an agreement with the United States Environmental Protection Agency,
440.34the commissioner shall ensure soil testing is available to households within one mile of the
440.35CMC Heartland Lite Yard Superfund site at no cost to the residents.
441.1    Subd. 4. Evaluation. The commissioner of health shall evaluate the cumulative
441.2health impact burdens of environmental toxins in the residential communities impacted by
441.3arsenic-contaminated soil from the CMC Heartland Lite Yard Superfund site. The first
441.4priority shall be to evaluate health burdens to those communities experiencing health
441.5disparities as documented by the Minority and Multicultural Health Division of the
441.6Minnesota Department of Health.

441.7    Sec. 17. [144.995] DEFINITIONS.
441.8    (a) For purposes of sections 144.995 to 144.998, the terms in this section have
441.9the meanings given.
441.10    (b) "Advisory panel" means the Environmental Health Tracking and Biomonitoring
441.11Advisory Panel established under section 144.998.
441.12    (c) "Biomonitoring" means the process by which chemicals and their metabolites are
441.13identified and measured within a biospecimen.
441.14    (d) "Biospecimen" means a sample of human fluid, serum, or tissue that is reasonably
441.15available as a medium to measure the presence and concentration of chemicals or their
441.16metabolites in a human body.
441.17    (e) "Commissioner" means the commissioner of the Department of Health.
441.18    (f) "Community" means geographically or nongeographically-based populations
441.19that may participate in the biomonitoring program. A "nongeographical community"
441.20includes, but is not limited to, populations that may share a common chemical exposure
441.21through similar occupations, populations experiencing a common health outcome that
441.22may be linked to chemical exposures, or populations that may experience similar chemical
441.23exposures because of comparable consumption, lifestyle, product use, or subpopulations
441.24that share ethnicity, age, or gender.
441.25    (g) "Department" means the Department of Health.
441.26    (h) "Designated chemicals" means those chemicals that are known to, or strongly
441.27suspected of, adversely impacting human health or development, based upon scientific,
441.28peer-reviewed animal, human, or in vitro studies, and baseline human exposure data,
441.29and consists of chemical families or metabolites that are included in the federal Centers
441.30for Disease Control and Prevention studies that are known collectively as the National
441.31Reports on Human Exposure to Environmental Chemicals program and any substances
441.32specified under section 144.998, subdivision 3, clause (6).
441.33    (i) "Environmental hazard" means a chemical, metal, or other substance for which
441.34scientific, peer-reviewed studies of humans, animals, or cells have demonstrated that the
441.35chemical is known or reasonably anticipated to adversely impact human health.
442.1    (j) "Environmental health tracking" means collection, integration, analysis, and
442.2dissemination of data on human exposures to chemicals in the environment and on
442.3diseases potentially caused or aggravated by those chemicals.

442.4    Sec. 18. [144.996] ENVIRONMENTAL HEALTH TRACKING;
442.5BIOMONITORING.
442.6    Subdivision 1. Environmental health tracking. In cooperation with the
442.7commissioner of the Pollution Control Agency, the commissioner shall establish an
442.8environmental health tracking program to:
442.9    (1) coordinate data collection activities with the Pollution Control Agency,
442.10Department of Agriculture, University of Minnesota, and any other relevant state agency
442.11and work to promote the sharing of and access to health and environmental databases
442.12in order to develop an environmental health tracking system for Minnesota, consistent
442.13with applicable data practices laws;
442.14    (2) facilitate the dissemination of public health tracking data to the public and
442.15researchers in accessible format and provide technical assistance on interpreting the data;
442.16    (3) develop written data sharing agreements with the Minnesota Pollution Control
442.17Agency, Department of Agriculture, and other relevant state agencies and organizations,
442.18and develop additional procedures as needed to protect individual privacy;
442.19    (4) develop a strategic plan that includes a mission statement, the identification of
442.20core priorities for research and epidemiologic surveillance, the identification of internal
442.21and external stakeholders, and a work plan describing future program development;
442.22    (5) organize, analyze, and interpret available data, in order to:
442.23    (i) characterize statewide and localized trends and geographic patterns of prevalence
442.24and incidence of chronic diseases, including, but not limited to, cancer, respiratory
442.25diseases, reproductive problems, birth defects, neurologic diseases, and developmental
442.26disorders;
442.27    (ii) recommend to the commissioner methods to improve data collection on
442.28statewide population rates of chronic diseases and the occurrence of environmental
442.29hazards and exposures;
442.30    (iii) characterize statewide and localized trends and geographic patterns in the
442.31occurrence of environmental hazards and exposures;
442.32    (iv) assess the level of correlation with disease rate data and indicators of exposure
442.33such as biomonitoring data, and other health and environmental data;
443.1    (v) incorporate newly collected and existing health tracking and biomonitoring
443.2data into efforts to identify communities with elevated rates of chronic disease, higher
443.3likelihood of exposure to environmental pollutants, or both;
443.4    (vi) analyze occurrence of environmental hazards, exposures, and diseases with
443.5relation to socioeconomic status, race, and ethnicity;
443.6    (vii) develop and implement targeted plans to conduct more intensive health tracking
443.7and biomonitoring among communities;
443.8    (viii) work with the Pollution Control Agency, the Department of Agriculture, and
443.9other relevant state agency personnel and organizations to develop, implement, and
443.10evaluate preventive measures to reduce elevated rates of diseases and exposures identified
443.11through activities performed under sections 144.995 to 144.998; and
443.12    (ix) provide baseline data and present descriptive information relevant to policy
443.13formation that are consistent with existing goals of the department; and
443.14    (6) submit a biennial report to the legislature by January 15, beginning January
443.1515, 2009, on the status of environmental health tracking activities and related research
443.16programs, and making recommendations regarding the continuation and improvement of
443.17the programs.
443.18    Subd. 2. Biomonitoring. The commissioner shall:
443.19    (1) conduct biomonitoring of communities on a voluntary basis by collecting and
443.20analyzing biospecimens, as appropriate, to assess environmental exposures to designated
443.21chemicals;
443.22    (2) conduct biomonitoring of pregnant women and minors on a voluntary basis,
443.23when scientifically appropriate;
443.24    (3) communicate findings to the public, and plan ensuing stages of biomonitoring
443.25and disease tracking work to further develop and refine the integrated analysis;
443.26    (4) share analytical results with the advisory panel and work with the panel
443.27to interpret results, communicate findings to the public, and plan ensuing stages of
443.28biomonitoring work; and
443.29    (5) submit a biennial report to the legislature by January 15, beginning January
443.3015, 2009, on the status of the biomonitoring program and any recommendations for
443.31improvement.
443.32    Subd. 3. Health data. Data collected under the biomonitoring program are health
443.33data under section 13.3805.

443.34    Sec. 19. [144.997] BIOMONITORING PILOT PROGRAM.
444.1    Subdivision 1. Pilot program. With advice from the advisory panel, the
444.2commissioner shall develop a biomonitoring pilot program. The program shall collect
444.3one biospecimen from each of the voluntary participants. The biospecimen selected must
444.4be the biospecimen that most accurately represents body concentration of the chemical
444.5of interest. Each biospecimen from the voluntary participants must be analyzed for one
444.6type or class of related chemicals or metals, based on recommendations from the advisory
444.7panel. The panel shall determine the chemical or class of chemicals that community
444.8members were most likely exposed to. The program shall collect and assess biospecimens
444.9in accordance with the following:
444.10    (1) 30 voluntary participants from each of three communities that the advisory panel
444.11identifies as likely to have been exposed to a designated chemical;
444.12    (2) 100 voluntary participants from each of two communities: (i) that the advisory
444.13panel identifies as likely to have been exposed to arsenic and (ii) that the advisory panel
444.14identifies as likely to have been exposed to mercury; and
444.15    (3) 100 voluntary participants from each of two communities that the advisory panel
444.16identifies as likely to have been exposed to perfluorinated chemicals.
444.17    Subd. 2. Base program. Following the conclusion of the pilot program and within
444.18the appropriations available, the program shall:
444.19    (1) collect and assess biospecimens from at least as many voluntary participants and
444.20communities as identified in subdivision 1, clause (1); and
444.21    (2) work with the advisory panel to assess the usefulness of continuing biomonitoring
444.22among members of communities assessed during the initial phase of the program,
444.23and to identify other communities and other designated chemicals to be assessed via
444.24biomonitoring.
444.25    Subd. 3. Participation. (a) Participation in the biomonitoring program by providing
444.26biospecimens is voluntary and requires written, informed consent. Minors may participate
444.27in the program if a written consent is signed by the minor's parent or legal guardian.
444.28The written consent must include the information required to be provided under this
444.29subdivision to all voluntary participants.
444.30    (b) All participants shall be evaluated for the presence of the designated chemical
444.31of interest as a component of the biomonitoring process. Participants shall be provided
444.32with information and fact sheets about the program's activities and its findings.
444.33Individual participants shall, if requested, receive their complete results. Any results
444.34provided to participants shall be subject to the Department of Health Institutional
444.35Review Board protocols and guidelines. When either physiological or chemical data
444.36obtained from a participant indicate a significant known health risk, program staff
445.1experienced in communicating biomonitoring results shall consult with the individual
445.2and recommend follow-up steps, as appropriate. Program administrators shall receive
445.3training in administering the program in an ethical, culturally sensitive, participatory,
445.4and community-based manner.
445.5    Subd. 4. Program guidelines. (a) The commissioner, in consultation with the
445.6advisory panel, shall develop:
445.7    (1) protocols or program guidelines that address the science and practice of
445.8biomonitoring to be utilized and procedures for changing those protocols to incorporate
445.9new and more accurate or efficient technologies as they become available. The protocols
445.10shall be developed utilizing a peer-review process in a manner that is participatory and
445.11community-based in design, implementation, and evaluation;
445.12    (2) guidelines for ensuring the privacy of information; informed consent; follow-up
445.13counseling and support; and communicating findings to participants, communities, and
445.14the general public. The informed consent used for the program must meet the informed
445.15consent protocols developed by the National Institutes of Health;
445.16    (3) educational and outreach materials that are culturally appropriate for
445.17dissemination to program participants and communities. Priority shall be given to the
445.18development of materials specifically designed to ensure that parents are informed about
445.19all of the benefits of breastfeeding so that the program does not result in an unjustified fear
445.20of toxins in breast milk, which might inadvertently lead parents to avoid breastfeeding.
445.21The materials shall communicate relevant scientific findings; data on the accumulation
445.22of pollutants to community health; and the required responses by local, state, and other
445.23governmental entities in regulating toxicant exposures;
445.24    (4) a training program that is culturally sensitive specifically for health care
445.25providers, health educators, and other program administrators;
445.26    (5) a designation process for state and private laboratories that are qualified to
445.27analyze biospecimens and report the findings; and
445.28    (6) a method for informing affected communities and local governments representing
445.29those communities concerning biomonitoring activities and for receiving comments from
445.30citizens concerning those activities.
445.31    (b) The commissioner may enter into contractual agreements with health clinics,
445.32community-based organizations, or experts in a particular field to perform any of the
445.33activities described under this section.

445.34    Sec. 20. [144.998] ENVIRONMENTAL HEALTH TRACKING AND
445.35BIOMONITORING ADVISORY PANEL.
446.1    Subdivision 1. Creation. The commissioner shall establish the Environmental
446.2Health Tracking and Biomonitoring Advisory Panel. The commissioner shall appoint,
446.3from the panel's membership, a chair. The panel shall meet as often as it deems necessary
446.4but, at a minimum, on a quarterly basis. Members of the panel shall serve without
446.5compensation but shall be reimbursed for travel and other necessary expenses incurred
446.6through performance of their duties. Members appointed under this subdivision are
446.7appointed for a three-year term and may be reappointed.
446.8    Subd. 2. Members. The commissioner shall appoint eight members, none of whom
446.9may be lobbyists registered under chapter 10A, who have backgrounds or training in
446.10designing, implementing, and interpreting health tracking and biomonitoring studies or
446.11in related fields of science, including epidemiology, biostatistics, environmental health,
446.12laboratory sciences, occupational health, industrial hygiene, toxicology, and public health,
446.13including:
446.14    (1) two scientists who represent nongovernmental organizations with a focus on
446.15environmental health, environmental justice, children's health, or on specific chronic
446.16diseases; and
446.17    (2) one scientist who is a representative of the University of Minnesota.
446.18    In addition, the commissioner shall appoint one member representing each of the
446.19following departments or divisions: the department's health promotion and chronic disease
446.20division, the Pollution Control Agency, and the Department of Agriculture.
446.21    Subd. 3. Duties. The advisory panel shall make recommendations to the
446.22commissioner and the legislature on:
446.23    (1) priorities for health tracking;
446.24    (2) priorities for biomonitoring that are based on sound science and practice, and
446.25that will advance the state of public health in Minnesota;
446.26    (3) specific chronic diseases to study under the environmental health tracking system;
446.27    (4) specific environmental pollutant exposures to study under the environmental
446.28health tracking system, with the agreement of at least seven of the advisory panel members;
446.29    (5) specific communities and geographic areas on which to focus environmental
446.30health tracking and biomonitoring efforts;
446.31    (6) specific chemicals and metals to study under the biomonitoring program that meet
446.32the following criteria, with the agreement of at least seven of the advisory panel members:
446.33    (i) the degree of potential exposure to the public or specific subgroups, including,
446.34but not limited to, occupational;
447.1    (ii) the likelihood of a chemical being a carcinogen or toxicant based on
447.2peer-reviewed health data, the chemical structure, or the toxicology of chemically related
447.3compounds;
447.4    (iii) the limits of laboratory detection for the chemical, including the ability to detect
447.5the chemical at low enough levels that could be expected in the general population;
447.6    (iv) exposure or potential exposure to the public or specific subgroups;
447.7    (v) the known or suspected health effects resulting from the same level of exposure
447.8based on peer-reviewed scientific studies;
447.9    (vi) the need to assess the efficacy of public health actions to reduce exposure to a
447.10chemical;
447.11    (vii) the availability of a biomonitoring analytical method with adequate accuracy,
447.12precision, sensitivity, specificity, and speed;
447.13    (viii) the availability of adequate biospecimen samples; and
447.14    (ix) other criteria that the panel may agree to; and
447.15    (7) other aspects of the design, implementation, and evaluation of the environmental
447.16health tracking and biomonitoring system, including, but not limited to:
447.17    (i) identifying possible community partners and sources of additional public or
447.18private funding;
447.19    (ii) developing outreach and educational methods and materials; and
447.20    (iii) disseminating environmental health tracking and biomonitoring findings to
447.21the public.
447.22    Subd. 4. Liability. No member of the panel shall be held civilly or criminally liable
447.23for an act or omission by that person if the act or omission was in good faith and within
447.24the scope of the member's responsibilities under sections 144.995 to 144.998.

447.25    Sec. 21. Minnesota Statutes 2006, section 144E.101, subdivision 6, is amended to read:
447.26    Subd. 6. Basic life support. (a) Except as provided in paragraph (e), a basic life
447.27support ambulance shall be staffed by at least two ambulance service personnel, at least
447.28one of which must be an EMT, who provide a level of care so as to ensure that:
447.29    (1) life-threatening situations and potentially serious injuries are recognized;
447.30    (2) patients are protected from additional hazards;
447.31    (3) basic treatment to reduce the seriousness of emergency situations is administered;
447.32and
447.33    (4) patients are transported to an appropriate medical facility for treatment.
447.34    (b) A basic life support service shall provide basic airway management.
448.1    (c) By January 1, 2001, a basic life support service shall provide automatic
448.2defibrillation, as provided in section 144E.103, subdivision 1, paragraph (b).
448.3    (d) A basic life support service licensee's medical director may authorize the
448.4ambulance service personnel to carry and to use medical antishock trousers and to perform
448.5intravenous infusion if the ambulance service personnel have been properly trained.
448.6    (e) Upon application from an ambulance service that includes evidence
448.7demonstrating hardship, the board may grant a temporary variance from the staff
448.8requirements in paragraph (a) and may authorize a basic life support ambulance to be
448.9staffed by one EMT and one first responder. The variance shall apply to basic life support
448.10ambulances operated by the ambulance service for up to one year from the date of the
448.11variance's issuance until the ambulance service renews its license. When a variance
448.12expires, an ambulance service may apply for a new variance under this paragraph. For
448.13purposes of this paragraph, "ambulance service" means either an ambulance service whose
448.14primary service area is located outside the metropolitan counties listed in section 473.121,
448.15subdivision 4 , and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
448.16Cloud; or an ambulance service based in a community with a population of less than 1,000.

448.17    Sec. 22. Minnesota Statutes 2006, section 144E.127, is amended to read:
448.18144E.127 INTERHOSPITAL; INTERFACILITY TRANSFER.
448.19    Subdivision 1. Interhospital transfers. When transporting a patient from one
448.20licensed hospital to another, a licensee may substitute for one of the required ambulance
448.21service personnel, a physician, a registered nurse, or physician's assistant who has been
448.22trained to use the equipment in the ambulance and is knowledgeable of the licensee's
448.23ambulance service protocols.
448.24    Subd. 2. Interfacility transfers. In an interfacility transport, a licensee whose
448.25primary service area is located outside the metropolitan counties listed in section 473.121,
448.26subdivision 4, and outside the cities of Duluth, Mankato, Moorhead, Rochester, and St.
448.27Cloud; or an ambulance service based in a community with a population of less than 1,000,
448.28may substitute one EMT with a registered first responder if an EMT or EMT-paramedic,
448.29physician, registered nurse, or physician's assistant is in the patient compartment. If using
448.30a physician, registered nurse, or physician's assistant as the sole provider in the patient
448.31compartment, the individual must be trained to use the equipment in the ambulance and be
448.32knowledgeable of the ambulance service protocols.

448.33    Sec. 23. Minnesota Statutes 2006, section 144E.35, subdivision 1, is amended to read:
449.1    Subdivision 1. Repayment for volunteer training. Any political subdivision, or
449.2nonprofit hospital or nonprofit corporation operating A licensed ambulance service shall
449.3be reimbursed by the board for the necessary expense of the initial training of a volunteer
449.4ambulance attendant upon successful completion by the attendant of a basic emergency
449.5care course, or a continuing education course for basic emergency care, or both, which has
449.6been approved by the board, pursuant to section 144E.285. Reimbursement may include
449.7tuition, transportation, food, lodging, hourly payment for the time spent in the training
449.8course, and other necessary expenditures, except that in no instance shall a volunteer
449.9ambulance attendant be reimbursed more than $450 $600 for successful completion of a
449.10basic course, and $225 $275 for successful completion of a continuing education course.

449.11    Sec. 24. [145.958] BISPHENOL-A IN PRODUCTS FOR CHILDREN.
449.12    Subdivision. 1. Bisphenol-A and phthalates committee. The commissioner of
449.13health shall create a committee under the direction of the environmental health division of
449.14the Department of Health to study the scientific literature and make recommendations to
449.15the legislature on the health impact of bisphenol-A and phthalates on children in products
449.16intended for use by young children, including, but not limited to, toys, pacifiers, baby
449.17bottles, and teethers, and report back by January 15, 2008. The committee shall also
449.18identify least harmful alternatives. Of the seven committee members at least one shall be a
449.19representative of the Department of Health, one shall be a representative of environmental
449.20health sciences research, one shall be a representative of the Minnesota Nurses
449.21Association, one shall be a representative of environmental health consumer advocates,
449.22one shall be a member of a children's product manufacturer's association, and one shall be
449.23a representative of the University of Minnesota, chemical plastics research department.
449.24    Subd. 2. Definitions. For the purposes of this section, the following terms have
449.25the meanings given them:
449.26    (a) "Toy" means all products designed or intended by the manufacturer to be used by
449.27children when they play.
449.28    (b) "Child care article" means all products designed or intended by the manufacturer
449.29to facilitate sleep, relaxation, or the feeding of children or to help children with sucking or
449.30teething.

449.31    Sec. 25. Minnesota Statutes 2006, section 145A.17, is amended to read:
449.32145A.17 FAMILY HOME VISITING PROGRAMS.
449.33    Subdivision 1. Establishment; goals. The commissioner shall establish a program
449.34to fund family home visiting programs designed to foster a healthy beginning for children
450.1in families at or below 200 percent of the federal poverty guidelines beginnings, improve
450.2pregnancy outcomes, promote school readiness, prevent child abuse and neglect, reduce
450.3juvenile delinquency, promote positive parenting and resiliency in children, and promote
450.4family health and economic self-sufficiency for children and families. The commissioner
450.5shall promote partnerships, collaboration, and multidisciplinary visiting done by teams of
450.6professionals and paraprofessionals from the fields of public health nursing, social work,
450.7and early childhood education. A program funded under this section must serve families
450.8at or below 200 percent of the federal poverty guidelines, and other families determined
450.9to be at risk, including but not limited to being at risk for child abuse, child neglect, or
450.10juvenile delinquency. Programs must give priority for services to families considered to
450.11be in need of services, including but not limited to begin prenatally whenever possible and
450.12must be targeted to families with:
450.13    (1) adolescent parents;
450.14    (2) a history of alcohol or other drug abuse;
450.15    (3) a history of child abuse, domestic abuse, or other types of violence;
450.16    (4) a history of domestic abuse, rape, or other forms of victimization;
450.17    (5) reduced cognitive functioning;
450.18    (6) a lack of knowledge of child growth and development stages;
450.19    (7) low resiliency to adversities and environmental stresses; or
450.20    (8) insufficient financial resources to meet family needs;
450.21    (9) a history of homelessness;
450.22    (10) a risk of long-term welfare dependence or family instability due to employment
450.23barriers; or
450.24    (11) other risk factors as determined by the commissioner.
450.25    Subd. 3. Requirements for programs; process. (a) Before a community health
450.26board or tribal government may receive an allocation under subdivision 2, a community
450.27health board or tribal government must submit a proposal to the commissioner that
450.28includes identification, based on a community assessment, of the populations at or below
450.29200 percent of the federal poverty guidelines that will be served and the other populations
450.30that will be served. Each program that receives funds must Community health boards
450.31and tribal governments that receive funding under this section must submit a plan to
450.32the commissioner describing a multidisciplinary approach to targeted home visiting for
450.33families. The plan must be submitted on forms provided by the commissioner. At a
450.34minimum, the plan must include the following:
450.35    (1) a description of outreach strategies to families prenatally or at birth;
450.36    (2) provisions for the seamless delivery of health, safety, and early learning services;
451.1    (3) methods to promote continuity of services when families move within the state;
451.2    (4) a description of the community demographics;
451.3    (5) a plan for meeting outcome measures; and
451.4    (6) a proposed work plan that includes:
451.5    (i) coordination to ensure nonduplication of services for children and families;
451.6    (ii) a description of the strategies to ensure that children and families at greatest risk
451.7receive appropriate services; and
451.8    (iii) collaboration with multidisciplinary partners including public health,
451.9ECFE, Head Start, community health workers, social workers, community home
451.10visiting programs, school districts, and other relevant partners. Letters of intent from
451.11multidisciplinary partners must be submitted with the plan.
451.12    (b) Each program that receives funds must accomplish the following program
451.13requirements:
451.14    (1) use either a broad community-based or selective community-based strategy to
451.15provide preventive and early intervention home visiting services;
451.16    (2) offer a home visit by a trained home visitor. If a home visit is accepted, the first
451.17home visit must occur prenatally or as soon after birth as possible and must include a
451.18public health nursing assessment by a public health nurse;
451.19    (3) offer, at a minimum, information on infant care, child growth and development,
451.20positive parenting, preventing diseases, preventing exposure to environmental hazards,
451.21and support services available in the community;
451.22    (4) provide information on and referrals to health care services, if needed, including
451.23information on and assistance in applying for health care coverage for which the child or
451.24family may be eligible; and provide information on preventive services, developmental
451.25assessments, and the availability of public assistance programs as appropriate;
451.26    (5) provide youth development programs when appropriate;
451.27    (6) recruit home visitors who will represent, to the extent possible, the races,
451.28cultures, and languages spoken by families that may be served;
451.29    (7) train and supervise home visitors in accordance with the requirements established
451.30under subdivision 4;
451.31    (8) maximize resources and minimize duplication by coordinating activities or
451.32contracting with local social and human services organizations, education organizations,
451.33and other appropriate governmental entities and community-based organizations and
451.34agencies; and
451.35    (9) utilize appropriate racial and ethnic approaches to providing home visiting
451.36services; and
452.1    (10) connect eligible families, as needed, to additional resources available in the
452.2community, including, but not limited to, early care and education programs, health or
452.3mental health services, family literacy programs, employment agencies, social services,
452.4and child care resources and referral agencies.
452.5    (c) When available, programs that receive funds under this section must offer or
452.6provide the family with a referral to center-based or group meetings that meet at least
452.7once per month for those families identified with additional needs. The meetings must
452.8focus on further enhancing the information, activities, and skill-building addressed during
452.9home visitation; offering opportunities for parents to meet with and support each other;
452.10and offering infants and toddlers a safe, nurturing, and stimulating environment for
452.11socialization and supervised play with qualified teachers.
452.12    (b) (d) Funds available under this section shall not be used for medical services. The
452.13commissioner shall establish an administrative cost limit for recipients of funds. The
452.14outcome measures established under subdivision 6 must be specified to recipients of
452.15funds at the time the funds are distributed.
452.16    (c) (e) Data collected on individuals served by the home visiting programs must
452.17remain confidential and must not be disclosed by providers of home visiting services
452.18without a specific informed written consent that identifies disclosures to be made.
452.19Upon request, agencies providing home visiting services must provide recipients with
452.20information on disclosures, including the names of entities and individuals receiving the
452.21information and the general purpose of the disclosure. Prospective and current recipients
452.22of home visiting services must be told and informed in writing that written consent for
452.23disclosure of data is not required for access to home visiting services.
452.24    Subd. 4. Training. The commissioner shall establish training requirements for
452.25home visitors and minimum requirements for supervision by a public health nurse. The
452.26requirements for nurses must be consistent with chapter 148. The commissioner must
452.27provide training for home visitors. Training must include child development, positive
452.28parenting techniques, screening and referrals for child abuse and neglect, and diverse
452.29cultural practices in child rearing and family systems the following:
452.30    (1) effective relationships for engaging and retaining families and ensuring family
452.31health, safety, and early learning;
452.32    (2) effective methods of implementing parent education, conducting home visiting,
452.33and promoting quality early childhood development;
452.34    (3) early childhood development from birth to age five;
452.35    (4) diverse cultural practices in child rearing and family systems;
452.36    (5) recruiting, supervising, and retaining qualified staff;
453.1    (6) increasing services for underserved populations; and
453.2    (7) relevant issues related to child welfare and protective services, with information
453.3provided being consistent with state child welfare agency training.
453.4    Subd. 5. Technical assistance. The commissioner shall provide administrative
453.5and technical assistance to each program, including assistance in data collection and
453.6other activities related to conducting short- and long-term evaluations of the programs
453.7as required under subdivision 7. The commissioner may request research and evaluation
453.8support from the University of Minnesota.
453.9    Subd. 6. Outcome and performance measures. The commissioner shall establish
453.10outcomes measures to determine the impact of family home visiting programs funded
453.11under this section on the following areas:
453.12    (1) appropriate utilization of preventive health care;
453.13    (2) rates of substantiated child abuse and neglect;
453.14    (3) rates of unintentional child injuries;
453.15    (4) rates of children who are screened and who pass early childhood screening; and
453.16    (5) rates of children accessing early care and educational services;
453.17    (6) program retention rates;
453.18    (7) number of home visits provided compared to the number of home visits planned;
453.19    (8) participant satisfaction;
453.20    (9) rates of at-risk populations reached; and
453.21    (10) any additional qualitative goals and quantitative measures established by the
453.22commissioner.
453.23    Subd. 7. Evaluation. Using the qualitative goals and quantitative outcome and
453.24performance measures established under subdivisions 1 and 6, the commissioner shall
453.25conduct ongoing evaluations of the programs funded under this section. Community
453.26health boards and tribal governments shall cooperate with the commissioner in the
453.27evaluations and shall provide the commissioner with the information necessary to conduct
453.28the evaluations. As part of the ongoing evaluations, the commissioner shall rate the impact
453.29of the programs on the outcome measures listed in subdivision 6, and shall periodically
453.30determine whether home visiting programs are the best way to achieve the qualitative
453.31goals established under subdivisions 1 and 6. If the commissioner determines that home
453.32visiting programs are not the best way to achieve these goals, the commissioner shall
453.33provide the legislature with alternative methods for achieving them.
453.34    Subd. 8. Report. By January 15, 2002, and January 15 of each even-numbered
453.35year thereafter, the commissioner shall submit a report to the legislature on the family
454.1home visiting programs funded under this section and on the results of the evaluations
454.2conducted under subdivision 7.
454.3    Subd. 9. No supplanting of existing funds. Funding available under this section
454.4may be used only to supplement, not to replace, nonstate funds being used for home
454.5visiting services as of July 1, 2001.

454.6    Sec. 26. Minnesota Statutes 2006, section 156.001, is amended by adding a subdivision
454.7to read:
454.8    Subd. 10a. Program for the Assessment of Veterinary Education Equivalence;
454.9PAVE certificate. A "Program for the Assessment of Veterinary Education Equivalence"
454.10or "PAVE" certificate is issued by the American Association of Veterinary State Boards,
454.11indicating that the holder has demonstrated knowledge and skill equivalent to that
454.12possessed by a graduate of an accredited or approved college of veterinary medicine.

454.13    Sec. 27. [156.015] FEES.
454.14    Subdivision 1. Verification of licensure. The board may charge a fee of $25 per
454.15license verification to a licensee for verification of licensure status provided to other
454.16veterinary licensing boards.
454.17    Subd. 2. Continuing education review. The board may charge a fee of $50 per
454.18submission to a sponsor for review and approval of individual continuing education
454.19seminars, courses, wet labs, and lectures. This fee does not apply to continuing education
454.20sponsors that already meet the criteria for preapproval under Minnesota Rules, part
454.219100.1000, subpart 3, item A.

454.22    Sec. 28. Minnesota Statutes 2006, section 156.02, subdivision 1, is amended to read:
454.23    Subdivision 1. License application. Application for a license to practice veterinary
454.24medicine in this state shall be made in writing to the Board of Veterinary Medicine upon a
454.25form furnished by the board, accompanied by satisfactory evidence that the applicant is at
454.26least 18 years of age, is of good moral character, and has one of the following:
454.27    (1) a diploma conferring the degree of doctor of veterinary medicine, or an
454.28equivalent degree, from an accredited or approved college of veterinary medicine;
454.29    (2) an ECFVG or PAVE certificate; or
454.30    (3) a certificate from the dean of an accredited or approved college of veterinary
454.31medicine stating that the applicant is a student in good standing expecting to be graduated
454.32at the completion of the current academic year of the college in which the applicant is
454.33enrolled.
455.1    The application shall contain the information and material required by subdivision
455.22 and any other information that the board may, in its sound judgment, require. The
455.3application shall be filed with the board at least 60 days before the date of the examination.
455.4If the board deems it advisable, it may require that such application be verified by the
455.5oath of the applicant.

455.6    Sec. 29. Minnesota Statutes 2006, section 156.02, subdivision 2, is amended to read:
455.7    Subd. 2. Required with application. Every application shall contain the following
455.8information and material:
455.9    (1) the application fee set by the board in the form of a check or money order payable
455.10to the board, which fee is not returnable in the event permission to take the examination
455.11is denied for good cause;
455.12    (2) a copy of a diploma from an accredited or approved college of veterinary
455.13medicine or a certificate from the dean or secretary of an accredited or approved college of
455.14veterinary medicine showing the time spent in the school and the date when the applicant
455.15was duly and regularly graduated or will duly and regularly graduate or verification of
455.16ECFVG or PAVE certification;
455.17    (3) affidavits of at least two veterinarians and three adults who are not related to
455.18the applicant setting forth how long a time, when, and under what circumstances they
455.19have known the applicant, and any other facts as may be proper to enable the board to
455.20determine the qualifications of the applicant; and
455.21    (4) if the applicant has served in the armed forces, a copy of discharge papers.

455.22    Sec. 30. Minnesota Statutes 2006, section 156.04, is amended to read:
455.23156.04 BOARD TO ISSUE LICENSE.
455.24    The Board of Veterinary Medicine shall issue to every applicant who has successfully
455.25passed the required examination, who has received a diploma conferring the degree of
455.26doctor of veterinary medicine or an equivalent degree from an accredited or approved
455.27college of veterinary medicine or an ECFVG or PAVE certificate, and who shall have been
455.28adjudged to be duly qualified to practice veterinary medicine, a license to practice.

455.29    Sec. 31. Minnesota Statutes 2006, section 156.072, subdivision 2, is amended to read:
455.30    Subd. 2. Required with application. Such doctor of veterinary medicine shall
455.31accompany the application by the following:
455.32    (1) a copy of a diploma from an accredited or approved college of veterinary
455.33medicine or certification from the dean, registrar, or secretary of an accredited or approved
456.1college of veterinary medicine attesting to the applicant's graduation from an accredited
456.2or approved college of veterinary medicine, or a certificate of satisfactory completion of
456.3the ECFVG or PAVE program.
456.4    (2) affidavits of two licensed practicing doctors of veterinary medicine residing in
456.5the United States or Canadian licensing jurisdiction in which the applicant is currently
456.6practicing, attesting that they are well acquainted with the applicant, that the applicant is a
456.7person of good moral character, and has been actively engaged in practicing or teaching in
456.8such jurisdiction for the period above prescribed;
456.9    (3) a certificate from the regulatory agency having jurisdiction over the conduct of
456.10practice of veterinary medicine that such applicant is in good standing and is not the
456.11subject of disciplinary action or pending disciplinary action;
456.12    (4) a certificate from all other jurisdictions in which the applicant holds a currently
456.13active license or held a license within the past ten years, stating that the applicant is and
456.14was in good standing and has not been subject to disciplinary action;
456.15    (5) in lieu of clauses (3) and (4), certification from the Veterinary Information
456.16Verification Agency that the applicant's licensure is in good standing;
456.17    (6) a fee as set by the board in form of check or money order payable to the board,
456.18no part of which shall be refunded should the application be denied;
456.19    (7) score reports on previously taken national examinations in veterinary medicine,
456.20certified by the Veterinary Information Verification Agency; and
456.21    (8) if requesting waiver of examination, provide evidence of meeting licensure
456.22requirements in the state of the applicant's original licensure that were substantially equal
456.23to the requirements for licensure in Minnesota in existence at that time.

456.24    Sec. 32. Minnesota Statutes 2006, section 156.073, is amended to read:
456.25156.073 TEMPORARY PERMIT.
456.26    The board may issue without examination a temporary permit to practice veterinary
456.27medicine in this state to a person who has submitted an application approved by the
456.28board for license pending examination, and holds a doctor of veterinary medicine degree
456.29or an equivalent degree from an approved or accredited college of veterinary medicine
456.30or an ECFVG or PAVE certification. The temporary permit shall expire the day after
456.31publication of the notice of results of the first examination given after the permit is
456.32issued. No temporary permit may be issued to any applicant who has previously failed
456.33the national examination and is currently not licensed in any licensing jurisdiction of the
456.34United States or Canada or to any person whose license has been revoked or suspended
457.1or who is currently subject to a disciplinary order in any licensing jurisdiction of the
457.2United States or Canada.

457.3    Sec. 33. Minnesota Statutes 2006, section 156.12, subdivision 2, is amended to read:
457.4    Subd. 2. Authorized activities. No provision of this chapter shall be construed to
457.5prohibit:
457.6    (a) a person from rendering necessary gratuitous assistance in the treatment of any
457.7animal when the assistance does not amount to prescribing, testing for, or diagnosing,
457.8operating, or vaccinating and when the attendance of a licensed veterinarian cannot be
457.9procured;
457.10    (b) a person who is a regular student in an accredited or approved college of
457.11veterinary medicine from performing duties or actions assigned by instructors or
457.12preceptors or working under the direct supervision of a licensed veterinarian;
457.13    (c) a veterinarian regularly licensed in another jurisdiction from consulting with a
457.14licensed veterinarian in this state;
457.15    (d) the owner of an animal and the owner's regular employee from caring for and
457.16administering to the animal belonging to the owner, except where the ownership of the
457.17animal was transferred for purposes of circumventing this chapter;
457.18    (e) veterinarians who are in compliance with subdivision 6 and who are employed by
457.19the University of Minnesota from performing their duties with the College of Veterinary
457.20Medicine, College of Agriculture, Agricultural Experiment Station, Agricultural Extension
457.21Service, Medical School, School of Public Health, or other unit within the university; or
457.22a person from lecturing or giving instructions or demonstrations at the university or in
457.23connection with a continuing education course or seminar to veterinarians or pathologists
457.24at the University of Minnesota Veterinary Diagnostic Laboratory;
457.25    (f) any person from selling or applying any pesticide, insecticide or herbicide;
457.26    (g) any person from engaging in bona fide scientific research or investigations which
457.27reasonably requires experimentation involving animals;
457.28    (h) any employee of a licensed veterinarian from performing duties other than
457.29diagnosis, prescription or surgical correction under the direction and supervision of the
457.30veterinarian, who shall be responsible for the performance of the employee;
457.31    (i) a graduate of a foreign college of veterinary medicine from working under the
457.32direct personal instruction, control, or supervision of a veterinarian faculty member of
457.33the College of Veterinary Medicine, University of Minnesota in order to complete the
457.34requirements necessary to obtain an ECFVG or PAVE certificate.

458.1    Sec. 34. Minnesota Statutes 2006, section 156.12, subdivision 4, is amended to read:
458.2    Subd. 4. Titles. It is unlawful for a person who has not received a professional
458.3degree from an accredited or approved college of veterinary medicine, or ECFVG or PAVE
458.4certification, to use any of the following titles or designations: Veterinary, veterinarian,
458.5animal doctor, animal surgeon, animal dentist, animal chiropractor, animal acupuncturist,
458.6or any other title, designation, word, letter, abbreviation, sign, card, or device tending to
458.7indicate that the person is qualified to practice veterinary medicine.

458.8    Sec. 35. Minnesota Statutes 2006, section 156.12, subdivision 6, is amended to read:
458.9    Subd. 6. Faculty licensure. (a) Veterinary Medical Center clinicians at the College
458.10of Veterinary Medicine, University of Minnesota, who are engaged in the practice of
458.11veterinary medicine as defined in subdivision 1 and who treat animals owned by clients of
458.12the Veterinary Medical Center must possess the same license required by other veterinary
458.13practitioners in the state of Minnesota except for persons covered by paragraphs (b) and (c).
458.14    (b) A specialty practitioner in a hard-to-fill faculty position who has been employed
458.15at the College of Veterinary Medicine, University of Minnesota, for five years or
458.16more prior to 2003 or is specialty board certified by the American Veterinary Medical
458.17Association or the European Board of Veterinary Specialization may be granted a specialty
458.18faculty Veterinary Medical Center clinician license which will allow the licensee to
458.19practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's
458.20training and only within the scope of employment at the Veterinary Medical Center.
458.21    (c) A specialty practitioner in a hard-to-fill faculty position at the College of
458.22Veterinary Medicine, University of Minnesota, who has graduated from a board-approved
458.23foreign veterinary school may be granted a temporary faculty Veterinary Medical Center
458.24clinician license. The temporary faculty Veterinary Medical Center clinician license
458.25expires in two years and allows the licensee to practice veterinary medicine as defined
458.26in subdivision 1 and treat animals owned by clients of the Veterinary Medical Center.
458.27The temporary faculty Veterinary Medical Center clinician license allows the licensee to
458.28practice veterinary medicine in the state of Minnesota in the specialty area of the licensee's
458.29training and only within the scope of employment at the Veterinary Medical Center while
458.30under the direct supervision of a veterinarian currently licensed and actively practicing
458.31veterinary medicine in Minnesota, as defined in section 156.04. The direct supervising
458.32veterinarian shall not have any current or past conditions, restrictions, or probationary
458.33status imposed on the veterinarian's license by the board within the past five years. The
458.34holder of a temporary faculty Veterinary Medical Center clinician license who is enrolled
458.35in a PhD program may apply for up to two additional consecutive two-year extensions
459.1of an expiring temporary faculty Veterinary Medical Center clinician license. Any other
459.2holder of a temporary faculty Veterinary Medical Center clinician license may apply for
459.3one two-year extension of the expiring temporary faculty Veterinary Medical Center
459.4clinician license. Temporary faculty Veterinary Medical Center clinician licenses that are
459.5allowed to expire may not be renewed. The board shall grant an extension to a licensee
459.6who demonstrates suitable progress toward completing the requirements of their academic
459.7program, specialty board certification, or full licensure in Minnesota by a graduate of a
459.8foreign veterinary college.
459.9    (d) Temporary and specialty faculty Veterinary Medical Center clinician licensees
459.10must abide by all the laws governing the practice of veterinary medicine in the state
459.11of Minnesota and are subject to the same disciplinary action as any other veterinarian
459.12licensed in the state of Minnesota.
459.13    (e) The fee for a license issued under this subdivision is the same as for a regular
459.14license to practice veterinary medicine in Minnesota. License payment deadlines, late
459.15payment fees, and other license requirements are also the same as for regular licenses.

459.16    Sec. 36. Minnesota Statutes 2006, section 156.15, subdivision 2, is amended to read:
459.17    Subd. 2. Service. Service of an order under this section is effective if the order is
459.18served on the person or counsel of record personally or by certified United States mail to
459.19the most recent address provided to the board for the person or counsel of record.

459.20    Sec. 37. Minnesota Statutes 2006, section 156.16, subdivision 3, is amended to read:
459.21    Subd. 3. Dispensing. "Dispensing" means distribution of veterinary prescription
459.22drugs or over-the-counter drugs for extra-label use or human drugs for extra-label use by a
459.23person licensed as a pharmacist by the Board of Pharmacy or a person licensed by the
459.24Board of Veterinary Medicine.

459.25    Sec. 38. Minnesota Statutes 2006, section 156.16, subdivision 10, is amended to read:
459.26    Subd. 10. Prescription. "Prescription" means an order from a veterinarian to a
459.27pharmacist or another veterinarian authorizing the dispensing of a veterinary prescription
459.28drug drugs, human drugs for extra-label use, or over-the-counter drugs for extra-label use
459.29to a client for use on or in a patient.

459.30    Sec. 39. Minnesota Statutes 2006, section 156.18, subdivision 1, is amended to read:
459.31    Subdivision 1. Prescription. (a) A person may not dispense a veterinary
459.32prescription drug to a client without a prescription or other veterinary authorization. A
460.1person may not make extra-label use of an animal or human drug for an animal without a
460.2prescription from a veterinarian. A veterinarian or the veterinarian's authorized employee
460.3may dispense a veterinary prescription drug to drugs, human drugs for extra-label use, or
460.4an over-the-counter drug for extra-label use by a client or oversee the extra-label use of
460.5a veterinary drug directly by a client without a separate written prescription, providing
460.6there is documentation of the prescription in the medical record and there is an existing
460.7veterinarian-client-patient relationship. The prescribing veterinarian must monitor the use
460.8of veterinary prescription drugs, human drugs for extra-label use, or over-the-counter
460.9drugs for extra-label use by a client.
460.10    (b) A veterinarian may dispense prescription veterinary drugs and prescribe and
460.11dispense extra-label use drugs to a client without personally examining the animal if
460.12a bona fide veterinarian-client-patient relationship exists and in the judgment of the
460.13veterinarian the client has sufficient knowledge to use the drugs properly.
460.14    (c) A veterinarian may issue a prescription or other veterinary authorization by oral or
460.15written communication to the dispenser, or by computer connection. If the communication
460.16is oral, the veterinarian must enter it into the patient's record. The dispenser must record
460.17the veterinarian's prescription or other veterinary authorization within 72 hours.
460.18    (d) A prescription or other veterinary authorization must include:
460.19    (1) the name, address, and, if written, the signature of the prescriber;
460.20    (2) the name and address of the client;
460.21    (3) identification of the species for which the drug is prescribed or ordered;
460.22    (4) the name, strength, and quantity of the drug;
460.23    (5) the date of issue;
460.24    (6) directions for use; and
460.25    (7) withdrawal time., if applicable; and
460.26    (8) number of authorized refills.
460.27    (e) A veterinarian may, in the course of professional practice and an existing
460.28veterinarian-client-patient relationship, prepare medicaments that combine drugs approved
460.29by the United States Food and Drug Administration and other legally obtained ingredients
460.30with appropriate vehicles.
460.31    (f) A veterinarian or a bona fide employee of a veterinarian may dispense veterinary
460.32prescription drugs to a person on the basis of a prescription issued by a licensed
460.33veterinarian. The provisions of paragraphs (c) and (d) apply.
460.34    (g) This section does not limit the authority of the Minnesota Racing Commission to
460.35regulate veterinarians providing services at a licensed racetrack.

461.1    Sec. 40. Minnesota Statutes 2006, section 156.18, subdivision 2, is amended to read:
461.2    Subd. 2. Label of dispensed veterinary drugs. (a) A veterinarian or the
461.3veterinarian's authorized agent or employee dispensing a veterinary prescription drug
461.4or prescribing the extra-label use of an over-the-counter drug, an over-the-counter drug
461.5for extra-label use, or a human drug for extra-label use must provide written information
461.6which includes the name and address of the veterinarian, date of filling, species of patient,
461.7name or names of drug, strength of drug or drugs, directions for use, withdrawal time,
461.8and cautionary statements, if any, appropriate for the drug.
461.9    (b) If the veterinary drug has been prepared, mixed, formulated, or packaged by the
461.10dispenser, all of the information required in paragraph (a) must be provided on a label
461.11affixed to the container.
461.12    (c) If the veterinary drug is in the manufacturer's original package, the information
461.13required in paragraph (a) must be supplied in writing but need not be affixed to the
461.14container. Information required in paragraph (a) that is provided by the manufacturer on
461.15the original package does not need to be repeated in the separate written information.
461.16Written information required by this paragraph may be written on the sales invoice.

461.17    Sec. 41. Minnesota Statutes 2006, section 156.19, is amended to read:
461.18156.19 EXTRA-LABEL USE.
461.19    A person, other than a veterinarian or a person working under the control an
461.20employee of a veterinarian, must not make extra-label use of a veterinary drug in or
461.21on a food-producing animal, unless permitted by the prescription of a veterinarian. A
461.22veterinarian may prescribe the extra-label use of a veterinary drug if:
461.23    (1) the veterinarian makes a careful medical diagnosis within the context of a valid
461.24veterinarian-client-patient relationship;
461.25    (2) the veterinarian determines that there is no marketed drug specifically labeled to
461.26treat the condition diagnosed, or that drug therapy as recommended by the labeling has, in
461.27the judgment of the attending veterinarian, been found to be clinically ineffective;
461.28    (3) the veterinarian recommends procedures to ensure that the identity of the treated
461.29animal will be carefully maintained; and
461.30    (4) the veterinarian prescribes a significantly extended time period for drug
461.31withdrawal before marketing meat, milk, or eggs.; and
461.32    (5) the veterinarian has met the criteria established in Code of Federal Regulations,
461.33title 21, part 530, which define the extra-label use of medication in or on animals.

462.1    Sec. 42. Minnesota Statutes 2006, section 198.075, is amended to read:
462.2198.075 MINNESOTA VETERANS HOME EMPLOYEES; EXCLUDED
462.3FROM COMMISSARY PRIVILEGES.
462.4    Except as provided in this section, no commissary privileges including food, laundry
462.5service, janitorial service, and household supplies shall be furnished to any employee of
462.6the Minnesota veterans homes. An employee of the Minnesota veterans homes who works
462.7a second shift that is consecutive with a regularly scheduled shift may be allowed one free
462.8meal at the veterans home on the day of that extra shift.

462.9    Sec. 43. Minnesota Statutes 2006, section 256B.0625, subdivision 14, is amended to
462.10read:
462.11    Subd. 14. Diagnostic, screening, and preventive services. (a) Medical assistance
462.12covers diagnostic, screening, and preventive services.
462.13    (b) "Preventive services" include services related to pregnancy, including:
462.14    (1) services for those conditions which may complicate a pregnancy and which may
462.15be available to a pregnant woman determined to be at risk of poor pregnancy outcome;
462.16    (2) prenatal HIV risk assessment, education, counseling, and testing; and
462.17    (3) alcohol abuse assessment, education, and counseling on the effects of alcohol
462.18usage while pregnant. Preventive services available to a woman at risk of poor pregnancy
462.19outcome may differ in an amount, duration, or scope from those available to other
462.20individuals eligible for medical assistance.
462.21    (c) "Screening services" include, but are not limited to, blood lead tests. Screening
462.22services also include, for children with blood lead levels equal to or greater than five
462.23micrograms of lead per deciliter of whole blood, environmental investigations to
462.24determine the source of lead exposure. Reimbursement is limited to a health professional's
462.25time and activities during an on-site investigation of a child's home or primary residence.

462.26    Sec. 44. Minnesota Statutes 2006, section 256B.0625, is amended by adding a
462.27subdivision to read:
462.28    Subd. 49. Lead risk assessments. (a) Effective October 1, 2007, or six months after
462.29federal approval, whichever is later, medical assistance covers lead risk assessments
462.30provided by a lead risk assessor who is licensed by the commissioner of health under
462.31section 144.9505 and employed by an assessing agency as defined in section 144.9501.
462.32Medical assistance covers a onetime on-site investigation of a recipient's home or primary
462.33residence to determine the existence of lead so long as the recipient is under the age
463.1of 21 and has a venous blood lead level specified in section 144.9504, subdivision 2,
463.2paragraph (a).
463.3    (b) Medical assistance reimbursement covers the lead risk assessor's time to
463.4complete the following activities:
463.5    (1) gathering samples;
463.6    (2) interviewing family members;
463.7    (3) gathering data, including meter readings; and
463.8    (4) providing a report with the results of the investigation and options for reducing
463.9lead-based paint hazards.
463.10    Medical assistance coverage of lead risk assessment does not include testing of
463.11environmental substances such as water, paint, or soil or any other laboratory services.
463.12Medical assistance coverage of lead risk assessments is not included in the capitated
463.13services for children enrolled in health plans through the prepaid medical assistance
463.14program and the MinnesotaCare program.
463.15    (c) Payment for lead risk assessment must be cost-based and must meet the criteria
463.16for federal financial participation under the Medicaid program. The rate must be based
463.17on allowable expenditures from cost information gathered. Under section 144.9507,
463.18subdivision 5, federal medical assistance funds may not replace existing funding for
463.19lead-related activities. The nonfederal share of costs for services provided under this
463.20subdivision must be from state or local funds and is the responsibility of the agency
463.21providing the risk assessment. Eligible expenditures for the nonfederal share of costs may
463.22not be made from federal funds or funds used to match other federal funds. Any federal
463.23disallowances are the responsibility of the agency providing risk assessment services.

463.24    Sec. 45. [325E.385] PRODUCTS CONTAINING POLYBROMINATED
463.25DIPHENYL ETHER.
463.26    Subdivision 1. Definitions. For the purposes of sections 325E.386 to 325E.388,
463.27the terms in this section have the meanings given them.
463.28    Subd. 2. Commercial decabromodiphenyl ether. "Commercial
463.29decabromodiphenyl ether" means the chemical mixture of decabromodiphenyl ether,
463.30including associated polybrominated diphenyl ether impurities not intentionally added.
463.31    Subd. 3. Commissioner. "Commissioner" means the commissioner of the Pollution
463.32Control Agency.
463.33    Subd. 4. Manufacturer. "Manufacturer" means any person, firm, association,
463.34partnership, corporation, governmental entity, organization, or joint venture that produces
464.1a product containing polybrominated diphenyl ethers or an importer or domestic
464.2distributor of a noncomestible product containing polybrominated diphenyl ethers.
464.3    Subd. 5. Polybrominated diphenyl ethers or PBDE's. "Polybrominated diphenyl
464.4ethers" or "PBDE's" means chemical forms that consist of diphenyl ethers bound with
464.5bromine atoms. Polybrominated diphenyl ethers include, but are not limited to, the
464.6three primary forms of the commercial mixtures known as pentabromodiphenyl ether,
464.7octabromodiphenyl ether, and decabromodiphenyl ether.
464.8    Subd. 6. Retailer. "Retailer" means a person who offers a product for sale at retail
464.9through any means, including, but not limited to, remote offerings such as sales outlets,
464.10catalogs, or the Internet, but does not include a sale that is a wholesale transaction with a
464.11distributor or a retailer.
464.12    Subd. 7. Used product. "Used product" means any product that has been previously
464.13owned, purchased, or sold in commerce. Used product does not include any product
464.14manufactured after January 1, 2008.

464.15    Sec. 46. [325E.386] PRODUCTS CONTAINING CERTAIN
464.16POLYBROMINATED DIPHENYL ETHERS BANNED; EXEMPTIONS.
464.17    Subdivision 1. Penta- and octabromodiphenyl ethers. Except as provided in
464.18subdivision 3, beginning January 1, 2008, a person may not manufacture, process, or
464.19distribute in commerce a product or flame-retardant part of a product containing more
464.20than one-tenth of one percent of pentabromodiphenyl ether or octabromodiphenyl ether
464.21by mass.
464.22    Subd. 2. Exemptions. The following products containing polybrominated diphenyl
464.23ethers are exempt from subdivision 1:
464.24    (1) the sale or distribution of any used transportation vehicle with component parts
464.25containing polybrominated diphenyl ethers;
464.26    (2) the sale or distribution of any used transportation vehicle parts or new
464.27transportation vehicle parts manufactured before January 1, 2008, that contain
464.28polybrominated diphenyl ethers;
464.29    (3) the manufacture, sale, repair, distribution, maintenance, refurbishment, or
464.30modification of equipment containing polybrominated diphenyl ethers and used primarily
464.31for military or federally funded space program applications. This exemption does not
464.32cover consumer-based goods with broad applicability;
464.33    (4) the sale or distribution by a business, charity, public entity, or private party of
464.34any used product containing polybrominated diphenyl ethers;
465.1    (5) the manufacture, sale, or distribution of new carpet cushion made from recycled
465.2foam containing more than one-tenth of one percent penta polybrominated diphenyl
465.3ether; or
465.4    (6) medical devices.
465.5    In-state retailers in possession of products on January 1, 2008, that are banned for
465.6sale under subdivision 1 may exhaust their stock through sales to the public. Nothing in
465.7this section restricts the ability of a manufacturer, importer, or distributor from transporting
465.8products containing polybrominated diphenyl ethers through the state, or storing such
465.9products in the state for later distribution outside the state.

465.10    Sec. 47. [325E.387] REVIEW OF DECABROMODIPHENYL ETHER.
465.11    Subdivision 1. Commissioner duties. The commissioner in consultation
465.12with the commissioners of health and public safety shall review uses of commercial
465.13decabromodiphenyl ether, availability of technically feasible and safer alternatives, fire
465.14safety and any evidence regarding the potential harm to public health and the environment
465.15posed by commercial decabromodiphenyl ether and the alternatives. The commissioner
465.16must consult with key stakeholders. The commissioner must also review the findings from
465.17similar state and federal agencies and must report their findings and recommendations to
465.18the appropriate committees of the legislature no later than January 15, 2008.
465.19    Subd. 2. State procurement. By January 1, 2008, the commissioner of
465.20administration shall make available for purchase and use by all state agencies only
465.21equipment, supplies, and other products that do not contain polybrominated diphenyl
465.22ethers, unless exempted under section 325E.386, subdivision 2.

465.23    Sec. 48. [325E.388] PENALTIES.
465.24    A manufacturer who violates sections 325E.386 to 325E.388 is subject to a
465.25civil penalty not to exceed $1,000 for each violation in the case of a first offense. A
465.26manufacturer is subject to a civil penalty not to exceed $5,000 for each repeat offense.
465.27Penalties collected under this section must be deposited in an account in the special
465.28revenue fund and are appropriated in fiscal years 2008 and 2009 to the commissioner to
465.29implement and enforce this section.

465.30    Sec. 49. Laws 2005, First Special Session chapter 4, article 9, section 3, subdivision 2,
465.31is amended to read:

465.32 465.33

Subd. 2.Community and Family Health Improvement

466.1	Summary by Fund
466.2	General	40,413,000	40,382,000
466.3 466.4	State Government Special Revenue	141,000	128,000
466.5	Health Care Access	3,510,000	3,516,000
466.6	Federal TANF	6,000,000	6,000,000

466.7Family Planning Base Reduction. Base
466.8level funding for the family planning
466.9special projects grant program is reduced
466.10by $1,877,000 each year of the biennium
466.11beginning July 1, 2007, provided that
466.12this reduction shall only take place
466.13upon full implementation of the family
466.14planning project section of the 1115 waiver.
466.15Notwithstanding Minnesota Statutes, section
466.16145.925, the commissioner shall give priority
466.17to community health care clinics providing
466.18family planning services that either serve a
466.19high number of women who do not qualify
466.20for medical assistance or are unable to
466.21participate in the medical assistance program
466.22as a medical assistance provider when
466.23allocating the remaining appropriations.
466.24Notwithstanding section 15, this paragraph
466.25shall not expire.
466.26Shaken Baby Video. Of the state
466.27government special revenue fund
466.28appropriation, $13,000 in 2006 is
466.29appropriated to the commissioner of health
466.30to provide a video to hospitals on shaken
466.31baby syndrome. The commissioner of health
466.32shall assess a fee to hospitals to cover the
466.33cost of the approved shaken baby video and
466.34the revenue received is to be deposited in the
466.35state government special revenue fund.

467.1    Sec. 50. FUNDING FOR ENVIRONMENTAL JUSTICE MAPPING.
467.2    The commissioner of health, in conjunction with the commissioner of the Pollution
467.3Control Agency, shall establish an environmental justice mapping program and shall
467.4apply for federal funding to renew and expand the state's environmental justice mapping
467.5capacity in order to promote public health tracking. The commissioner shall coordinate
467.6the project with the Pollution Control Agency and the Department of Agriculture in order
467.7to explore possible links between environmental health and toxic exposures and to help
467.8create a system for environmental public health tracking. The commissioner shall also
467.9make recommendations to the legislature for additional sources of funding within the state.
467.10EFFECTIVE DATE.This section is effective the day following final enactment.

467.11    Sec. 51. LEGISLATIVE FINDINGS AND PURPOSE.
467.12    The legislature hereby finds that hearing loss occurs in newborn infants more
467.13frequently than any other health condition for which newborn infant screening is required.
467.14Early detection of hearing loss in a child and early intervention and treatment has been
467.15demonstrated to be highly effective in facilitating a child's healthy development in a
467.16manner consistent with the child's age, language acquisition, and cognitive ability.
467.17Without early hearing detection and intervention, children with hearing loss experience
467.18serious delays in language acquisition and social and cognitive development. With
467.19appropriate testing and identification of newborn infants, hearing loss screening will
467.20facilitate early intervention and treatment and will serve the public purpose of promoting
467.21the healthy development of children.
467.22    For these reasons, the legislature hereby determines that it is beneficial and in the
467.23best interests of the development of the children of the state of Minnesota that newborn
467.24infants' hearing be screened.

467.25    Sec. 52. INFORMATION SHARING.
467.26    By August 1, 2007, the commissioner of health, the Pollution Control Agency, the
467.27commissioner of agriculture, and the University of Minnesota are requested to jointly
467.28develop and sign a memorandum of understanding declaring their intent to share new
467.29and existing environmental hazard, exposure, and health outcome data, consistent with
467.30applicable data practices laws, and to cooperate and communicate effectively to ensure
467.31sufficient clarity and understanding of the data between these organizations.

467.32    Sec. 53. COMMISSIONER OF HEALTH REPORT; ROUTINE RADIATION
467.33EMISSIONS.
468.1    The commissioner of health, within the limits of available appropriations, in
468.2cooperation with the utilities that own the Monticello and Prairie Island nuclear plants,
468.3shall issue a report detailing where routine radiation releases go and the health impacts of
468.4the radiation emissions on affected communities. By April 1, 2008, the report must be
468.5distributed to house and senate committees having jurisdiction over public health and to
468.6all communities that are part of the emergency response planning.

468.7    Sec. 54. FRAGRANCE-FREE SCHOOLS EDUCATION PILOT PROJECT.
468.8    Subdivision 1. Purpose. Recognizing that scented products may trigger asthma or
468.9chemical sensitivity reactions in students and school staff, which can contribute to learning
468.10and breathing problems, the commissioner of health shall develop a fragrance-free schools
468.11education pilot project.
468.12    Subd. 2. Education. The commissioner of health, in collaboration with the
468.13commissioner of education and the Minneapolis Board of Education, shall establish a
468.14working group composed of at least three students, two teachers, one school administrator,
468.15and one member of the Minneapolis Board of Education to recommend an education
468.16campaign in Minneapolis public schools to inform students and parents about the
468.17potentially harmful effects of the use of fragrance products on sensitive students and
468.18school personnel in Minneapolis schools. The commissioner shall report findings to the
468.19legislature by February 1, 2008.
468.20EFFECTIVE DATE.This section is effective the day following final enactment.

468.21    Sec. 55. LINDANE COMMITTEE.
468.22    The commissioner of health shall create a committee of stakeholders, including
468.23at least one environmental health research scientist and at least one parent consumer
468.24advocate, to review the scientific literature and make recommendations to the legislature
468.25on the health impact of Lindane on children and report back by January 15, 2008.

468.26    Sec. 56. MEDICAL ASSISTANCE COVERAGE FOR ARSENIC TESTING.
468.27    The commissioner of human services shall ensure that testing for arsenic under
468.28Minnesota Statutes, section 144.967, is covered under medical assistance.

468.29    Sec. 57. BLOOD LEAD TESTING STUDY.
468.30    The commissioner of health, in consultation with the Department of Human
468.31Services; cities of the first class; health care providers; and other interested parties shall
469.1conduct a study to evaluate blood lead testing methods used to confirm elevated blood
469.2lead status. The study shall examine and/or develop:
469.3    (1) the false positive rate of capillary tests for children less than 72 months old;
469.4    (2) current protocols for conducting capillary testing, including filter paper
469.5methodology;
469.6    (3) existing guidelines and regulations from other states and federal agencies
469.7regarding lead testing;
469.8    (4) recommendations regarding the use of capillary tests to initiate environmental
469.9investigations and case management, including number and timing of tests and fiscal
469.10implications for state and local lead programs; and
469.11    (5) recommendations regarding reducing the state mandatory intervention to ten
469.12micrograms of lead per deciliter of whole blood.
469.13    The commissioner shall submit the results of the study and any recommendations,
469.14including any necessary legislative changes, to the legislature by February 15, 2008.

469.15    Sec. 58. WINDOW SAFETY EDUCATION.
469.16    The commissioner of health shall create in the department's current educational
469.17safety program a component targeted at parents and caregivers of young children to
469.18provide awareness of the need to take precautions to prevent children from falling
469.19through open windows. The commissioner of health shall consult with representatives
469.20of the residential building industry, the window products industry, the child safety
469.21advocacy community, and the Department of Labor and Industry to create the window
469.22safety program component. The program must include the gathering of data about
469.23falls from windows that result in severe injury in order to measure the effectiveness of
469.24the safety program. The commissioner of health may consult with other child safety
469.25advocacy groups, experts, and interested parties in the development and implementation
469.26of the window safety program. The commissioner of health shall prepare and submit
469.27a final report on the window safety program to the legislature by March 1, 2011. The
469.28commissioner shall prepare and submit a yearly progress report to the legislature by
469.29March 1 of each year beginning in 2008 until the submission of the final report. The
469.30final report must include a summary of the safety program, the impact of the program on
469.31children falling from windows, and any recommendations for further study or action.

469.32    Sec. 59. REVISOR'S INSTRUCTION.
470.1    The revisor of statutes shall change the range reference "144.9501 to 144.9509"
470.2to "144.9501 to 144.9512" wherever the reference appears in Minnesota Statutes and
470.3Minnesota Rules.

470.4    Sec. 60. REPEALER.
470.5Laws 2004, chapter 288, article 6, section 27, is repealed.

470.6ARTICLE 11

470.7HUMAN SERVICES FORECAST ADJUSTMENTS

470.8 470.9

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

470.10    The dollar amounts shown are added to or, if shown in parentheses, are subtracted
470.11from the appropriations in Laws 2006, chapter 282, from the general fund, or any other
470.12fund named, to the Department of Human Services for the purposes specified in this
470.13article, to be available for the fiscal year indicated for each purpose. The figure "2007"
470.14used in this article means that the appropriation or appropriations listed are available
470.15for the fiscal year ending June 30, 2007.

470.16							2007
470.17	General Fund					$	(25,226,000)
470.18	Health Care Access					$	(53,980,000)
470.19	TANF					$	(24,805,000)
470.20	Total					$	(104,011,000)

470.21 470.22

Sec. 2. COMMISSIONER OF HUMAN SERVICES

470.23

Subdivision 1.Total Appropriation

$

(104,011,000)

470.24	Appropriations by Fund
470.25			2007
470.26	General		(25,226,000)
470.27	Health Care Access		(53,980,000)
470.28	TANF		(24,805,000)

470.29

Subd. 2.Revenue and Pass Through

470.30

TANF

(106,000)

470.31 470.32

Subd. 3.Children and Economic Assistance Grants

470.33	General						3,221,000
470.34	TANF						(24,699,000)

471.1The amounts that may be spent from this
471.2appropriation for each purpose are as follows:

471.3	(a) MFIP/DWP Grants
471.4	General						13,827,000
471.5	TANF						(24,699,000)

471.6	(b) MFIP Child Care Assistance Grants
471.7	General						(4,733,000)

471.8	(c) General Assistance Grants
471.9	General						1,081,000

471.10	(d) Minnesota Supplemental Aid Grants
471.11	General						(1,099,000)

471.12	(e) Group Residential Housing Grants
471.13	General						(5,855,000)

471.14

Subd. 4.Basic Health Care Grants

471.15	General						17,592,000
471.16	Health Care Access						(53,980,000)

471.17The amounts that may be spent from this
471.18appropriation for each purpose are as follows:

471.19

(a) MinnesotaCare Health Care Access

(53,980,000)

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

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

471.24	(d) General Assistance Medical Care
471.25	General						6,403,000

471.26

Subd. 5.Continuing Care Grants

471.27

General

(46,039,000)

471.28The amounts that may be spent from this
471.29appropriation for each purpose are as follows:

471.30	(a) MA Long-Term Care Facilities
471.31	General						(15,028,000)

471.32	(b) MA Long-Term Care Waivers
471.33	General						(20,677,000)

472.1	(c) Chemical Dependency Entitlement Grants
472.2	General						(10,334,000)

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

472.5ARTICLE 12

472.6HUMAN SERVICES APPROPRIATIONS

472.7

Section 1. SUMMARY OF APPROPRIATIONS.

472.8    The amounts shown in this section summarize direct appropriations, by fund, made
472.9in this article.

472.10			2008		2009		Total
472.11	General	$	4,836,759,000	$	5,194,751,000	$	10,031,510,000
472.12 472.13	State Government Special Revenue		55,737,000		56,428,000		112,165,000
472.14	Health Care Access		436,050,000		549,573,000		985,623,000
472.15	Federal TANF		266,864,000		277,866,000		544,730,000
472.16	Environment Fund		300,000		300,000		600,000
472.17	Lottery Prize Fund		2,184,000		1,787,000		3,971,000
472.18	Total	$	5,597,894,000	$	6,080,705,000	$	11,678,599,000

472.19

Sec. 2. HEALTH AND HUMAN SERVICES APPROPRIATIONS.

472.20    The sums shown in the columns marked "Appropriations" are appropriated to the
472.21agencies and for the purposes specified in this article. The appropriations are from the
472.22general fund, or another named fund, and are available for the fiscal years indicated
472.23for each purpose. The figures "2008" and "2009" used in this article mean that the
472.24appropriations listed under them are available for the fiscal year ending June 30, 2008, or
472.25June 30, 2009, respectively. "The first year" is fiscal year 2008. "The second year" is fiscal
472.26year 2009. "The biennium" is fiscal years 2008 and 2009. Appropriations for the fiscal
472.27year ending June 30, 2007, are effective the day following final enactment.

472.28				APPROPRIATIONS
472.29				Available for the Year
472.30				Ending June 30
472.31					2008		2009

472.32

Sec. 3. HUMAN SERVICES

472.33

Subdivision 1.Total Appropriation

$

5,356,970,000

$

5,848,682,000

473.1	Appropriations by Fund
473.2		2008	2009
473.3	General	4,688,475,000	5,050,169,000
473.4 473.5	State Government Special Revenue	545,000	555,000
473.6	Health Care Access	409,602,000	529,655,000
473.7	Federal TANF	255,514,000	265,866,000
473.8	Lottery Prize Fund	2,184,000	1,787,000

473.9The amounts that may be spent for each
473.10purpose are specified in the following
473.11subdivisions.
473.12Receipts for Systems Projects.
473.13Appropriations and federal receipts for
473.14information system projects for MAXIS,
473.15PRISM, MMIS, and SSIS must be deposited
473.16in the state system account authorized in
473.17Minnesota Statutes, section 256.014. Money
473.18appropriated for computer projects approved
473.19by the Minnesota Office of Enterprise
473.20Technology, funded by the legislature, and
473.21approved by the commissioner of finance,
473.22may be transferred from one project to
473.23another and from development to operations
473.24as the commissioner of human services
473.25considers necessary. Any unexpended
473.26balance in the appropriation for these
473.27projects does not cancel but is available for
473.28ongoing development and operations.
473.29Systems Continuity. In the event of
473.30disruption of technical systems or computer
473.31operations, the commissioner may use
473.32available grant appropriations to ensure
473.33continuity of payments for maintaining the
473.34health, safety, and well-being of clients
473.35served by programs administered by the
473.36Department of Human Services. Grant funds
474.1must be used in a manner consistent with the
474.2original intent of the appropriation.
474.3Nonfederal Share Transfers. The
474.4nonfederal share of activities for which
474.5federal administrative reimbursement is
474.6appropriated to the commissioner may be
474.7transferred to the special revenue fund.
474.8Gifts. Notwithstanding Minnesota
474.9Statutes, sections 16A.013 to 16A.016, the
474.10commissioner may accept, on behalf of the
474.11state, additional funding from sources other
474.12than state funds for the purpose of financing
474.13the cost of assistance program grants or
474.14nongrant administration. All additional
474.15funding is appropriated to the commissioner
474.16for use as designated by the grantor of
474.17funding.
474.18TANF Funds Appropriated to Other
474.19Entities. Any expenditures from the TANF
474.20block grant shall be expended according
474.21to the requirements and limitations of part
474.22A of title IV of the Social Security Act, as
474.23amended, and any other applicable federal
474.24requirement or limitation. Prior to any
474.25expenditure of these funds, the commissioner
474.26shall ensure that funds are expended in
474.27compliance with the requirements and
474.28limitations of federal law and that any
474.29reporting requirements of federal law are
474.30met. It shall be the responsibility of any entity
474.31to which these funds are appropriated to
474.32implement a memorandum of understanding
474.33with the commissioner that provides the
474.34necessary assurance of compliance prior to
474.35any expenditure of funds. The commissioner
475.1shall receipt TANF funds appropriated
475.2to other state agencies and coordinate all
475.3related interagency accounting transactions
475.4necessary to implement these appropriations.
475.5Unexpended TANF funds appropriated to
475.6any state, local, or nonprofit entity cancel
475.7at the end of the state fiscal year unless
475.8appropriating or statutory language permits
475.9otherwise.
475.10TANF Block Grant. Of this amount,
475.11$750,000 the first year and $750,000 the
475.12second year are onetime appropriations
475.13from the state's federal TANF block grant
475.14under Title I of Public Law 104-193. If the
475.15appropriation in either year is insufficient, the
475.16appropriation for the other year is available.
475.17TANF Maintenance of Effort. (a) In
475.18order to meet the basic maintenance of
475.19effort (MOE) requirements of the TANF
475.20block grant specified under Code of Federal
475.21Regulations, title 45, section 263.1, the
475.22commissioner may only report nonfederal
475.23money expended for allowable activities
475.24listed in the following clauses as TANF/MOE
475.25expenditures:
475.26(1) MFIP cash, diversionary work program,
475.27and food assistance benefits under Minnesota
475.28Statutes, chapter 256J;
475.29(2) the child care assistance programs
475.30under Minnesota Statutes, sections 119B.03
475.31and 119B.05, and county child care
475.32administrative costs under Minnesota
475.33Statutes, section 119B.15;
476.1(3) state and county MFIP administrative
476.2costs under Minnesota Statutes, chapters
476.3256J and 256K;
476.4(4) state, county, and tribal MFIP
476.5employment services under Minnesota
476.6Statutes, chapters 256J and 256K;
476.7(5) expenditures made on behalf of
476.8noncitizen MFIP recipients who qualify
476.9for the medical assistance without federal
476.10financial participation program under
476.11Minnesota Statutes, section 256B.06,
476.12subdivision 4, paragraphs (d), (e), and (j);
476.13and
476.14(6) qualifying working family credit
476.15expenditures under Minnesota Statutes,
476.16section 290.0671.
476.17(b) The commissioner shall ensure that
476.18sufficient qualified nonfederal expenditures
476.19are made each year to meet the state's
476.20TANF/MOE requirements. For the activities
476.21listed in paragraph (a), clauses (2) to
476.22(6), the commissioner may only report
476.23expenditures that are excluded from the
476.24definition of assistance under Code of
476.25Federal Regulations, title 45, section 260.31.
476.26(c) The commissioner shall ensure that
476.27the maintenance of effort used by the
476.28commissioner of finance for the February
476.29and November forecasts required under
476.30Minnesota Statutes, section 16A.103,
476.31contains expenditures under paragraph (a),
476.32clause (1), equal to at least 25 percent of
476.33the total required under Code of Federal
476.34Regulations, title 45, section 263.1.
477.1(d) Minnesota Statutes, section 256.011,
477.2subdivision 3, which requires that federal
477.3grants or aids secured or obtained under that
477.4subdivision be used to reduce any direct
477.5appropriations provided by law, does not
477.6apply if the grants or aids are federal TANF
477.7funds.
477.8(e) Notwithstanding section 13, this rider
477.9expires June 30, 2011.
477.10Working Family Credit Expenditures
477.11as TANF/MOE. The commissioner may
477.12claim as TANF maintenance of effort up
477.13to $6,707,000 per year for fiscal year 2008
477.14through fiscal year 2011. Notwithstanding
477.15section 13, this rider expires June 30, 2011.
477.16Additional Working Family Credit
477.17Expenditures to be Claimed for
477.18TANF/MOE. In addition to the amounts
477.19provided in this section, the commissioner
477.20may count the following amounts of working
477.21family credit expenditure as TANF/MOE:
477.22(1) fiscal year 2008, $4,269,000; and
477.23(2) fiscal year 2009, $4,889,000.
477.24Notwithstanding section 13, this rider expires
477.25June 30, 2011.
477.26Capitation Rate Increase. Of the health care
477.27access fund appropriations to the University
477.28of Minnesota in the higher education
477.29omnibus appropriation bill, $2,157,000 in
477.30fiscal year 2008 and $2,157,000 in fiscal year
477.312009 are to be used to increase the capitation
477.32payments under Minnesota Statutes, section
477.33256B.69.
478.1Health Care Access Fund Transfer.
478.2Notwithstanding Minnesota Statutes, section
478.3295.581, in addition to the transfers in
478.4Minnesota Statutes, section 16A.724,
478.5subdivision 2, the commissioner of finance
478.6shall transfer up to the following amounts
478.7from the health care access fund to the
478.8general fund on June 30 of each fiscal year:
478.9(1) fiscal year 2008, $6,416,000;
478.10(2) fiscal year 2009, $5,643,000;
478.11(3) fiscal year 2010, $6,677,000; and
478.12(4) fiscal year 2011, $7,866,000.
478.13Notwithstanding section 13, this rider expires
478.14June 30, 2011.

478.15

Subd. 2.Agency Management

57,727,000

58,161,000

478.16	Appropriations by Fund
478.17	General	48,413,000	48,882,000
478.18 478.19	State Government Special Revenue	424,000	432,000
478.20	Health Care Access	8,018,000	7,975,000
478.21	Federal TANF	222,000	222,000

478.22The amounts that may be spent from the
478.23appropriation for each purpose are as follows:

478.24

(a) Financial Operations

478.25	Appropriations by Fund
478.26	General	7,102,000	7,523,000
478.27	Health Care Access	889,000	880,000
478.28	Federal TANF	122,000	122,000

478.29

(b) Legal and Regulation Operations

478.30	Appropriations by Fund
478.31	General	13,037,000	13,138,000
478.32 478.33	State Government Special Revenue	424,000	432,000
478.34	Health Care Access	891,000	908,000
478.35	Federal TANF	100,000	100,000

479.1Base Adjustment. The general fund base is
479.2decreased by $177,000 in fiscal year 2010
479.3and $353,000 in fiscal year 2011 for legal
479.4and regulatory.
479.5Child Care Licensing. $697,000 is
479.6appropriated from the general fund to
479.7the commissioner of human services for
479.8the biennium beginning July 1, 2007, for
479.9purposes of completing background studies
479.10for family and group family child care
479.11providers under Minnesota Statutes, chapter
479.12245C. This appropriation will be $288,000 in
479.13fiscal year 2010 and $112,000 in fiscal year
479.142011.

479.15

(c) Management Operations

479.16	Appropriations by Fund
479.17	General	4,390,000	4,433,000
479.18	Health Care Access	234,000	238,000

479.19

(d) Information Technology Operations

479.20	Appropriations by Fund
479.21	General	23,884,000	23,788,000
479.22	Health Care Access	6,004,000	5,949,000

479.23 479.24

Subd. 3.Revenue and Pass-Through Expenditures

66,842,000

69,723,000

479.25

Federal TANF

66,842,000

69,723,000

479.26TANF Transfer to Federal Child Care
479.27and Development Fund. The following
479.28TANF fund amounts are appropriated to
479.29the commissioner for the purposes of MFIP
479.30transition year child care under MFIP,
479.31Minnesota Statutes, section 119B.05:
479.32(1) fiscal year 2008, $10,333,000
479.33(2) fiscal year 2009, $12,826,000
479.34(3) fiscal year 2010, $4,104,000 and
480.1(4) fiscal year 2011, $5,460,000.
480.2The commissioner shall authorize transfer
480.3of sufficient TANF funds to the federal
480.4child care and development fund to meet
480.5this appropriation and shall ensure that all
480.6transferred funds are expended according
480.7the federal child care and development fund
480.8regulations.

480.9 480.10

Subd. 4.Children and Economic Assistance Grants

749,318,000

730,623,000

480.11	Appropriations by Fund
480.12	General	561,814,000	535,898,000
480.13	Federal TANF	187,254,000	194,725,000
480.14	Health Care Access	250,000	-0-

480.15The amounts that may be spent from this
480.16appropriation for each purpose are as follows:

480.17

(a) MFIP/DWP Grants

480.18	Appropriations by Fund
480.19	General	62,000,000	61,911,000
480.20	Federal TANF	82,532,000	90,003,000

480.21

(b) Support Services Grants

480.22	Appropriations by Fund
480.23	General	8,815,000	9,465,000
480.24	Federal TANF	103,382,000	103,382,000

480.25TANF Prior Appropriation Cancellation.
480.26Notwithstanding Laws 2001, First Special
480.27Session chapter 9, article 17, section
480.282, subdivision 11, paragraph (b), any
480.29unexpended TANF funds appropriated to the
480.30commissioner to contract with the Board of
480.31Trustees of Minnesota State Colleges and
480.32Universities, to provide tuition waivers to
480.33employees of health care and human service
480.34providers that are members of qualifying
480.35consortia operating under Minnesota
481.1Statutes, sections 116L.10 to 116L.15, must
481.2cancel at the end of fiscal year 2007.
481.3MFIP Pilot Program. Of the general fund
481.4appropriation, $100,000 in fiscal year 2008
481.5and $750,000 in fiscal year 2009 are for a
481.6grant to the Stearns-Benton Employment and
481.7Training Council for the Workforce U pilot
481.8program.
481.9Work Study. $750,000 in fiscal year
481.102008 and $750,000 in fiscal year 2009 are
481.11appropriated from the TANF reserve account
481.12to the Minnesota Office of Higher Education
481.13for work study grants under Minnesota
481.14Statutes, section 136A.233, specifically
481.15for low-income individuals who receive
481.16assistance under Minnesota Statutes, chapter
481.17256J.

481.18

(c) MFIP Child Care Assistance Grants

481.19

General

74,797,000

73,699,000

481.20 481.21

(d) Basic Sliding Fee Child Care Assistance Grants

481.22

General

43,012,000

45,432,000

481.23Base Adjustment. The general fund base
481.24is increased by $1,262,000 in fiscal year
481.252010 and decreased by $951,000 in fiscal
481.26year 2011 for basic sliding fee child care
481.27assistance grants.

481.28

(e) Child Care Development Grants

481.29

General

5,865,000

5,865,000

481.30Child Care Services Grants. $5,000,000
481.31is appropriated from the general fund to
481.32the commissioner of human services for
481.33the biennium beginning July 1, 2007, for
481.34purposes of providing child care services
482.1grants under Minnesota Statutes, section
482.2119B.21, subdivision 5. This appropriation
482.3is for the 2008-2009 biennium only, and does
482.4not increase the base funding.
482.5Early Childhood Professional
482.6Development System. $2,000,000 is
482.7appropriated from the general fund to
482.8the commissioner of human services for
482.9the biennium beginning July 1, 2007, for
482.10purposes of the early childhood professional
482.11development system, which increases the
482.12quality and continuum of professional
482.13development opportunities for child care
482.14practitioners. This appropriation is for the
482.152008-2009 biennium only, and does not
482.16increase the base funding.
482.17Family, Friend, and Neighbor Grant
482.18Program. $750,000 in fiscal year 2008 and
482.19$750,000 in fiscal year 2009 are appropriated
482.20from the general fund to the commissioner
482.21of human services for the family, friend,
482.22and neighbor grant program in section 31.
482.23Any balance in the first year does not cancel
482.24but is available in the second year. This
482.25appropriation is for the 2008-2009 biennium
482.26only, and does not increase the base funding.
482.27(f) Increased Child Care Provider
482.28Connections. (1) $200,000 is appropriated
482.29from the general fund to the commissioner of
482.30human services for the biennium beginning
482.31July 1, 2007, for the following purposes:
482.32$100,000 each year is for a grant to Hennepin
482.33County, and $100,000 each year is for a grant
482.34to Ramsey County. The two counties shall
482.35each contract with a nonprofit organization
483.1to work with the contracting county
483.2and county-based licensed family child
483.3care providers to facilitate county-based
483.4information regarding family and children's
483.5resources and to make training and peer
483.6support available to licensed family child
483.7care providers consistent with clause (2).
483.8These appropriations are available until
483.9June 30, 2009, and shall not become part
483.10of base-level funding for the biennium
483.11beginning July 1, 2009.
483.12(2) Programs to improve child care provider
483.13connections to county services shall be
483.14established in Hennepin and Ramsey
483.15counties to:
483.16(i) improve county contact activities
483.17with county-licensed family child care
483.18providers that facilitate utilization of county
483.19educational, social service, public health,
483.20and economic assistance services by eligible
483.21families, parents, and children using licensed
483.22family child care; and
483.23(ii) support licensed family child care
483.24providers to qualify as quality-rated child
483.25care providers through peer support and
483.26coaching networks.
483.27Hennepin and Ramsey Counties shall
483.28contract with a nonprofit organization under
483.29clause (1) that utilizes licensed family child
483.30care providers as contacts for families using
483.31licensed family child care and to provide
483.32peer support to licensed family child care
483.33providers.
483.34(3) Hennepin and Ramsey Counties must
483.35report back on successful strategies for
484.1increasing contact with county-based
484.2licensed family child care providers and
484.3report their findings to the appropriate
484.4legislative committees by February 15, 2010.
484.5Base Adjustment. The general fund base
484.6is $1,515,000 for each of fiscal years 2010
484.7and 2011.

484.8

(g) Child Support Enforcement Grants

484.9

General

9,038,000

3,705,000

484.10Child Support Enforcement. $5,333,000
484.11for fiscal year 2008 is to make grants to
484.12counties for child support enforcement
484.13programs to make up for the loss under the
484.142006 federal Deficit Reduction Act of federal
484.15matching funds for federal incentive funds
484.16passed on to the counties by the state.
484.17This appropriation is available until spent.

484.18

(h) Children's Services Grants

484.19	Appropriations by Fund
484.20	General	62,745,000	73,133,000
484.21	Health Care Access	250,000	-0-

484.22Base Adjustment. The general fund base
484.23is decreased by $673,000 in fiscal year
484.242010 and $670,000 in fiscal year 2011 for
484.25children's services grants.
484.26Privatized Adoption Grants. Federal
484.27reimbursement for privatized adoption grant
484.28and foster care recruitment grant expenditures
484.29is appropriated to the commissioner for
484.30adoption grants and foster care and adoption
484.31administrative purposes.
484.32Adoption Assistance Incentive Grants.
484.33Federal funds available during fiscal year
484.342008 and fiscal year 2009 for the adoption
485.1incentive grants are appropriated to the
485.2commissioner for these purposes.
485.3Adoption Assistance and Relative Custody
485.4Assistance. The commissioner may transfer
485.5unencumbered appropriation balances for
485.6adoption assistance and relative custody
485.7assistance between fiscal years and between
485.8programs.
485.9Adoption Assistance and Relative
485.10Custody Assistance Subsidy Payment
485.11Increase. Notwithstanding Minnesota
485.12Rules, part 9560.0083, subparts 5 and 6, the
485.13commissioner shall increase the payment
485.14schedules for basic and supplemental
485.15maintenance needs subsidies by 3.95 percent
485.16effective July 1, 2007. The commissioner
485.17may make cost-neutral adjustments between
485.18schedules and between brackets within
485.19schedules to allow for whole-dollar bracket
485.20levels and account for differential cost
485.21increases in caring for children with special
485.22needs. Counties have until December 31,
485.232007, to implement the relative custody
485.24assistance payment increases and shall make
485.25payment adjustments retroactive to July 1,
485.262007.
485.27Crisis Nurseries. $1,100,000 in fiscal year
485.282008 and $1,100,000 in fiscal year 2009 are
485.29appropriated from the general fund for the
485.30crisis nurseries program. Of this amount,
485.31$100,000 each year is to be made available
485.32for capacity development and technical
485.33support for crisis nurseries.
485.34Respite Care. Of the general fund
485.35appropriation, $1,250,000 in fiscal year
486.12008 and $2,500,000 in fiscal year 2009 are
486.2to the commissioner of human services to
486.3fund respite care for children who have a
486.4diagnosis of emotional disturbance or severe
486.5emotional disturbance.
486.6Childhood Trauma; Grants. Of the general
486.7fund appropriation, $125,000 in fiscal year
486.82008 and $250,000 in fiscal year 2009 are
486.9to the commissioner of human services to
486.10make grants for the purpose of maintaining
486.11and expanding evidence-based practices that
486.12support children and youth who have been
486.13exposed to violence or who are refugees.
486.14Collaborative Services for High-Risk
486.15Children. Of the general fund appropriation,
486.16$2,632,000 in fiscal year 2008 and
486.17$6,150,000 in fiscal year 2009 are to the
486.18commissioner of human services to fund
486.19early intervention collaborative programs.
486.20Evidence-Based Practice. Of the general
486.21fund appropriation, $2,175,000 in fiscal year
486.222008 and $4,350,000 in fiscal year 2009
486.23are to the commissioner of human services
486.24to develop and implement evidence-based
486.25practice in children's mental health care and
486.26treatment.
486.27MFIP and Children's Mental Health Pilot
486.28Project. Of the general fund appropriation,
486.29$100,000 in fiscal year 2008 and $200,000
486.30in fiscal year 2009 are to the commissioner
486.31of human services to fund the MFIP and
486.32children's mental health pilot project.
486.33Regional Children's Mental Health
486.34Initiative. $700,000 in fiscal year 2008 and
486.35$700,000 in fiscal year 2009 are appropriated
487.1to the commissioner of human services to
487.2fund the Regional Children's Mental Health
487.3Initiative pilot project. This is a onetime
487.4appropriation.
487.5Child Safety Efforts. $1,000,000 in fiscal
487.6year 2008 and $1,000,000 in fiscal year 2009
487.7are appropriated to counties based on their
487.8population of residents under age 18. Funds
487.9are to be used to maintain and improve child
487.10safety services. By February 1, 2008, each
487.11county shall submit a report regarding current
487.12child safety efforts, child safety funding, and
487.13unmet needs including investments needed.
487.14The report shall also include methods and
487.15community partners available to ensure
487.16early identification of at-risk families. The
487.17Association of Minnesota Counties and
487.18county agencies shall develop a uniform
487.19report structure so that statewide data can
487.20be easily summarized. This is a onetime
487.21appropriation.
487.22Fetal Alcohol Syndrome. Of the general
487.23fund appropriation, $75,000 in fiscal year
487.242008 and $75,000 in fiscal year 2009 are
487.25for three programs that provide services
487.26to reduce fetal alcohol syndrome under
487.27Minnesota Statutes, section 145.9266. The
487.28three program grantees are the University
487.29of Minnesota, the Meeker-McLeod-Sibley
487.30Community, and the American Indian Family
487.31Center. This appropriation shall become part
487.32of the base appropriation.
487.33Base Adjustment. The general fund base is
487.34increased by $366,000 in fiscal year 2010 and
488.1$369,000 in fiscal year 2011 for children's
488.2services grants.

488.3

(i) Children and Community Services Grants

488.4

General

110,802,000

69,567,000

488.5Base Adjustment. The general fund base is
488.6increased by $99,000 in each of fiscal years
488.72010 and 2011 for children and community
488.8services grants.
488.9Targeted Case Management Temporary
488.10Funding. Of the general fund appropriation,
488.11$40,000,000 in fiscal year 2008 is allocated to
488.12counties and tribes affected by reductions in
488.13targeted case management federal Medicaid
488.14revenue as a result of the provisions in
488.15the federal Deficit Reduction Act of 2005,
488.16Public Law 109-171. The commissioner
488.17shall distribute the funds proportionate
488.18to each affected county or tribe's targeted
488.19case management federal earnings for
488.20calendar year 2005. Prior to distribution
488.21of funds, the commissioner shall estimate
488.22and certify the amount by which the federal
488.23regulations will reduce case management
488.24revenue over the 2008-2009 biennium. The
488.25commissioner may provide grants up to the
488.26amount of the estimated reduction, not to
488.27exceed $40,000,000 for the biennium. The
488.28commissioner may determine the timing and
488.29frequency of payments to counties. These
488.30funds are available in either year of the
488.31biennium. Counties shall use these funds to
488.32pay for social service-related costs, but the
488.33funds are not subject to provisions of the
488.34Children and Community Services Act grant
488.35under Minnesota Statutes, chapter 256M.
489.1Child Welfare Project. Of the general fund
489.2appropriation, $2,000,000 for the biennium
489.3beginning July 1, 2007, is for expanding
489.4the American Indian chid welfare project
489.5under Minnesota Statutes, section 256.01,
489.6subdivision 14b, to include the Red Lake
489.7Band of Chippewa Indians Tribe, provided
489.8the tribe meets the criteria in Minnesota
489.9Statutes, section 256.01, subdivision 14b.

489.10

(j) General Assistance Grants

489.11

General

37,876,000

38,253,000

489.12General Assistance Standard. The
489.13commissioner shall set the monthly standard
489.14of assistance for general assistance units
489.15consisting of an adult recipient who is
489.16childless and unmarried or living apart
489.17from parents or a legal guardian at $203.
489.18The commissioner may reduce this amount
489.19according to Laws 1997, chapter 85, article
489.203, section 54.
489.21Emergency General Assistance. The
489.22amount appropriated for emergency general
489.23assistance funds is limited to no more
489.24than $7,889,812 in fiscal year 2008 and
489.25$7,889,812 in fiscal year 2009. Funds
489.26to counties must be allocated by the
489.27commissioner using the allocation method
489.28specified in Minnesota Statutes, section
489.29256D.06.

489.30

(k) Minnesota Supplemental Aid Grants

489.31

General

30,798,000

31,439,000

489.32Emergency Minnesota Supplemental
489.33Aid Funds. The amount appropriated for
489.34emergency Minnesota supplemental aid
490.1funds is limited to no more than $1,100,000
490.2in fiscal year 2008 and $1,100,000 in fiscal
490.3year 2009. Funds to counties must be
490.4allocated by the commissioner using the
490.5allocation method specified in Minnesota
490.6Statutes, section 256D.46.

490.7

(l) Group Residential Housing Grants

490.8

General

91,441,000

99,304,000

490.9Base Adjustment. The general fund base is
490.10increased by $6,665,000 in fiscal year 2010
490.11and $13,419,000 in fiscal year 2011.
490.12People Incorporated. $460,000 in fiscal
490.13year 2008 and $460,000 in fiscal year 2009
490.14are appropriated from the general fund to the
490.15commissioner of human services to augment
490.16community support and mental health
490.17services provided to individuals residing in
490.18facilities under Minnesota Statutes, section
490.19256I.05, subdivision 1h.

490.20 490.21

(m) Other Children and Economic Assistance Grants

490.22

General

24,625,000

24,125,000

490.23

Federal TANF

1,340,000

1,340,000

490.24Base Adjustment. The general fund base
490.25shall be $20,447,000 in each of fiscal years
490.262010 and 2011.
490.27New Chance. $140,000 in fiscal year
490.282008 and $140,000 in fiscal year 2009 are
490.29appropriated from federal TANF funds to the
490.30Hennepin County new chance program.
490.31Mothers First. Of the TANF appropriation,
490.32$450,000 in fiscal year 2008 and $450,000
490.33in fiscal year 2009 are to fund the Ramsey
490.34County mothers first program. The
491.1appropriations are available until spent and
491.2are a onetime appropriation.
491.3Homeless and Runaway Youth. $3,500,000
491.4in the first year and $3,500,000 in the second
491.5year are for the Runaway and Homeless
491.6Youth Act under Minnesota Statutes, section
491.7256K.45. Funds shall be spent in each area
491.8of the continuum of care to ensure that
491.9programs are meeting the greatest need. The
491.10base is decreased by $2,000,000 each year in
491.11fiscal year 2010 and fiscal year 2011.
491.12Transitional Housing and Emergency
491.13Services.
491.14(1) $750,000 each year from the federal
491.15TANF fund is for transitional housing
491.16programs under Minnesota Statutes, section
491.17256E.33. The TANF appropriations
491.18are onetime. The general fund base for
491.19transitional housing is increased by $422,000
491.20each year for the fiscal 2010-2011 biennium.
491.21Up to ten percent of this appropriation may
491.22be used for housing and services which
491.23extend beyond 24 months. $300,000 in each
491.24year of this amount is for grants for safe
491.25housing pilot projects for battered women
491.26and families in Anoka County, Houston
491.27County, and Beltrami County; and
491.28(2) $527,000 each year is added to the
491.29base for emergency services grants under
491.30Laws 1997, chapter 162, article 3, section
491.317. The base for emergency services grants
491.32is decreased each year by $300,000 in fiscal
491.33year 2010 and fiscal year 2011.
491.34Foodshelf Programs. $575,000 each year
491.35is added to the base for foodshelf programs
492.1under Minnesota Statutes, section 256E.34.
492.2The base is decreased by $250,000 each year
492.3in fiscal year 2010 and fiscal year 2011.
492.4Long-term Homeless Services. $2,440,000
492.5each year is added to the base for the
492.6long-term homeless services under
492.7Minnesota Statutes, section 256K.26. The
492.8base is decreased by $1,000,000 each year in
492.9fiscal year 2010 and fiscal year 2011.
492.10Minnesota Community Action Grants.
492.11$1,500,000 each year is added to the base for
492.12the purposes of Minnesota community action
492.13grants under Minnesota Statutes, sections
492.14256E.30 to 256E.32. The base is reduced by
492.15$500,000 each year in fiscal year 2010 and
492.16fiscal year 2011.
492.17Tenant Hotline Services Program. $50,000
492.18each year is added to the base for a grant to
492.19HOME Line for the tenant hotline services
492.20program. This is a onetime appropriation.

492.21 492.22

Subd. 5.Children and Economic Assistance Management

47,035,000

46,884,000

492.23	Appropriations by Fund
492.24	General	45,492,000	45,335,000
492.25	Health Care Access	347,000	354,000
492.26	Federal TANF	1,196,000	1,196,000

492.27The amounts that may be spent from the
492.28appropriation for each purpose are as follows:

492.29 492.30

(a) Children and Economic Assistance Administration

492.31	Appropriations by Fund
492.32	General	9,725,000	9,612,000
492.33	Federal TANF	1,196,000	1,196,000

493.1Base Adjustment. The general fund base is
493.2$9,574,000 in each of fiscal years 2010 and
493.32011.

493.4 493.5

(b) Children and Economic Assistance Operations

493.6	Appropriations by Fund
493.7	General	35,767,000	35,722,000
493.8	Health Care Access	347,000	354,000

493.9Spending Authority for Food Stamps
493.10Bonus Awards. In the event that Minnesota
493.11qualifies for the United States Department
493.12of Agriculture Food and Nutrition Services
493.13Food Stamp Program performance bonus
493.14awards, the funding is appropriated to the
493.15commissioner. The commissioner shall
493.16retain 25 percent of the funding, with the
493.17other 75 percent divided among the counties
493.18according to a formula that takes into account
493.19each county's impact on state performance in
493.20the applicable bonus categories.
493.21Child Support Payment Center. Payments
493.22to the commissioner from other governmental
493.23units, private enterprises, and individuals
493.24for services performed by the child support
493.25payment center must be deposited in the state
493.26systems account authorized under Minnesota
493.27Statutes, section 256.014. These payments
493.28are appropriated to the commissioner for the
493.29operation of the child support payment center
493.30or system, according to Minnesota Statutes,
493.31section 256.014.
493.32Financial Institution Data Match and
493.33Payment of Fees. The commissioner is
493.34authorized to allocate up to $310,000 each
493.35year in fiscal years 2008 and 2009 from the
493.36PRISM special revenue account to make
494.1payments to financial institutions in exchange
494.2for performing data matches between account
494.3information held by financial institutions
494.4and the public authority's database of child
494.5support obligors as authorized by Minnesota
494.6Statutes, section 13B.06, subdivision 7.
494.7Base Adjustment. The general fund base is
494.8decreased by $22,000 in each of fiscal years
494.92010 and 2011.

494.10

Subd. 6.Basic Health Care Grants

2,397,260,000

2,739,194,000

494.11	Appropriations by Fund
494.12	General	2,019,435,000	2,246,743,000
494.13	Health Care Access	377,825,000	492,451,000

494.14The amounts that may be spent from the
494.15appropriation for each purpose are as follows:

494.16

(a) MinnesotaCare Grants

494.17

Health Care Access

376,938,000

459,891,000

494.18MinnesotaCare Federal Receipts. Receipts
494.19received as a result of federal participation
494.20in administering costs of the Minnesota
494.21health care reform waiver must be deposited
494.22as nondedicated revenue in the health care
494.23access fund. Receipts received as a result of
494.24federal participation in making grants must
494.25be deposited in the federal fund and must
494.26offset health care access funds for payments
494.27to providers.
494.28MinnesotaCare Funding. The
494.29commissioner may expend money
494.30appropriated from the health care access fund
494.31for MinnesotaCare in either fiscal year of the
494.32biennium.
494.33HealthMatch Delay. Of this appropriation,
494.34$2,560,000 in fiscal year 2008 and
495.1$29,647,000 in fiscal year 2009 are for
495.2MinnesotaCare program costs related to
495.3implementation of the HealthMatch program.

495.4 495.5

(b) MA Basic Health Care - Families and Children

495.6	Appropriations by Fund
495.7	General	758,212,000	847,163,000
495.8	Health Care Access	-0-	31,661,000

495.9 495.10

(c) MA Basic Health Care - Elderly and Disabled

495.11

General

1,019,297,000

1,145,789,000

495.12Provider-Directed Care Coordination. In
495.13addition to medical assistance reimbursement
495.14under Minnesota Statutes, sections
495.15256B.0625 and 256B.76, clinics participating
495.16in provider-directed care coordination under
495.17Minnesota Statutes, section 256B.0625, also
495.18receive a monthly payment per client when
495.19the clinic serves an eligible client. The
495.20payments across the program must average
495.21$50 per month per client.
495.22Services for Developmentally Disabled.
495.23The commissioner must serve: an additional
495.24200 persons in the MR/RC waiver program;
495.25an additional 200 persons in the family
495.26support grant program under Minnesota
495.27Statutes, section 252.32; and an additional
495.28200 persons in the semi-independent living
495.29services program under Minnesota Statutes,
495.30section 252.275.
495.31County CADI allocation adjustment. (1)
495.32The commissioner shall adjust 2007 home
495.33and community-based allocations under
495.34section 256B.49 to qualifying counties
495.35that transferred persons to the community
496.1alternatives for disabled individuals
496.2(CADI) waiver program under Laws 2006,
496.3chapter 282, article 20, section 35. The
496.4adjustment shall reflect the amount that
496.5county-authorized funding for CADI waiver
496.6services exceeded the allowable amount
496.7as shown in the Medicaid Management
496.8Information System (MMIS) on March 1,
496.92007.
496.10(2) A county that may qualify under
496.11paragraph (1) shall apply to the commissioner
496.12by June 10, 2007. Following a review of the
496.13county request and the MMIS documentation,
496.14the commissioner shall adjust the county
496.15allocation, as appropriate, by June 25, 2007.
496.16(3) The amounts provided to a county under
496.17this section shall become part of the county's
496.18base level state allocation for the CADI
496.19waiver for the biennium beginning July 1,
496.202007.
496.21(4) This rider is effective the day following
496.22final enactment.

496.23

(d) General Assistance Medical Care Grants

496.24

General

238,887,000

251,082,000

496.25

(e) Other Health Care Grants

496.26	General	3,039,000	2,709,000
496.27	Health Care Access	887,000	899,000

496.28Care Coordination. Of the general fund
496.29appropriation, $500,000 in fiscal year 2008
496.30and $1,000,000 in fiscal year 2009 are for
496.31the commissioner of human services for
496.32contracting for care coordination with the
496.33U special kids program under Minnesota
496.34Statutes, section 256B.0751.
497.1Community-Based Health Care. Of the
497.2general fund appropriation, $1,050,000
497.3for the biennium beginning July 1, 2007,
497.4is to the commissioner of human services
497.5for the demonstration project grant
497.6described in Minnesota Statutes, section
497.762Q.80, subdivision 1a. This is a onetime
497.8appropriation and is available until June 30,
497.92012.
497.10Health Care Payment Reform Pilot. Of
497.11the general fund appropriation, $1,018,000
497.12in fiscal year 2008 and $1,027,000 in fiscal
497.13year 2009 are for the health care payment
497.14reform pilot project. These are onetime
497.15appropriations.
497.16Patient Incentive Programs. Of the general
497.17fund appropriation, $500,000 in fiscal year
497.182008 and $500,000 in fiscal year 2009 are
497.19for patient incentive programs.
497.20State Health Policies Grant. Of the general
497.21fund appropriation, $300,000 in fiscal year
497.222008 is to provide a grant to a research center
497.23associated with a safety net hospital and
497.24county-affiliated health system to develop
497.25the capabilities necessary for evaluating the
497.26effects of changes in state health policies
497.27on low-income and uninsured individuals,
497.28including the impact on state health care
497.29program costs, health outcomes, cost-shifting
497.30to different units and levels of government,
497.31and utilization patterns including use of
497.32emergency room care and hospitalization
497.33rates.
497.34Neighborhood Health Care Network. Of
497.35the general fund appropriation, $150,000 in
498.1fiscal year 2008 and $150,000 in fiscal year
498.22009 are for a grant to the Neighborhood
498.3Health Care Network to maintain and staff a
498.4toll-free health care access telephone number.

498.5

Subd. 7.Health Care Management

54,536,000

58,696,000

498.6	Appropriations by Fund
498.7	General	32,416,000	30,571,000
498.8	Health Care Access	22,120,000	28,125,000

498.9The amounts that may be spent from the
498.10appropriation for each purpose are as follows:

498.11

(a) Health Care Policy Administration

498.12	Appropriations by Fund
498.13	General	10,236,000	8,813,000
498.14	Health Care Access	2,323,000	10,074,000

498.15Minnesota Senior Health Options
498.16Reimbursement. Federal administrative
498.17reimbursement resulting from the Minnesota
498.18senior health options project is appropriated
498.19to the commissioner for this activity.
498.20Utilization Review. Federal administrative
498.21reimbursement resulting from prior
498.22authorization and inpatient admission
498.23certification by a professional review
498.24organization is dedicated to the commissioner
498.25for these purposes. A portion of these funds
498.26must be used for activities to decrease
498.27unnecessary pharmaceutical costs in medical
498.28assistance.
498.29Dental Access for Persons with Disabilities.
498.30Of the general fund appropriation, $82,000
498.31in fiscal year 2008 is for a study on access to
498.32dental services for persons with disabilities.
498.33Base Adjustment. The health care access
498.34fund base is $10,716,000 in fiscal year 2010
499.1and $8,870,000 in fiscal year 2011, for health
499.2care administration.

499.3

(b) Health Care Operations

499.4	Appropriations by Fund
499.5	General	22,180,000	21,758,000
499.6	Health Care Access	19,797,000	18,051,000

499.7Base Adjustment. The general fund base is
499.8decreased by $214,000 in fiscal year 2010
499.9for health care operations.

499.10

Subd. 8.Continuing Care Grants

1,697,359,000

1,858,283,000

499.11	Appropriations by Fund
499.12	General	1,694,876,000	1,855,900,000
499.13	Health Care Access	750,000	750,000
499.14	Lottery Prize	1,733,000	1,633,000

499.15The amounts that may be spent from the
499.16appropriation for each purpose are as follows:

499.17

(a) Aging and Adult Services Grants

499.18

General

15,986,000

16,605,000

499.19Information and Assistance
499.20Reimbursement. Federal administrative
499.21reimbursement obtained from information
499.22and assistance services provided by the
499.23Senior LinkAge Line to people who are
499.24identified as eligible for medical assistance
499.25are appropriated to the commissioner for this
499.26activity.
499.27Senior Companion Program. Of the
499.28general fund appropriation, $191,000 in
499.29fiscal year 2008 and $191,000 in fiscal year
499.302009 are for the senior companion program
499.31under Minnesota Statutes, section 256.977.
499.32Volunteer Senior Citizens. Of the general
499.33fund appropriation, $192,000 in fiscal year
499.342008 and $192,000 in fiscal year 2009 are
500.1for the volunteer programs for retired senior
500.2citizens under Minnesota Statutes, section
500.3256.9753.
500.4Foster Grandparent Program. Of the
500.5general fund appropriation, $192,000 in
500.6fiscal year 2008 and $192,000 in fiscal year
500.72009 are for the foster grandparent program
500.8in Minnesota Statutes, section 256.976.
500.9Senior Nutrition. Of the general fund
500.10appropriation, $250,000 in fiscal year
500.112008 and $250,000 in fiscal year 2009 are
500.12for the senior nutrition programs under
500.13Minnesota Statutes, section 256.9752.
500.14The commissioner shall give priority to
500.15increase services to: (1) persons facing
500.16language or cultural barriers, (2) persons with
500.17special diets, (3) persons living in isolated
500.18rural areas, and (4) other hard-to-serve
500.19populations.
500.20Living At Home/Block Nurse Program. Of
500.21the general fund appropriation, $580,000 in
500.22fiscal year 2008 and $655,000 in fiscal year
500.232009 are for the living at home/block nurse
500.24program. The purpose of the appropriation is
500.25to increase base funding levels to $25,000
500.26per program year, provide base funding for
500.27nine programs currently operating without
500.28base funding, provide base funding for five
500.29new programs beginning July 1, 2007, and
500.30provide base funding for six additional
500.31programs beginning July 1, 2008.
500.32$76,000 in fiscal year 2008 and $62,000 in
500.33fiscal year 2009 are for increased staff for
500.34the ombudsman for older Minnesotans and
500.35related costs.
501.1$150,000 in fiscal year 2008 and $150,000 in
501.2fiscal year 2009 are to increase the base of
501.3the Senior LinkAge line program.
501.4Minnesota Kinship Caregivers
501.5Association. (1) Of the general fund
501.6appropriation, $175,000 in fiscal year
501.72008 and $175,000 in fiscal year 2009
501.8are transferred to a nonprofit organization
501.9experienced in kinship caregiver programs,
501.10with at least 50 percent of its board
501.11composed of kinship caregivers for purposes
501.12of providing support to grandparents or
501.13relatives who are raising kinship children.
501.14(2) The demonstration grant sites must
501.15include the Minnesota Kinship Caregivers
501.16Association central site in the metropolitan
501.17area and another site in the Bemidji region.
501.18The support must provide a one-stop services
501.19program. The services that may be provided
501.20include but are not limited to legal services,
501.21education, information, family activities,
501.22support groups, mental health access,
501.23advocacy, mentors, and information related
501.24to foster care licensing. The funds may also
501.25be used for a media campaign to inform
501.26kinship families about available information
501.27and services, support sites, and other program
501.28development. The general fund base for the
501.29program shall be $160,000 in fiscal year
501.302010 and $160,000 in fiscal year 2011.
501.31Base Adjustment. The general fund base
501.32is increased by $72,000 in fiscal year 2010
501.33and $72,000 in fiscal year 2011 for aging and
501.34adult services grants.

501.35

(b) Alternative Care Grants

502.1

General

50,063,000

52,511,000

502.2Alternative Care Transfer. Any money
502.3allocated to the alternative care program that
502.4is not spent for the purposes indicated does
502.5not cancel but is transferred to the medical
502.6assistance account.
502.7Base Adjustment. The general fund base is
502.8increased by $547,000 in fiscal year 2010 and
502.9$784,000 in fiscal year 2011 for alternative
502.10care grants.

502.11 502.12

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

502.13

General

499,278,000

513,016,000

502.14New Nursing Facility Reimbursement
502.15System Delay. Notwithstanding Minnesota
502.16Statutes, section 256B.441, subdivision 1,
502.17paragraph (c), the commissioner shall begin
502.18to phase in the new reimbursement system
502.19for nursing facilities on or after October 1,
502.202009.
502.21Long-Term Care Consultation Funding
502.22Increase. For the rate year beginning
502.23October 1, 2008, the county long-term
502.24care consultation allocations in Minnesota
502.25Statutes, section 256B.0911, subdivision
502.266, must be increased based on the number
502.27of transitional long-term care consultation
502.28visits projected by the commissioner in
502.29each county. For the rate year beginning
502.30October 1, 2009, final allocations must be
502.31determined based on the average between
502.32the actual number of transitional long-term
502.33care visits that were conducted in the prior
502.3412-month period and the projected number
503.1of consultations that will be provided in
503.2the rate year beginning October 1, 2009.
503.3Notwithstanding section 7, this rider expires
503.4June 30, 2010.
503.5Life Safety Code Compliance. Of the
503.6general fund appropriation, $1,000,000 in
503.7fiscal year 2008 is for payments to nursing
503.8facilities for life safety code compliance
503.9under Minnesota Statutes, section 256B.434,
503.10subdivision 4, paragraph (e). This is a
503.11onetime appropriation and available until
503.12spent.

503.13 503.14

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

503.15

General

966,623,000

1,099,540,000

503.16

(e) Mental Health Grants

503.17	Appropriations by Fund
503.18	General	57,522,000	60,678,000
503.19	Health Care Access	750,000	750,000
503.20	Lottery Prize	1,733,000	1,633,000

503.21Dual Diagnosis; Demonstration Project.
503.22Of the general fund appropriation, $800,000
503.23in fiscal year 2008 and $1,600,000 in fiscal
503.24year 2009 are to the commissioner of
503.25human services to fund the dual diagnosis
503.26demonstration project.
503.27Mobile Mental Health Crisis Services. Of
503.28the general fund appropriation, $2,500,000
503.29in fiscal year 2008 and $3,625,000 in fiscal
503.30year 2009 are to the commissioner of human
503.31services for statewide funding of adult mobile
503.32mental health crisis services. Providers must
503.33utilize all available funding streams.
503.34National Council on Problem Gambling.
503.35(1) $225,000 in fiscal year 2008 and $225,000
504.1in fiscal year 2009 are appropriated from
504.2the lottery prize fund to the commissioner
504.3of human services for a grant to the state
504.4affiliate recognized by the National Council
504.5on Problem Gambling. The affiliate must
504.6provide services to increase public awareness
504.7of problem gambling, education, and training
504.8for individuals and organizations providing
504.9effective treatment services to problem
504.10gamblers and their families, and research
504.11relating to problem gambling. These
504.12services must be complementary to and not
504.13duplicative of the services provided through
504.14the problem gambling program administered
504.15by the commissioner of human services. This
504.16grant does not prevent the commissioner
504.17from regular monitoring and oversight of the
504.18grant or the ability to reallocate the funds to
504.19other services within the problem gambling
504.20program for nonperformance of duties by
504.21the grantee.
504.22(2) Of this appropriation, $100,000 in
504.23fiscal year 2008 and $100,000 in fiscal year
504.242009 are contingent on the contribution
504.25of nonstate matching funds. Matching
504.26funds may be either cash or qualifying
504.27in-kind contributions. The commissioner of
504.28finance may disburse the state portion of the
504.29matching funds in increments of $25,000
504.30upon receipt of a commitment for an equal
504.31amount of matching nonstate funds. The
504.32general fund base shall be $100,000 in fiscal
504.33year 2010 and $100,000 in fiscal year 2011
504.34(3) $100,000 in fiscal year 2008 is
504.35appropriated from the lottery prize fund to
504.36the commissioner of human services for a
505.1grant or grants to be awarded competitively
505.2to develop programs and services for
505.3problem gambling treatment, prevention,
505.4and education in immigrant communities.
505.5This appropriation is available until June
505.630, 2009, at which time the project must
505.7be completed and final products delivered,
505.8unless an earlier completion date is specified
505.9in the work program.
505.10Compulsive Gambling. $300,000 in fiscal
505.11year 2008 and $100,000 in fiscal year 2009
505.12are appropriated from the lottery prize fund
505.13to the commissioner of human services for
505.14purposes of compulsive gambling education,
505.15assessment, and treatment under Minnesota
505.16Statutes, section 245.98.
505.17Compulsive Gambling Study. $100,000
505.18in fiscal year 2008 is to continue the
505.19study currently being done on compulsive
505.20gambling treatment effectiveness and
505.21long-term effects of gambling.
505.22Base Adjustment. The general fund base is
505.23increased by $266,000 in fiscal year 2010.

505.24

(f) Deaf and Hard-of-Hearing Grants

505.25

General

1,932,000

2,380,000

505.26Hearing Loss Mentors. Of the general fund
505.27appropriation, $80,000 is to provide mentors
505.28who have a hearing loss to parents of newly
505.29identified infants and children with hearing
505.30loss.
505.31Base Adjustment. The general fund base
505.32is increased by $7,000 in fiscal year 2010
505.33and $7,000 in fiscal year 2011 for deaf and
505.34hard-of-hearing grants.

506.1

(g) Chemical Dependency Entitlement Grants

506.2

General

78,749,000

89,946,000

506.3 506.4

(h) Chemical Dependency Nonentitlement Grants

506.5

General

1,055,000

1,055,000

506.6

(i) Other Continuing Care Grants

506.7	Appropriations by Fund
506.8	General	23,668,000	20,169,000

506.9Native American Juvenile Treatment
506.10Center. Of the general fund appropriation,
506.11$50,000 is to conduct a feasibility study
506.12of and to predesign a Native American
506.13juvenile treatment center on or near the
506.14White Earth Reservation. The facility must
506.15house and treat Native American juveniles
506.16and provide culturally specific programming
506.17to juveniles placed in the treatment center.
506.18The commissioner of human services may
506.19contract with parties who have experience
506.20in the design and construction of juvenile
506.21treatment centers to assist in the feasibility
506.22study and predesign. On or before January
506.2315, 2008, the commissioner shall present
506.24the results of the feasibility study and the
506.25predesign of the facility to the chairs of house
506.26of representatives and senate committees
506.27having jurisdiction over human services
506.28finance, public safety finance, and capital
506.29investment.
506.30Leech Lake Youth Treatment Center. Of
506.31the general fund appropriation, $75,000 in
506.32fiscal year 2008 and $75,000 in fiscal year
506.332009 are for a grant to the Leech Lake Youth
506.34Treatment Center project partners, in order
507.1to pay the salaries and other directly related
507.2costs associated with the development of this
507.3project.
507.4Assistive Technology. Of the general fund
507.5appropriation, $300,000 in fiscal year 2008 is
507.6to the Minnesota State Council on Disability
507.7for the purposes of providing $100,000
507.8in financial support to the Minnesota
507.9Regions Assistive Technology Collaborative
507.10and $200,000 in fiscal year 2008 is for
507.11a local match required to access the
507.12federal Technology-Related Assistance for
507.13Individuals with Disabilities Act, alternate
507.14finance project.
507.15Repayment. For the fiscal year ending June
507.1630, 2008, $5,287,000 is appropriated to the
507.17commissioner of human services to repay
507.18the amount of overspending in the waiver
507.19program for persons with developmental
507.20disabilities incurred by affected counties in
507.21calendar years 2004 and 2005.
507.22Base Adjustment. The general fund base
507.23is $20,276,000 in fiscal year 2010 and
507.24$20,332,000 in fiscal year 2011 for other
507.25continuing care grants.

507.26

Subd. 9.Continuing Care Management

20,248,000

19,400,000

507.27	Appropriations by Fund
507.28	General	19,384,000	19,123,000
507.29 507.30	State Government Special Revenue	121,000	123,000
507.31	Health Care Access	292,000	-0-
507.32	Lottery Prize	451,000	154,000

507.33Community Trainee and Consultation.
507.34Of the general fund appropriation, $125,000
507.35in fiscal year 2008 is to the commissioner
508.1of human services to contract for training
508.2and consultation for clinical supervisors and
508.3staff of community mental health centers
508.4who provide services to children and adults.
508.5The purpose of the training and consultation
508.6is to improve clinical supervision of
508.7staff, strengthen compliance with federal
508.8and state rules and regulations, and to
508.9recommend strategies for standardization and
508.10simplification of administrative functions
508.11among community mental health centers.
508.12Mental Health Tracking System. Of the
508.13general fund appropriation, $448,000 in fiscal
508.14year 2008 and $324,000 in fiscal year 2009
508.15are to the commissioner of human services
508.16to fund implementation of the mental health
508.17services outcomes and tracking system.
508.18Quality Management; Assurance; and
508.19Improvement System for Minnesotans
508.20Receiving Disability Services. Of the
508.21general fund appropriation, up to $300,000
508.22for the biennium beginning July 1, 2007,
508.23may be used for the purposes of the quality
508.24management, assurance, and improvement
508.25system for Minnesotans receiving disability
508.26services. Federal Medicaid matching funds
508.27obtained for this purpose shall be dedicated
508.28to the commissioner for this purpose.
508.29Base Adjustment. The health care access
508.30fund base is $0 in each of the fiscal years 2010
508.31and 2011 for continuing care management.
508.32Disability Linkage Line. Of the general
508.33fund appropriation, $650,000 in fiscal year
508.342008 and $626,000 in fiscal year 2009 are to
509.1establish and maintain the disability linkage
509.2line.

509.3

Subd. 10.State-Operated Services

266,645,000

267,718,000

509.4

General

266,645,000

267,718,000

509.5Remembering With Dignity Project. (1)
509.6$200,000 is appropriated from the general
509.7fund to the commissioner of human services
509.8to be available until September 30, 2008, to
509.9make a grant to Advocating Change Together
509.10for the purposes of the Remembering With
509.11Dignity project in paragraph (2).
509.12(2) As part of the Remembering With Dignity
509.13project, the grant recipient shall:
509.14(i) conduct necessary research on persons
509.15buried in state cemeteries who were residents
509.16of state hospitals or regional treatment
509.17centers and buried in numbered or unmarked
509.18graves;
509.19(ii) purchase and install headstones that are
509.20properly inscribed with their names on the
509.21graves of those persons; and
509.22(iii) collaborate with community groups
509.23and state and local government agencies to
509.24build community involvement and public
509.25awareness, ensure public access to the
509.26graves, and ensure appropriate perpetual
509.27maintenance of state cemeteries.
509.28(3) This rider is effective the day following
509.29final enactment.
509.30Transfer Authority Related to
509.31State-Operated Services. Money
509.32appropriated to finance state-operated
509.33services programs and administrative
509.34services may be transferred between fiscal
510.1years of the biennium with the approval of
510.2the commissioner of finance.
510.3The amounts that may be spent from the
510.4appropriation for each purpose are as follows:

510.5

(a) Mental Health Services

510.6

General

116,270,000

120,095,000

510.7Appropriation Limitation. No part of
510.8the appropriation in this article to the
510.9commissioner for mental health treatment
510.10services at the regional treatment centers
510.11shall be used for the Minnesota sex offender
510.12program.

510.13

(b) Minnesota Sex Offender Services

510.14

General

67,719,000

62,787,000

510.15 510.16

(c) Minnesota Security Hospital and METO Services

510.17

General

82,656,000

84,836,000

510.18Minnesota Security Hospital. For the
510.19purposes of enhancing the safety of
510.20the public, improving supervision, and
510.21enhancing community-based mental health
510.22treatment, state-operated services may
510.23establish additional community capacity
510.24for providing treatment and supervision
510.25of clients who have been ordered into a
510.26less restrictive alternative care from the
510.27state-operated services transitional services
510.28program consistent with Minnesota Statutes,
510.29section 246.014.

510.30

Sec. 4. COMMISSIONER OF HEALTH

510.31

Subdivision 1.Total Appropriation

$

176,686,000

$

165,689,000

510.32	Appropriations by Fund
510.33		2008	2009
511.1	General	98,737,000	92,829,000
511.2 511.3	State Government Special Revenue	39,851,000	40,642,000
511.4	Health Care Access	26,448,000	19,918,000
511.5	Federal TANF	11,350,000	12,000,000
511.6	Environment	300,000	300,000

511.7 511.8

Subd. 2.Community and Family Health Promotion

511.9	Appropriations by Fund
511.10	General	59,881,000	59,978,000
511.11 511.12	State Government Special Revenue	468,000	471,000
511.13	Health Care Access	3,539,000	3,562,000
511.14	Federal TANF	8,667,000	9,002,000

511.15TANF Appropriations. (a) $3,579,000 of
511.16the TANF funds is appropriated in each year
511.17of the biennium to the commissioner for
511.18home visiting and nutritional services listed
511.19under Minnesota Statutes, section 145.882,
511.20subdivision 7, clauses (6) and (7). Funding
511.21shall be distributed to community health
511.22boards based on Minnesota Statutes, section
511.23145A.131, subdivision 1.
511.24(b) $5,088,000 in the first year and $5,423,000
511.25in the second year are appropriated to the
511.26commissioner of health for the family home
511.27visiting grant program. The commissioner
511.28shall distribute funds to community health
511.29boards using a formula developed in
511.30conjunction with the state Community
511.31Health Services Advisory Committee. The
511.32commissioner may use five percent of the
511.33funds appropriated in each fiscal year to
511.34conduct the ongoing evaluations required
511.35under Minnesota Statutes, section 145A.17,
511.36subdivision 7, and may use ten percent of
511.37the funds appropriated each fiscal year to
512.1provide training and technical assistance as
512.2required under Minnesota Statutes, section
512.3145A.17, subdivisions 4 and 5.
512.4TANF Carryforward. Any unexpended
512.5balance of the TANF appropriation in the
512.6first year of the biennium does not cancel but
512.7is available for the second year.
512.8Loan Forgiveness. $605,000 the first year
512.9and $775,000 the second year and thereafter
512.10are for the loan forgiveness program under
512.11Minnesota Statutes, section 144.1501. This
512.12funding is in addition to the loan forgiveness
512.13program base.
512.14MN ENABL. Base level funding for the MN
512.15ENABL program, under Minnesota Statutes,
512.16section 145.9255, is reduced by $220,000
512.17each year of the biennium beginning July 1,
512.182007.
512.19Fetal Alcohol Spectrum Disorder. (a)
512.20$900,000 each year is added to the base for
512.21fetal alcohol spectrum disorder. On July 1
512.22each fiscal year, the portion of the general
512.23fund appropriation to the commissioner of
512.24health for fetal alcohol spectrum disorder
512.25administration and grants shall be transferred
512.26to a statewide organization that focuses
512.27solely on prevention of and intervention with
512.28fetal alcohol spectrum disorder as follows:
512.29(1) on July 1, 2007, $2,090,000; and
512.30(2) on July 2, 2008, and annually thereafter,
512.31$2,090,000.
512.32(b) The money shall be used for prevention
512.33and intervention services and programs,
512.34including, but not limited to, community
513.1grants, professional education, public
513.2awareness, and diagnosis. The organization
513.3may retain $60,000 of the transferred money
513.4for administrative costs. The organization
513.5shall report to the commissioner annually
513.6by January 15 on the services and programs
513.7funded by the appropriation.
513.8Deaf or Hearing Loss Support. $100,000
513.9for the first year and $100,000 for the second
513.10year is for the purpose of providing family
513.11support and assistance to families with
513.12children who are deaf or have a hearing
513.13loss. The family support provided must
513.14include direct parent-to-parent assistance and
513.15information on communication, educational,
513.16and medical options. The commissioner
513.17may contract with a nonprofit organization
513.18that has the ability to provide these services
513.19throughout the state.
513.20Heart Disease and Stroke Prevention.
513.21$200,000 is appropriated in the first year for
513.22the heart disease and stroke prevention unit
513.23of the Department of Health to fund data
513.24collection and other activities to improve
513.25cardiovascular health and reduce the burden
513.26of heart disease and stroke in Minnesota.
513.27This is a onetime appropriation.
513.28Family Planning Grants. $1,000,000 each
513.29year is for family planning grants under
513.30Minnesota Statutes, section 145.925.
513.31Bright Smiles Pilot Project. (a) $384,000
513.32in the first year and $50,000 in the second
513.33year is to fund a grant for the Bright Smiles
513.34pilot project.
514.1(b) Of these amounts, $50,000 each year is to
514.2fund a dental health coordinator position at
514.3the Minnesota Department of Health.
514.4(c) The commissioner of health shall
514.5establish a pilot project to fund a Bright
514.6Smiles program designed to increase access
514.7to oral health care for low-income and
514.8immigrant children, ages birth to five
514.9years, and their families and to build the
514.10knowledge and ability of parents to care
514.11for the oral health of their children. Under
514.12this pilot project, a Bright Smiles program
514.13shall serve the medically underserved areas
514.14in Minneapolis and the Bemidji area, as
514.15determined by the commissioner of health.
514.16(d) A grant shall be used to fund costs related
514.17to improving oral health outreach, education,
514.18screening, and access to care for families
514.19with children, ages birth to five years.
514.20(e) Grant applicants shall submit to
514.21the commissioner a written plan that
514.22demonstrates the ability to provide the
514.23following:
514.24(1) new programs or continued expansion
514.25of current access programs that have
514.26demonstrated success in providing dental
514.27services in underserved areas of Minneapolis
514.28and the Bemidji area;
514.29(2) programs for screening children entering
514.30the Minneapolis and the Bemidji area public
514.31school systems and facilitating access to care
514.32for their families;
514.33(3) programs testing new models of care
514.34that are sensitive to cultural needs of the
514.35recipients;
515.1(4) programs creating new educational
515.2campaigns that inform individuals of the
515.3importance of good oral health and the
515.4link between dental diseases, overall health
515.5status, and success in school; and
515.6(5) programs testing new delivery models
515.7by creating partnerships between local early
515.8childhood and school-age education and
515.9community clinic dental providers.
515.10(f) Qualified applicants are partnerships
515.11among early childhood experts, Minneapolis
515.12or Bemidji area public schools, and nonprofit
515.13clinics that are established to provide health
515.14services to low-income patients, provide
515.15preventive and dental care services, and
515.16utilize a sliding-scale fee or other method of
515.17providing charity care that ensures that no
515.18person is denied services because of inability
515.19to pay.
515.20(g) Applicants shall submit to the
515.21commissioner an application and supporting
515.22documentation, in the form and manner
515.23specified by the commissioner. Applicants
515.24must be able to provide culturally appropriate
515.25outreach, screenings, and access to dental
515.26care for children, ages birth to five years,
515.27their parents, and pregnant women most at
515.28risk of poor oral health due to lack of access
515.29to dental care. Applicants must also meet the
515.30following criteria:
515.31(1) have the potential to successfully increase
515.32access to families with children, ages birth
515.33to five years;
515.34(2) incorporate quality program evaluation;
515.35(3) maximize use of grant funds; and
516.1(4) have experience in providing services to
516.2the target populations of this program.
516.3(h) The commissioner shall evaluate the
516.4effectiveness of this pilot program on the
516.5oral health of children and their families and
516.6report to the house of representatives and
516.7senate committees with jurisdiction over
516.8public health policy and finance by January
516.91, 2009, with recommendations as to how to
516.10develop programs throughout Minnesota that
516.11provide education and access to oral health
516.12care for low-income and immigrant children.
516.13Suicide prevention programs. $600,000
516.14each year is to fund the suicide prevention
516.15program. The base for fiscal years 2010 and
516.162011 is reduced by $300,000.
516.17Hearing Aid Loan Bank. Of the general
516.18fund appropriation, $70,000 in fiscal year
516.192008 and $70,000 in fiscal year 2009 are
516.20for the purpose of providing a statewide
516.21hearing aid and instrument loan bank to
516.22families with children newly diagnosed with
516.23hearing loss from birth to the age of ten. This
516.24appropriation shall cover the administrative
516.25costs of the program.
516.26Medical Home Learning Collaborative.
516.27Of the general fund appropriation, $500,000
516.28in fiscal year 2008 and $500,000 in fiscal
516.29year 2009 are to expand the medical
516.30home learning collaborative initiative in
516.31collaboration with the commissioner of
516.32human services. Services provided under this
516.33funding must support a medical home model
516.34for children with special health care needs.
516.35The collaborative shall report back to the
517.1legislature on use of the funds by January 15,
517.22010. This appropriation shall not become
517.3part of the base funding for the 2010-2011
517.4biennium.
517.5Community Collaboratives. Of the general
517.6fund appropriation, $330,000 in fiscal year
517.72008 and $850,000 in fiscal year 2009 are to
517.8provide grants to community collaboratives
517.9to cover the uninsured. These are onetime
517.10appropriations.
517.11Base Adjustment. General fund base is
517.12$46,143,000 in each of fiscal years 2010 and
517.132011.

517.14

Subd. 3.Policy, Quality, and Compliance

51,209,000

45,590,000

517.15	Appropriations by Fund
517.16	General	14,897,000	15,737,000
517.17 517.18	State Government Special Revenue	13,403,000	13,497,000
517.19	Health Care Access	22,909,000	16,356,000

517.20Health Care Access Survey. Of the
517.21health care access fund appropriation,
517.22$600,000 in fiscal year 2008 is appropriated
517.23to the commissioner to conduct a health
517.24insurance survey of Minnesota households,
517.25in partnership with the State Health Access
517.26Data Assistance Center at the University
517.27of Minnesota. The commissioner shall
517.28contract with the State Health Access Data
517.29Assistance Center to conduct a survey that
517.30provides information on the characteristics
517.31of the uninsured in Minnesota and the
517.32reasons for changing patterns of insurance
517.33coverage and access to health care services.
517.34This appropriation shall become part of the
517.35agency's base budget for even-numbered
517.36fiscal years.
518.1MERC. Of the general fund appropriation,
518.2$8,000,000 each fiscal year is for distribution
518.3of MERC grants as follows:
518.4(1) $5,000,000 according to Minnesota
518.5Statutes, section 62J.692, subdivision 4,
518.6paragraph (c);
518.7(2) $900,000 according to Minnesota
518.8Statutes, section 62J.692, subdivision 4,
518.9paragraph (d);
518.10(3) $100,000 according to Minnesota
518.11Statutes, section 62J.692, subdivision 4,
518.12paragraph (e); and
518.13(4) $2,000,000 according to Minnesota
518.14Statutes, section 62J.692, subdivision 7a,
518.15paragraph (b).
518.16Health Information Technology. Of
518.17the health care access fund appropriation,
518.18$6,750,000 each fiscal year is to implement
518.19Minnesota Statutes, section 144.3345. Up
518.20to $350,000 each fiscal year is available for
518.21grant administration and health information
518.22technology technical assistance and
518.23$6,400,000 each year is to be transferred
518.24to the commissioner of finance to establish
518.25and implement a revolving account under
518.26Minnesota Statutes, section 62J.496. This
518.27appropriation shall not be included in the
518.28agency's base budget for the fiscal year
518.29beginning July 1, 2009.
518.30Health Insurance Exchange. Of the health
518.31care access fund appropriation, $6,000,000
518.32in fiscal year 2008 is appropriated to
518.33the commissioner to establish the health
518.34insurance exchange in Minnesota Statutes,
518.35section 62A.76. Up to $50,000 in fiscal year
519.12008 is available for administrative costs
519.2incurred by the Department of Health in
519.3establishing and providing grant funding to
519.4the legal entity responsible for implementing
519.5the health insurance exchange. This is a
519.6onetime appropriation.
519.7Uncompensated Care Fund. Of the general
519.8fund appropriation, $65,000 in fiscal year
519.92008 is for the commissioner of health to
519.10study and present recommendations to the
519.11governor and the legislature by January
519.1215, 2008, on the design, operation, and
519.13funding of an uncompensated care fund to
519.14be used to provide subsidies to hospitals,
519.15community clinics, federally qualified health
519.16centers, community mental health centers,
519.17and other health care providers that serve
519.18a disproportionately large percentage of
519.19uninsured patients. An organization must not
519.20provide or perform abortion services under
519.21this program.
519.22Community Collaboratives. Of the
519.23general fund appropriation, $300,000 for the
519.24biennium beginning July 1, 2007, is to the
519.25commissioner of health to provide grants
519.26to community collaboratives to cover the
519.27uninsured. This is a onetime appropriation.
519.28Uniform Electronic Transactions. Of the
519.29general fund appropriation, $146,000 in fiscal
519.30year 2008 is for development of uniform
519.31electronic transactions and implementation
519.32guide standards under Minnesota Statutes,
519.33section 62J.536.
519.34Federally Qualified Health Centers. Of the
519.35general fund appropriation, $3,000,000 in
520.1fiscal year 2008 and $3,900,000 in fiscal year
520.22009 are for subsidies to federally qualified
520.3health centers under Minnesota Statutes,
520.4section 145.9269.
520.5Base Adjustment. The general fund base
520.6is reduced $500,000 in each of fiscal years
520.72010 and 2011. The health care access fund
520.8base is $3,456,000 in fiscal year 2010 and
520.9$2,856,000 in fiscal year 2011.

520.10

Subd. 4.Health Protection

520.11	Appropriations by Fund
520.12	General	20,544,000	13,900,000
520.13 520.14	State Government Special Revenue	25,980,000	26,674,000
520.15	Environment	300,000	300,000

520.16Pandemic Influenza Preparedness. Of
520.17the general fund appropriation to the
520.18commissioner, $6,035,000 in fiscal year 2008
520.19is for preparation, planning, and response
520.20to a pandemic influenza outbreak. This
520.21appropriation is available until June 30, 2009.
520.22Base funding for the 2010-2011 biennium is
520.23$0 each fiscal year.
520.24Environmental Health Tracking and
520.25Biomonitoring. (a) $500,000 in the first
520.26year and $900,000 in the second year are
520.27for the environmental health tracking and
520.28biomonitoring program. The base for fiscal
520.29year 2010 and fiscal year 2011 is increased
520.30by $300,000 each year.
520.31(b) $300,000 each year is from the
520.32environmental fund to the Pollution Control
520.33Agency for transfer to the Department
520.34of Health for the health tracking and
520.35biomonitoring program. The base for the
521.1environmental fund is $0 in fiscal year 2010
521.2and after.
521.3AIDS Prevention Initiative Focusing
521.4on African-born Residents. $300,000 in
521.52008 is for an AIDS prevention initiative
521.6focusing on African-born residents. This
521.7appropriation is a onetime appropriation
521.8and shall not become part of the base-level
521.9funding for the 2010-2011 biennium.
521.10The commissioner of health shall award
521.11grants in accordance with Minnesota Statutes,
521.12section 145.924, paragraph (b), for a public
521.13education and awareness campaign targeting
521.14communities of African-born Minnesota
521.15residents. The grants shall be designed to
521.16promote knowledge and understanding about
521.17HIV and to increase knowledge in order
521.18to eliminate and reduce the risk for HIV
521.19infection; to encourage screening and testing
521.20for HIV; and to link individuals to public
521.21health and health care resources. The grants
521.22must be awarded to collaborative efforts that
521.23bring together nonprofit community-based
521.24groups with demonstrated experience in
521.25addressing the public health, health care,
521.26and social service needs of African-born
521.27communities.
521.28Arsenic Health Risk Standard. $920,000 in
521.29the first year and $461,000 in the second year
521.30is to fund the study relating to arsenic health
521.31risk standards, under Minnesota Statutes,
521.32section 144.967.
521.33Lindane and Bisphenol-A Studies.
521.34$114,000 in the first year is for the Lindane
521.35committee and the study of bisphenol-A,
522.1under Minnesota Statutes, section 145.958.
522.2This is a onetime appropriation.
522.3Decabromodiphenyl Ether Study.
522.4$118,000 in the first year is for transfer to the
522.5commissioner of the pollution control agency
522.6for the study of decabromodiphenyl ether
522.7under Minnesota Statutes, section 325E.387.
522.8This is a onetime appropriation.
522.9Radiation Study. $45,000 in the first year
522.10from the general fund and $15,000 in the
522.11first year from the state government special
522.12revenue fund are for the radiation study in
522.13section 62. This is a onetime appropriation.
522.14Lead Abatement. $925,000 in the first
522.15year and $950,000 in the second year are
522.16for changes in lead abatement requirements.
522.17Of this amount, $6,000 in the first year and
522.18$11,000 in the second year are for transfer
522.19to the commissioner of human services for
522.20increased medical assistance costs. A portion
522.21of this amount may be used to reimburse
522.22local governments for costs of implementing
522.23the new requirements.
522.24Water Treatment. $40,000 in fiscal year
522.252008 is to augment any appropriation from the
522.26remediation fund to conduct an evaluation of
522.27point of use water treatment units at removing
522.28perfluorooctanoic acid, perfluorooctane
522.29sulfonate, and perfluorobutanoic acid from
522.30known concentrations of these compounds
522.31in drinking water. The evaluation shall be
522.32completed by December 31, 2007, and the
522.33commissioner may contract for services to
522.34complete the evaluation. This is a onetime
522.35appropriation.
523.1Environmental Justice Mapping. $137,000
523.2in the first year and $53,000 in the second
523.3year is for environmental justice mapping.
523.4HIV Information. $80,000 each year
523.5is to fund a community-based nonprofit
523.6organization with demonstrated capacity to
523.7operate a statewide HIV information and
523.8referral service using telephone, Internet, and
523.9other appropriate technologies.
523.10Lead Hazard Reduction. $250,000 is
523.11appropriated each year of the biennium for a
523.12grant to a nonprofit organization operating
523.13the CLEARCorps to conduct a pilot project
523.14to determine the incidence of lead hazards in
523.15pre-1978 rental property. Any balance in the
523.16first year does not cancel but is available in
523.17the second year.
523.18Minnesota Birth Defects Information
523.19System. $750,000 each year is to maintain
523.20the birth defects information system that was
523.21established by Minnesota Statutes, section
523.22144.2215.

523.23

Subd. 5.Minority and Multicultural Health

523.24	Appropriations by Fund
523.25	General	5,042,000	5,052,000
523.26	Federal TANF	2,683,000	2,998,000

523.27TANF Appropriations. (a) $2,421,000 of
523.28the TANF funds is appropriated in each year
523.29of the biennium to the commissioner for
523.30home visiting and nutritional services listed
523.31under Minnesota Statutes, section 145.882,
523.32subdivision 7, clauses (6) and (7). Funding
523.33shall be distributed to tribal governments
523.34based on Minnesota Statutes, section
523.35145A.14, subdivision 2a, paragraph (b).
524.1(b) $262,000 in the first year and $577,000
524.2in the second year are appropriated
524.3to the commissioner of health for the
524.4family home visiting grant program. The
524.5commissioner shall distribute funds to tribal
524.6governments using a formula developed in
524.7conjunction with tribal governments. The
524.8commissioner may use five percent of the
524.9funds appropriated in each fiscal year to
524.10conduct the ongoing evaluations required
524.11under Minnesota Statutes, section 145A.17,
524.12subdivision 7, and may use ten percent of
524.13the funds appropriated each fiscal year to
524.14provide training and technical assistance as
524.15required under Minnesota Statutes, section
524.16145A.17, subdivisions 4 and 5.
524.17TANF Carryforward. Any unexpended
524.18balance of the TANF appropriation in the
524.19first year of the biennium does not cancel but
524.20is available for the second year.

524.21

Subd. 6.Administrative Support Services

524.22	Appropriations by Fund
524.23	General	11,047,000	11,197,000

524.24Disease Surveillance. $2,000,000 each fiscal
524.25year is for redesigning and implementing
524.26coordinated and modern disease surveillance
524.27systems for the department, ensuring that
524.28occupational and residential histories are
524.29included in the database. Base level funding
524.30for the 2012-2013 biennium will be $600,000
524.31each fiscal year for maintaining and operating
524.32the systems.

524.33 524.34

Sec. 5. VETERANS NURSING HOMES BOARD

$

44,124,000

$

46,244,000

525.1Veterans Homes Special Revenue Account.
525.2The general fund appropriations made to
525.3the board may be transferred to a veterans
525.4homes special revenue account in the
525.5special revenue fund in the same manner
525.6as other receipts are deposited according to
525.7Minnesota Statutes, section 198.34, and are
525.8appropriated to the board for the operation of
525.9board facilities and programs.
525.10Repair and Betterment. Of this
525.11appropriation, $4,000,000 in fiscal year
525.122008 and $4,000,000 in fiscal year 2009
525.13are to be used for repair, maintenance,
525.14rehabilitation, and betterment activities at
525.15facilities statewide.
525.16Base Adjustment. The general fund base is
525.17decreased by $2,000,000 in fiscal year 2010
525.18and $2,000,000 in fiscal year 2011.

525.19

Sec. 6. HEALTH-RELATED BOARDS

525.20 525.21

Subdivision 1.Total Appropriation; State Government Special Revenue Fund

$

14,654,000

$

14,527,000

525.22The commissioner of finance shall not permit
525.23the allotment, encumbrance, or expenditure
525.24of money appropriated in this section in
525.25excess of the anticipated biennial revenues
525.26or accumulated surplus revenues from fees
525.27collected by the boards.

525.28

Subd. 2.Board of Chiropractic Examiners

450,000

447,000

525.29

Subd. 3.Board of Dentistry

987,000

1,009,000

525.30 525.31

Subd. 4.Board of Dietetic and Nutrition Practice

103,000

119,000

525.32Base Adjustment. Of this appropriation in
525.33fiscal year 2009, $14,000 is onetime.

526.1 526.2

Subd. 5.Board of Marriage and Family Therapy

134,000

154,000

526.3Base Adjustment. Of this appropriation in
526.4fiscal year 2009, $17,000 is onetime.

526.5

Subd. 6.Board of Medical Practice

4,120,000

3,674,000

526.6

Subd. 7.Board of Nursing

3,985,000

4,146,000

526.7 526.8

Subd. 8.Board of Nursing Home Administrators

633,000

647,000

526.9Administrative Services Unit. Of this
526.10appropriation, $430,000 in fiscal year
526.112008 and $439,000 in fiscal year 2009 are
526.12for the administrative services unit. The
526.13administrative services unit may receive
526.14and expend reimbursements for services
526.15performed by other agencies.

526.16

Subd. 9.Board of Optometry

98,000

114,000

526.17Base Adjustment. Of this appropriation in
526.18fiscal year 2009, $13,000 is onetime.

526.19

Subd. 10.Board of Pharmacy

1,375,000

1,442,000

526.20Base Adjustment. Of this appropriation in
526.21fiscal year 2009, $29,000 is onetime.

526.22

Subd. 11.Board of Physical Therapy

306,000

295,000

526.23

Subd. 12.Board of Podiatry

54,000

63,000

526.24Base Adjustment. Of this appropriation in
526.25fiscal year 2009, $7,000 is onetime.

526.26

Subd. 13.Board of Psychology

788,000

806,000

526.27

Subd. 14.Board of Social Work

997,000

1,022,000

526.28

Subd. 15.Board of Veterinary Medicine

230,000

195,000

526.29 526.30

Subd. 16.Board of Behavioral Health and Therapy

394,000

394,000

526.31 526.32

Sec. 7. EMERGENCY MEDICAL SERVICES BOARD

$

4,617,000

$

4,645,000

527.1	Appropriations by Fund
527.2		2008	2009
527.3	General	3,023,000	3,041,000
527.4 527.5	State Government Special Revenue	687,000	704,000

527.6Regional Emergency Medical Services
527.7Programs. $400,000 each year is for
527.8regional emergency medical services
527.9programs, to be distributed equally to the
527.10eight emergency medical service regions.
527.11This amount shall be added to the base
527.12funding. Notwithstanding Minnesota
527.13Statutes, section 144E.50, 100 percent of
527.14the appropriation shall be passed on to the
527.15emergency medical service regions.
527.16Health Professional Services Program.
527.17$687,000 in fiscal year 2008 and $704,000 in
527.18fiscal year 2009 from the state government
527.19special revenue fund are for the health
527.20professional services program.

527.21

Sec. 8. COUNCIL ON DISABILITY

$

582,000

$

590,000

527.22Options Too. (a) $75,000 for the first
527.23year and $75,000 for the second year are
527.24to continue the work of the Options Too
527.25disability services interagency work group
527.26established under Laws 2005, First Special
527.27Session chapter 4, article 7, section 57.
527.28Funds shall be used to monitor and assist the
527.29work group and the Options Too Steering
527.30Committee in the implementation of the
527.31recommendations in the Options Too report
527.32dated February 15, 2007.
527.33(b) For purposes of this section, the Options
527.34Too Steering Committee shall consist of the
527.35following members:
528.1(1) a representative from the Minnesota
528.2Housing Finance Agency;
528.3(2) a representative from the Minnesota State
528.4Council on Disability;
528.5(3) a representative from the Department of
528.6Veterans Affairs;
528.7(4) a representative from the Department of
528.8Transportation;
528.9(5) a representative from the Department of
528.10Human Services; and
528.11(6) representatives from interested
528.12stakeholders including counties, local
528.13public housing authorities, the Metropolitan
528.14Council, disability service providers, and
528.15disability advocacy organizations who are
528.16appointed by the Minnesota State Council on
528.17Disability for two-year terms.
528.18(c) Notwithstanding Laws 2005, First Special
528.19Session chapter 4, article 7, section 57, the
528.20interagency work group shall be administered
528.21by the Minnesota Housing Finance Agency,
528.22the Minnesota State Council on Disability,
528.23Department of Human Services, and the
528.24Department of Transportation.
528.25(d) The Options Too Steering Committee
528.26shall report to the chairs of the health
528.27and human services policy and finance
528.28committees of the senate and house of
528.29representatives by October 15, 2007, and
528.30October 15, 2008, on the continued progress
528.31of the work group towards implementing the
528.32recommendations in the Options Too report
528.33dated February 15, 2007.

529.1 529.2 529.3

Sec. 9. OMBUDSMAN FOR MENTAL HEALTH AND DEVELOPMENTAL DISABILITIES

$

1,567,000

$

1,621,000

529.4

Sec. 10. OMBUDSMAN FOR FAMILIES

$

251,000

$

257,000

529.5    Sec. 11. TRANSFERS.
529.6    Subdivision 1. Grants. The commissioner of human services, with the approval
529.7of the commissioner of finance and after notifying the chairs of the senate and house
529.8committees with jurisdiction, may transfer unencumbered appropriation balances for the
529.9biennium ending June 30, 2009, within fiscal years among the MFIP; general assistance;
529.10general assistance medical care; medical assistance; MFIP child care assistance under
529.11Minnesota Statutes, section 119B.05; Minnesota supplemental aid and group residential
529.12housing programs; and the entitlement portion of the chemical dependency consolidated
529.13treatment fund and between fiscal years of the biennium.
529.14    Subd. 2. Administration. Positions, salary money, and nonsalary administrative
529.15money may be transferred within the Departments of Human Services and Health and
529.16within the programs operated by the Veterans Nursing Homes Board as the commissioners
529.17and the board consider necessary, with the advance approval of the commissioner of
529.18finance. The commissioner or the board shall inform the chairs of the house and senate
529.19committees with jurisdiction quarterly about transfers made under this provision.

529.20    Sec. 12. INDIRECT COSTS NOT TO FUND PROGRAMS.
529.21    The commissioners of health and of human services shall not use indirect cost
529.22allocations to pay for the operational costs of any program for which they are responsible.

529.23    Sec. 13. SUNSET OF UNCODIFIED LANGUAGE.
529.24    All uncodified language contained in this article expires on June 30, 2009, unless a
529.25different expiration date is explicit.

529.26    Sec. 14. EFFECTIVE DATE.
529.27    The provisions in this article are effective July 1, 2007, unless a different effective
529.28date is specified.