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Minnesota Legislature

Office of the Revisor of Statutes

SF 2225

3rd Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am

KEY: stricken = removed, old language.
underscored = added, new language.

Current Version - 3rd Engrossment

  1.1                          A bill for an act 
  1.2             relating to the operation of state government; 
  1.3             modifying provisions relating to health; health 
  1.4             department; human services; human services department; 
  1.5             long-term care; medical assistance; general assistance 
  1.6             medical care; MinnesotaCare; senior drug program; home 
  1.7             and community-based waivers; services for persons with 
  1.8             disabilities; medical assistance reimbursement for 
  1.9             special education and other services; county-based 
  1.10            purchasing; group residential housing; state-operated 
  1.11            services; chemical dependency; mental health; 
  1.12            Minnesota family investment program; general 
  1.13            assistance program; child support enforcement; 
  1.14            adoption; recreational licenses; paternity; children 
  1.15            in need of protection or services; termination of 
  1.16            parental rights; child protection; veterans nursing 
  1.17            homes board; health-related licensing boards; 
  1.18            emergency medical services regulatory board; Minnesota 
  1.19            state council on disability; ombudsman for mental 
  1.20            health and mental retardation; ombudsman for families; 
  1.21            creating a medical education endowment fund and a 
  1.22            tobacco use prevention and local public health 
  1.23            endowment fund; establishing the state board of 
  1.24            physical therapy; modifying fees; providing penalties; 
  1.25            requiring reports; appropriating money; amending 
  1.26            Minnesota Statutes 1998, sections 13.46, subdivision 
  1.27            2; 13.99, subdivision 38a, and by adding a 
  1.28            subdivision; 15.059, subdivision 5a; 16C.10, 
  1.29            subdivision 5; 62A.045; 62E.11, by adding a 
  1.30            subdivision; 62J.04, subdivision 3; 62J.06; 62J.07, 
  1.31            subdivisions 1 and 3; 62J.09, subdivision 8; 62J.2930, 
  1.32            subdivision 3; 62Q.03, subdivision 5a; 62Q.075; 
  1.33            62R.06, subdivision 1; 116L.02; 122A.09, subdivision 
  1.34            4; 125A.08; 125A.744, subdivision 3; 125A.76, 
  1.35            subdivision 2; 144.05, by adding a subdivision; 
  1.36            144.065; 144.121, by adding a subdivision; 144.148; 
  1.37            144.1483; 144.1492, subdivision 3; 144.1761, 
  1.38            subdivision 1; 144.413, subdivision 2; 144.414, 
  1.39            subdivision 1; 144.4165; 144.56, subdivision 2b; 
  1.40            144.99, subdivision 1, and by adding a subdivision; 
  1.41            144A.073, subdivision 5; 144A.10, by adding 
  1.42            subdivisions; 144A.46, subdivision 2; 144A.4605, 
  1.43            subdivision 2; 144D.01, subdivision 4; 144E.001, by 
  1.44            adding subdivisions; 144E.10, subdivision 1; 144E.11, 
  1.45            by adding a subdivision; 144E.16, subdivision 4; 
  1.46            144E.18; 144E.27, by adding subdivisions; 144E.50, by 
  2.1             adding a subdivision; 145.924; 145.9255, subdivisions 
  2.2             1 and 4; 145A.02, subdivision 10; 148.5194, 
  2.3             subdivisions 2, 3, 4, and by adding a subdivision; 
  2.4             148.66; 148.67; 148.70; 148.705; 148.71; 148.72, 
  2.5             subdivisions 1, 2, and 4; 148.73; 148.74; 148.75; 
  2.6             148.76; 148.78; 198.003, by adding a subdivision; 
  2.7             214.01, subdivision 2; 245.462, subdivisions 4 and 17; 
  2.8             245.4711, subdivision 1; 245.4712, subdivision 2; 
  2.9             245.4871, subdivisions 4 and 26; 245.4881, subdivision 
  2.10            1; 245A.04, subdivision 3a; 245A.08, subdivision 5; 
  2.11            245A.30; 245B.05, subdivision 7; 245B.07, subdivisions 
  2.12            5, 8, and 10; 246.18, subdivision 6; 252.28, 
  2.13            subdivision 1; 252.291, by adding a subdivision; 
  2.14            252.32, subdivision 3a; 252.46, subdivision 6; 
  2.15            253B.045, by adding subdivisions; 253B.07, subdivision 
  2.16            1; 253B.185, by adding a subdivision; 254B.01, by 
  2.17            adding a subdivision; 254B.03, subdivision 2; 254B.04, 
  2.18            subdivision 1; 254B.05, subdivision 1; 256.01, 
  2.19            subdivisions 2, 6, and by adding a subdivision; 
  2.20            256.014, by adding a subdivision; 256.015, 
  2.21            subdivisions 1 and 3; 256.485; 256.87, subdivision 1a; 
  2.22            256.955, subdivisions 3, 4, 7, 8, and 9; 256.9685, 
  2.23            subdivision 1a; 256.969, subdivision 1; 256.978, 
  2.24            subdivision 1; 256B.04, subdivision 16, and by adding 
  2.25            a subdivision; 256B.042, subdivisions 1, 2, and 3; 
  2.26            256B.055, subdivision 3a; 256B.056, subdivision 4; 
  2.27            256B.057, subdivision 3, and by adding a subdivision; 
  2.28            256B.0575; 256B.061; 256B.0625, subdivisions 6a, 8, 
  2.29            8a, 13, 19c, 20, 26, 28, 30, 32, 35, and by adding 
  2.30            subdivisions; 256B.0627, subdivisions 1, 2, 4, 5, 8, 
  2.31            and by adding subdivisions; 256B.0635, subdivision 3; 
  2.32            256B.0911, subdivision 6; 256B.0913, subdivisions 5, 
  2.33            10, 12, and 16; 256B.0916; 256B.0917, subdivision 8; 
  2.34            256B.094, subdivisions 3, 5, and 6; 256B.0951, 
  2.35            subdivisions 1 and 3; 256B.0955; 256B.37, subdivision 
  2.36            2; 256B.431, subdivisions 2i, 17, 26, and by adding a 
  2.37            subdivision; 256B.434, subdivisions 3, 4, 13, and by 
  2.38            adding a subdivision; 256B.435; 256B.48, subdivisions 
  2.39            1, 1a, 1b, and 6; 256B.50, subdivision 1e; 256B.501, 
  2.40            subdivision 8a; 256B.5011, subdivisions 1 and 2; 
  2.41            256B.69, subdivisions 3a, 5a, 5b, 5c, 6a, 6b, and by 
  2.42            adding subdivisions; 256B.692, subdivision 2; 256B.75; 
  2.43            256B.76; 256B.77, subdivisions 7a, 8, 10, 14, and by 
  2.44            adding subdivisions; 256D.03, subdivisions 3, 4, and 
  2.45            8; 256D.051, subdivision 2a, and by adding a 
  2.46            subdivision; 256D.053, subdivision 1; 256D.06, 
  2.47            subdivision 5; 256F.03, subdivision 5; 256F.05, 
  2.48            subdivision 8; 256F.10, subdivisions 1, 4, 6, 7, 8, 9, 
  2.49            and 10; 256I.04, subdivision 3; 256I.05, subdivisions 
  2.50            1, 1a, and by adding a subdivision; 256J.02, 
  2.51            subdivision 2; 256J.08, subdivisions 11, 24, 65, 82, 
  2.52            83, 86a, and by adding subdivisions; 256J.11, 
  2.53            subdivisions 2 and 3; 256J.12, subdivisions 1a and 2; 
  2.54            256J.14; 256J.20, subdivision 3; 256J.21, subdivisions 
  2.55            2, 3, and 4; 256J.24, subdivisions 2, 3, 7, 8, 9, and 
  2.56            by adding a subdivision; 256J.26, subdivision 1; 
  2.57            256J.30, subdivisions 2, 7, 8, and 9; 256J.31, 
  2.58            subdivisions 5 and 12; 256J.32, subdivisions 4 and 6; 
  2.59            256J.33; 256J.34, subdivisions 1, 3, and 4; 256J.35; 
  2.60            256J.36; 256J.37, subdivisions 1, 1a, 2, 9, and 10; 
  2.61            256J.38, subdivision 4; 256J.39, subdivision 1; 
  2.62            256J.42, subdivisions 1 and 5; 256J.43; 256J.45, 
  2.63            subdivision 1, and by adding a subdivision; 256J.46, 
  2.64            subdivisions 1, 2, and 2a; 256J.47, subdivision 4; 
  2.65            256J.48, subdivisions 2 and 3; 256J.50, subdivision 1; 
  2.66            256J.515; 256J.52, subdivisions 1, 3, 4, 5, and by 
  2.67            adding a subdivision; 256J.54, subdivision 2; 256J.55, 
  2.68            subdivision 4; 256J.56; 256J.57, subdivision 1; 
  2.69            256J.62, subdivisions 1, 6, 7, 8, 9, and by adding a 
  2.70            subdivision; 256J.67, subdivision 4; 256J.74, 
  2.71            subdivision 2; 256J.76, subdivisions 1, 2, and 4; 
  3.1             256L.03, subdivisions 5 and 6; 256L.04, subdivisions 
  3.2             2, 8, 11, and 13; 256L.05, subdivision 4, and by 
  3.3             adding a subdivision; 256L.06, subdivision 3; 256L.07; 
  3.4             256L.15, subdivisions 1, 1b, and 2; 257.071, 
  3.5             subdivisions 1, 1a, 1c, 1d, 1e, 3, and 4; 257.62, 
  3.6             subdivision 5; 257.66, subdivision 3; 257.75, 
  3.7             subdivision 2; 257.85, subdivisions 2, 3, 4, 5, 6, 7, 
  3.8             9, and 11; 259.67, subdivisions 6 and 7; 259.73; 
  3.9             259.85, subdivisions 2, 3, and 5; 259.89, by adding a 
  3.10            subdivision; 260.011, subdivision 2; 260.012; 260.015, 
  3.11            subdivisions 2a, 13, and 29; 260.131, subdivision 1a; 
  3.12            260.133, subdivisions 1 and 2; 260.135, by adding a 
  3.13            subdivision; 260.155, subdivisions 4 and 8; 260.172, 
  3.14            subdivision 1, and by adding a subdivision; 260.191, 
  3.15            subdivisions 1, 1a, 1b, and 3b; 260.192; 260.221, 
  3.16            subdivisions 1, 1a, 1b, 1c, 3, and 5; 326.40, 
  3.17            subdivisions 2, 4, and 5; 518.10; 518.551, by adding a 
  3.18            subdivision; 518.5851, by adding a subdivision; 
  3.19            518.5853, by adding a subdivision; 518.64, subdivision 
  3.20            2; 548.09, subdivision 1; 548.091, subdivisions 1, 1a, 
  3.21            2a, 3a, 4, 10, 11, 12, and by adding a subdivision; 
  3.22            626.556, subdivisions 2, 3, 4, 7, 10, 10b, 10d, 10e, 
  3.23            10f, 10i, 10j, 11, 11b, 11c, and by adding a 
  3.24            subdivision; 626.558, subdivision 1; Laws 1995, 
  3.25            chapters 178, article 2, section 46, subdivision 10; 
  3.26            207, articles 3, section 21; 8, section 41, as 
  3.27            amended; 257, article 1, section 35, subdivision 1; 
  3.28            Laws 1997, chapters 203, article 9, section 19; 225, 
  3.29            article 4, section 4; and Laws 1998 chapter 407, 
  3.30            article 7, section 2, subdivision 3; proposing coding 
  3.31            for new law in Minnesota Statutes, chapters 16A; 62J; 
  3.32            116L; 127A; 137; 144; 144A; 144E; 148; 214; 245; 246; 
  3.33            252; 254A; 256; 256B; 256J; and 626; repealing 
  3.34            Minnesota Statutes 1998, sections 13.99, subdivision 
  3.35            19m; 62J.69; 62J.77; 62J.78; 62J.79; 144.0723; 
  3.36            144.9507, subdivision 4; 144.9511; 144E.16, 
  3.37            subdivisions 1, 2, 3, and 6; 144E.17; 144E.25; 
  3.38            144E.30, subdivisions 1, 2, and 6; 145.46; 254A.145; 
  3.39            256.973; 256B.434, subdivision 17; 256B.501, 
  3.40            subdivision 3g; 256B.5011, subdivision 3; 256B.74, 
  3.41            subdivisions 2 and 5; 256D.051, subdivisions 6 and 19; 
  3.42            256D.053, subdivision 4; 256J.03; 256J.30, subdivision 
  3.43            6; 256J.62, subdivisions 2, 3, and 5; 257.071, 
  3.44            subdivisions 8 and 10; 462A.208; 548.091, subdivisions 
  3.45            3, 5, and 6; Laws 1997, chapters 85, article 1, 
  3.46            section 63; 203, article 4, section 55; 225, article 
  3.47            6, section 8; and Laws 1998, chapter 407, article 2, 
  3.48            section 104; Minnesota Rules, parts 4690.0100, 
  3.49            subparts 4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, 
  3.50            and 29; 4690.0300; 4690.0400; 4690.0500; 4690.0600; 
  3.51            4690.0700; 4690.0800, subparts 1 and 2; 4690.0900; 
  3.52            4690.1000; 4690.1100; 4690.1200; 4690.1300; 4690.1600; 
  3.53            4690.1700; 4690.2100; 4690.2200, subparts 1, 3, 4, and 
  3.54            5; 4690.2300; 4690.2400, subparts 1, 2, and 3; 
  3.55            4690.2500; 4690.2900; 4690.3000; 4690.3700; 4690.3900; 
  3.56            4690.4000; 4690.4100; 4690.4200; 4690.4300; 4690.4400; 
  3.57            4690.4500; 4690.4600; 4690.4700; 4690.4800; 4690.4900; 
  3.58            4690.5000; 4690.5100; 4690.5200; 4690.5300; 4690.5400; 
  3.59            4690.5500; 4690.5700; 4690.5800; 4690.5900; 4690.6000; 
  3.60            4690.6100; 4690.6200; 4690.6300; 4690.6400; 4690.6500; 
  3.61            4690.6600; 4690.6700; 4690.6800; 4690.7000; 4690.7100; 
  3.62            4690.7200; 4690.7300; 4690.7400; 4690.7500; 4690.7600; 
  3.63            4690.7700; 4690.7800; 4690.8300, subparts 1, 2, 3, 4, 
  3.64            and 5; and 4735.5000. 
  3.65  BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 
  3.66                             ARTICLE 1 
  3.67                           APPROPRIATIONS 
  4.1   Section 1.  [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 
  4.2      The sums shown in the columns marked "APPROPRIATIONS" are 
  4.3   appropriated from the general fund, or any other fund named, to 
  4.4   the agencies and for the purposes specified in the following 
  4.5   sections of this article, to be available for the fiscal years 
  4.6   indicated for each purpose.  The figures "2000" and "2001" where 
  4.7   used in this article, mean that the appropriation or 
  4.8   appropriations listed under them are available for the fiscal 
  4.9   year ending June 30, 2000, or June 30, 2001, respectively.  
  4.10  Where a dollar amount appears in parentheses, it means a 
  4.11  reduction of an appropriation.  
  4.12                          SUMMARY BY FUND 
  4.13  APPROPRIATIONS                                      BIENNIAL
  4.14                            2000          2001           TOTAL
  4.15  General          $2,650,812,000 $2,774,558,000 $5,425,370,000
  4.16  State Government
  4.17  Special Revenue      36,424,000     36,103,000     72,527,000
  4.18  Health Care
  4.19  Access              146,224,000    175,017,000    321,241,000
  4.20  Trunk Highway         1,726,000      1,773,000      3,499,000
  4.21  Lottery Prize         1,300,000      1,300,000      2,600,000
  4.22  TOTAL            $2,836,486,000 $2,988,751,000 $5,825,237,000
  4.23                                             APPROPRIATIONS 
  4.24                                         Available for the Year 
  4.25                                             Ending June 30 
  4.26                                            2000         2001 
  4.27  Sec. 2.  COMMISSIONER OF 
  4.28  HUMAN SERVICES 
  4.29  Subdivision 1.  Total 
  4.30  Appropriation                     $2,694,991,000 $2,847,745,000
  4.31                Summary by Fund
  4.32  General           2,556,927,000 2,680,977,000
  4.33  State Government
  4.34  Special Revenue         485,000       507,000
  4.35  Health Care 
  4.36  Access              136,279,000   164,961,000
  4.37  Lottery Prize         1,300,000     1,300,000
  4.38  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
  4.39  The commissioner shall not use indirect 
  4.40  cost allocations to pay for the 
  4.41  operational costs of any program for 
  4.42  which the commissioner is responsible. 
  4.43  [FUND AND ACCOUNT REPORTING REQUIRED.] 
  5.1   On December 1, 1999, and December 1, 
  5.2   2000, the commissioner shall provide 
  5.3   the chairs of the house health and 
  5.4   human services finance committee and 
  5.5   the senate health and family security 
  5.6   budget division with detailed fund 
  5.7   balance statements for:  (1) each fund 
  5.8   or account used by the commissioner in 
  5.9   the ongoing operations of the agency; 
  5.10  (2) each state-operated computer system 
  5.11  under Minnesota Statutes, section 
  5.12  256.014, including but not limited to 
  5.13  MAXIS, the current Medicaid management 
  5.14  information system (MMIS II), the child 
  5.15  support enforcement system (PRISM), the 
  5.16  electronic benefit transfer system 
  5.17  (EBT), and the executive information 
  5.18  system (EIS); and (3) the social 
  5.19  services information system (SSIS). 
  5.20  Subd. 2.  Agency Management 
  5.21  General              28,311,000    28,345,000
  5.22  State Government
  5.23  Special Revenue         371,000       392,000
  5.24  Health Care 
  5.25  Access                3,268,000     3,321,000
  5.26  The amounts that may be spent from the 
  5.27  appropriation for each purpose are as 
  5.28  follows: 
  5.29  (a) Financial Operations 
  5.30  General               7,471,000     7,647,000
  5.31  Health Care
  5.32  Access                  691,000       702,000
  5.33  [RECEIPTS FOR SYSTEMS PROJECTS.] 
  5.34  Appropriations and federal receipts for 
  5.35  information system projects for MAXIS, 
  5.36  electronic benefit system, social 
  5.37  services information system, child 
  5.38  support enforcement, and Minnesota 
  5.39  Medicaid information system (MMIS II) 
  5.40  must be deposited in the state system 
  5.41  account authorized in Minnesota 
  5.42  Statutes, section 256.014.  Money 
  5.43  appropriated for computer projects 
  5.44  approved by the Minnesota office of 
  5.45  technology, funded by the legislature, 
  5.46  and approved by the commissioner of 
  5.47  finance may be transferred from one 
  5.48  project to another and from development 
  5.49  to operations as the commissioner of 
  5.50  human services considers necessary.  
  5.51  Any unexpended balance in the 
  5.52  appropriation for these projects does 
  5.53  not cancel but is available for ongoing 
  5.54  development and operations. 
  5.55  (b) Legal & Regulation Operations 
  5.56  General               6,541,000     6,593,000
  5.57  State Government
  5.58  Special Revenue         371,000       392,000
  6.1   Health Care
  6.2   Access                  141,000       145,000
  6.3   [REIMBURSEMENT OF COUNTY COSTS.] Of the 
  6.4   general fund appropriation, $10,000 is 
  6.5   for the commissioner for the biennium 
  6.6   beginning July 1, 1999, to reimburse 
  6.7   counties for the legal and related 
  6.8   costs of contesting through the 
  6.9   administrative and judicial systems 
  6.10  decisions that affect state spending 
  6.11  but not county spending on programs 
  6.12  administered or financed by the 
  6.13  commissioner.  The commissioner may 
  6.14  reimburse expenses that occurred on or 
  6.15  after January 1, 1998. 
  6.16  (c) Management Operations 
  6.17  General              14,299,000    14,105,000
  6.18  Health Care
  6.19  Access                2,436,000     2,474,000
  6.20  Subd. 3.  Children's Grants
  6.21  General              52,845,000    54,931,000
  6.22  [ADOPTION ASSISTANCE.] Federal funds 
  6.23  available during the biennium ending 
  6.24  June 30, 2001, for adoption incentive 
  6.25  grants, adoption and foster care 
  6.26  recruitment, and other adoption 
  6.27  services, are appropriated to the 
  6.28  commissioner for these purposes. 
  6.29  Subd. 4.  Children's Services Management
  6.30  General               3,900,000     3,740,000
  6.31  Subd. 5.  Basic Health Care Grants
  6.32                Summary by Fund
  6.33  General             867,174,000   916,234,000
  6.34  Health Care
  6.35  Access              116,490,000   145,469,000
  6.36  The amounts that may be spent from this 
  6.37  appropriation for each purpose are as 
  6.38  follows: 
  6.39  (a) Minnesota Care Grants-
  6.40  Health Care
  6.41  Access              116,490,000   145,469,000
  6.42  [HOSPITAL INPATIENT COPAYMENTS.] The 
  6.43  commissioner of human services may 
  6.44  require hospitals to refund hospital 
  6.45  inpatient copayments paid by enrollees 
  6.46  pursuant to Minnesota Statutes, section 
  6.47  256L.03, subdivision 5, between March 
  6.48  1, 1999, and December 31, 1999.  If the 
  6.49  commissioner requires hospitals to 
  6.50  refund these copayments, the hospitals 
  6.51  shall collect the copayment directly 
  6.52  from the commissioner. 
  6.53  [MINNESOTACARE OUTREACH FEDERAL 
  6.54  MATCHING FUNDS.] Any federal matching 
  7.1   funds received as a result of the 
  7.2   MinnesotaCare outreach activities 
  7.3   authorized by Laws 1997, chapter 225, 
  7.4   article 7, section 2, subdivision 1, 
  7.5   shall be deposited in the health care 
  7.6   access fund and dedicated to the 
  7.7   commissioner to be used for those 
  7.8   outreach purposes. 
  7.9   [FEDERAL RECEIPTS FOR ADMINISTRATION.] 
  7.10  Receipts received as a result of 
  7.11  federal participation pertaining to 
  7.12  administrative costs of the Minnesota 
  7.13  health care reform waiver shall be 
  7.14  deposited as nondedicated revenue in 
  7.15  the health care access fund.  Receipts 
  7.16  received as a result of federal 
  7.17  participation pertaining to grants 
  7.18  shall be deposited in the federal fund 
  7.19  and shall offset health care access 
  7.20  funds for payments to providers. 
  7.21  [HEALTH CARE ACCESS FUND.] The 
  7.22  commissioner may expend money 
  7.23  appropriated from the health care 
  7.24  access fund for MinnesotaCare in either 
  7.25  fiscal year of the biennium. 
  7.26  (b) MA Basic Health Care Grants-
  7.27  Families and Children
  7.28  General             307,053,000   320,112,000
  7.29  [COMMUNITY DENTAL CLINICS.] Of this 
  7.30  appropriation, $600,000 in fiscal year 
  7.31  2000 is for the commissioner to provide 
  7.32  start-up grants to establish community 
  7.33  dental clinics under Minnesota 
  7.34  Statutes, section 256B.76, paragraph 
  7.35  (b), clause (5).  The commissioner 
  7.36  shall award grants and shall require 
  7.37  grant recipients to match the state 
  7.38  grant with nonstate funding on a 
  7.39  one-to-one basis.  This is a one-time 
  7.40  appropriation and shall not become part 
  7.41  of base level funding for this activity 
  7.42  for the 2002-2003 biennium. 
  7.43  (c) MA Basic Health Care Grants- 
  7.44  Elderly & Disabled
  7.45  General             404,814,000   451,928,000
  7.46  [SURCHARGE COMPLIANCE.] In the event 
  7.47  that federal financial participation in 
  7.48  the Minnesota medical assistance 
  7.49  program is reduced as a result of a 
  7.50  determination that the surcharge and 
  7.51  intergovernmental transfers governed by 
  7.52  Minnesota Statutes, sections 256.9657 
  7.53  and 256B.19 are out of compliance with 
  7.54  United States Code, title 42, section 
  7.55  1396b(w), or its implementing 
  7.56  regulations or with any other federal 
  7.57  law designed to restrict provider tax 
  7.58  programs or intergovernmental 
  7.59  transfers, the commissioner shall 
  7.60  appeal the determination to the fullest 
  7.61  extent permitted by law and may ratably 
  7.62  reduce all medical assistance and 
  7.63  general assistance medical care 
  8.1   payments to providers other than the 
  8.2   state of Minnesota in order to 
  8.3   eliminate any shortfall resulting from 
  8.4   the reduced federal funding.  Any 
  8.5   amount later recovered through the 
  8.6   appeals process shall be used to 
  8.7   reimburse providers for any ratable 
  8.8   reductions taken. 
  8.9   [BLOOD PRODUCTS LITIGATION.] To the 
  8.10  extent permitted by federal law, 
  8.11  Minnesota Statutes, section 256.015, 
  8.12  256B.042, and 256B.15, are waived as 
  8.13  necessary for the limited purpose of 
  8.14  resolving the state's claims in 
  8.15  connection with In re Factor VIII or IX 
  8.16  Concentrate Blood Products Litigation, 
  8.17  MDL-986, No. 93-C7452 (N.D.III.). 
  8.18  (d) General Assistance Medical Care
  8.19  General             141,805,000   128,012,000
  8.20  (e) Basic Health Care - Nonentitlement
  8.21  General              13,502,000    16,182,000
  8.22  [DENTAL ACCESS GRANT.] Of this 
  8.23  appropriation, $75,000 is from the 
  8.24  general fund to the commissioner in 
  8.25  fiscal year 2000 for a grant to a 
  8.26  nonprofit dental provider group 
  8.27  operating a dental clinic in Clay 
  8.28  county.  The grant must be used to 
  8.29  increase access to dental services for 
  8.30  recipients of medical assistance, 
  8.31  general assistance medical care, and 
  8.32  the MinnesotaCare program in the 
  8.33  northwest area of the state.  This 
  8.34  appropriation is available the day 
  8.35  following final enactment. 
  8.36  Subd. 6.  Basic Health Care Management
  8.37  General              23,268,000    23,227,000
  8.38  Health Care
  8.39  Access               15,208,000    14,853,000
  8.40  The amounts that may be spent from this 
  8.41  appropriation for each purpose are as 
  8.42  follows: 
  8.43  (a) Health Care Policy Administration
  8.44  General               3,109,000     3,008,000
  8.45  Health Care 
  8.46  Access                  570,000       582,000
  8.47  [TELEMEDICINE REPORT.] The commissioner 
  8.48  shall report to the legislature by 
  8.49  January 15, 2001, with an analysis of 
  8.50  whether the expansion of medical 
  8.51  assistance and general assistance 
  8.52  medical care to cover certain 
  8.53  telemedicine services resulted in cost 
  8.54  savings or other benefits to the health 
  8.55  care system and with a recommendation 
  8.56  on whether coverage of telemedicine 
  8.57  services should be continued beyond 
  9.1   June 30, 2001. 
  9.2   (b) Health Care Operations
  9.3   General              20,159,000    20,219,000
  9.4   Health Care
  9.5   Access               14,638,000    14,271,000
  9.6   [MINNESOTACARE STAFF.] Of this 
  9.7   appropriation, $1,060,000 for fiscal 
  9.8   year 2000 and $733,000 for fiscal year 
  9.9   2001 is from the health care access 
  9.10  fund to the commissioner for staff and 
  9.11  other administrative services 
  9.12  associated with improving MinnesotaCare 
  9.13  processing and caseload management.  Of 
  9.14  this appropriation, $483,000 shall 
  9.15  become part of the base. 
  9.16  [WORK INCENTIVES FOR DISABLED.] Of this 
  9.17  appropriation, $28,000 each year is for 
  9.18  the commissioner to provide the five 
  9.19  percent state match that is required in 
  9.20  order for the state to access federal 
  9.21  funding in the amount of $550,000 
  9.22  annually in fiscal years 2000 to 2003, 
  9.23  for the Social Security 
  9.24  Administration's work incentives 
  9.25  demonstration project.  The 
  9.26  commissioner shall transfer these 
  9.27  matching funds to the commissioner of 
  9.28  economic security.  The base level 
  9.29  funding for this activity must be 
  9.30  established at $28,000 for the 
  9.31  2002-2003 biennium. 
  9.32  [SYSTEMS CONTINUITY.] In the event of 
  9.33  disruption of technical systems or 
  9.34  computer operations, the commissioner 
  9.35  may use available grant appropriations 
  9.36  to ensure continuity of payments for 
  9.37  maintaining the health, safety, and 
  9.38  well-being of clients served by 
  9.39  programs administered by the department 
  9.40  of human services.  Grant funds must be 
  9.41  used in a manner consistent with the 
  9.42  original intent of the appropriation. 
  9.43  [PREPAID MEDICAL PROGRAMS.] The 
  9.44  nonfederal share of the prepaid medical 
  9.45  assistance program fund, which has been 
  9.46  appropriated to fund county managed 
  9.47  care advocacy and enrollment operating 
  9.48  costs, shall be disbursed as grants 
  9.49  using either a reimbursement or block 
  9.50  grant mechanism and may also be 
  9.51  transferred between grants and nongrant 
  9.52  administration costs with approval of 
  9.53  the commissioner of finance. 
  9.54  Subd. 7.  State-Operated Services
  9.55  General             206,929,000   212,002,000
  9.56  The amounts that may be spent from this 
  9.57  appropriation for each purpose are as 
  9.58  follows: 
  9.59  (a) SOS-Campus Based Programs
 10.1   General             185,696,000   190,143,000
 10.2   [DAY TRAINING SERVICES.] In order to 
 10.3   ensure eligible individuals have access 
 10.4   to day training and habilitation 
 10.5   services, the regional treatment 
 10.6   centers, the Minnesota extended 
 10.7   treatment options program, and 
 10.8   state-operated community services 
 10.9   operating according to Minnesota 
 10.10  Statutes, section 252.50, are exempt 
 10.11  from the provisions of Minnesota 
 10.12  Statutes, section 252.41, subdivision 
 10.13  9, clause (2).  Notwithstanding section 
 10.14  13, this provision shall not expire. 
 10.15  [MITIGATION RELATED TO DEVELOPMENTAL 
 10.16  DISABILITIES DOWNSIZING.] Money 
 10.17  appropriated to finance mitigation 
 10.18  expenses related to the downsizing of 
 10.19  regional treatment center developmental 
 10.20  disabilities programs may be 
 10.21  transferred between fiscal years within 
 10.22  the biennium. 
 10.23  [REGIONAL TREATMENT CENTER CHEMICAL 
 10.24  DEPENDENCY PROGRAMS.] When the 
 10.25  operations of the regional treatment 
 10.26  center chemical dependency fund created 
 10.27  in Minnesota Statutes, section 246.18, 
 10.28  subdivision 2, are impeded by projected 
 10.29  cash deficiencies resulting from delays 
 10.30  in the receipt of grants, dedicated 
 10.31  income, or other similar receivables, 
 10.32  and when the deficiencies would be 
 10.33  corrected within the budget period 
 10.34  involved, the commissioner of finance 
 10.35  may transfer general fund cash reserves 
 10.36  into this account as necessary to meet 
 10.37  cash demands.  The cash flow transfers 
 10.38  must be returned to the general fund in 
 10.39  the fiscal year that the transfer was 
 10.40  made.  Any interest earned on general 
 10.41  fund cash flow transfers accrues to the 
 10.42  general fund and not the regional 
 10.43  treatment center chemical dependency 
 10.44  fund. 
 10.45  [LEAVE LIABILITIES.] The accrued leave 
 10.46  liabilities of state employees 
 10.47  transferred to state-operated community 
 10.48  services programs may be paid from the 
 10.49  appropriation in this subdivision for 
 10.50  state-operated services.  Funds set 
 10.51  aside for this purpose shall not exceed 
 10.52  the amount of the actual leave 
 10.53  liability calculated as of June 30, 
 10.54  2000, and shall be available until 
 10.55  expended. 
 10.56  [REGIONAL TREATMENT CENTER 
 10.57  RESTRUCTURING.] For purposes of 
 10.58  restructuring the regional treatment 
 10.59  centers and state nursing homes, any 
 10.60  regional treatment center or state 
 10.61  nursing home employee whose position is 
 10.62  to be eliminated shall be afforded the 
 10.63  options provided in applicable 
 10.64  collective bargaining agreements.  All 
 10.65  salary and mitigation allocations from 
 10.66  fiscal year 2000 shall be carried 
 11.1   forward into fiscal year 2001.  
 11.2   Provided there is no conflict with any 
 11.3   collective bargaining agreement, any 
 11.4   regional treatment center or state 
 11.5   nursing home position reduction must 
 11.6   only be accomplished through 
 11.7   mitigation, attrition, transfer, and 
 11.8   other measures as provided in state or 
 11.9   applicable collective bargaining 
 11.10  agreements and in Minnesota Statutes, 
 11.11  section 252.50, subdivision 11, and not 
 11.12  through layoff. 
 11.13  [REGIONAL TREATMENT CENTER POPULATION.] 
 11.14  If the resident population at the 
 11.15  regional treatment centers is projected 
 11.16  to be higher than the estimates upon 
 11.17  which the medical assistance forecast 
 11.18  and budget recommendations for the 
 11.19  2000-2001 biennium is based, the amount 
 11.20  of the medical assistance appropriation 
 11.21  that is attributable to the cost of 
 11.22  services that would have been provided 
 11.23  as an alternative to regional treatment 
 11.24  center services, including resources 
 11.25  for community placements and waivered 
 11.26  services for persons with mental 
 11.27  retardation and related conditions, is 
 11.28  transferred to the residential 
 11.29  facilities appropriation. 
 11.30  [REPAIRS AND BETTERMENTS.] The 
 11.31  commissioner may transfer unencumbered 
 11.32  appropriation balances between fiscal 
 11.33  years for the state residential 
 11.34  facilities repairs and betterments 
 11.35  account and special equipment. 
 11.36  [PROJECT LABOR.] Wages for project 
 11.37  labor may be paid by the commissioner 
 11.38  out of repairs and betterments money if 
 11.39  the individual is to be engaged in a 
 11.40  construction project or a repair 
 11.41  project of short-term and nonrecurring 
 11.42  nature.  Compensation for project labor 
 11.43  shall be based on the prevailing wage 
 11.44  rates, as defined in Minnesota 
 11.45  Statutes, section 177.42, subdivision 
 11.46  6.  Project laborers are excluded from 
 11.47  the provisions of Minnesota Statutes, 
 11.48  sections 43A.22 to 43A.30, and shall 
 11.49  not be eligible for state-paid 
 11.50  insurance and benefits. 
 11.51  [YEAR 2000 COSTS AT RTCS.] Of this 
 11.52  appropriation, $44,000 is for the costs 
 11.53  associated with addressing potential 
 11.54  year 2000 problems.  Of this amount, 
 11.55  $19,000 is available the day following 
 11.56  final enactment. 
 11.57  (b) State-Operated Community
 11.58  Services - Northeast Minnesota
 11.59  Mental Health Services
 11.60  General               3,983,000     4,055,000
 11.61  (c) State-Operated Community 
 11.62  Services - Statewide DD Supports
 11.63  General              15,493,000    16,047,000
 12.1   (d) State-Operated Services - 
 12.2   Enterprise Activities 
 12.3   General               1,757,000     1,757,000
 12.4   Subd. 8.  Continuing Care and 
 12.5   Community Support Grants
 12.6   General           1,174,195,000 1,259,767,000
 12.7   Lottery Prize         1,158,000     1,158,000
 12.8   The amounts that may be spent from this 
 12.9   appropriation for each purpose are as 
 12.10  follows: 
 12.11  (a) Community Social Services
 12.12  Block Grants
 12.13      42,597,000     43,498,000 
 12.14  [CSSA TRADITIONAL APPROPRIATION.] 
 12.15  Notwithstanding Minnesota Statutes, 
 12.16  section 256E.06, subdivisions 1 and 2, 
 12.17  the appropriations available under that 
 12.18  section in fiscal years 2000 and 2001 
 12.19  must be distributed to each county 
 12.20  proportionately to the aid received by 
 12.21  the county in calendar year 1998.  The 
 12.22  commissioner, in consultation with 
 12.23  counties, shall study the formula 
 12.24  limitations in subdivision 2 of that 
 12.25  section, and report findings and any 
 12.26  recommendations for revision of the 
 12.27  CSSA formula and its formula limitation 
 12.28  provisions to the legislature by 
 12.29  January 15, 2000. 
 12.30  (b) Consumer Support Grants
 12.31       1,123,000      1,123,000 
 12.32  (c) Aging Adult Service Grants
 12.33       7,965,000      7,765,000 
 12.34  [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 
 12.35  Of the general fund appropriation, 
 12.36  $120,000 in fiscal year 2000 and 
 12.37  $120,000 in fiscal year 2001 is for the 
 12.38  commissioner to provide funding to six 
 12.39  additional living-at-home/block nurse 
 12.40  programs.  This appropriation shall 
 12.41  become part of the base for the 
 12.42  2002-2003 biennium. 
 12.43  [MINNESOTA SENIOR SERVICE CORPS.] Of 
 12.44  this appropriation, $160,000 for the 
 12.45  biennium is from the general fund to 
 12.46  the commissioner for the following 
 12.47  purposes: 
 12.48  (a) $40,000 in fiscal year 2000 and 
 12.49  $40,000 in fiscal year 2001 is to 
 12.50  increase the hourly stipend by ten 
 12.51  cents per hour in the foster 
 12.52  grandparent program, the retired and 
 12.53  senior volunteer program, and the 
 12.54  senior companion program. 
 12.55  (b) $40,000 in fiscal year 2000 and 
 13.1   $40,000 in fiscal year 2001 is for a 
 13.2   grant to the tri-valley opportunity 
 13.3   council in Crookston to expand services 
 13.4   in the ten-county area of northwestern 
 13.5   Minnesota. 
 13.6   (c) This appropriation shall become 
 13.7   part of the base for the 2002-2003 
 13.8   biennium.
 13.9   [HEALTH INSURANCE COUNSELING.] Of this 
 13.10  appropriation, $100,000 in fiscal year 
 13.11  2000 and $100,000 in fiscal year 2001 
 13.12  is from the general fund to the 
 13.13  commissioner to transfer to the board 
 13.14  on aging for the purpose of awarding 
 13.15  health insurance counseling and 
 13.16  assistance grants to the area agencies 
 13.17  on aging providing state-funded health 
 13.18  insurance counseling services.  Access 
 13.19  to health insurance counseling programs 
 13.20  shall be provided by the senior linkage 
 13.21  line service of the board on aging and 
 13.22  the area agencies on aging. The board 
 13.23  on aging shall explore opportunities 
 13.24  for obtaining alternative funding from 
 13.25  nonstate sources, including 
 13.26  contributions from individuals seeking 
 13.27  health insurance counseling services.  
 13.28  This is a one-time appropriation and 
 13.29  shall not become part of base level 
 13.30  funding for this activity for the 
 13.31  2002-2003 biennium. 
 13.32  (d) Deaf and Hard-of-Hearing 
 13.33  Services Grants
 13.34       1,859,000      1,760,000 
 13.35  [SERVICES TO DEAF PERSONS WITH MENTAL 
 13.36  ILLNESS.] Of this appropriation, 
 13.37  $100,000 each year is to the 
 13.38  commissioner for a grant to a nonprofit 
 13.39  agency that currently serves deaf and 
 13.40  hard-of-hearing adults with mental 
 13.41  illness through residential programs 
 13.42  and supported housing outreach.  The 
 13.43  grant must be used to operate a 
 13.44  community support program for persons 
 13.45  with mental illness that is 
 13.46  communicatively accessible for persons 
 13.47  who are deaf or hard-of-hearing.  This 
 13.48  is a one-time appropriation and shall 
 13.49  not become part of base level funding 
 13.50  for this activity for the 2002-2003 
 13.51  biennium. 
 13.52  [DEAF-BLIND ORIENTATION AND MOBILITY 
 13.53  SERVICES.] Of this appropriation, 
 13.54  $120,000 for the biennium is to the 
 13.55  commissioner for a grant to DeafBlind 
 13.56  Services Minnesota to hire an 
 13.57  orientation and mobility specialist to 
 13.58  work with deaf-blind people.  The 
 13.59  specialist will provide services to 
 13.60  deaf-blind Minnesotans, and training to 
 13.61  teachers and rehabilitation counselors, 
 13.62  on a statewide basis.  This is a 
 13.63  one-time appropriation and shall not 
 13.64  become part of base level funding for 
 13.65  this activity for the 2002-2003 
 14.1   biennium. 
 14.2   (e) Mental Health Grants
 14.3   General          45,169,000     46,528,000 
 14.4   Lottery Prize     1,158,000      1,158,000 
 14.5   [CRISIS HOUSING.] Of the general fund 
 14.6   appropriation, $126,000 in fiscal year 
 14.7   2000 and $150,000 in fiscal year 2001 
 14.8   is to the commissioner for the adult 
 14.9   mental illness crisis housing 
 14.10  assistance program under Minnesota 
 14.11  Statutes, section 245.99.  This 
 14.12  appropriation shall become part of the 
 14.13  base for the 2002-2003 biennium. 
 14.14  [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 
 14.15  $150,000 in fiscal year 2000 and 
 14.16  $150,000 in fiscal year 2001 is 
 14.17  appropriated from the lottery prize 
 14.18  fund created under Minnesota Statutes, 
 14.19  section 349A.10, subdivision 2, to the 
 14.20  commissioner for the purposes of a 
 14.21  grant to a compulsive gambling council 
 14.22  located in St. Louis county for a 
 14.23  statewide compulsive gambling 
 14.24  prevention and education project for 
 14.25  adolescents. 
 14.26  (f) Developmental Disabilities
 14.27  Community Support Grants
 14.28     9,323,000     10,958,000 
 14.29  [CRISIS INTERVENTION PROJECT.] Of this 
 14.30  appropriation, $40,000 in fiscal year 
 14.31  2000 is to the commissioner for the 
 14.32  action, support, and prevention project 
 14.33  of southeastern Minnesota. 
 14.34  [SILS FUNDING.] Of this appropriation, 
 14.35  $1,000,000 each year is for 
 14.36  semi-independent living services under 
 14.37  Minnesota Statutes, section 252.275. 
 14.38  This appropriation must be added to the 
 14.39  base level funding for this activity 
 14.40  for the 2002-2003 biennium.  Unexpended 
 14.41  funds for fiscal year 2000 do not 
 14.42  cancel but are available to the 
 14.43  commissioner for this purpose in fiscal 
 14.44  year 2001. 
 14.45  [FAMILY SUPPORT GRANTS.] Of this 
 14.46  appropriation, $1,000,000 in fiscal 
 14.47  year 2000 and $2,500,000 in fiscal year 
 14.48  2001 is to increase the availability of 
 14.49  family support grants under Minnesota 
 14.50  Statutes, section 252.32.  This 
 14.51  appropriation must be added to the base 
 14.52  level funding for this activity for the 
 14.53  2002-2003 biennium.  Unexpended funds 
 14.54  for fiscal year 2000 do not cancel but 
 14.55  are available to the commissioner for 
 14.56  this purpose in fiscal year 2001. 
 14.57  (g) Medical Assistance Long-Term 
 14.58  Care Waivers and Home Care
 14.59     349,052,000    414,240,000 
 15.1   [PROVIDER RATE INCREASES.] (a) The 
 15.2   commissioner shall increase 
 15.3   reimbursement rates by four percent the 
 15.4   first year of the biennium and by three 
 15.5   percent the second year for the 
 15.6   providers listed in paragraph (b).  The 
 15.7   increases shall be effective for 
 15.8   services rendered on or after July 1 of 
 15.9   each year. 
 15.10  (b) The rate increases described in 
 15.11  this section shall be provided to home 
 15.12  and community-based waivered services 
 15.13  for persons with mental retardation or 
 15.14  related conditions under Minnesota 
 15.15  Statutes, section 256B.501; home and 
 15.16  community-based waivered services for 
 15.17  the elderly under Minnesota Statutes, 
 15.18  section 256B.0915; waivered services 
 15.19  under community alternatives for 
 15.20  disabled individuals under Minnesota 
 15.21  Statutes, section 256B.49; community 
 15.22  alternative care waivered services 
 15.23  under Minnesota Statutes, section 
 15.24  256B.49; traumatic brain injury 
 15.25  waivered services under Minnesota 
 15.26  Statutes, section 256B.49; nursing 
 15.27  services and home health services under 
 15.28  Minnesota Statutes, section 256B.0625, 
 15.29  subdivision 6a; personal care services 
 15.30  and nursing supervision of personal 
 15.31  care services under Minnesota Statutes, 
 15.32  section 256B.0625, subdivision 19a; 
 15.33  private-duty nursing services under 
 15.34  Minnesota Statutes, section 256B.0625, 
 15.35  subdivision 7; day training and 
 15.36  habilitation services for adults with 
 15.37  mental retardation or related 
 15.38  conditions under Minnesota Statutes, 
 15.39  sections 252.40 to 252.46; alternative 
 15.40  care services under Minnesota Statutes, 
 15.41  section 256B.0913; adult residential 
 15.42  program grants under Minnesota Rules, 
 15.43  parts 9535.2000 to 9535.3000; adult and 
 15.44  family community support grants under 
 15.45  Minnesota Rules, parts 9535.1700 to 
 15.46  9535.1760; semi-independent living 
 15.47  services under Minnesota Statutes, 
 15.48  section 252.275, including SILS funding 
 15.49  under county social services grants 
 15.50  formerly funded under Minnesota 
 15.51  Statutes, chapter 256I; and community 
 15.52  support services for deaf and 
 15.53  hard-of-hearing adults with mental 
 15.54  illness who use or wish to use sign 
 15.55  language as their primary means of 
 15.56  communication. 
 15.57  (c) The commissioner shall increase 
 15.58  reimbursement rates by two percent for 
 15.59  the group residential housing 
 15.60  supplementary service rate under 
 15.61  Minnesota Statutes, section 256I.05, 
 15.62  subdivision 1a, for services rendered 
 15.63  on or after January 1, 2000. 
 15.64  (d) Providers that receive a rate 
 15.65  increase under this section shall use 
 15.66  at least 80 percent of the additional 
 15.67  revenue to increase the compensation 
 15.68  paid to employees other than the 
 16.1   administrator and central office staff. 
 16.2   (e) A copy of the provider's plan for 
 16.3   complying with paragraph (d) must be 
 16.4   made available to all employees.  This 
 16.5   must be done by giving each employee a 
 16.6   copy or by posting it in an area of the 
 16.7   provider's operation to which all 
 16.8   employees have access.  If an employee 
 16.9   does not receive the salary adjustment 
 16.10  described in the plan and is unable to 
 16.11  resolve the problem with the provider, 
 16.12  the employee may contact the employee's 
 16.13  union representative.  If the employee 
 16.14  is not covered by a collective 
 16.15  bargaining agreement, the employee may 
 16.16  contact the commissioner at a phone 
 16.17  number provided by the commissioner and 
 16.18  included in the provider's plan. 
 16.19  (f) Section 13, sunset of uncodified 
 16.20  language, does not apply to this 
 16.21  provision. 
 16.22  [DEVELOPMENTAL DISABILITIES WAIVER 
 16.23  SLOTS.] Of this appropriation, 
 16.24  $1,746,000 in fiscal year 2000 and 
 16.25  $4,683,000 in fiscal year 2001 is to 
 16.26  increase the availability of home and 
 16.27  community-based waiver services for 
 16.28  persons with mental retardation or 
 16.29  related conditions.  
 16.30  (h) Medical Assistance Long-Term
 16.31  Care Facilities
 16.32     546,228,000    558,349,000 
 16.33  [MORATORIUM EXCEPTIONS.] Of this 
 16.34  appropriation, $250,000 in fiscal year 
 16.35  2000 and $250,000 in fiscal year 2001 
 16.36  is from the general fund to the 
 16.37  commissioner for the medical assistance 
 16.38  costs of moratorium exceptions approved 
 16.39  by the commissioner of health under 
 16.40  Minnesota Statutes, section 144A.073.  
 16.41  Unexpended money appropriated for 
 16.42  fiscal year 2000 shall not cancel but 
 16.43  shall be available for fiscal year 2001.
 16.44  [NURSING FACILITY OPERATED BY THE RED 
 16.45  LAKE BAND OF CHIPPEWA INDIANS.] (1) The 
 16.46  medical assistance payment rates for 
 16.47  the 47-bed nursing facility operated by 
 16.48  the Red Lake Band of Chippewa Indians 
 16.49  must be calculated according to 
 16.50  allowable reimbursement costs under the 
 16.51  medical assistance program, as 
 16.52  specified in Minnesota Statutes, 
 16.53  section 246.50, and are subject to the 
 16.54  facility-specific Medicare upper limits.
 16.55  (2) In addition, the commissioner shall 
 16.56  make available an operating payment 
 16.57  rate adjustment effective July 1, 1999, 
 16.58  and July 1, 2000, that is equal to the 
 16.59  adjustment provided under Minnesota 
 16.60  Statutes, section 256B.431, subdivision 
 16.61  28.  The commissioner must use the 
 16.62  facility's final 1998 and 1999 Medicare 
 16.63  cost reports, respectively, to 
 17.1   calculate the adjustment.  The 
 17.2   adjustment shall be available based on 
 17.3   a plan submitted and approved according 
 17.4   to Minnesota Statutes, section 
 17.5   256B.431, subdivision 28.  Section 13, 
 17.6   sunset of uncodified language, does not 
 17.7   apply to this paragraph. 
 17.8   [ICF/MR DISALLOWANCES.] Of this 
 17.9   appropriation, $65,000 in fiscal 2000 
 17.10  is to reimburse a four-bed ICF/MR in 
 17.11  Ramsey county for disallowances 
 17.12  resulting from field audit findings.  
 17.13  This is a one-time appropriation and 
 17.14  shall not become part of base level 
 17.15  funding for this activity for the 
 17.16  2002-2003 biennium. 
 17.17  [COSTS RELATED TO FACILITY 
 17.18  CERTIFICATION.] Of this appropriation, 
 17.19  $168,000 is for the costs of providing 
 17.20  one-half the state share of medical 
 17.21  assistance reimbursement for 
 17.22  residential and day habilitation 
 17.23  services under article 3, section 39.  
 17.24  This amount is available the day 
 17.25  following final enactment. 
 17.26  (i) Alternative Care Grants  
 17.27  General              60,873,000    59,981,000
 17.28  [ALTERNATIVE CARE TRANSFER.] Any money 
 17.29  allocated to the alternative care 
 17.30  program that is not spent for the 
 17.31  purposes indicated does not cancel but 
 17.32  shall be transferred to the medical 
 17.33  assistance account. 
 17.34  [PREADMISSION SCREENING AMOUNT.] The 
 17.35  preadmission screening payment to all 
 17.36  counties shall continue at the payment 
 17.37  amount in effect for fiscal year 1999. 
 17.38  [ALTERNATIVE CARE APPROPRIATION.] The 
 17.39  commissioner may expend the money 
 17.40  appropriated for the alternative care 
 17.41  program for that purpose in either year 
 17.42  of the biennium. 
 17.43  (j) Group Residential Housing
 17.44  General              66,477,000    70,390,000
 17.45  [GROUP RESIDENTIAL FACILITY FOR WOMEN 
 17.46  IN RAMSEY COUNTY.] (a) Notwithstanding 
 17.47  Minnesota Statutes 1998, section 
 17.48  256I.05, subdivision 1d, the new 23-bed 
 17.49  group residential facility for women in 
 17.50  Ramsey county, with approval by the 
 17.51  county agency, may negotiate a 
 17.52  supplementary service rate in addition 
 17.53  to the board and lodging rate for 
 17.54  facilities licensed and registered by 
 17.55  the Minnesota department of health 
 17.56  under Minnesota Statutes, section 
 17.57  15.17.  The supplementary service rate 
 17.58  shall not exceed $564 per person per 
 17.59  month and the total rate may not exceed 
 17.60  $1,177 per person per month. 
 18.1   (b) Of the general fund appropriation, 
 18.2   $19,000 in fiscal year 2000 and $38,000 
 18.3   in fiscal year 2001 is to the 
 18.4   commissioner for the costs associated 
 18.5   with paragraph (a).  This appropriation 
 18.6   shall become part of the base for the 
 18.7   2002-2003 biennium. 
 18.8   (k) Chemical Dependency
 18.9   Entitlement Grants
 18.10  General              36,751,000    38,847,000
 18.11  (l) Chemical Dependency 
 18.12  Nonentitlement Grants
 18.13  General               6,778,000     6,328,000
 18.14  [CHEMICAL DEPENDENCY SERVICES.] Of this 
 18.15  appropriation, $450,000 in fiscal year 
 18.16  2000 is to the commissioner for 
 18.17  chemical dependency services to persons 
 18.18  who qualify under Minnesota Statutes, 
 18.19  section 254B.04, subdivision 1, 
 18.20  paragraph (b). 
 18.21  [REPEAT DWI OFFENDER PROGRAM.] Of this 
 18.22  appropriation, $100,000 in fiscal year 
 18.23  2000 and $100,000 in fiscal year 2001 
 18.24  is for the commissioner to pay for 
 18.25  chemical dependency treatment for 
 18.26  repeat DWI offenders at Brainerd 
 18.27  regional human services center.  
 18.28  Payment to the Brainerd regional human 
 18.29  services center may only be authorized 
 18.30  from this appropriation after all 
 18.31  potential public and private 
 18.32  third-party payers have been billed and 
 18.33  a determination made that the offender 
 18.34  is not eligible for reimbursement of 
 18.35  the treatment costs.  This 
 18.36  appropriation shall not become part of 
 18.37  the base for the 2002-2003 biennium. 
 18.38  Subd. 9.  Continuing Care and
 18.39  Community Support Management
 18.40  General              17,318,000    17,616,000
 18.41  Lottery Prize           142,000       142,000
 18.42  State Government
 18.43  Special Revenue         114,000       115,000
 18.44  [MINNESOTA SENIOR HEALTH OPTIONS 
 18.45  PROJECT.] Of the general fund 
 18.46  appropriation, up to $200,000 may be 
 18.47  transferred to the Minnesota senior 
 18.48  health options project special revenue 
 18.49  account during the biennium ending June 
 18.50  30, 2001, to serve as matching funds. 
 18.51  [PERSONS WITH BRAIN INJURIES.] (a) The 
 18.52  commissioner shall study and report to 
 18.53  the legislature by January 15, 2000, on 
 18.54  the status of persons with brain 
 18.55  injuries residing in public and private 
 18.56  institutions.  The report shall include 
 18.57  information on lengths of stay, ages of 
 18.58  institutionalized persons, and on the 
 18.59  supports and services needed to allow 
 19.1   these persons to return to their 
 19.2   communities. 
 19.3   (b) The commissioner shall apply to the 
 19.4   Health Care Financing Administration 
 19.5   for a grant to carry out a 
 19.6   demonstration project to transition 
 19.7   disabled persons out of nursing homes.  
 19.8   The project must: 
 19.9   (1) identify persons with brain 
 19.10  injuries and other disabled persons 
 19.11  residing in nursing homes who could 
 19.12  live successfully in the community with 
 19.13  appropriate supports; 
 19.14  (2) develop community-based services 
 19.15  and supports for institutionalized 
 19.16  persons; 
 19.17  (3) eliminate incentives to keep these 
 19.18  persons in institutions; 
 19.19  (4) foster the independence of 
 19.20  institutionalized persons by involving 
 19.21  them in the selection and management of 
 19.22  community-based services, such as 
 19.23  personal care assistance; 
 19.24  (5) develop innovative funding 
 19.25  arrangements to enable funding to 
 19.26  follow the individual; and 
 19.27  (6) empower disabled persons, families, 
 19.28  and advocacy groups by including them 
 19.29  in the design and implementation of 
 19.30  service delivery models that maximize 
 19.31  consumer choice and direction. 
 19.32  (c) Paragraph (b) is effective the day 
 19.33  following final enactment. 
 19.34  [CAMP.] Of this appropriation, $15,000 
 19.35  each year is from the mental health 
 19.36  special projects account, for adults 
 19.37  and children with mental illness from 
 19.38  across the state, for a camping program 
 19.39  which utilizes the Boundary Waters 
 19.40  Canoe Area and is cooperatively 
 19.41  sponsored by client advocacy, mental 
 19.42  health treatment, and outdoor 
 19.43  recreation agencies. 
 19.44  [DEMO PROJECT EXTERNAL ADVOCACY FUNDING 
 19.45  CAP.] Of the appropriation for the 
 19.46  demonstration project for people with 
 19.47  disabilities under Minnesota Statutes, 
 19.48  section 256B.77, no more than $79,000 
 19.49  per year may be paid for external 
 19.50  advocacy under Minnesota Statutes, 
 19.51  section 256B.77, subdivision 14. 
 19.52  [REGION 10 QUALITY ASSURANCE 
 19.53  COMMISSION.] (1) Of this appropriation, 
 19.54  $210,000 each year is appropriated to 
 19.55  the commissioner for a grant to the 
 19.56  region 10 quality assurance commission 
 19.57  established under Minnesota Statutes, 
 19.58  section 256B.0951, for the purposes 
 19.59  specified in clauses (2) to (4).  
 19.60  Unexpended funds for fiscal year 2000 
 20.1   do not cancel, but are available to the 
 20.2   commission for fiscal year 2001. 
 20.3   (2) $180,000 each year is for the 
 20.4   operating costs of the alternative 
 20.5   quality assurance licensing system 
 20.6   pilot project, and for the commission 
 20.7   to provide grants to counties 
 20.8   participating in the alternative 
 20.9   quality assurance licensing system 
 20.10  under Minnesota Statutes, section 
 20.11  256B.0953. 
 20.12  (3) $20,000 each year is for the 
 20.13  commission to contract with an 
 20.14  independent entity to conduct a 
 20.15  financial review of the alternative 
 20.16  quality assurance licensing system, 
 20.17  including an evaluation of possible 
 20.18  budgetary savings within the affected 
 20.19  state agencies as the result of 
 20.20  implementing the system. 
 20.21  (4) $10,000 each year is for the 
 20.22  commission, in consultation with the 
 20.23  commissioner of human services, to 
 20.24  establish an ongoing review process for 
 20.25  the alternative quality assurance 
 20.26  licensing system. 
 20.27  (5) This appropriation shall not become 
 20.28  part of the base for the 2002-2003 
 20.29  biennium. 
 20.30  Subd. 10.  Economic Support Grants
 20.31  General             142,037,000   124,758,000
 20.32  [GIFTS.] Notwithstanding Minnesota 
 20.33  Statutes, chapter 7, the commissioner 
 20.34  may accept on behalf of the state 
 20.35  additional funding from sources other 
 20.36  than state funds for the purpose of 
 20.37  financing the cost of assistance 
 20.38  program grants or nongrant 
 20.39  administration.  All additional funding 
 20.40  is appropriated to the commissioner for 
 20.41  use as designated by the grantee of 
 20.42  funding. 
 20.43  [CHILD SUPPORT PAYMENT CENTER 
 20.44  RECOUPMENT ACCOUNT.] The child support 
 20.45  payment center is authorized to 
 20.46  establish an account to cover checks 
 20.47  issued in error or in cases where 
 20.48  insufficient funds are available to pay 
 20.49  the checks.  All recoupments against 
 20.50  payments from the account must be 
 20.51  deposited in the child support payment 
 20.52  center recoupment account and are 
 20.53  appropriated to the commissioner for 
 20.54  the purposes of the account.  Any 
 20.55  unexpended balance in the account does 
 20.56  not cancel, but is available until 
 20.57  expended. 
 20.58  [FEDERAL TANF FUNDS.] (1) Federal 
 20.59  Temporary Assistance for Needy Families 
 20.60  block grant funds authorized under 
 20.61  title I, Public Law Number 104-193, the 
 20.62  Personal Responsibility and Work 
 21.1   Opportunity Reconciliation Act of 1996, 
 21.2   and awarded in federal fiscal years 
 21.3   1997 to 2002 are appropriated to the 
 21.4   commissioner in amounts up to 
 21.5   $256,265,000 is fiscal year 2000 and 
 21.6   $249,682,000 in fiscal year 2001.  In 
 21.7   addition to these funds, the 
 21.8   commissioner may draw or transfer any 
 21.9   other appropriations or transfers of 
 21.10  federal TANF block grant funds that are 
 21.11  enacted into state law. 
 21.12  (2) Of the amounts in clause (1), 
 21.13  $15,000,000 is transferred each year of 
 21.14  the biennium to the state's federal 
 21.15  Title XX block grant.  Notwithstanding 
 21.16  the provisions of Minnesota Statutes, 
 21.17  section 256E.07, in each year of the 
 21.18  biennium the commissioner shall 
 21.19  allocate $15,000,000 of the state's 
 21.20  Title XX block grant funds based on the 
 21.21  community social services aids formula 
 21.22  in Minnesota Statutes, section 
 21.23  256E.06.  The commissioner shall ensure 
 21.24  that money allocated to counties under 
 21.25  this provision is used according to the 
 21.26  requirements of United States Code, 
 21.27  title 42, section 604(d)(3)(B).  
 21.28  (3) Of the amounts in clause (1), 
 21.29  $10,990,000 is transferred each year 
 21.30  from the state's federal TANF block 
 21.31  grant to the state's federal Title XX 
 21.32  block grant.  In each year $140,000 is 
 21.33  for grants according to Minnesota 
 21.34  Statutes, section 257.3571, subdivision 
 21.35  2a, to the Indian child welfare defense 
 21.36  corporation to promote statewide 
 21.37  compliance with the Indian Child 
 21.38  Welfare Act of 1978; $4,650,000 is for 
 21.39  grants to counties for concurrent 
 21.40  permanency planning; and $6,200,000 is 
 21.41  for the commissioner to distribute 
 21.42  according to the formula in Minnesota 
 21.43  Statutes, section 256E.07.  The 
 21.44  commissioner shall ensure that money 
 21.45  allocated under this clause is used 
 21.46  according to the requirements of United 
 21.47  States Code, title 42, section 
 21.48  604(d)(3)(B).  In fiscal years 2002 and 
 21.49  2003, $140,000 per year is for grants 
 21.50  according to Minnesota Statutes, 
 21.51  section 257.3571, subdivision 2a, to 
 21.52  the Indian child welfare defense 
 21.53  corporation to promote statewide 
 21.54  compliance with the Indian Child 
 21.55  Welfare Act of 1978.  Section 13, 
 21.56  sunset of uncodified language, does not 
 21.57  apply to this provision. 
 21.58  (4) Of the amounts in clause (1), 
 21.59  $13,360,000 each year is for increased 
 21.60  employment and training efforts and 
 21.61  shall be expended as follows: 
 21.62  (a) $140,000 each year is for a grant 
 21.63  to the new chance program.  The new 
 21.64  chance program shall provide 
 21.65  comprehensive services through a 
 21.66  private, nonprofit agency to young 
 21.67  parents in Hennepin county who have 
 22.1   dropped out of school and are receiving 
 22.2   public assistance.  The program 
 22.3   administrator shall report annually to 
 22.4   the commissioner on skills development, 
 22.5   education, job training, and job 
 22.6   placement outcomes for program 
 22.7   participants.  This appropriation is 
 22.8   available for either year of the 
 22.9   biennium. 
 22.10  (b) $260,000 each year is for grants to 
 22.11  counties to operate the parents fair 
 22.12  share program to assist unemployed, 
 22.13  noncustodial parents with job search 
 22.14  and parenting skills. 
 22.15  (c) $12,960,000 each year is to 
 22.16  increase employment and training 
 22.17  services grants for MFIP of which 
 22.18  $750,000 each year is to be transferred 
 22.19  to the job skills partnership board for 
 22.20  the health care and human services 
 22.21  worker training and retention program. 
 22.22  (d) $10,400,000 of these appropriations 
 22.23  shall become part of the base for the 
 22.24  2002-2003 biennium. 
 22.25  (5) Of the amounts in clause (1), 
 22.26  $1,094,000 in fiscal year 2000 and 
 22.27  $1,676,000 in fiscal year 2001 is 
 22.28  transferred from the state's federal 
 22.29  TANF block grant to the state's federal 
 22.30  child care and development fund block 
 22.31  grant, and is appropriated to the 
 22.32  commissioner of children, families, and 
 22.33  learning for the purposes of Minnesota 
 22.34  Statutes, section 119B.05. 
 22.35  (6) Of the amounts in clause (1), 
 22.36  $1,000,000 for the biennium is for the 
 22.37  purposes of creating and expanding 
 22.38  adult-supervised supportive living 
 22.39  arrangement services under Minnesota 
 22.40  Statutes, section 256J.14.  The 
 22.41  commissioner shall request proposals 
 22.42  from interested parties that have 
 22.43  knowledge and experience in the area of 
 22.44  adult-supervised adolescent housing and 
 22.45  supportive services, and award grants 
 22.46  for the purpose of either expanding 
 22.47  existing or creating new living 
 22.48  arrangements and supportive services.  
 22.49  Minor parents who are MFIP participants 
 22.50  shall be given priority for housing, 
 22.51  and excess living arrangements may be 
 22.52  used by minor parents who are not MFIP 
 22.53  participants. 
 22.54  (7) In order to maximize transfers from 
 22.55  Minnesota's 1998 and 1999 federal TANF 
 22.56  block grant awards, the commissioner 
 22.57  may implement the transfers of TANF 
 22.58  funds in clauses (2), (3), and (5) in 
 22.59  the first year of the biennium.  This 
 22.60  must only be done to the extent allowed 
 22.61  by federal law and to the extent that 
 22.62  program funding requirements can be met 
 22.63  in the second year of the biennium. 
 22.64  (8) The commissioner shall ensure that 
 23.1   sufficient qualified state expenditures 
 23.2   are made each year to meet the TANF 
 23.3   basic maintenance of effort 
 23.4   requirements.  The commissioner may 
 23.5   apply any allowable source of state 
 23.6   expenditures toward these requirements, 
 23.7   as necessary to meet minimum basic 
 23.8   maintenance of effort requirements and 
 23.9   to prevent the loss of federal funds. 
 23.10  [WORKER TRAINING AND RETENTION 
 23.11  ELIGIBILITY PROCEDURES.] The 
 23.12  commissioner shall develop eligibility 
 23.13  procedures for TANF expenditures under 
 23.14  Minnesota Statutes, section 256J.02, 
 23.15  subdivision 2, clause (5). 
 23.16  The amounts that may be spent from this 
 23.17  appropriation for each purpose are as 
 23.18  follows: 
 23.19  (a) Assistance to Families Grants
 23.20  General              64,870,000    66,117,000
 23.21  [EMPLOYMENT SERVICES CARRYOVER.] 
 23.22  General fund and federal TANF block 
 23.23  grant appropriations for employment 
 23.24  services that remain unexpended 
 23.25  subsequent to the reallocation process 
 23.26  required in Minnesota Statutes, section 
 23.27  256J.62, do not cancel but are 
 23.28  available for these purposes in fiscal 
 23.29  year 2001. 
 23.30  (b) Work Grants              
 23.31  General              10,731,000    10,731,000
 23.32  (c) Aid to Families With     
 23.33  Dependent Children and Other
 23.34  Assistance
 23.35  General               1,053,000       374,000
 23.36  (d) Child Support Enforcement
 23.37  General               5,359,000     5,359,000
 23.38  [CHILD SUPPORT PAYMENT CENTER.] 
 23.39  Payments to the commissioner from other 
 23.40  governmental units, private 
 23.41  enterprises, and individuals for 
 23.42  services performed by the child support 
 23.43  payment center must be deposited in the 
 23.44  state systems account authorized under 
 23.45  Minnesota Statutes, section 256.014.  
 23.46  These payments are appropriated to the 
 23.47  commissioner for the operation of the 
 23.48  child support payment center or system, 
 23.49  according to Minnesota Statutes, 
 23.50  section 256.014. 
 23.51  [CHILD SUPPORT EXPEDITED PROCESS.] Of 
 23.52  this appropriation for child support 
 23.53  enforcement, $2,340,000 for the 
 23.54  biennium shall be transferred to the 
 23.55  state court administrator to fund the 
 23.56  child support expedited process, in 
 23.57  accordance with a cooperative agreement 
 23.58  to be negotiated between the parties.  
 24.1   State funds transferred for this 
 24.2   purpose in fiscal year 2000 may exceed 
 24.3   the base funding amount of $1,170,000 
 24.4   to the extent that there is an increase 
 24.5   in the number of orders issued in the 
 24.6   expedited process, but may not exceed 
 24.7   $1,420,000 in any case.  Unexpended 
 24.8   expedited process appropriations in 
 24.9   fiscal year 2000 may be transferred to 
 24.10  fiscal year 2001 for this purpose.  
 24.11  Base funding for this program is set at 
 24.12  $1,170,000 for each year of the 
 24.13  2002-2003 biennium.  The commissioner 
 24.14  shall include cost reimbursement claims 
 24.15  from the state court administrator for 
 24.16  the child support expedited process in 
 24.17  the department of human services 
 24.18  federal cost reimbursement claim 
 24.19  process according to federal law.  
 24.20  Federal dollars earned under these 
 24.21  claims are appropriated to the 
 24.22  commissioner and shall be disbursed to 
 24.23  the state court administrator according 
 24.24  to department procedures and schedules. 
 24.25  (e) General Assistance
 24.26  General              33,927,000    14,973,000
 24.27  [TRANSFERS FROM STATE TANF RESERVE.] 
 24.28  $4,666,000 in fiscal year 2000 is 
 24.29  transferred from the state TANF reserve 
 24.30  account to the general fund. 
 24.31  [GENERAL ASSISTANCE STANDARD.] The 
 24.32  commissioner shall set the monthly 
 24.33  standard of assistance for general 
 24.34  assistance units consisting of an adult 
 24.35  recipient who is childless and 
 24.36  unmarried or living apart from his or 
 24.37  her parents or a legal guardian at 
 24.38  $203.  The commissioner may reduce this 
 24.39  amount in accordance with Laws 1997, 
 24.40  chapter 85, article 3, section 54. 
 24.41  (f) Minnesota Supplemental Aid
 24.42  General              25,767,000    26,874,000
 24.43  (g) Refugee Services         
 24.44  General                 330,000       330,000
 24.45  Subd. 11.  Economic Support  
 24.46  Management
 24.47  General              40,950,000    40,357,000
 24.48  Health Care
 24.49  Access                1,313,000     1,318,000
 24.50  The amounts that may be spent from this 
 24.51  appropriation for each purpose are as 
 24.52  follows: 
 24.53  (a) Economic Support Policy  
 24.54  Administration
 24.55  General               7,100,000     6,951,000
 24.56  [FOOD STAMP ADMINISTRATIVE 
 25.1   REIMBURSEMENT.] The commissioner shall 
 25.2   reduce quarterly food stamp 
 25.3   administrative reimbursement to 
 25.4   counties in fiscal years 1999, 2000, 
 25.5   and 2001 by the amount that the United 
 25.6   States Department of Health and Human 
 25.7   Services determines to be the county 
 25.8   random moment study share of the food 
 25.9   stamp adjustment under Public Law 
 25.10  Number 105-185.  The reductions shall 
 25.11  be allocated to each county in 
 25.12  proportion to each county's 
 25.13  contribution, if any, to the amount of 
 25.14  the adjustment.  Any adjustment to 
 25.15  medical assistance administrative 
 25.16  reimbursement that is based on the 
 25.17  United States Department of Health and 
 25.18  Human Services' determinations under 
 25.19  Public Law Number 105-185 shall be 
 25.20  distributed to counties in the same 
 25.21  manner.  This provision is effective 
 25.22  the day following final enactment. 
 25.23  [SPENDING AUTHORITY FOR FOOD STAMP 
 25.24  ENHANCED FUNDING.] In the event that 
 25.25  Minnesota qualifies for United States 
 25.26  Department of Agriculture Food and 
 25.27  Nutrition Services Food Stamp Program 
 25.28  enhanced funding beginning in federal 
 25.29  fiscal year 1998, the money is 
 25.30  appropriated to the commissioner for 
 25.31  the purposes of the program.  The 
 25.32  commissioner may retain 25 percent of 
 25.33  the enhanced funding, with the 
 25.34  remaining 75 percent divided among the 
 25.35  counties according to a formula that 
 25.36  takes into account each county's impact 
 25.37  on the statewide food stamp error rate. 
 25.38  [ELIGIBILITY DETERMINATION FUNDING.] 
 25.39  Increased federal funds for the costs 
 25.40  of eligibility determination and other 
 25.41  permitted activities that are available 
 25.42  to the state through section 114 of the 
 25.43  Personal Responsibility and Work 
 25.44  Opportunity Reconciliation Act, Public 
 25.45  Law Number 104-193, are appropriated to 
 25.46  the commissioner. 
 25.47  (b) Economic Support Operations  
 25.48  General              33,850,000    33,406,000
 25.49  Health Care 
 25.50  Access                1,313,000     1,318,000
 25.51  [MAXIS BASE REDUCTION.] The base level 
 25.52  appropriation for MAXIS shall be 
 25.53  reduced by $2,500,000 each year of the 
 25.54  biennium beginning July 1, 2001.  
 25.55  Section 13, sunset of uncodified 
 25.56  language, does not apply to this 
 25.57  provision. 
 25.58  [FRAUD PREVENTION AND CONTROL FUNDING.] 
 25.59  Unexpended funds appropriated for the 
 25.60  provision of program integrity 
 25.61  activities for fiscal year 2000 are 
 25.62  also available to the commissioner to 
 25.63  fund fraud prevention and control 
 25.64  initiatives, and do not cancel but are 
 26.1   available to the commissioner for these 
 26.2   purposes for fiscal year 2001.  
 26.3   Unexpended funds may be transferred 
 26.4   between the fraud prevention 
 26.5   investigation program and fraud control 
 26.6   programs to promote the provisions of 
 26.7   Minnesota Statutes, sections 256.983 
 26.8   and 256.9861. 
 26.9   [TRANSFERS TO TITLE XX FOR CSSA.] When 
 26.10  preparing the governor's budget for the 
 26.11  2002-2003 biennium, the commissioner of 
 26.12  finance shall ensure that the base 
 26.13  level funding for the community social 
 26.14  services aids includes $11,000,000 in 
 26.15  fiscal year 2002 and $11,000,000 in 
 26.16  fiscal year 2003 in funding that is 
 26.17  transferred from the state's federal 
 26.18  TANF block grant to the state's federal 
 26.19  Title XX block grant.  Notwithstanding 
 26.20  the provisions of Minnesota Statutes, 
 26.21  section 256E.07, the commissioner shall 
 26.22  allocate the portion of the state's 
 26.23  community social services aids funding 
 26.24  that is comprised of these transferred 
 26.25  funds based on the community social 
 26.26  services aids formula in Minnesota 
 26.27  Statutes, section 256E.06.  The 
 26.28  commissioner shall ensure that money 
 26.29  allocated under this provision is used 
 26.30  in accordance with the requirements of 
 26.31  United States Code, title 42, section 
 26.32  604(d)(3)(B). Any reductions to the 
 26.33  amount of the state community social 
 26.34  services (CSSA) block grant funding in 
 26.35  fiscal year 2002 or 2003 shall not 
 26.36  reduce the base for the CSSA block 
 26.37  grant for the 2004-2005 biennial 
 26.38  budget.  Section 13, sunset of 
 26.39  uncodified language, does not apply to 
 26.40  this provision. 
 26.41  Sec. 3.  COMMISSIONER OF HEALTH 
 26.42  Subdivision 1.  Total 
 26.43  Appropriation                        100,424,000     98,641,000
 26.44                Summary by Fund
 26.45  General              64,916,000    63,565,000
 26.46  State Government
 26.47  Special Revenue      25,563,000    25,020,000
 26.48  Health Care
 26.49  Access                9,945,000    10,056,000
 26.50  [INDIRECT COSTS NOT TO FUND PROGRAMS.] 
 26.51  The commissioner shall not use indirect 
 26.52  cost allocations to pay for the 
 26.53  operational costs of any program for 
 26.54  which the commissioner is responsible. 
 26.55  [GENERAL FUND GRANT REDUCTIONS.] The 
 26.56  commissioner may not reduce general 
 26.57  fund appropriations for grants without 
 26.58  specific legislative authority. 
 26.59  Subd. 2.  Health Systems
 26.60  and Special Populations               66,999,000     66,269,000
 27.1                 Summary by Fund
 27.2   General              46,593,000    46,299,000
 27.3   State Government
 27.4   Special Revenue      10,557,000    10,012,000
 27.5   Health Care 
 27.6   Access                9,849,000     9,958,000
 27.7   [WIC TRANSFERS.] The general fund 
 27.8   appropriation for the women, infants, 
 27.9   and children (WIC) food supplement 
 27.10  program is available for either year of 
 27.11  the biennium.  Transfers of these funds 
 27.12  between fiscal years must either be to 
 27.13  maximize federal funds or to minimize 
 27.14  fluctuations in the number of program 
 27.15  participants. 
 27.16  [MINNESOTA CHILDREN WITH SPECIAL HEALTH 
 27.17  NEEDS CARRYOVER.] General fund 
 27.18  appropriations for treatment services 
 27.19  in the services for Minnesota children 
 27.20  with special health needs program are 
 27.21  available for either year of the 
 27.22  biennium. 
 27.23  [SUICIDE PREVENTION STUDY.] Of the 
 27.24  general fund appropriation, $100,000 in 
 27.25  fiscal year 2000 is for the 
 27.26  commissioner to study suicide issues 
 27.27  and develop a suicide prevention plan.  
 27.28  The study must be conducted in 
 27.29  consultation with local community 
 27.30  health boards, mental health 
 27.31  professionals, schools, and other 
 27.32  interested parties.  The plan must be 
 27.33  reported to the legislature by January 
 27.34  15, 2000.  
 27.35  [FAMILY PRACTICE RESIDENCY PROGRAM.] Of 
 27.36  the general fund appropriation, 
 27.37  $300,000 in fiscal year 2000 is to the 
 27.38  commissioner to make a grant to the 
 27.39  city of Duluth for a family practice 
 27.40  residency program for northeastern 
 27.41  Minnesota. 
 27.42  [UNCOMPENSATED CARE.] The commissioner 
 27.43  shall study and report to the 
 27.44  legislature by January 15, 2000, with: 
 27.45  (1) statistical information on the 
 27.46  amount of uncompensated health care 
 27.47  provided in Minnesota, the types of 
 27.48  care provided, the settings in which 
 27.49  the care is provided, and, if known, 
 27.50  the most common reasons why the care is 
 27.51  uncompensated; and 
 27.52  (2) recommendations for reducing the 
 27.53  level of uncompensated care, including, 
 27.54  but not limited to, methods to enroll 
 27.55  eligible persons in public health care 
 27.56  programs through simplification of the 
 27.57  application process and other efforts. 
 27.58  [RURAL HOSPITAL CAPITAL IMPROVEMENT 
 27.59  GRANT PROGRAM.] (a) Of this 
 27.60  appropriation, $2,800,000 for each 
 28.1   fiscal year is from the health care 
 28.2   access fund to the commissioner for the 
 28.3   rural hospital capital improvement 
 28.4   grant program described in Minnesota 
 28.5   Statutes, section 144.148. This 
 28.6   appropriation shall not become part of 
 28.7   the base for the 2002-2003 biennium. 
 28.8   (b) The commissioner may provide up to 
 28.9   $300,000 for the Westbrook health 
 28.10  center for hospital and clinic 
 28.11  improvements, upon receipt of 
 28.12  information from the Westbrook health 
 28.13  center indicating how it has fulfilled 
 28.14  the requirements of Minnesota Statutes, 
 28.15  section 144.148, and evidence that it 
 28.16  has raised at least a dollar-for-dollar 
 28.17  match from nonstate sources. 
 28.18  [ACCESS TO SUMMARY MINIMUM DATA SET 
 28.19  (MDS).] The commissioner, in 
 28.20  cooperation with the commissioner of 
 28.21  administration, shall work to obtain 
 28.22  access to Minimum Data Set (MDS) data 
 28.23  that is electronically transmitted by 
 28.24  nursing facilities to the health 
 28.25  department.  The MDS data shall be made 
 28.26  available on a quarterly basis to 
 28.27  industry trade associations for use in 
 28.28  quality improvement efforts and 
 28.29  comparative analysis.  The MDS data 
 28.30  shall be provided to the industry trade 
 28.31  associations in the form of summary 
 28.32  aggregate data, without patient 
 28.33  identifiers, to ensure patient 
 28.34  privacy.  The commissioner may charge 
 28.35  for the actual cost of production of 
 28.36  these documents. 
 28.37  [NURSING HOME MORATORIUM REPORT.] In 
 28.38  preparing the report required by 
 28.39  Minnesota Statutes, section 144A.071, 
 28.40  subdivision 5, the commissioner and the 
 28.41  commissioner of human services shall 
 28.42  analyze the adequacy of the supply of 
 28.43  nursing home beds by measuring the 
 28.44  ability of hospitals to promptly 
 28.45  discharge patients to a nursing home 
 28.46  within the hospital's primary service 
 28.47  area.  If it is determined that a 
 28.48  shortage of beds exists, the report 
 28.49  shall present a plan to correct the 
 28.50  service deficits.  The report shall 
 28.51  also analyze the impact of assisted 
 28.52  living services on the medical 
 28.53  assistance utilization of nursing homes.
 28.54  [HEALTH CARE PURCHASING ALLIANCES.] Of 
 28.55  the health care access fund 
 28.56  appropriation, $100,000 each year is to 
 28.57  the commissioner for grants to two 
 28.58  local organizations to develop health 
 28.59  care purchasing alliances under 
 28.60  Minnesota Statutes, section 62T.02, to 
 28.61  negotiate the purchase of health care 
 28.62  services from licensed entities.  Of 
 28.63  this amount, $50,000 each year is for a 
 28.64  grant to the Southwest Regional 
 28.65  Development Commissioner to coordinate 
 28.66  purchasing alliance development in the 
 28.67  southwest area of the state, and 
 29.1   $50,000 each year is for a grant to the 
 29.2   University of Minnesota extension 
 29.3   services in Crookston to coordinate 
 29.4   purchasing alliance development in the 
 29.5   northwest area of the state.  This is a 
 29.6   one-time appropriation and shall not 
 29.7   become part of base level funding for 
 29.8   this activity for the 2002-2003 
 29.9   biennium. 
 29.10  [GENERAL FUND TOBACCO BASE REDUCTION.] 
 29.11  The general fund base level 
 29.12  appropriation for tobacco prevention 
 29.13  and control programs and activities 
 29.14  shall be reduced by $1,100,000 each 
 29.15  year of the biennium beginning July 1, 
 29.16  2001.  Section 13, sunset of uncodified 
 29.17  language, does not apply to this 
 29.18  provision. 
 29.19  [STANDARDS FOR SPECIAL CASE AUTOPSIES.] 
 29.20  Of this general fund appropriation, 
 29.21  $20,000 for the biennium is for a grant 
 29.22  to a professional association 
 29.23  representing coroners and medical 
 29.24  examiners in Minnesota to conduct case 
 29.25  studies, and develop and disseminate 
 29.26  guidelines, for autopsy practice in 
 29.27  special cases.  This is a one-time 
 29.28  appropriation and shall not become part 
 29.29  of base level funding for the 2002-2003 
 29.30  biennium. 
 29.31  Subd. 3.  Health Protection          27,046,000     27,240,000
 29.32                Summary by Fund
 29.33  General              12,221,000    12,417,000
 29.34  State Government 
 29.35  Special Revenue      14,825,000    14,823,000
 29.36  [PORTABLE WADING POOLS.] (a) Portable 
 29.37  wading pools used in the following 
 29.38  settings are defined as private 
 29.39  residential pools, and not public 
 29.40  pools, for purposes of public swimming 
 29.41  pool regulation under Minnesota Rules, 
 29.42  chapter 4717, provided they have a 
 29.43  maximum depth of 24 inches and are 
 29.44  capable of being manually emptied and 
 29.45  moved: 
 29.46  (1) a portable wading pool operated at 
 29.47  a family day care or group family day 
 29.48  care home that is licensed under 
 29.49  Minnesota Rules, chapter 9502; and 
 29.50  (2) a portable wading pool operated at 
 29.51  a home at which child care services are 
 29.52  provided under Minnesota Statutes, 
 29.53  section 245A.03, subdivision 2, clause 
 29.54  (2), or under Laws 1997, chapter 248, 
 29.55  section 46, including subsequent 
 29.56  amendments. 
 29.57  (b) Portable wading pools may not be 
 29.58  used by a child at a setting specified 
 29.59  in paragraph (a), clause (1) or (2), 
 29.60  unless the parent or legal guardian for 
 29.61  the child in care has provided written 
 30.1   consent.  The written consent shall 
 30.2   include a statement that the parent or 
 30.3   legal guardian has received and read 
 30.4   material provided by the department of 
 30.5   health to the department of human 
 30.6   services for distribution to all child 
 30.7   care facilities, related to the use of 
 30.8   portable wading pools concerning the 
 30.9   risk of disease transmission as well as 
 30.10  other health risks. 
 30.11  (c) This provision is effective the day 
 30.12  following final enactment. 
 30.13  Subd. 4.  Management and
 30.14  Support Services                      6,379,000      5,132,000
 30.15                Summary by Fund
 30.16  General               6,102,000     4,849,000
 30.17  State Government
 30.18  Special Revenue         181,000       185,000
 30.19  Health Care
 30.20  Access                   96,000        98,000
 30.21  [HEALTH NEEDS OF SPECIAL POPULATIONS.] 
 30.22  Of the general fund appropriation, 
 30.23  $400,000 in fiscal year 2000 is for 
 30.24  grants to local health agencies to 
 30.25  conduct a health needs assessment that 
 30.26  is specific to populations of color.  
 30.27  Any portion of this appropriation that 
 30.28  is unspent does not cancel but shall be 
 30.29  available for these purposes in fiscal 
 30.30  year 2001.  This appropriation shall 
 30.31  not become part of the base for the 
 30.32  2002-2003 biennium. 
 30.33  [YEAR 2000 SURVEY OF FACILITIES AND 
 30.34  WATER SYSTEMS.] Of this general fund 
 30.35  appropriation, $100,000 is for the 
 30.36  costs associated with surveying by July 
 30.37  1, 1999, all hospitals, nursing homes, 
 30.38  nontransient community water systems 
 30.39  operated by a public entity, and 
 30.40  community water supply systems for year 
 30.41  2000 problems and proposed solutions.  
 30.42  Of this amount, $50,000 is available 
 30.43  the day following final enactment. 
 30.44  [SINGLE POINT OF ENTRY.] The 
 30.45  commissioner, in consultation with the 
 30.46  commissioners of commerce and human 
 30.47  services, the ombudsman for mental 
 30.48  health and mental retardation, and the 
 30.49  board on aging, shall report to the 
 30.50  chairs of the senate health and family 
 30.51  security committee and the house health 
 30.52  and human services committee by January 
 30.53  15, 2000, with a plan to: 
 30.54  (1) create a single point of entry for 
 30.55  health care consumer assistance and 
 30.56  advocacy services; 
 30.57  (2) integrate state offices of health 
 30.58  care consumer assistance; and 
 30.59  (3) coordinate and collaborate with 
 31.1   other state agencies and 
 31.2   nongovernmental entities to provide 
 31.3   consumers with assistance and advocacy 
 31.4   services related to health insurance 
 31.5   and health services. 
 31.6   The report shall also discuss the 
 31.7   feasibility of obtaining grants and 
 31.8   other revenue to provide these services.
 31.9   Sec. 4.  VETERANS NURSING   
 31.10  HOMES BOARD                           26,121,000     27,103,000 
 31.11  [ALLOWANCE FOR FOOD.] The allowance for 
 31.12  food may be adjusted annually to 
 31.13  reflect changes in the producer price 
 31.14  index, as prepared by the United States 
 31.15  Bureau of Labor Statistics, with the 
 31.16  approval of the commissioner of 
 31.17  finance.  Adjustments for fiscal year 
 31.18  2000 and fiscal year 2001 must be based 
 31.19  on the June 1998 and June 1999 producer 
 31.20  price index respectively, but the 
 31.21  adjustment must be prorated if it would 
 31.22  require money in excess of the 
 31.23  appropriation. 
 31.24  [IMPROVEMENTS USING DONATED MONEY.] 
 31.25  Notwithstanding Minnesota Statutes, 
 31.26  section 16B.30, the board may make and 
 31.27  maintain the following improvements to 
 31.28  the veterans homes using money donated 
 31.29  for those purposes: 
 31.30  (1) a picnic pavilion at the 
 31.31  Minneapolis veterans home; 
 31.32  (2) walking trails at the Hastings 
 31.33  veterans home; 
 31.34  (3) walking trails and landscaping at 
 31.35  the Silver Bay veterans home; 
 31.36  (4) an entrance canopy at the Fergus 
 31.37  Falls veterans home; and 
 31.38  (5) a suspended wooden dining deck at 
 31.39  the Luverne veterans home. 
 31.40  [ASSET PRESERVATION; FACILITY REPAIR.] 
 31.41  Of the general fund appropriation, 
 31.42  $1,190,000 each year is for asset 
 31.43  preservation and facility repair.  The 
 31.44  appropriations are available in either 
 31.45  year of the biennium and may be used 
 31.46  for abatement and repair at the Luverne 
 31.47  home.  This appropriation shall become 
 31.48  part of the board's base level funding 
 31.49  for the 2002-2003 biennium. 
 31.50  [VETERANS HOMES SPECIAL REVENUE 
 31.51  ACCOUNT.] The general fund 
 31.52  appropriations made to the board shall 
 31.53  be transferred to a veterans homes 
 31.54  special revenue account in the special 
 31.55  revenue fund in the same manner as 
 31.56  other receipts are deposited according 
 31.57  to Minnesota Statutes, section 198.34, 
 31.58  and are appropriated to the board for 
 31.59  the operation of board facilities and 
 31.60  programs. 
 32.1   [SETTING COST OF CARE.] (a) The board 
 32.2   may set the cost of care at the Fergus 
 32.3   Falls facility for fiscal year 2000 
 32.4   based on the cost of average skilled 
 32.5   nursing care provided to residents of 
 32.6   the Minneapolis veterans home for 
 32.7   fiscal year 2000. 
 32.8   (b) The cost of care for the 
 32.9   domiciliary residents at the 
 32.10  Minneapolis veterans home and the 
 32.11  skilled nursing care residents at the 
 32.12  Luverne veterans home for fiscal year 
 32.13  2000 and fiscal year 2001 shall be 
 32.14  calculated based on 100 percent 
 32.15  occupancy at each facility. 
 32.16  [LICENSED BED CAPACITY FOR MINNEAPOLIS 
 32.17  VETERANS HOME.] The commissioner of 
 32.18  health shall not reduce the licensed 
 32.19  bed capacity for the Minneapolis 
 32.20  veterans home pending completion of the 
 32.21  project authorized by Laws 1990, 
 32.22  chapter 610, article 1, section 9, 
 32.23  subdivision 3. 
 32.24  [LUVERNE ENVIRONMENTAL QUALITY.] Of 
 32.25  this appropriation, $591,000 in fiscal 
 32.26  year 2000 is from the general fund to 
 32.27  the board to ensure an adequate 
 32.28  staffing complement during the repairs 
 32.29  at the Luverne home.  Of that amount, 
 32.30  $229,000 is available the day following 
 32.31  final enactment. 
 32.32  Sec. 5.  HEALTH-RELATED BOARDS 
 32.33  Subdivision 1.  Total       
 32.34  Appropriation                         10,376,000     10,576,000 
 32.35  [STATE GOVERNMENT SPECIAL REVENUE 
 32.36  FUND.] The appropriations in this 
 32.37  section are from the state government 
 32.38  special revenue fund. 
 32.39  [NO SPENDING IN EXCESS OF REVENUES.] 
 32.40  The commissioner of finance shall not 
 32.41  permit the allotment, encumbrance, or 
 32.42  expenditure of money appropriated in 
 32.43  this section in excess of the 
 32.44  anticipated biennial revenues or 
 32.45  accumulated surplus revenues from fees 
 32.46  collected by the boards.  Neither this 
 32.47  provision nor Minnesota Statutes, 
 32.48  section 214.06, applies to transfers 
 32.49  from the general contingent account. 
 32.50  Subd. 2.  Board of Chiropractic 
 32.51  Examiners                                350,000        361,000
 32.52  Subd. 3.  Board of Dentistry             783,000        806,000
 32.53  Subd. 4.  Board of Dietetic
 32.54  and Nutrition Practice                    92,000         95,000
 32.55  Subd. 5.  Board of Marriage and 
 32.56  Family Therapy                           107,000        111,000
 32.57  Subd. 6.  Board of Medical  
 32.58  Practice                               3,469,000      3,593,000
 33.1   Subd. 7.  Board of Nursing             2,202,000      2,245,000
 33.2   Subd. 8.  Board of Nursing 
 33.3   Home Administrators                      548,000        566,000
 33.4   [HEALTH PROFESSIONAL SERVICES 
 33.5   ACTIVITY.] Of these appropriations, 
 33.6   $368,000 the first year and $380,000 
 33.7   the second year are for the Health 
 33.8   Professional Services Activity. 
 33.9   Subd. 9.  Board of Optometry              87,000         90,000
 33.10  Subd. 10.  Board of Pharmacy           1,125,000      1,137,000
 33.11  [ADMINISTRATIVE SERVICES UNIT.] Of this 
 33.12  appropriation, $259,000 the first year 
 33.13  and $270,000 the second year are for 
 33.14  the health boards administrative 
 33.15  services unit.  The administrative 
 33.16  services unit may receive and expend 
 33.17  reimbursements for services performed 
 33.18  for other agencies. 
 33.19  Subd. 11.  Board of Physical Therapy     227,000        185,000
 33.20  Subd. 12.  Board of Podiatry              41,000         42,000
 33.21  Subd. 13.  Board of Psychology           556,000        534,000
 33.22  [PART-TIME POSITIONS FUNDING.] Of this 
 33.23  appropriation, $34,000 in fiscal year 
 33.24  2000 is from the state government 
 33.25  special revenue fund to the board to 
 33.26  fund two part-time positions previously 
 33.27  funded through the legislative advisory 
 33.28  commission and for a budget shortage 
 33.29  due to position reallocations.  This 
 33.30  appropriation is available the day 
 33.31  following final enactment. 
 33.32  Subd. 14.  Board of Social Work          641,000        658,000
 33.33  Subd. 15.  Board of Veterinary 
 33.34  Medicine                                 148,000        153,000
 33.35  Sec. 6.  EMERGENCY MEDICAL
 33.36  SERVICES BOARD                         2,420,000      2,467,000 
 33.37                Summary by Fund
 33.38  General                 694,000       694,000
 33.39  Trunk Highway         1,726,000     1,773,000
 33.40  [COMPREHENSIVE ADVANCED LIFE SUPPORT 
 33.41  (CALS).] Of the general fund 
 33.42  appropriation, $108,000 each year is 
 33.43  for the board to establish a 
 33.44  comprehensive advanced life support 
 33.45  educational program under Minnesota 
 33.46  Statutes, section 144E.37. 
 33.47  [EMERGENCY MEDICAL SERVICES GRANTS.] Of 
 33.48  the appropriation from the trunk 
 33.49  highway fund, $18,000 in fiscal year 
 33.50  2000 and $36,000 in fiscal year 2001 is 
 33.51  to the board for grants to regional 
 33.52  emergency medical services programs.  
 33.53  This appropriation shall become part of 
 33.54  the base for the 2002-2003 biennium. 
 34.1   Sec. 7.  COUNCIL ON DISABILITY           650,000        670,000
 34.2   Sec. 8.  OMBUDSMAN FOR MENTAL 
 34.3   HEALTH AND MENTAL RETARDATION          1,338,000      1,378,000
 34.4   Sec. 9.  OMBUDSMAN
 34.5   FOR FAMILIES                             166,000        171,000
 34.6   Sec. 10.  TRANSFERS 
 34.7   Subdivision 1.  Grant Programs
 34.8   The commissioner of human services, 
 34.9   with the approval of the commissioner 
 34.10  of finance, and after notification of 
 34.11  the chair of the senate health and 
 34.12  family security budget division and the 
 34.13  chair of the house health and human 
 34.14  services finance committee, may 
 34.15  transfer unencumbered appropriation 
 34.16  balances for the biennium ending June 
 34.17  30, 2001, within fiscal years among the 
 34.18  MFIP, general assistance, general 
 34.19  assistance medical care, medical 
 34.20  assistance, Minnesota supplemental aid, 
 34.21  and group residential housing programs, 
 34.22  and the entitlement portion of the 
 34.23  chemical dependency consolidated 
 34.24  treatment fund, and between fiscal 
 34.25  years of the biennium. 
 34.26  Subd. 2.  Approval Required
 34.27  Positions, salary money, and nonsalary 
 34.28  administrative money may be transferred 
 34.29  within the departments of human 
 34.30  services and health and within the 
 34.31  programs operated by the veterans 
 34.32  nursing homes board as the 
 34.33  commissioners and the board consider 
 34.34  necessary, with the advance approval of 
 34.35  the commissioner of finance.  The 
 34.36  commissioner or the board shall inform 
 34.37  the chairs of the house health and 
 34.38  human services finance committee and 
 34.39  the senate health and family security 
 34.40  budget division quarterly about 
 34.41  transfers made under this provision. 
 34.42  Sec. 11.  PROVISIONS
 34.43  (a) Money appropriated to the 
 34.44  commissioner of human services for the 
 34.45  purchase of provisions must be used 
 34.46  solely for that purpose.  Money 
 34.47  provided and not used for the purchase 
 34.48  of provisions must be canceled into the 
 34.49  fund from which appropriated, except 
 34.50  that money provided and not used for 
 34.51  the purchase of provisions because of 
 34.52  population decreases may be transferred 
 34.53  and used for the purchase of drugs and 
 34.54  medical and hospital supplies and 
 34.55  equipment with the approval of the 
 34.56  commissioner of finance after 
 34.57  notification of the chairs of the house 
 34.58  health and human services finance 
 34.59  committee and the senate health and 
 34.60  family security budget division. 
 34.61  (b) For fiscal year 2000, the allowance 
 35.1   for food may be adjusted to the 
 35.2   equivalent of the 75th percentile of 
 35.3   the comparable raw food costs for 
 35.4   community nursing homes as reported to 
 35.5   the commissioner of human services.  
 35.6   For fiscal year 2001, an adjustment may 
 35.7   be made to reflect the annual change in 
 35.8   the United States Bureau of Labor 
 35.9   Statistics producer price index as of 
 35.10  June 2000 with the approval of the 
 35.11  commissioner of finance.  The 
 35.12  adjustments for either year must be 
 35.13  prorated if they would require money in 
 35.14  excess of this appropriation. 
 35.15  Sec. 12.  CARRYOVER LIMITATION
 35.16  None of the appropriations in this act 
 35.17  which are allowed to be carried forward 
 35.18  from fiscal year 2000 to fiscal year 
 35.19  2001 shall become part of the base 
 35.20  level funding for the 2002-2003 
 35.21  biennial budget, unless specifically 
 35.22  directed by the legislature. 
 35.23  Sec. 13.  SUNSET OF UNCODIFIED LANGUAGE
 35.24  All uncodified language contained in 
 35.25  this article expires on June 30, 2001, 
 35.26  unless a different expiration date is 
 35.27  explicit. 
 35.28     Sec. 14.  Minnesota Statutes 1998, section 144.05, is 
 35.29  amended by adding a subdivision to read: 
 35.30     Subd. 3.  [APPROPRIATION TRANSFERS TO BE REPORTED.] When 
 35.31  the commissioner transfers operational money between programs 
 35.32  under section 16A.285, in addition to the requirements of that 
 35.33  section the commissioner must provide the chairs of the 
 35.34  legislative committees that have jurisdiction over the agency's 
 35.35  budget with sufficient detail to identify the account to which 
 35.36  the money was originally appropriated, and the account to which 
 35.37  the money is being transferred. 
 35.38     Sec. 15.  Minnesota Statutes 1998, section 198.003, is 
 35.39  amended by adding a subdivision to read: 
 35.40     Subd. 5.  [APPROPRIATION TRANSFERS TO BE REPORTED.] When 
 35.41  the board transfers operational money between programs under 
 35.42  section 16A.285, in addition to the requirements of that section 
 35.43  the board must provide the chairs of the legislative committees 
 35.44  that have jurisdiction over the board's budget with sufficient 
 35.45  detail to identify the account to which the money was originally 
 35.46  appropriated, and the account to which the money is being 
 35.47  transferred. 
 36.1      Sec. 16.  Minnesota Statutes 1998, section 256.01, 
 36.2   subdivision 2, is amended to read: 
 36.3      Subd. 2.  [SPECIFIC POWERS.] Subject to the provisions of 
 36.4   section 241.021, subdivision 2, the commissioner of human 
 36.5   services shall: 
 36.6      (1) Administer and supervise all forms of public assistance 
 36.7   provided for by state law and other welfare activities or 
 36.8   services as are vested in the commissioner.  Administration and 
 36.9   supervision of human services activities or services includes, 
 36.10  but is not limited to, assuring timely and accurate distribution 
 36.11  of benefits, completeness of service, and quality program 
 36.12  management.  In addition to administering and supervising human 
 36.13  services activities vested by law in the department, the 
 36.14  commissioner shall have the authority to: 
 36.15     (a) require county agency participation in training and 
 36.16  technical assistance programs to promote compliance with 
 36.17  statutes, rules, federal laws, regulations, and policies 
 36.18  governing human services; 
 36.19     (b) monitor, on an ongoing basis, the performance of county 
 36.20  agencies in the operation and administration of human services, 
 36.21  enforce compliance with statutes, rules, federal laws, 
 36.22  regulations, and policies governing welfare services and promote 
 36.23  excellence of administration and program operation; 
 36.24     (c) develop a quality control program or other monitoring 
 36.25  program to review county performance and accuracy of benefit 
 36.26  determinations; 
 36.27     (d) require county agencies to make an adjustment to the 
 36.28  public assistance benefits issued to any individual consistent 
 36.29  with federal law and regulation and state law and rule and to 
 36.30  issue or recover benefits as appropriate; 
 36.31     (e) delay or deny payment of all or part of the state and 
 36.32  federal share of benefits and administrative reimbursement 
 36.33  according to the procedures set forth in section 256.017; 
 36.34     (f) make contracts with and grants to public and private 
 36.35  agencies and organizations, both profit and nonprofit, and 
 36.36  individuals, using appropriated funds; and 
 37.1      (g) enter into contractual agreements with federally 
 37.2   recognized Indian tribes with a reservation in Minnesota to the 
 37.3   extent necessary for the tribe to operate a federally approved 
 37.4   family assistance program or any other program under the 
 37.5   supervision of the commissioner.  The commissioner shall consult 
 37.6   with the affected county or counties in the contractual 
 37.7   agreement negotiations, if the county or counties wish to be 
 37.8   included, in order to avoid the duplication of county and tribal 
 37.9   assistance program services.  The commissioner may establish 
 37.10  necessary accounts for the purposes of receiving and disbursing 
 37.11  funds as necessary for the operation of the programs. 
 37.12     (2) Inform county agencies, on a timely basis, of changes 
 37.13  in statute, rule, federal law, regulation, and policy necessary 
 37.14  to county agency administration of the programs. 
 37.15     (3) Administer and supervise all child welfare activities; 
 37.16  promote the enforcement of laws protecting handicapped, 
 37.17  dependent, neglected and delinquent children, and children born 
 37.18  to mothers who were not married to the children's fathers at the 
 37.19  times of the conception nor at the births of the children; 
 37.20  license and supervise child-caring and child-placing agencies 
 37.21  and institutions; supervise the care of children in boarding and 
 37.22  foster homes or in private institutions; and generally perform 
 37.23  all functions relating to the field of child welfare now vested 
 37.24  in the state board of control. 
 37.25     (4) Administer and supervise all noninstitutional service 
 37.26  to handicapped persons, including those who are visually 
 37.27  impaired, hearing impaired, or physically impaired or otherwise 
 37.28  handicapped.  The commissioner may provide and contract for the 
 37.29  care and treatment of qualified indigent children in facilities 
 37.30  other than those located and available at state hospitals when 
 37.31  it is not feasible to provide the service in state hospitals. 
 37.32     (5) Assist and actively cooperate with other departments, 
 37.33  agencies and institutions, local, state, and federal, by 
 37.34  performing services in conformity with the purposes of Laws 
 37.35  1939, chapter 431. 
 37.36     (6) Act as the agent of and cooperate with the federal 
 38.1   government in matters of mutual concern relative to and in 
 38.2   conformity with the provisions of Laws 1939, chapter 431, 
 38.3   including the administration of any federal funds granted to the 
 38.4   state to aid in the performance of any functions of the 
 38.5   commissioner as specified in Laws 1939, chapter 431, and 
 38.6   including the promulgation of rules making uniformly available 
 38.7   medical care benefits to all recipients of public assistance, at 
 38.8   such times as the federal government increases its participation 
 38.9   in assistance expenditures for medical care to recipients of 
 38.10  public assistance, the cost thereof to be borne in the same 
 38.11  proportion as are grants of aid to said recipients. 
 38.12     (7) Establish and maintain any administrative units 
 38.13  reasonably necessary for the performance of administrative 
 38.14  functions common to all divisions of the department. 
 38.15     (8) Act as designated guardian of both the estate and the 
 38.16  person of all the wards of the state of Minnesota, whether by 
 38.17  operation of law or by an order of court, without any further 
 38.18  act or proceeding whatever, except as to persons committed as 
 38.19  mentally retarded.  For children under the guardianship of the 
 38.20  commissioner whose interests would be best served by adoptive 
 38.21  placement, the commissioner may contract with a licensed 
 38.22  child-placing agency to provide adoption services.  A contract 
 38.23  with a licensed child-placing agency must be designed to 
 38.24  supplement existing county efforts and may not replace existing 
 38.25  county programs, unless the replacement is agreed to by the 
 38.26  county board and the appropriate exclusive bargaining 
 38.27  representative or the commissioner has evidence that child 
 38.28  placements of the county continue to be substantially below that 
 38.29  of other counties.  Funds encumbered and obligated under an 
 38.30  agreement for a specific child shall remain available until the 
 38.31  terms of the agreement are fulfilled or the agreement is 
 38.32  terminated. 
 38.33     (9) Act as coordinating referral and informational center 
 38.34  on requests for service for newly arrived immigrants coming to 
 38.35  Minnesota. 
 38.36     (10) The specific enumeration of powers and duties as 
 39.1   hereinabove set forth shall in no way be construed to be a 
 39.2   limitation upon the general transfer of powers herein contained. 
 39.3      (11) Establish county, regional, or statewide schedules of 
 39.4   maximum fees and charges which may be paid by county agencies 
 39.5   for medical, dental, surgical, hospital, nursing and nursing 
 39.6   home care and medicine and medical supplies under all programs 
 39.7   of medical care provided by the state and for congregate living 
 39.8   care under the income maintenance programs. 
 39.9      (12) Have the authority to conduct and administer 
 39.10  experimental projects to test methods and procedures of 
 39.11  administering assistance and services to recipients or potential 
 39.12  recipients of public welfare.  To carry out such experimental 
 39.13  projects, it is further provided that the commissioner of human 
 39.14  services is authorized to waive the enforcement of existing 
 39.15  specific statutory program requirements, rules, and standards in 
 39.16  one or more counties.  The order establishing the waiver shall 
 39.17  provide alternative methods and procedures of administration, 
 39.18  shall not be in conflict with the basic purposes, coverage, or 
 39.19  benefits provided by law, and in no event shall the duration of 
 39.20  a project exceed four years.  It is further provided that no 
 39.21  order establishing an experimental project as authorized by the 
 39.22  provisions of this section shall become effective until the 
 39.23  following conditions have been met: 
 39.24     (a) The secretary of health, education, and welfare of the 
 39.25  United States has agreed, for the same project, to waive state 
 39.26  plan requirements relative to statewide uniformity. 
 39.27     (b) A comprehensive plan, including estimated project 
 39.28  costs, shall be approved by the legislative advisory commission 
 39.29  and filed with the commissioner of administration.  
 39.30     (13) According to federal requirements, establish 
 39.31  procedures to be followed by local welfare boards in creating 
 39.32  citizen advisory committees, including procedures for selection 
 39.33  of committee members. 
 39.34     (14) Allocate federal fiscal disallowances or sanctions 
 39.35  which are based on quality control error rates for the aid to 
 39.36  families with dependent children, Minnesota family investment 
 40.1   program-statewide, medical assistance, or food stamp program in 
 40.2   the following manner:  
 40.3      (a) One-half of the total amount of the disallowance shall 
 40.4   be borne by the county boards responsible for administering the 
 40.5   programs.  For the medical assistance, MFIP-S, and AFDC 
 40.6   programs, disallowances shall be shared by each county board in 
 40.7   the same proportion as that county's expenditures for the 
 40.8   sanctioned program are to the total of all counties' 
 40.9   expenditures for the AFDC, MFIP-S, and medical assistance 
 40.10  programs.  For the food stamp program, sanctions shall be shared 
 40.11  by each county board, with 50 percent of the sanction being 
 40.12  distributed to each county in the same proportion as that 
 40.13  county's administrative costs for food stamps are to the total 
 40.14  of all food stamp administrative costs for all counties, and 50 
 40.15  percent of the sanctions being distributed to each county in the 
 40.16  same proportion as that county's value of food stamp benefits 
 40.17  issued are to the total of all benefits issued for all 
 40.18  counties.  Each county shall pay its share of the disallowance 
 40.19  to the state of Minnesota.  When a county fails to pay the 
 40.20  amount due hereunder, the commissioner may deduct the amount 
 40.21  from reimbursement otherwise due the county, or the attorney 
 40.22  general, upon the request of the commissioner, may institute 
 40.23  civil action to recover the amount due. 
 40.24     (b) Notwithstanding the provisions of paragraph (a), if the 
 40.25  disallowance results from knowing noncompliance by one or more 
 40.26  counties with a specific program instruction, and that knowing 
 40.27  noncompliance is a matter of official county board record, the 
 40.28  commissioner may require payment or recover from the county or 
 40.29  counties, in the manner prescribed in paragraph (a), an amount 
 40.30  equal to the portion of the total disallowance which resulted 
 40.31  from the noncompliance, and may distribute the balance of the 
 40.32  disallowance according to paragraph (a).  
 40.33     (15) Develop and implement special projects that maximize 
 40.34  reimbursements and result in the recovery of money to the 
 40.35  state.  For the purpose of recovering state money, the 
 40.36  commissioner may enter into contracts with third parties.  Any 
 41.1   recoveries that result from projects or contracts entered into 
 41.2   under this paragraph shall be deposited in the state treasury 
 41.3   and credited to a special account until the balance in the 
 41.4   account reaches $1,000,000.  When the balance in the account 
 41.5   exceeds $1,000,000, the excess shall be transferred and credited 
 41.6   to the general fund.  All money in the account is appropriated 
 41.7   to the commissioner for the purposes of this paragraph. 
 41.8      (16) Have the authority to make direct payments to 
 41.9   facilities providing shelter to women and their children 
 41.10  according to section 256D.05, subdivision 3.  Upon the written 
 41.11  request of a shelter facility that has been denied payments 
 41.12  under section 256D.05, subdivision 3, the commissioner shall 
 41.13  review all relevant evidence and make a determination within 30 
 41.14  days of the request for review regarding issuance of direct 
 41.15  payments to the shelter facility.  Failure to act within 30 days 
 41.16  shall be considered a determination not to issue direct payments.
 41.17     (17) Have the authority to establish and enforce the 
 41.18  following county reporting requirements:  
 41.19     (a) The commissioner shall establish fiscal and statistical 
 41.20  reporting requirements necessary to account for the expenditure 
 41.21  of funds allocated to counties for human services programs.  
 41.22  When establishing financial and statistical reporting 
 41.23  requirements, the commissioner shall evaluate all reports, in 
 41.24  consultation with the counties, to determine if the reports can 
 41.25  be simplified or the number of reports can be reduced. 
 41.26     (b) The county board shall submit monthly or quarterly 
 41.27  reports to the department as required by the commissioner.  
 41.28  Monthly reports are due no later than 15 working days after the 
 41.29  end of the month.  Quarterly reports are due no later than 30 
 41.30  calendar days after the end of the quarter, unless the 
 41.31  commissioner determines that the deadline must be shortened to 
 41.32  20 calendar days to avoid jeopardizing compliance with federal 
 41.33  deadlines or risking a loss of federal funding.  Only reports 
 41.34  that are complete, legible, and in the required format shall be 
 41.35  accepted by the commissioner.  
 41.36     (c) If the required reports are not received by the 
 42.1   deadlines established in clause (b), the commissioner may delay 
 42.2   payments and withhold funds from the county board until the next 
 42.3   reporting period.  When the report is needed to account for the 
 42.4   use of federal funds and the late report results in a reduction 
 42.5   in federal funding, the commissioner shall withhold from the 
 42.6   county boards with late reports an amount equal to the reduction 
 42.7   in federal funding until full federal funding is received.  
 42.8      (d) A county board that submits reports that are late, 
 42.9   illegible, incomplete, or not in the required format for two out 
 42.10  of three consecutive reporting periods is considered 
 42.11  noncompliant.  When a county board is found to be noncompliant, 
 42.12  the commissioner shall notify the county board of the reason the 
 42.13  county board is considered noncompliant and request that the 
 42.14  county board develop a corrective action plan stating how the 
 42.15  county board plans to correct the problem.  The corrective 
 42.16  action plan must be submitted to the commissioner within 45 days 
 42.17  after the date the county board received notice of noncompliance.
 42.18     (e) The final deadline for fiscal reports or amendments to 
 42.19  fiscal reports is one year after the date the report was 
 42.20  originally due.  If the commissioner does not receive a report 
 42.21  by the final deadline, the county board forfeits the funding 
 42.22  associated with the report for that reporting period and the 
 42.23  county board must repay any funds associated with the report 
 42.24  received for that reporting period. 
 42.25     (f) The commissioner may not delay payments, withhold 
 42.26  funds, or require repayment under paragraph (c) or (e) if the 
 42.27  county demonstrates that the commissioner failed to provide 
 42.28  appropriate forms, guidelines, and technical assistance to 
 42.29  enable the county to comply with the requirements.  If the 
 42.30  county board disagrees with an action taken by the commissioner 
 42.31  under paragraph (c) or (e), the county board may appeal the 
 42.32  action according to sections 14.57 to 14.69. 
 42.33     (g) Counties subject to withholding of funds under 
 42.34  paragraph (c) or forfeiture or repayment of funds under 
 42.35  paragraph (e) shall not reduce or withhold benefits or services 
 42.36  to clients to cover costs incurred due to actions taken by the 
 43.1   commissioner under paragraph (c) or (e). 
 43.2      (18) Allocate federal fiscal disallowances or sanctions for 
 43.3   audit exceptions when federal fiscal disallowances or sanctions 
 43.4   are based on a statewide random sample for the foster care 
 43.5   program under title IV-E of the Social Security Act, United 
 43.6   States Code, title 42, in direct proportion to each county's 
 43.7   title IV-E foster care maintenance claim for that period. 
 43.8      (19) Be responsible for ensuring the detection, prevention, 
 43.9   investigation, and resolution of fraudulent activities or 
 43.10  behavior by applicants, recipients, and other participants in 
 43.11  the human services programs administered by the department. 
 43.12     (20) Require county agencies to identify overpayments, 
 43.13  establish claims, and utilize all available and cost-beneficial 
 43.14  methodologies to collect and recover these overpayments in the 
 43.15  human services programs administered by the department. 
 43.16     (21) Have the authority to administer a drug rebate program 
 43.17  for drugs purchased pursuant to the senior citizen drug program 
 43.18  established under section 256.955 after the beneficiary's 
 43.19  satisfaction of any deductible established in the program.  The 
 43.20  commissioner shall require a rebate agreement from all 
 43.21  manufacturers of covered drugs as defined in section 256B.0625, 
 43.22  subdivision 13.  For each drug, the amount of the rebate shall 
 43.23  be equal to the basic rebate as defined for purposes of the 
 43.24  federal rebate program in United States Code, title 42, section 
 43.25  1396r-8(c)(1).  This basic rebate shall be applied to 
 43.26  single-source and multiple-source drugs.  The manufacturers must 
 43.27  provide full payment within 30 days of receipt of the state 
 43.28  invoice for the rebate within the terms and conditions used for 
 43.29  the federal rebate program established pursuant to section 1927 
 43.30  of title XIX of the Social Security Act.  The manufacturers must 
 43.31  provide the commissioner with any information necessary to 
 43.32  verify the rebate determined per drug.  The rebate program shall 
 43.33  utilize the terms and conditions used for the federal rebate 
 43.34  program established pursuant to section 1927 of title XIX of the 
 43.35  Social Security Act. 
 43.36     (22) Operate the department's communication systems account 
 44.1   established in Laws 1993, First Special Session chapter 1, 
 44.2   article 1, section 2, subdivision 2, to manage shared 
 44.3   communication costs necessary for the operation of the programs 
 44.4   the commissioner supervises.  A communications account may also 
 44.5   be established for each regional treatment center which operates 
 44.6   communications systems.  Each account must be used to manage 
 44.7   shared communication costs necessary for the operations of the 
 44.8   programs the commissioner supervises.  The commissioner may 
 44.9   distribute the costs of operating and maintaining communication 
 44.10  systems to participants in a manner that reflects actual usage. 
 44.11  Costs may include acquisition, licensing, insurance, 
 44.12  maintenance, repair, staff time and other costs as determined by 
 44.13  the commissioner.  Nonprofit organizations and state, county, 
 44.14  and local government agencies involved in the operation of 
 44.15  programs the commissioner supervises may participate in the use 
 44.16  of the department's communications technology and share in the 
 44.17  cost of operation.  The commissioner may accept on behalf of the 
 44.18  state any gift, bequest, devise or personal property of any 
 44.19  kind, or money tendered to the state for any lawful purpose 
 44.20  pertaining to the communication activities of the department.  
 44.21  Any money received for this purpose must be deposited in the 
 44.22  department's communication systems accounts.  Money collected by 
 44.23  the commissioner for the use of communication systems must be 
 44.24  deposited in the state communication systems account, and is 
 44.25  appropriated to the commissioner for purposes of this section. 
 44.26     (23) Receive any federal matching money that is made 
 44.27  available through the medical assistance program for the 
 44.28  consumer satisfaction survey.  Any federal money received for 
 44.29  the survey is appropriated to the commissioner for this 
 44.30  purpose.  The commissioner may expend the federal money received 
 44.31  for the consumer satisfaction survey in either year of the 
 44.32  biennium. 
 44.33     (24) Incorporate cost reimbursement claims from First Call 
 44.34  Minnesota into the federal cost reimbursement claiming processes 
 44.35  of the department according to federal law, rule, and 
 44.36  regulations.  Any reimbursement received is appropriated to the 
 45.1   commissioner and shall be disbursed to First Call Minnesota 
 45.2   according to normal department payment schedules. 
 45.3      Sec. 17.  Minnesota Statutes 1998, section 256.01, is 
 45.4   amended by adding a subdivision to read: 
 45.5      Subd. 18.  [APPROPRIATION TRANSFERS TO BE REPORTED.] When 
 45.6   the commissioner transfers operational money between programs 
 45.7   under section 16A.285, in addition to the requirements of that 
 45.8   section the commissioner must provide the chairs of the 
 45.9   legislative committees that have jurisdiction over the agency's 
 45.10  budget with sufficient detail to identify the account to which 
 45.11  the money was originally appropriated, and the account to which 
 45.12  the money is being transferred. 
 45.13     Sec. 18.  Minnesota Statutes 1998, section 256.014, is 
 45.14  amended by adding a subdivision to read: 
 45.15     Subd. 4.  [ISSUANCE OPERATIONS CENTER.] Payments to the 
 45.16  commissioner from other governmental units and private 
 45.17  enterprises for:  services performed by the issuance operations 
 45.18  center; or reports generated by the payment and eligibility 
 45.19  systems must be deposited in the account created under 
 45.20  subdivision 2.  These payments are appropriated to the 
 45.21  commissioner for the operation of the issuance center or system, 
 45.22  according to the provisions of this section. 
 45.23     Sec. 19.  Minnesota Statutes 1998, section 256J.39, 
 45.24  subdivision 1, is amended to read: 
 45.25     Subdivision 1.  [PAYMENT POLICY.] The following policies 
 45.26  apply to monthly assistance payments and corrective payments: 
 45.27     (1) Grant payments may be issued in the form of warrants 
 45.28  immediately redeemable in cash, electronic benefits transfer, or 
 45.29  by direct deposit into the recipient's account in a financial 
 45.30  institution. 
 45.31     (2) The commissioner shall mail assistance payment checks 
 45.32  to the address where a caregiver lives unless the county agency 
 45.33  approves an alternate arrangement. 
 45.34     (3) The commissioner shall mail monthly assistance payment 
 45.35  checks within time to allow postal service delivery to occur no 
 45.36  later than the first day of each month.  Monthly assistance 
 46.1   payment checks must be dated the first day of the month.  The 
 46.2   commissioner shall issue electronic benefits transfer payments 
 46.3   so that caregivers have access to the payments no later than the 
 46.4   first of the month.  
 46.5      (4) The commissioner shall issue replacement checks 
 46.6   promptly, but no later than seven calendar days after the 
 46.7   provisions of sections 16A.46; 256.01, subdivision 11; and 
 46.8   471.415 have been met. 
 46.9      (5) The commissioner, with the advance approval of the 
 46.10  commissioner of finance, may issue cash assistance grant 
 46.11  payments up to three days before the first day of each month, 
 46.12  including three days before the start of each state fiscal 
 46.13  year.  Of the money appropriated for cash assistance grant 
 46.14  payments for each fiscal year, up to three percent of the annual 
 46.15  state appropriation is available to the commissioner in the 
 46.16  previous fiscal year.  If that amount is insufficient for the 
 46.17  costs incurred, an additional amount of the appropriation as 
 46.18  needed may be transferred with the advance approval of the 
 46.19  commissioner of finance. 
 46.20     Sec. 20. [REPEALER.] 
 46.21     Minnesota Statutes 1998, section 256J.03, is repealed 
 46.22  effective July 2, 1999.  Section 13, sunset of uncodified 
 46.23  language, does not apply to this section. 
 46.24     Sec. 21.  [EFFECTIVE DATE.] 
 46.25     Section 19 is effective the day following final enactment. 
 46.26                             ARTICLE 2 
 46.27                         HEALTH DEPARTMENT 
 46.28     Section 1.  Minnesota Statutes 1998, section 15.059, 
 46.29  subdivision 5a, is amended to read: 
 46.30     Subd. 5a.  [LATER EXPIRATION.] Notwithstanding subdivision 
 46.31  5, the advisory councils and committees listed in this 
 46.32  subdivision do not expire June 30, 1997.  These groups expire 
 46.33  June 30, 2001, unless the law creating the group or this 
 46.34  subdivision specifies an earlier expiration date. 
 46.35     Investment advisory council, created in section 11A.08; 
 46.36     Intergovernmental information systems advisory council, 
 47.1   created in section 16B.42, expires June 30, 1999; 
 47.2      Feedlot and manure management advisory committee, created 
 47.3   in section 17.136; 
 47.4      Aquaculture advisory committee, created in section 17.49; 
 47.5      Dairy producers board, created in section 17.76; 
 47.6      Pesticide applicator education and examination review 
 47.7   board, created in section 18B.305; 
 47.8      Advisory seed potato certification task force, created in 
 47.9   section 21.112; 
 47.10     Food safety advisory committee, created in section 28A.20; 
 47.11     Minnesota organic advisory task force, created in section 
 47.12  31.95; 
 47.13     Public programs risk adjustment work group, created in 
 47.14  section 62Q.03, expires June 30, 1999; 
 47.15     Workers' compensation self-insurers' advisory committee, 
 47.16  created in section 79A.02; 
 47.17     Youth corps advisory committee, created in section 84.0887; 
 47.18     Iron range off-highway vehicle advisory committee, created 
 47.19  in section 85.013; 
 47.20     Mineral coordinating committee, created in section 93.002; 
 47.21     Game and fish fund citizen advisory committees, created in 
 47.22  section 97A.055; 
 47.23     Wetland heritage advisory committee, created in section 
 47.24  103G.2242; 
 47.25     Wastewater treatment technical advisory committee, created 
 47.26  in section 115.54; 
 47.27     Solid waste management advisory council, created in section 
 47.28  115A.12; 
 47.29     Nuclear waste council, created in section 116C.711; 
 47.30     Genetically engineered organism advisory committee, created 
 47.31  in section 116C.93; 
 47.32     Environment and natural resources trust fund advisory 
 47.33  committee, created in section 116P.06; 
 47.34     Child abuse prevention advisory council, created in section 
 47.35  119A.13; 
 47.36     Chemical abuse and violence prevention council, created in 
 48.1   section 119A.27; 
 48.2      Youth neighborhood services advisory board, created in 
 48.3   section 119A.29; 
 48.4      Interagency coordinating council, created in section 
 48.5   125A.28, expires June 30, 1999; 
 48.6      Desegregation/integration advisory board, created in 
 48.7   section 124D.892; 
 48.8      Nonpublic education council, created in section 123B.445; 
 48.9      Permanent school fund advisory committee, created in 
 48.10  section 127A.30; 
 48.11     Indian scholarship committee, created in section 124D.84, 
 48.12  subdivision 2; 
 48.13     American Indian education committees, created in section 
 48.14  124D.80; 
 48.15     Summer scholarship advisory committee, created in section 
 48.16  124D.95; 
 48.17     Multicultural education advisory committee, created in 
 48.18  section 124D.894; 
 48.19     Male responsibility and fathering grants review committee, 
 48.20  created in section 124D.33; 
 48.21     Library for the blind and physically handicapped advisory 
 48.22  committee, created in section 134.31; 
 48.23     Higher education advisory council, created in section 
 48.24  136A.031; 
 48.25     Student advisory council, created in section 136A.031; 
 48.26     Cancer surveillance advisory committee, created in section 
 48.27  144.672; 
 48.28     Maternal and child health task force, created in section 
 48.29  145.881; 
 48.30     State community health advisory committee, created in 
 48.31  section 145A.10; 
 48.32     Mississippi River Parkway commission, created in section 
 48.33  161.1419; 
 48.34     School bus safety advisory committee, created in section 
 48.35  169.435; 
 48.36     Advisory council on workers' compensation, created in 
 49.1   section 175.007; 
 49.2      Code enforcement advisory council, created in section 
 49.3   175.008; 
 49.4      Medical services review board, created in section 176.103; 
 49.5      Apprenticeship advisory council, created in section 178.02; 
 49.6      OSHA advisory council, created in section 182.656; 
 49.7      Health professionals services program advisory committee, 
 49.8   created in section 214.32; 
 49.9      Rehabilitation advisory council for the blind, created in 
 49.10  section 248.10; 
 49.11     American Indian advisory council, created in section 
 49.12  254A.035; 
 49.13     Alcohol and other drug abuse advisory council, created in 
 49.14  section 254A.04; 
 49.15     Medical assistance drug formulary committee, created in 
 49.16  section 256B.0625; 
 49.17     Home care advisory committee, created in section 256B.071; 
 49.18     Preadmission screening, alternative care, and home and 
 49.19  community-based services advisory committee, created in section 
 49.20  256B.0911; 
 49.21     Traumatic brain injury advisory committee, created in 
 49.22  section 256B.093; 
 49.23     Minnesota commission serving deaf and hard-of-hearing 
 49.24  people, created in section 256C.28; 
 49.25     American Indian child welfare advisory council, created in 
 49.26  section 257.3579; 
 49.27     Juvenile justice advisory committee, created in section 
 49.28  268.29; 
 49.29     Northeast Minnesota economic development fund technical 
 49.30  advisory committees, created in section 298.2213; 
 49.31     Iron range higher education committee, created in section 
 49.32  298.2214; 
 49.33     Northeast Minnesota economic protection trust fund 
 49.34  technical advisory committee, created in section 298.297; 
 49.35     Pipeline safety advisory committee, created in section 
 49.36  299J.06, expires June 30, 1998; 
 50.1      Battered women's advisory council, created in section 
 50.2   611A.34. 
 50.3      Sec. 2.  Minnesota Statutes 1998, section 62J.04, 
 50.4   subdivision 3, is amended to read: 
 50.5      Subd. 3.  [COST CONTAINMENT DUTIES.] After obtaining the 
 50.6   advice and recommendations of the Minnesota health care 
 50.7   commission, The commissioner shall: 
 50.8      (1) establish statewide and regional cost containment goals 
 50.9   for total health care spending under this section and collect 
 50.10  data as described in sections 62J.38 to 62J.41 to monitor 
 50.11  statewide achievement of the cost containment goals; 
 50.12     (2) divide the state into no fewer than four regions, with 
 50.13  one of those regions being the Minneapolis/St. Paul metropolitan 
 50.14  statistical area but excluding Chisago, Isanti, Wright, and 
 50.15  Sherburne counties, for purposes of fostering the development of 
 50.16  regional health planning and coordination of health care 
 50.17  delivery among regional health care systems and working to 
 50.18  achieve the cost containment goals; 
 50.19     (3) provide technical assistance to regional coordinating 
 50.20  boards; 
 50.21     (4) monitor the quality of health care throughout the state 
 50.22  and take action as necessary to ensure an appropriate level of 
 50.23  quality; 
 50.24     (5) (4) issue recommendations regarding uniform billing 
 50.25  forms, uniform electronic billing procedures and data 
 50.26  interchanges, patient identification cards, and other uniform 
 50.27  claims and administrative procedures for health care providers 
 50.28  and private and public sector payers.  In developing the 
 50.29  recommendations, the commissioner shall review the work of the 
 50.30  work group on electronic data interchange (WEDI) and the 
 50.31  American National Standards Institute (ANSI) at the national 
 50.32  level, and the work being done at the state and local level.  
 50.33  The commissioner may adopt rules requiring the use of the 
 50.34  Uniform Bill 82/92 form, the National Council of Prescription 
 50.35  Drug Providers (NCPDP) 3.2 electronic version, the Health Care 
 50.36  Financing Administration 1500 form, or other standardized forms 
 51.1   or procedures; 
 51.2      (6) (5) undertake health planning responsibilities as 
 51.3   provided in section 62J.15; 
 51.4      (7) (6) authorize, fund, or promote research and 
 51.5   experimentation on new technologies and health care procedures; 
 51.6      (8) (7) within the limits of appropriations for these 
 51.7   purposes, administer or contract for statewide consumer 
 51.8   education and wellness programs that will improve the health of 
 51.9   Minnesotans and increase individual responsibility relating to 
 51.10  personal health and the delivery of health care services, 
 51.11  undertake prevention programs including initiatives to improve 
 51.12  birth outcomes, expand childhood immunization efforts, and 
 51.13  provide start-up grants for worksite wellness programs; 
 51.14     (9) (8) undertake other activities to monitor and oversee 
 51.15  the delivery of health care services in Minnesota with the goal 
 51.16  of improving affordability, quality, and accessibility of health 
 51.17  care for all Minnesotans; and 
 51.18     (10) (9) make the cost containment goal data available to 
 51.19  the public in a consumer-oriented manner. 
 51.20     Sec. 3.  Minnesota Statutes 1998, section 62J.06, is 
 51.21  amended to read: 
 51.22     62J.06 [IMMUNITY FROM LIABILITY.] 
 51.23     No member of the regional coordinating boards established 
 51.24  under section 62J.09, or the health technology advisory 
 51.25  committee established under section 62J.15, shall be held 
 51.26  civilly or criminally liable for an act or omission by that 
 51.27  person if the act or omission was in good faith and within the 
 51.28  scope of the member's responsibilities under this chapter.  
 51.29     Sec. 4.  Minnesota Statutes 1998, section 62J.07, 
 51.30  subdivision 1, is amended to read: 
 51.31     Subdivision 1.  [LEGISLATIVE OVERSIGHT.] The legislative 
 51.32  commission on health care access reviews the activities of the 
 51.33  commissioner of health, the regional coordinating boards, the 
 51.34  health technology advisory committee, and all other state 
 51.35  agencies involved in the implementation and administration of 
 51.36  this chapter, including efforts to obtain federal approval 
 52.1   through waivers and other means.  
 52.2      Sec. 5.  Minnesota Statutes 1998, section 62J.07, 
 52.3   subdivision 3, is amended to read: 
 52.4      Subd. 3.  [REPORTS TO THE COMMISSION.] The commissioner of 
 52.5   health, the regional coordinating boards, and the health 
 52.6   technology advisory committee shall report on their activities 
 52.7   annually and at other times at the request of the legislative 
 52.8   commission on health care access.  The commissioners of health, 
 52.9   commerce, and human services shall provide periodic reports to 
 52.10  the legislative commission on the progress of rulemaking that is 
 52.11  authorized or required under this chapter and shall notify 
 52.12  members of the commission when a draft of a proposed rule has 
 52.13  been completed and scheduled for publication in the State 
 52.14  Register.  At the request of a member of the commission, a 
 52.15  commissioner shall provide a description and a copy of a 
 52.16  proposed rule. 
 52.17     Sec. 6.  Minnesota Statutes 1998, section 62J.09, 
 52.18  subdivision 8, is amended to read: 
 52.19     Subd. 8.  [REPEALER.] This section is repealed effective 
 52.20  July 1, 2000 1999. 
 52.21     Sec. 7.  Minnesota Statutes 1998, section 62J.2930, 
 52.22  subdivision 3, is amended to read: 
 52.23     Subd. 3.  [CONSUMER INFORMATION.] The information 
 52.24  clearinghouse or another entity designated by the commissioner 
 52.25  shall provide consumer information to health plan company 
 52.26  enrollees to: 
 52.27     (1) assist enrollees in understanding their rights; 
 52.28     (2) explain and assist in the use of all available 
 52.29  complaint systems, including internal complaint systems within 
 52.30  health carriers, community integrated service networks, and the 
 52.31  departments of health and commerce; 
 52.32     (3) provide information on coverage options in each 
 52.33  regional coordinating board region of the state; 
 52.34     (4) provide information on the availability of purchasing 
 52.35  pools and enrollee subsidies; and 
 52.36     (5) help consumers use the health care system to obtain 
 53.1   coverage. 
 53.2      The information clearinghouse or other entity designated by 
 53.3   the commissioner for the purposes of this subdivision shall not: 
 53.4      (1) provide legal services to consumers; 
 53.5      (2) represent a consumer or enrollee; or 
 53.6      (3) serve as an advocate for consumers in disputes with 
 53.7   health plan companies.  
 53.8   Nothing in this subdivision shall interfere with the ombudsman 
 53.9   program established under section 256B.031, subdivision 6, or 
 53.10  other existing ombudsman programs. 
 53.11     Sec. 8.  [62J.535] [UNIFORM BILLING REQUIREMENTS.] 
 53.12     Subdivision 1.  [DEVELOPMENT OF UNIFORM BILLING 
 53.13  TRANSACTIONS.] The commissioner of health, after consultation 
 53.14  with the commissioner of commerce, shall adopt uniform billing 
 53.15  standards that comply with United States Code, title 42, 
 53.16  sections 1320d to 1320d-8, as amended from time to time.  The 
 53.17  uniform billing standards shall apply to all paper and 
 53.18  electronic claim transactions and shall apply to all Minnesota 
 53.19  payers, including government programs.  
 53.20     Subd. 2.  [COMPLIANCE.] (a) Concurrent with the effective 
 53.21  dates established under United States Code, title 42, sections 
 53.22  1320d to 1320d-8, as amended from time to time, for uniform 
 53.23  electronic billing standards, all health care providers must 
 53.24  conform to the uniform billing standards developed under 
 53.25  subdivision 1. 
 53.26     (b) Notwithstanding paragraph (a), the requirements for the 
 53.27  uniform remittance advice report shall be effective 12 months 
 53.28  after the date of the required compliance of the standards for 
 53.29  the electronic remittance advice transaction are effective under 
 53.30  United States Code, title 42, sections 1320d to 1320d-8, as 
 53.31  amended from time to time. 
 53.32     Sec. 9.  [62J.691] [PURPOSE.] 
 53.33     The legislature finds that medical education and research 
 53.34  are important to the health and economic well being of 
 53.35  Minnesotans.  The legislature further finds that, as a result of 
 53.36  competition in the health care marketplace, these teaching and 
 54.1   research institutions are facing increased difficulty funding 
 54.2   medical education and research.  The purpose of sections 62J.692 
 54.3   and 62J.693 is to help offset lost patient care revenue for 
 54.4   those teaching institutions affected by increased competition in 
 54.5   the health care marketplace and to help ensure the continued 
 54.6   excellence of health care research in Minnesota. 
 54.7      Sec. 10.  [62J.692] [MEDICAL EDUCATION.] 
 54.8      Subdivision 1.  [DEFINITIONS.] For purposes of this 
 54.9   section, the following definitions apply: 
 54.10     (a) "Accredited clinical training" means the clinical 
 54.11  training provided by a medical education program that is 
 54.12  accredited through an organization recognized by the department 
 54.13  of education or the health care financing administration as the 
 54.14  official accrediting body for that program. 
 54.15     (b) "Commissioner" means the commissioner of health. 
 54.16     (c) "Clinical medical education program" means the 
 54.17  accredited clinical training of physicians (medical students and 
 54.18  residents), doctor of pharmacy practitioners, doctors of 
 54.19  chiropractic, dentists, advanced practice nurses (clinical nurse 
 54.20  specialists, certified registered nurse anesthetists, nurse 
 54.21  practitioners, and certified nurse midwives), and physician 
 54.22  assistants. 
 54.23     (d) "Sponsoring institution" means a hospital, school, or 
 54.24  consortium located in Minnesota that sponsors and maintains 
 54.25  primary organizational and financial responsibility for a 
 54.26  clinical medical education program in Minnesota and which is 
 54.27  accountable to the accrediting body. 
 54.28     (e) "Teaching institution" means a hospital, medical 
 54.29  center, clinic, or other organization that conducts a clinical 
 54.30  medical education program in Minnesota. 
 54.31     (f) "Trainee" means a student or resident involved in a 
 54.32  clinical medical education program.  
 54.33     (g) "Eligible trainee FTEs" means the number of trainees, 
 54.34  as measured by full-time equivalent counts, that are at training 
 54.35  sites located in Minnesota with a medical assistance provider 
 54.36  number where training occurs in either an inpatient or 
 55.1   ambulatory patient care setting and where the training is 
 55.2   funded, in part, by patient care revenues. 
 55.3      Subd. 2.  [MEDICAL EDUCATION AND RESEARCH ADVISORY 
 55.4   COMMITTEE.] The commissioner shall appoint an advisory committee 
 55.5   to provide advice and oversight on the distribution of funds 
 55.6   appropriated for distribution under this section.  In appointing 
 55.7   the members, the commissioner shall:  
 55.8      (1) consider the interest of all stakeholders; 
 55.9      (2) appoint members that represent both urban and rural 
 55.10  interests; and 
 55.11     (3) appoint members that represent ambulatory care as well 
 55.12  as inpatient perspectives.  
 55.13  The commissioner shall appoint to the advisory committee 
 55.14  representatives of the following groups to ensure appropriate 
 55.15  representation of all eligible provider groups and other 
 55.16  stakeholders:  public and private medical researchers; public 
 55.17  and private academic medical centers, including representatives 
 55.18  from academic centers offering accredited training programs for 
 55.19  physicians, pharmacists, chiropractors, dentists, nurses, and 
 55.20  physician assistants; managed care organizations; employers; 
 55.21  consumers and other relevant stakeholders.  The advisory 
 55.22  committee is governed by section 15.059 for membership terms and 
 55.23  removal of members and expires on June 30, 2001. 
 55.24     Subd. 3.  [APPLICATION PROCESS.] (a) A clinical medical 
 55.25  education program conducted in Minnesota by a teaching 
 55.26  institution is eligible for funds under subdivision 4 if the 
 55.27  program: 
 55.28     (1) is funded, in part, by patient care revenues; 
 55.29     (2) occurs in patient care settings that face increased 
 55.30  financial pressure as a result of competition with nonteaching 
 55.31  patient care entities; and 
 55.32     (3) emphasizes primary care or specialties that are in 
 55.33  undersupply in Minnesota. 
 55.34     (b) Applications must be submitted to the commissioner by a 
 55.35  sponsoring institution on behalf of an eligible clinical medical 
 55.36  education program and must be received by September 30 of each 
 56.1   year for distribution in the following year.  An application for 
 56.2   funds must contain the following information: 
 56.3      (1) the official name and address of the sponsoring 
 56.4   institution and the official name and site address of the 
 56.5   clinical medical education programs on whose behalf the 
 56.6   sponsoring institution is applying; 
 56.7      (2) the name, title, and business address of those persons 
 56.8   responsible for administering the funds; 
 56.9      (3) for each clinical medical education program for which 
 56.10  funds are being sought; the type and specialty orientation of 
 56.11  trainees in the program; the name, site address, and medical 
 56.12  assistance provider number of each training site used in the 
 56.13  program; the total number of trainees at each training site; and 
 56.14  the total number of eligible trainee FTEs at each site; 
 56.15     (4) audited clinical training costs per trainee for each 
 56.16  clinical medical education program where available or estimates 
 56.17  of clinical training costs based on audited financial data; 
 56.18     (5) a description of current sources of funding for 
 56.19  clinical medical education costs, including a description and 
 56.20  dollar amount of all state and federal financial support, 
 56.21  including Medicare direct and indirect payments; 
 56.22     (6) other revenue received for the purposes of clinical 
 56.23  training; and 
 56.24     (7) other supporting information the commissioner deems 
 56.25  necessary to determine program eligibility based on the criteria 
 56.26  in paragraph (a) and to ensure the equitable distribution of 
 56.27  funds.  
 56.28     (c) An applicant that does not provide information 
 56.29  requested by the commissioner shall not be eligible for funds 
 56.30  for the current funding cycle. 
 56.31     Subd. 4.  [DISTRIBUTION OF FUNDS.] (a) The commissioner 
 56.32  shall annually distribute medical education funds to all 
 56.33  qualifying applicants based on the following criteria:  
 56.34     (1) total medical education funds available for 
 56.35  distribution; 
 56.36     (2) total number of eligible trainee FTEs in each clinical 
 57.1   medical education program; and 
 57.2      (3) the statewide average cost per trainee, by type of 
 57.3   trainee, in each clinical medical education program.  
 57.4      (b) Funds distributed shall not be used to displace current 
 57.5   funding appropriations from federal or state sources.  
 57.6      (c) Funds shall be distributed to the sponsoring 
 57.7   institutions indicating the amount to be distributed to each of 
 57.8   the sponsor's clinical medical education programs based on the 
 57.9   criteria in this subdivision and in accordance with the 
 57.10  commissioner's approval letter.  Each clinical medical education 
 57.11  program must distribute funds to the training sites as specified 
 57.12  in the commissioner's approval letter.  Sponsoring institutions, 
 57.13  which are accredited through an organization recognized by the 
 57.14  department of education or the health care financing 
 57.15  administration, may contract directly with training sites to 
 57.16  provide clinical training.  To ensure the quality of clinical 
 57.17  training, those accredited sponsoring institutions must: 
 57.18     (1) develop contracts specifying the terms, expectations, 
 57.19  and outcomes of the clinical training conducted at sites; and 
 57.20     (2) take necessary action if the contract requirements are 
 57.21  not met.  Action may include the withholding of payments under 
 57.22  this section or the removal of students from the site.  
 57.23     (d) Any funds not distributed in accordance with the 
 57.24  commissioner's approval letter must be returned to the medical 
 57.25  education and research fund within 30 days of receiving notice 
 57.26  from the commissioner.  The commissioner shall distribute 
 57.27  returned funds to the appropriate training sites in accordance 
 57.28  with the commissioner's approval letter. 
 57.29     Subd. 5.  [REPORT.] (a) Sponsoring institutions receiving 
 57.30  funds under this section must sign and submit a medical 
 57.31  education grant verification report (GVR) to verify that the 
 57.32  correct grant amount was forwarded to each eligible training 
 57.33  site.  If the sponsoring institution fails to submit the GVR by 
 57.34  the stated deadline, or to request and meet the deadline for an 
 57.35  extension, the sponsoring institution is required to return the 
 57.36  full amount of funds received to the commissioner within 30 days 
 58.1   of receiving notice from the commissioner.  The commissioner 
 58.2   shall distribute returned funds to the appropriate training 
 58.3   sites in accordance with the commissioner's approval letter.  
 58.4      (b) The reports must provide verification of the 
 58.5   distribution of the funds and must include:  
 58.6      (1) the total number of eligible trainee FTEs in each 
 58.7   clinical medical education program; 
 58.8      (2) the name of each funded program and, for each program, 
 58.9   the dollar amount distributed to each training site; 
 58.10     (3) documentation of any discrepancies between the initial 
 58.11  grant distribution notice included in the commissioner's 
 58.12  approval letter and the actual distribution; 
 58.13     (4) a statement by the sponsoring institution stating that 
 58.14  the completed grant verification report is valid and accurate; 
 58.15  and 
 58.16     (5) other information the commissioner, with advice from 
 58.17  the advisory committee, deems appropriate to evaluate the 
 58.18  effectiveness of the use of funds for medical education.  
 58.19     (c) By February 15 of each year, the commissioner, with 
 58.20  advice from the advisory committee, shall provide an annual 
 58.21  summary report to the legislature on the implementation of this 
 58.22  section. 
 58.23     Subd. 6.  [OTHER AVAILABLE FUNDS.] The commissioner is 
 58.24  authorized to distribute, in accordance with subdivision 4, 
 58.25  funds made available through: 
 58.26     (1) voluntary contributions by employers or other entities; 
 58.27     (2) allocations for the commissioner of human services to 
 58.28  support medical education and research; and 
 58.29     (3) other sources as identified and deemed appropriate by 
 58.30  the legislature for inclusion in the fund. 
 58.31     Subd. 7.  [TRANSFERS FROM THE COMMISSIONER OF HUMAN 
 58.32  SERVICES.] (a) The amount transferred according to section 
 58.33  256B.69, subdivision 5c, shall be distributed by the 
 58.34  commissioner to clinical medical education programs that meet 
 58.35  the qualifications of subdivision 3 based on a distribution 
 58.36  formula that reflects a summation of two factors: 
 59.1      (1) an education factor, which is determined by the total 
 59.2   number of eligible trainee FTEs and the total statewide average 
 59.3   costs per trainee, by type of trainee, in each clinical medical 
 59.4   education program; and 
 59.5      (2) a public program volume factor, which is determined by 
 59.6   the total volume of public program revenue received by each 
 59.7   training site as a percentage of all public program revenue 
 59.8   received by all training sites in the fund pool created under 
 59.9   this subdivision.  
 59.10     In this formula, the education factor shall be weighted at 
 59.11  50 percent and the public program volume factor shall be 
 59.12  weighted at 50 percent. 
 59.13     (b) Public program revenue for the formula in paragraph (a) 
 59.14  shall include revenue from medical assistance, prepaid medical 
 59.15  assistance, general assistance medical care, and prepaid general 
 59.16  assistance medical care. 
 59.17     (c) Training sites that receive no public program revenue 
 59.18  shall be ineligible for funds available under this subdivision.  
 59.19     Subd. 8.  [FEDERAL FINANCIAL PARTICIPATION.] The 
 59.20  commissioner of human services shall seek to maximize federal 
 59.21  financial participation in payments for medical education and 
 59.22  research costs.  If the commissioner of human services 
 59.23  determines that federal financial participation is available for 
 59.24  the medical education and research, the commissioner of health 
 59.25  shall transfer to the commissioner of human services the amount 
 59.26  of state funds necessary to maximize the federal funds 
 59.27  available.  The amount transferred to the commissioner of human 
 59.28  services, plus the amount of federal financial participation, 
 59.29  shall be distributed to medical assistance providers in 
 59.30  accordance with the distribution methodology described in 
 59.31  subdivision 4. 
 59.32     Subd. 9.  [REVIEW OF ELIGIBLE PROVIDERS.] The commissioner 
 59.33  and the medical education and research costs advisory committee 
 59.34  may review provider groups included in the definition of a 
 59.35  clinical medical education program to assure that the 
 59.36  distribution of the funds continue to be consistent with the 
 60.1   purpose of this section.  The results of any such reviews must 
 60.2   be reported to the legislative commission on health care access. 
 60.3      Sec. 11.  [62J.693] [MEDICAL RESEARCH.] 
 60.4      Subdivision 1.  [DEFINITIONS.] For purposes of this 
 60.5   section, health care research means approved clinical, outcomes, 
 60.6   and health services investigations.  
 60.7      Subd. 2.  [GRANT APPLICATION PROCESS.] (a) The commissioner 
 60.8   of health shall make recommendations for a process for the 
 60.9   submission, review, and approval of research grant 
 60.10  applications.  The process shall give priority for grants to 
 60.11  applications that are intended to gather preliminary data for 
 60.12  submission for a subsequent proposal for funding from a federal 
 60.13  agency or foundation, which awards research money on a 
 60.14  competitive, peer-reviewed basis.  Grant recipients must be able 
 60.15  to demonstrate the ability to comply with federal regulations on 
 60.16  human subjects research in accordance with Code of Federal 
 60.17  Regulations, title 45, section 46, and shall conduct the 
 60.18  proposed research.  Grants may be awarded to the University of 
 60.19  Minnesota, the Mayo clinic, or any other public or private 
 60.20  organization in the state involved in medical research.  The 
 60.21  commissioner shall report to the legislature by January 15, 
 60.22  2000, with recommendations.  
 60.23     (b) The commissioner may consult with the medical education 
 60.24  and research advisory committee established in section 62J.692 
 60.25  in developing these recommendations or may appoint a research 
 60.26  advisory committee to provide advice and oversight on the grant 
 60.27  application process.  If the commissioner appoints a research 
 60.28  advisory committee, the committee shall be governed by section 
 60.29  15.059 for membership terms and removal of members.  
 60.30     Sec. 12.  Minnesota Statutes 1998, section 62Q.03, 
 60.31  subdivision 5a, is amended to read: 
 60.32     Subd. 5a.  [PUBLIC PROGRAMS.] (a) A separate risk 
 60.33  adjustment system must be developed for state-run public 
 60.34  programs, including medical assistance, general assistance 
 60.35  medical care, and MinnesotaCare.  The system must be developed 
 60.36  in accordance with the general risk adjustment methodologies 
 61.1   described in this section, must include factors in addition to 
 61.2   age and sex adjustment, and may include additional demographic 
 61.3   factors, different targeted conditions, and/or different payment 
 61.4   amounts for conditions.  The risk adjustment system for public 
 61.5   programs must attempt to reflect the special needs related to 
 61.6   poverty, cultural, or language barriers and other needs of the 
 61.7   public program population. 
 61.8      (b) The commissioners of health and human services shall 
 61.9   jointly convene a public programs risk adjustment work group 
 61.10  responsible for advising the commissioners in the design of the 
 61.11  public programs risk adjustment system.  The public programs 
 61.12  risk adjustment work group is governed by section 15.059 for 
 61.13  purposes of membership terms, expiration, and removal of members 
 61.14  and shall terminate on June 30, 1999.  The work group shall meet 
 61.15  at the discretion of the commissioners of health and human 
 61.16  services. The commissioner of health shall work with the risk 
 61.17  adjustment association to ensure coordination between the risk 
 61.18  adjustment systems for the public and private sectors.  The 
 61.19  commissioner of human services shall seek any needed federal 
 61.20  approvals necessary for the inclusion of the medical assistance 
 61.21  program in the public programs risk adjustment system.  
 61.22     (c) The public programs risk adjustment work group must be 
 61.23  representative of the persons served by publicly paid health 
 61.24  programs and providers and health plans that meet their needs.  
 61.25  To the greatest extent possible, the appointing authorities 
 61.26  shall attempt to select representatives that have historically 
 61.27  served a significant number of persons in publicly paid health 
 61.28  programs or the uninsured.  Membership of the work group shall 
 61.29  be as follows: 
 61.30     (1) one provider member appointed by the Minnesota Medical 
 61.31  Association; 
 61.32     (2) two provider members appointed by the Minnesota 
 61.33  Hospital Association, at least one of whom must represent a 
 61.34  major disproportionate share hospital; 
 61.35     (3) five members appointed by the Minnesota Council of 
 61.36  HMOs, one of whom must represent an HMO with fewer than 50,000 
 62.1   enrollees located outside the metropolitan area and one of whom 
 62.2   must represent an HMO with at least 50 percent of total 
 62.3   membership enrolled through a public program; 
 62.4      (4) two representatives of counties appointed by the 
 62.5   Association of Minnesota Counties; 
 62.6      (5) three representatives of organizations representing the 
 62.7   interests of families, children, childless adults, and elderly 
 62.8   persons served by the various publicly paid health programs 
 62.9   appointed by the governor; 
 62.10     (6) two representatives of persons with mental health, 
 62.11  developmental or physical disabilities, chemical dependency, or 
 62.12  chronic illness appointed by the governor; and 
 62.13     (7) three public members appointed by the governor, at 
 62.14  least one of whom must represent a community health board.  The 
 62.15  risk adjustment association may appoint a representative, if a 
 62.16  representative is not otherwise appointed by an appointing 
 62.17  authority. 
 62.18     (d) The commissioners of health and human services, with 
 62.19  the advice of the public programs risk adjustment work group, 
 62.20  shall develop a work plan and time frame and shall coordinate 
 62.21  their efforts with the private sector risk adjustment 
 62.22  association's activities and other state initiatives related to 
 62.23  public program managed care reimbursement. 
 62.24     (e) Before including risk adjustment in a contract for the 
 62.25  prepaid medical assistance program, the prepaid general 
 62.26  assistance medical care program, or the MinnesotaCare program, 
 62.27  the commissioner of human services shall provide to the 
 62.28  contractor an analysis of the expected impact on the contractor 
 62.29  of the implementation of risk adjustment.  This analysis may be 
 62.30  limited by the available data and resources, as determined by 
 62.31  the commissioner, and shall not be binding on future contract 
 62.32  periods.  This paragraph shall not apply if the contractor has 
 62.33  not supplied information to the commissioner related to the risk 
 62.34  adjustment analysis. 
 62.35     (f) The commissioner of human services shall report to the 
 62.36  public program risk adjustment work group on the methodology the 
 63.1   department will use for risk adjustment prior to implementation 
 63.2   of the risk adjustment payment methodology.  Upon completion of 
 63.3   the report to the work group, the commissioner shall phase in 
 63.4   risk adjustment according to the following schedule: 
 63.5      (1) for the first contract year, no more than ten percent 
 63.6   of reimbursements shall be risk adjusted; and 
 63.7      (2) for the second contract year, no more than 30 percent 
 63.8   of reimbursements shall be risk adjusted. 
 63.9      Sec. 13.  Minnesota Statutes 1998, section 62Q.075, is 
 63.10  amended to read: 
 63.11     62Q.075 [LOCAL PUBLIC ACCOUNTABILITY AND COLLABORATION 
 63.12  PLAN.] 
 63.13     Subdivision 1.  [DEFINITION.] For purposes of this section, 
 63.14  "managed care organization" means a health maintenance 
 63.15  organization or community integrated service network. 
 63.16     Subd. 2.  [REQUIREMENT.] Beginning October 31, 1997, all 
 63.17  managed care organizations shall file biennially with the action 
 63.18  plans required under section 62Q.07 a plan describing the 
 63.19  actions the managed care organization has taken and those it 
 63.20  intends to take to contribute to achieving public health goals 
 63.21  for each service area in which an enrollee of the managed care 
 63.22  organization resides.  This plan must be jointly developed in 
 63.23  collaboration with the local public health units, appropriate 
 63.24  regional coordinating boards, and other community organizations 
 63.25  providing health services within the same service area as the 
 63.26  managed care organization.  Local government units with 
 63.27  responsibilities and authority defined under chapters 145A and 
 63.28  256E may designate individuals to participate in the 
 63.29  collaborative planning with the managed care organization to 
 63.30  provide expertise and represent community needs and goals as 
 63.31  identified under chapters 145A and 256E. 
 63.32     Subd. 3.  [CONTENTS.] The plan must address the following: 
 63.33     (a) specific measurement strategies and a description of 
 63.34  any activities which contribute to public health goals and needs 
 63.35  of high risk and special needs populations as defined and 
 63.36  developed under chapters 145A and 256E; 
 64.1      (b) description of the process by which the managed care 
 64.2   organization will coordinate its activities with the community 
 64.3   health boards, regional coordinating boards, and other relevant 
 64.4   community organizations servicing the same area; 
 64.5      (c) documentation indicating that local public health units 
 64.6   and local government unit designees were involved in the 
 64.7   development of the plan; 
 64.8      (d) documentation of compliance with the plan filed the 
 64.9   previous year, including data on the previously identified 
 64.10  progress measures. 
 64.11     Subd. 4.  [REVIEW.] Upon receipt of the plan, the 
 64.12  appropriate commissioner shall provide a copy to the regional 
 64.13  coordinating boards, local community health boards, and other 
 64.14  relevant community organizations within the managed care 
 64.15  organization's service area.  After reviewing the plan, these 
 64.16  community groups may submit written comments on the plan to 
 64.17  either the commissioner of health or commerce, as applicable, 
 64.18  and may advise the commissioner of the managed care 
 64.19  organization's effectiveness in assisting to achieve regional 
 64.20  public health goals.  The plan may be reviewed by the county 
 64.21  boards, or city councils acting as a local board of health in 
 64.22  accordance with chapter 145A, within the managed care 
 64.23  organization's service area to determine whether the plan is 
 64.24  consistent with the goals and objectives of the plans required 
 64.25  under chapters 145A and 256E and whether the plan meets the 
 64.26  needs of the community.  The county board, or applicable city 
 64.27  council, may also review and make recommendations on the 
 64.28  availability and accessibility of services provided by the 
 64.29  managed care organization.  The county board, or applicable city 
 64.30  council, may submit written comments to the appropriate 
 64.31  commissioner, and may advise the commissioner of the managed 
 64.32  care organization's effectiveness in assisting to meet the needs 
 64.33  and goals as defined under the responsibilities of chapters 145A 
 64.34  and 256E.  The commissioner of health shall develop 
 64.35  recommendations to utilize the written comments submitted as 
 64.36  part of the licensure process to ensure local public 
 65.1   accountability.  These recommendations shall be reported to the 
 65.2   legislative commission on health care access by January 15, 
 65.3   1996.  Copies of these written comments must be provided to the 
 65.4   managed care organization.  The plan and any comments submitted 
 65.5   must be filed with the information clearinghouse to be 
 65.6   distributed to the public. 
 65.7      Sec. 14.  Minnesota Statutes 1998, section 62R.06, 
 65.8   subdivision 1, is amended to read: 
 65.9      Subdivision 1.  [PROVIDER CONTRACTS.] A health provider 
 65.10  cooperative and its licensed members may execute marketing and 
 65.11  service contracts requiring the provider members to provide some 
 65.12  or all of their health care services through the provider 
 65.13  cooperative to the enrollees, members, subscribers, or insureds, 
 65.14  of a health care network cooperative, community integrated 
 65.15  service network, nonprofit health service plan, health 
 65.16  maintenance organization, accident and health insurance company, 
 65.17  or any other purchaser, including the state of Minnesota and its 
 65.18  agencies, instruments, or units of local government.  Each 
 65.19  purchasing entity is authorized to execute contracts for the 
 65.20  purchase of health care services from a health provider 
 65.21  cooperative in accordance with this section.  Any A contract 
 65.22  between a provider cooperative and a purchaser must may provide 
 65.23  for payment by the purchaser to the health provider cooperative 
 65.24  on a substantially capitated or similar risk-sharing basis, by 
 65.25  fee-for-service arrangements, or by other financial arrangements 
 65.26  authorized under state law.  Each contract between a provider 
 65.27  cooperative and a purchaser shall be filed by the provider 
 65.28  network cooperative with the commissioner of health and is 
 65.29  subject to the provisions of section 62D.19. 
 65.30     Sec. 15.  Minnesota Statutes 1998, section 144.065, is 
 65.31  amended to read: 
 65.32     144.065 [VENEREAL DISEASE TREATMENT CENTERS PREVENTION AND 
 65.33  TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS.] 
 65.34     The state commissioner of health shall assist local health 
 65.35  agencies and organizations throughout the state with the 
 65.36  development and maintenance of services for the detection and 
 66.1   treatment of venereal diseases sexually transmitted infections.  
 66.2   These services shall provide for research, screening and 
 66.3   diagnosis, treatment, case finding, investigation, and the 
 66.4   dissemination of appropriate educational information.  The state 
 66.5   commissioner of health shall promulgate rules relative to 
 66.6   determine the composition of such services and shall establish a 
 66.7   method of providing funds to local health agencies boards of 
 66.8   health as defined in section 145A.02, subdivision 2, state 
 66.9   agencies, state councils, and organizations nonprofit 
 66.10  corporations, which offer such services.  The state commissioner 
 66.11  of health shall provide technical assistance to such agencies 
 66.12  and organizations in accordance with the needs of the local 
 66.13  area.  Planning and implementation of services, and technical 
 66.14  assistance may be conducted in collaboration with boards of 
 66.15  health; state agencies, including the University of Minnesota 
 66.16  and the department of children, families, and learning; state 
 66.17  councils; nonprofit organizations; and representatives of 
 66.18  affected populations.  
 66.19     Sec. 16.  [144.1201] [DEFINITIONS.] 
 66.20     Subdivision 1.  [APPLICABILITY.] For purposes of sections 
 66.21  144.1201 to 144.1204, the terms defined in this section have the 
 66.22  meanings given to them. 
 66.23     Subd. 2.  [BY-PRODUCT NUCLEAR MATERIAL.] "By-product 
 66.24  nuclear material" means a radioactive material, other than 
 66.25  special nuclear material, yielded in or made radioactive by 
 66.26  exposure to radiation created incident to the process of 
 66.27  producing or utilizing special nuclear material. 
 66.28     Subd. 3.  [RADIATION.] "Radiation" means ionizing radiation 
 66.29  and includes alpha rays; beta rays; gamma rays; x-rays; high 
 66.30  energy neutrons, protons, or electrons; and other atomic 
 66.31  particles. 
 66.32     Subd. 4.  [RADIOACTIVE MATERIAL.] "Radioactive material" 
 66.33  means a matter that emits radiation.  Radioactive material 
 66.34  includes special nuclear material, source nuclear material, and 
 66.35  by-product nuclear material. 
 66.36     Subd. 5.  [SOURCE NUCLEAR MATERIAL.] "Source nuclear 
 67.1   material" means uranium or thorium, or a combination thereof, in 
 67.2   any physical or chemical form; or ores that contain by weight 
 67.3   1/20 of one percent (0.05 percent) or more of uranium, thorium, 
 67.4   or a combination thereof.  Source nuclear material does not 
 67.5   include special nuclear material. 
 67.6      Subd. 6.  [SPECIAL NUCLEAR MATERIAL.] "Special nuclear 
 67.7   material" means: 
 67.8      (1) plutonium, uranium enriched in the isotope 233 or in 
 67.9   the isotope 235, and any other material that the Nuclear 
 67.10  Regulatory Commission determines to be special nuclear material 
 67.11  according to United States Code, title 42, section 2071, except 
 67.12  that source nuclear material is not included; and 
 67.13     (2) a material artificially enriched by any of the 
 67.14  materials listed in clause (1), except that source nuclear 
 67.15  material is not included. 
 67.16     Sec. 17.  [144.1202] [UNITED STATES NUCLEAR REGULATORY 
 67.17  COMMISSION AGREEMENT.] 
 67.18     Subdivision 1.  [AGREEMENT AUTHORIZED.] In order to have a 
 67.19  comprehensive program to protect the public from radiation 
 67.20  hazards, the governor, on behalf of the state, is authorized to 
 67.21  enter into agreements with the United States Nuclear Regulatory 
 67.22  Commission under the Atomic Energy Act of 1954, section 274b, as 
 67.23  amended.  The agreement shall provide for the discontinuance of 
 67.24  portions of the Nuclear Regulatory Commission's licensing and 
 67.25  related regulatory authority over by-product, source, and 
 67.26  special nuclear materials, and the assumption of regulatory 
 67.27  authority over these materials by the state. 
 67.28     Subd. 2.  [HEALTH DEPARTMENT DESIGNATED LEAD.] The 
 67.29  department of health is designated as the lead agency to pursue 
 67.30  an agreement on behalf of the governor and for any assumption of 
 67.31  specified licensing and regulatory authority from the Nuclear 
 67.32  Regulatory Commission under an agreement with the commission.  
 67.33  The commissioner of health shall establish an advisory group to 
 67.34  assist in preparing the state to meet the requirements for 
 67.35  reaching an agreement.  The commissioner may adopt rules to 
 67.36  allow the state to assume regulatory authority under an 
 68.1   agreement under this section, including the licensing and 
 68.2   regulation of radioactive materials.  Any regulatory authority 
 68.3   assumed by the state includes the ability to set and collect 
 68.4   fees. 
 68.5      Subd. 3.  [TRANSITION.] A person who, on the effective date 
 68.6   of an agreement under this section, possesses a Nuclear 
 68.7   Regulatory Commission license that is subject to the agreement 
 68.8   is deemed to possess a similar license issued by the department 
 68.9   of health.  A department of health license obtained under this 
 68.10  subdivision expires on the expiration date specified in the 
 68.11  federal license. 
 68.12     Subd. 4.  [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 
 68.13  agreement entered into before August 2, 2002, must remain in 
 68.14  effect until terminated under the Atomic Energy Act of 1954, 
 68.15  United States Code, title 42, section 2021, paragraph (j).  The 
 68.16  governor may not enter into an initial agreement with the 
 68.17  Nuclear Regulatory Commission after August 1, 2002.  If an 
 68.18  agreement is not entered into by August 1, 2002, any rules 
 68.19  adopted under this section are repealed effective August 1, 2002.
 68.20     (b) An agreement authorized under subdivision 1 must be 
 68.21  approved by law before it may be implemented. 
 68.22     Sec. 18.  [144.1203] [TRAINING; RULEMAKING.] 
 68.23     The commissioner shall adopt rules to ensure that 
 68.24  individuals handling or utilizing radioactive materials under 
 68.25  the terms of a license issued by the commissioner under section 
 68.26  144.1202 have proper training and qualifications to do so.  The 
 68.27  rules adopted must be at least as stringent as federal 
 68.28  regulations on proper training and qualifications adopted by the 
 68.29  Nuclear Regulatory Commission.  Rules adopted under this section 
 68.30  may incorporate federal regulations by reference. 
 68.31     Sec. 19.  [144.1204] [SURETY REQUIREMENTS.] 
 68.32     Subdivision 1.  [FINANCIAL ASSURANCE REQUIRED.] The 
 68.33  commissioner may require an applicant for a license under 
 68.34  section 144.1202, or a person who was formerly licensed by the 
 68.35  Nuclear Regulatory Commission and is now subject to sections 
 68.36  144.1201 to 144.1204, to post financial assurances to ensure the 
 69.1   completion of all requirements established by the commissioner 
 69.2   for the decontamination, closure, decommissioning, and 
 69.3   reclamation of sites, structures, and equipment used in 
 69.4   conjunction with activities related to licensure.  The financial 
 69.5   assurances posted must be sufficient to restore the site to 
 69.6   unrestricted future use and must be sufficient to provide for 
 69.7   surveillance and care when radioactive materials remain at the 
 69.8   site after the licensed activities cease.  The commissioner may 
 69.9   establish financial assurance criteria by rule.  In establishing 
 69.10  such criteria, the commissioner may consider: 
 69.11     (1) the chemical and physical form of the licensed 
 69.12  radioactive material; 
 69.13     (2) the quantity of radioactive material authorized; 
 69.14     (3) the particular radioisotopes authorized and their 
 69.15  subsequent radiotoxicity; 
 69.16     (4) the method in which the radioactive material is held, 
 69.17  used, stored, processed, transferred, or disposed of; and 
 69.18     (5) the potential costs of decontamination, treatment, or 
 69.19  disposal of a licensee's equipment and facilities. 
 69.20     Subd. 2.  [ACCEPTABLE FINANCIAL ASSURANCES.] The 
 69.21  commissioner may, by rule, establish types of financial 
 69.22  assurances that meet the requirements of this section.  Such 
 69.23  financial assurances may include bank letters of credit, 
 69.24  deposits of cash, or deposits of government securities. 
 69.25     Subd. 3.  [TRUST AGREEMENTS.] Financial assurances must be 
 69.26  established together with trust agreements.  Both the financial 
 69.27  assurances and the trust agreements must be in a form and 
 69.28  substance that meet requirements established by the commissioner.
 69.29     Subd. 4.  [EXEMPTIONS.] The commissioner is authorized to 
 69.30  exempt from the requirements of this section, by rule, any 
 69.31  category of licensee upon a determination by the commissioner 
 69.32  that an exemption does not result in a significant risk to the 
 69.33  public health or safety or to the environment and does not pose 
 69.34  a financial risk to the state. 
 69.35     Subd. 5.  [OTHER REMEDIES UNAFFECTED.] Nothing in this 
 69.36  section relieves a licensee of a civil liability incurred, nor 
 70.1   may this section be construed to relieve the licensee of 
 70.2   obligations to prevent or mitigate the consequences of improper 
 70.3   handling or abandonment of radioactive materials. 
 70.4      Sec. 20.  Minnesota Statutes 1998, section 144.121, is 
 70.5   amended by adding a subdivision to read: 
 70.6      Subd. 8.  [EXEMPTION FROM EXAMINATION REQUIREMENTS; 
 70.7   OPERATORS OF CERTAIN BONE DENSITOMETERS.] (a) This subdivision 
 70.8   applies to a bone densitometer that is used on humans to 
 70.9   estimate bone mineral content and bone mineral density in a 
 70.10  region of a finger on a person's nondominant hand, gives an 
 70.11  x-ray dose equivalent of less than 0.001 microsieverts per scan, 
 70.12  and has an x-ray leakage exposure rate of less than two 
 70.13  milliroentgens per hour at a distance of one meter, provided 
 70.14  that the bone densitometer is operating in accordance with 
 70.15  manufacturer specifications. 
 70.16     (b) An individual who operates a bone densitometer that 
 70.17  satisfies the definition in paragraph (a) and the facility in 
 70.18  which an individual operates such a bone densitometer are exempt 
 70.19  from the requirements of subdivisions 5 and 6. 
 70.20     Sec. 21.  Minnesota Statutes 1998, section 144.148, is 
 70.21  amended to read: 
 70.22     144.148 [RURAL HOSPITAL CAPITAL IMPROVEMENT GRANT AND LOAN 
 70.23  PROGRAM.] 
 70.24     Subdivision 1.  [DEFINITION.] (a) For purposes of this 
 70.25  section, the following definitions apply. 
 70.26     (b) "Eligible rural hospital" means a any nonfederal, 
 70.27  general acute care hospital that: 
 70.28     (1) is either located in a rural area, as defined in the 
 70.29  federal Medicare regulations, Code of Federal Regulations, title 
 70.30  42, section 405.1041, or located in a community with a 
 70.31  population of less than 5,000, according to United States Census 
 70.32  Bureau Statistics, outside the seven-county metropolitan area; 
 70.33     (2) has 50 or fewer licensed hospital beds with a net 
 70.34  hospital operating margin not greater than two percent in the 
 70.35  two fiscal years prior to application; and 
 70.36     (3) is 25 miles or more from another hospital not for 
 71.1   profit. 
 71.2      (c) "Eligible project" means a modernization project to 
 71.3   update, remodel, or replace aging hospital facilities and 
 71.4   equipment necessary to maintain the operations of a hospital. 
 71.5      Subd. 2.  [PROGRAM.] The commissioner of health shall award 
 71.6   rural hospital capital improvement grants or loans to eligible 
 71.7   rural hospitals.  A grant or loan shall not exceed 
 71.8   $1,500,000 $300,000 per hospital.  Grants or loans shall be 
 71.9   interest free.  An eligible rural hospital may apply the funds 
 71.10  retroactively to capital improvements made during the two fiscal 
 71.11  years preceding the fiscal year in which the grant or loan was 
 71.12  received, provided the hospital met the eligibility criteria 
 71.13  during that time period Prior to the receipt of any grant, the 
 71.14  hospital must certify to the commissioner that at least 
 71.15  one-quarter of the grant amount, which may include in-kind 
 71.16  services, is available for the same purposes from nonstate 
 71.17  resources.  
 71.18     Subd. 3.  [APPLICATIONS.] Eligible hospitals seeking a 
 71.19  grant or loan shall apply to the commissioner.  Applications 
 71.20  must include a description of the problem that the proposed 
 71.21  project will address, a description of the project including 
 71.22  construction and remodeling drawings or specifications, sources 
 71.23  of funds for the project, uses of funds for the project, the 
 71.24  results expected, and a plan to maintain or operate any facility 
 71.25  or equipment included in the project.  The applicant must 
 71.26  describe achievable objectives, a timetable, and roles and 
 71.27  capabilities of responsible individuals and organization.  
 71.28  Applicants must submit to the commissioner evidence that 
 71.29  competitive bidding was used to select contractors for the 
 71.30  project.  
 71.31     Subd. 4.  [CONSIDERATION OF APPLICATIONS.] The commissioner 
 71.32  shall review each application to determine whether or not the 
 71.33  hospital's application is complete and whether the hospital and 
 71.34  the project are eligible for a grant or loan.  In evaluating 
 71.35  applications, the commissioner shall score each application on a 
 71.36  100 point scale, assigning:  a maximum of 40 points for an 
 72.1   applicant's clarity and thoroughness in describing the problem 
 72.2   and the project; a maximum of 40 points for the extent to which 
 72.3   the applicant has demonstrated that it has made adequate 
 72.4   provisions to assure proper and efficient operation of the 
 72.5   facility once the project is completed; and a maximum of 20 
 72.6   points for the extent to which the proposed project is 
 72.7   consistent with the hospital's capital improvement plan or 
 72.8   strategic plan.  The commissioner may also take into account 
 72.9   other relevant factors.  During application review, the 
 72.10  commissioner may request additional information about a proposed 
 72.11  project, including information on project cost.  Failure to 
 72.12  provide the information requested disqualifies a loan an 
 72.13  applicant. 
 72.14     Subd. 5.  [PROGRAM OVERSIGHT.] The commissioner of health 
 72.15  shall review audited financial information of the hospital to 
 72.16  assess eligibility.  The commissioner shall determine the amount 
 72.17  of a grant or loan to be given to an eligible rural hospital 
 72.18  based on the relative score of each eligible hospital's 
 72.19  application and the funds available to the commissioner.  The 
 72.20  grant or loan shall be used to update, remodel, or replace aging 
 72.21  facilities and equipment necessary to maintain the operations of 
 72.22  the hospital.  The commissioner may collect, from the hospitals 
 72.23  receiving grants, any information necessary to evaluate the 
 72.24  program.  
 72.25     Subd. 6.  [LOAN PAYMENT.] Loans shall be repaid as provided 
 72.26  in this subdivision over a period of 15 years.  In those years 
 72.27  when an eligible rural hospital experiences a positive net 
 72.28  operating margin in excess of two percent, the eligible rural 
 72.29  hospital shall pay to the state one-half of the excess above two 
 72.30  percent, up to the yearly payment amount based upon a loan 
 72.31  period of 15 years.  If the amount paid back in any year is less 
 72.32  than the yearly payment amount, or if no payment is required 
 72.33  because the eligible rural hospital does not experience a 
 72.34  positive net operating margin in excess of two percent, the 
 72.35  amount unpaid for that year shall be forgiven by the state 
 72.36  without any financial penalty.  As a condition of receiving an 
 73.1   award through this program, eligible hospitals must agree to any 
 73.2   and all collection activities the commissioner finds necessary 
 73.3   to collect loan payments in those years a payment is due. 
 73.4      Subd. 7.  [ACCOUNTING TREATMENT.] The commissioner of 
 73.5   finance shall record as grants in the state accounting system 
 73.6   funds obligated by this section.  Loan payments received under 
 73.7   this section shall be deposited in the health care access fund. 
 73.8      Subd. 8.  [EXPIRATION.] This section expires June 30, 
 73.9   1999 2001. 
 73.10     Sec. 22.  Minnesota Statutes 1998, section 144.1483, is 
 73.11  amended to read: 
 73.12     144.1483 [RURAL HEALTH INITIATIVES.] 
 73.13     The commissioner of health, through the office of rural 
 73.14  health, and consulting as necessary with the commissioner of 
 73.15  human services, the commissioner of commerce, the higher 
 73.16  education services office, and other state agencies, shall: 
 73.17     (1) develop a detailed plan regarding the feasibility of 
 73.18  coordinating rural health care services by organizing individual 
 73.19  medical providers and smaller hospitals and clinics into 
 73.20  referral networks with larger rural hospitals and clinics that 
 73.21  provide a broader array of services; 
 73.22     (2) develop and implement a program to assist rural 
 73.23  communities in establishing community health centers, as 
 73.24  required by section 144.1486; 
 73.25     (3) administer the program of financial assistance 
 73.26  established under section 144.1484 for rural hospitals in 
 73.27  isolated areas of the state that are in danger of closing 
 73.28  without financial assistance, and that have exhausted local 
 73.29  sources of support; 
 73.30     (4) develop recommendations regarding health education and 
 73.31  training programs in rural areas, including but not limited to a 
 73.32  physician assistants' training program, continuing education 
 73.33  programs for rural health care providers, and rural outreach 
 73.34  programs for nurse practitioners within existing training 
 73.35  programs; 
 73.36     (5) develop a statewide, coordinated recruitment strategy 
 74.1   for health care personnel and maintain a database on health care 
 74.2   personnel as required under section 144.1485; 
 74.3      (6) develop and administer technical assistance programs to 
 74.4   assist rural communities in:  (i) planning and coordinating the 
 74.5   delivery of local health care services; and (ii) hiring 
 74.6   physicians, nurse practitioners, public health nurses, physician 
 74.7   assistants, and other health personnel; 
 74.8      (7) study and recommend changes in the regulation of health 
 74.9   care personnel, such as nurse practitioners and physician 
 74.10  assistants, related to scope of practice, the amount of on-site 
 74.11  physician supervision, and dispensing of medication, to address 
 74.12  rural health personnel shortages; 
 74.13     (8) support efforts to ensure continued funding for medical 
 74.14  and nursing education programs that will increase the number of 
 74.15  health professionals serving in rural areas; 
 74.16     (9) support efforts to secure higher reimbursement for 
 74.17  rural health care providers from the Medicare and medical 
 74.18  assistance programs; 
 74.19     (10) coordinate the development of a statewide plan for 
 74.20  emergency medical services, in cooperation with the emergency 
 74.21  medical services advisory council; 
 74.22     (11) establish a Medicare rural hospital flexibility 
 74.23  program pursuant to section 1820 of the federal Social Security 
 74.24  Act, United States Code, title 42, section 1395i-4, by 
 74.25  developing a state rural health plan and designating, consistent 
 74.26  with the rural health plan, rural nonprofit or public hospitals 
 74.27  in the state as critical access hospitals.  Critical access 
 74.28  hospitals shall include facilities that are certified by the 
 74.29  state as necessary providers of health care services to 
 74.30  residents in the area.  Necessary providers of health care 
 74.31  services are designated as critical access hospitals on the 
 74.32  basis of being more than 20 miles, defined as official mileage 
 74.33  as reported by the Minnesota department of transportation, from 
 74.34  the next nearest hospital or being the sole hospital in the 
 74.35  county or being a hospital located in a designated medical 
 74.36  underserved area or health professional shortage area.  A 
 75.1   critical access hospital located in a designated medical 
 75.2   underserved area or a health professional shortage area shall 
 75.3   continue to be recognized as a critical access hospital in the 
 75.4   event the medical underserved area or health professional 
 75.5   shortage area designation is subsequently withdrawn; and 
 75.6      (12) carry out other activities necessary to address rural 
 75.7   health problems. 
 75.8      Sec. 23.  Minnesota Statutes 1998, section 144.1492, 
 75.9   subdivision 3, is amended to read: 
 75.10     Subd. 3.  [ELIGIBLE APPLICANTS AND CRITERIA FOR AWARDING OF 
 75.11  GRANTS TO RURAL COMMUNITIES.] (a) Funding which the department 
 75.12  receives to award grants to rural communities to establish 
 75.13  health care networks shall be awarded through a request for 
 75.14  proposals process.  Planning grant funds may be used for 
 75.15  community facilitation and initial network development 
 75.16  activities including incorporation as a nonprofit organization 
 75.17  or cooperative, assessment of network models, and determination 
 75.18  of the best fit for the community.  Implementation grant funds 
 75.19  can be used to enable incorporated nonprofit organizations and 
 75.20  cooperatives to purchase technical services needed for further 
 75.21  network development such as legal, actuarial, financial, 
 75.22  marketing, and administrative services. 
 75.23     (b) In order to be eligible to apply for a planning or 
 75.24  implementation grant under the federally funded health care 
 75.25  network reform program, an organization must be located in a 
 75.26  rural area of Minnesota excluding the seven-county Twin Cities 
 75.27  metropolitan area and the census-defined urbanized areas of 
 75.28  Duluth, Rochester, St. Cloud, and Moorhead.  The proposed 
 75.29  network organization must also meet or plan to meet the criteria 
 75.30  for a community integrated service network. 
 75.31     (c) In determining which organizations will receive grants, 
 75.32  the commissioner may consider the following factors: 
 75.33     (1) the applicant's description of their plans for health 
 75.34  care network development, their need for technical assistance, 
 75.35  and other technical assistance resources available to the 
 75.36  applicant.  The applicant must clearly describe the service area 
 76.1   to be served by the network, how the grant funds will be used, 
 76.2   what will be accomplished, and the expected results.  The 
 76.3   applicant should describe achievable objectives, a timetable, 
 76.4   and roles and capabilities of responsible individuals and 
 76.5   organizations; 
 76.6      (2) the extent of community support for the applicant and 
 76.7   the health care network.  The applicant should demonstrate 
 76.8   support from private and public health care providers in the 
 76.9   service area, and local community and government leaders, and 
 76.10  the regional coordinating board for the area.  Evidence of such 
 76.11  support may include a commitment of financial support, in-kind 
 76.12  services, or cash, for development of the network; 
 76.13     (3) the size and demographic characteristics of the 
 76.14  population in the service area for the proposed network and the 
 76.15  distance of the service area from the nearest metropolitan area; 
 76.16  and 
 76.17     (4) the technical assistance resources available to the 
 76.18  applicant from nonstate sources and the financial ability of the 
 76.19  applicant to purchase technical assistance services with 
 76.20  nonstate funds. 
 76.21     Sec. 24.  Minnesota Statutes 1998, section 144.413, 
 76.22  subdivision 2, is amended to read: 
 76.23     Subd. 2.  [PUBLIC PLACE.] "Public place" means any 
 76.24  enclosed, indoor area used by the general public or serving as a 
 76.25  place of work, including, but not limited to, restaurants, 
 76.26  retail stores, offices and other commercial establishments, 
 76.27  public conveyances, educational facilities other than public 
 76.28  schools, as defined in section 120A.05, subdivision subdivisions 
 76.29  9, 11, and 13, hospitals, nursing homes, auditoriums, arenas, 
 76.30  meeting rooms, and common areas of rental apartment buildings, 
 76.31  but excluding private, enclosed offices occupied exclusively by 
 76.32  smokers even though such offices may be visited by nonsmokers. 
 76.33     Sec. 25.  Minnesota Statutes 1998, section 144.414, 
 76.34  subdivision 1, is amended to read: 
 76.35     Subdivision 1.  [PUBLIC PLACES.] No person shall smoke in a 
 76.36  public place or at a public meeting except in designated smoking 
 77.1   areas.  This prohibition does not apply in cases in which an 
 77.2   entire room or hall is used for a private social function and 
 77.3   seating arrangements are under the control of the sponsor of the 
 77.4   function and not of the proprietor or person in charge of the 
 77.5   place.  Furthermore, this prohibition shall not apply to 
 77.6   factories, warehouses, and similar places of work not usually 
 77.7   frequented by the general public, except that the state 
 77.8   commissioner of health shall establish rules to restrict or 
 77.9   prohibit smoking in factories, warehouses, and those places of 
 77.10  work where the close proximity of workers or the inadequacy of 
 77.11  ventilation causes smoke pollution detrimental to the health and 
 77.12  comfort of nonsmoking employees.  
 77.13     Sec. 26.  Minnesota Statutes 1998, section 144.4165, is 
 77.14  amended to read: 
 77.15     144.4165 [TOBACCO PRODUCTS PROHIBITED IN PUBLIC SCHOOLS.] 
 77.16     No person shall at any time smoke, chew, or otherwise 
 77.17  ingest tobacco or a tobacco product in a public school, as 
 77.18  defined in section 120A.05, subdivision subdivisions 9, 11, and 
 77.19  13.  This prohibition extends to all facilities, whether owned, 
 77.20  rented, or leased, and all vehicles that a school district owns, 
 77.21  leases, rents, contracts for, or controls.  Nothing in this 
 77.22  section shall prohibit the lighting of tobacco by an adult as a 
 77.23  part of a traditional Indian spiritual or cultural ceremony.  
 77.24  For purposes of this section, an Indian is a person who is a 
 77.25  member of an Indian tribe as defined in section 257.351, 
 77.26  subdivision 9. 
 77.27     Sec. 27.  Minnesota Statutes 1998, section 144.56, 
 77.28  subdivision 2b, is amended to read: 
 77.29     Subd. 2b.  [BOARDING CARE HOMES.] The commissioner shall 
 77.30  not adopt or enforce any rule that limits: 
 77.31     (1) a certified boarding care home from providing nursing 
 77.32  services in accordance with the home's Medicaid certification; 
 77.33  or 
 77.34     (2) a noncertified boarding care home registered under 
 77.35  chapter 144D from providing home care services in accordance 
 77.36  with the home's registration. 
 78.1      Sec. 28.  Minnesota Statutes 1998, section 144.99, 
 78.2   subdivision 1, is amended to read: 
 78.3      Subdivision 1.  [REMEDIES AVAILABLE.] The provisions of 
 78.4   chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 
 78.5   subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 
 78.6   (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 
 78.7   144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 
 78.8   144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 
 78.9   to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 
 78.10  rules, orders, stipulation agreements, settlements, compliance 
 78.11  agreements, licenses, registrations, certificates, and permits 
 78.12  adopted or issued by the department or under any other law now 
 78.13  in force or later enacted for the preservation of public health 
 78.14  may, in addition to provisions in other statutes, be enforced 
 78.15  under this section. 
 78.16     Sec. 29.  Minnesota Statutes 1998, section 144.99, is 
 78.17  amended by adding a subdivision to read: 
 78.18     Subd. 12.  [SECURING RADIOACTIVE MATERIALS.] (a) In the 
 78.19  event of an emergency that poses a danger to the public health, 
 78.20  the commissioner shall have the authority to impound radioactive 
 78.21  materials and the associated shielding in the possession of a 
 78.22  person who fails to abide by the provisions of the statutes, 
 78.23  rules, and any other item listed in subdivision 1.  If 
 78.24  impounding the source of these materials is impractical, the 
 78.25  commissioner shall have the authority to lock or otherwise 
 78.26  secure a facility that contains the source of such materials, 
 78.27  but only the portions of the facility as is necessary to protect 
 78.28  the public health.  An action taken under this paragraph is 
 78.29  effective for up to 72 hours.  The commissioner must seek an 
 78.30  injunction or take other administrative action to secure 
 78.31  radioactive materials beyond the initial 72-hour period. 
 78.32     (b) The commissioner may release impounded radioactive 
 78.33  materials and the associated shielding to the owner of the 
 78.34  radioactive materials and associated shielding, upon terms and 
 78.35  conditions that are in accordance with the provisions of 
 78.36  statutes, rules, and other items listed in subdivision 1.  In 
 79.1   the alternative, the commissioner may bring an action in a court 
 79.2   of competent jurisdiction for an order directing the disposal of 
 79.3   impounded radioactive materials and associated shielding or 
 79.4   directing other disposition as necessary to protect the public 
 79.5   health and safety and the environment.  The costs of 
 79.6   decontamination, transportation, burial, disposal, or other 
 79.7   disposition shall be borne by the owner or licensee of the 
 79.8   radioactive materials and shielding or by any other person who 
 79.9   has used the radioactive materials and shielding for business 
 79.10  purposes. 
 79.11     Sec. 30.  Minnesota Statutes 1998, section 144A.4605, 
 79.12  subdivision 2, is amended to read: 
 79.13     Subd. 2.  [ASSISTED LIVING HOME CARE LICENSE ESTABLISHED.] 
 79.14  A home care provider license category entitled assisted living 
 79.15  home care provider is hereby established.  A home care provider 
 79.16  may obtain an assisted living license if the program meets the 
 79.17  following requirements: 
 79.18     (a) nursing services, delegated nursing services, other 
 79.19  services performed by unlicensed personnel, or central storage 
 79.20  of medications under the assisted living license are provided 
 79.21  solely for residents of one or more housing with services 
 79.22  establishments registered under chapter 144D; 
 79.23     (b) unlicensed personnel perform home health aide and home 
 79.24  care aide tasks identified in Minnesota Rules, parts 4668.0100, 
 79.25  subparts 1 and 2, and 4668.0110, subpart 1.  Qualifications to 
 79.26  perform these tasks shall be established in accordance with 
 79.27  subdivision 3; 
 79.28     (c) periodic supervision of unlicensed personnel is 
 79.29  provided as required by rule; 
 79.30     (d) notwithstanding Minnesota Rules, part 4668.0160, 
 79.31  subpart 6, item D, client records shall include: 
 79.32     (1) daily records or a weekly summary of the client's 
 79.33  status and home care services provided; 
 79.34     (2) documentation each time medications are administered to 
 79.35  a client; and 
 79.36     (3) documentation on the day of occurrence of any 
 80.1   significant change in the client's status or any significant 
 80.2   incident, such as a fall or refusal to take medications. 
 80.3      All entries must be signed by the staff providing the 
 80.4   services and entered into the record no later than two weeks 
 80.5   after the end of the service day, except as specified in clauses 
 80.6   (2) and (3); 
 80.7      (e) medication and treatment orders, if any, are included 
 80.8   in the client record and are renewed at least every 12 months, 
 80.9   or more frequently when indicated by a clinical assessment; 
 80.10     (f) the central storage of medications in a housing with 
 80.11  services establishment registered under chapter 144D is managed 
 80.12  under a system that is established by a registered nurse and 
 80.13  addresses the control of medications, handling of medications, 
 80.14  medication containers, medication records, and disposition of 
 80.15  medications; and 
 80.16     (g) in other respects meets the requirements established by 
 80.17  rules adopted under sections 144A.45 to 144A.48. 
 80.18     Sec. 31.  Minnesota Statutes 1998, section 145.924, is 
 80.19  amended to read: 
 80.20     145.924 [AIDS PREVENTION GRANTS.] 
 80.21     (a) The commissioner may award grants to boards of health 
 80.22  as defined in section 145A.02, subdivision 2, state agencies, 
 80.23  state councils, or nonprofit corporations to provide evaluation 
 80.24  and counseling services to populations at risk for acquiring 
 80.25  human immunodeficiency virus infection, including, but not 
 80.26  limited to, minorities, adolescents, intravenous drug users, and 
 80.27  homosexual men. 
 80.28     (b) The commissioner may award grants to agencies 
 80.29  experienced in providing services to communities of color, for 
 80.30  the design of innovative outreach and education programs for 
 80.31  targeted groups within the community who may be at risk of 
 80.32  acquiring the human immunodeficiency virus infection, including 
 80.33  intravenous drug users and their partners, adolescents, gay and 
 80.34  bisexual individuals and women.  Grants shall be awarded on a 
 80.35  request for proposal basis and shall include funds for 
 80.36  administrative costs.  Priority for grants shall be given to 
 81.1   agencies or organizations that have experience in providing 
 81.2   service to the particular community which the grantee proposes 
 81.3   to serve; that have policymakers representative of the targeted 
 81.4   population; that have experience in dealing with issues relating 
 81.5   to HIV/AIDS; and that have the capacity to deal effectively with 
 81.6   persons of differing sexual orientations.  For purposes of this 
 81.7   paragraph, the "communities of color" are:  the American-Indian 
 81.8   community; the Hispanic community; the African-American 
 81.9   community; and the Asian-Pacific community. 
 81.10     (c) All state grants awarded under this section for 
 81.11  programs targeted to adolescents shall include the promotion of 
 81.12  abstinence from sexual activity and drug use. 
 81.13     Sec. 32.  Minnesota Statutes 1998, section 145.9255, 
 81.14  subdivision 1, is amended to read: 
 81.15     Subdivision 1.  [ESTABLISHMENT.] The commissioner of 
 81.16  health, in consultation with a representative from Minnesota 
 81.17  planning, the commissioner of human services, and the 
 81.18  commissioner of children, families, and learning, shall develop 
 81.19  and implement the Minnesota education now and babies later (MN 
 81.20  ENABL) program, targeted to adolescents ages 12 to 14, with the 
 81.21  goal of reducing the incidence of adolescent pregnancy in the 
 81.22  state and promoting abstinence until marriage.  The program must 
 81.23  provide a multifaceted, primary prevention, community health 
 81.24  promotion approach to educating and supporting adolescents in 
 81.25  the decision to postpone sexual involvement modeled after the 
 81.26  ENABL program in California.  The commissioner of health shall 
 81.27  consult with the chief of the health education section of the 
 81.28  California department of health services for general guidance in 
 81.29  developing and implementing the program. 
 81.30     Sec. 33.  Minnesota Statutes 1998, section 145.9255, 
 81.31  subdivision 4, is amended to read: 
 81.32     Subd. 4.  [PROGRAM COMPONENTS.] The program must include 
 81.33  the following four major components: 
 81.34     (a) A community organization component in which the 
 81.35  community-based local contractors shall include: 
 81.36     (1) use of a postponing sexual involvement education 
 82.1   curriculum targeted to boys and girls ages 12 to 14 in schools 
 82.2   and/or community settings; 
 82.3      (2) planning and implementing community organization 
 82.4   strategies to convey and reinforce the MN ENABL message of 
 82.5   postponing sexual involvement, including activities promoting 
 82.6   awareness and involvement of parents and other primary 
 82.7   caregivers/significant adults, schools, and community; and 
 82.8      (3) development of local media linkages.  
 82.9      (b) A statewide, comprehensive media and public relations 
 82.10  campaign to promote changes in sexual attitudes and behaviors, 
 82.11  and reinforce the message of postponing adolescent sexual 
 82.12  involvement and promoting abstinence from sexual activity until 
 82.13  marriage.  Nothing in this paragraph shall be construed to 
 82.14  prevent the commissioner from targeting populations that 
 82.15  historically have had a high incidence of adolescent pregnancy 
 82.16  with culturally appropriate messages on abstinence from sexual 
 82.17  activity. 
 82.18     The commissioner of health, in consultation with the 
 82.19  commissioner of children, families, and learning, shall contract 
 82.20  with the attorney general's office to develop and implement the 
 82.21  media and public relations campaign.  In developing the 
 82.22  campaign, the attorney general's office commissioner of health 
 82.23  shall coordinate and consult with representatives from ethnic 
 82.24  and local communities to maximize effectiveness of the social 
 82.25  marketing approach to health promotion among the culturally 
 82.26  diverse population of the state.  The development and 
 82.27  implementation of the campaign is subject to input and approval 
 82.28  by the commissioner of health.  The commissioner may continue to 
 82.29  use any campaign materials or media messages developed or 
 82.30  produced prior to July 1, 1999. 
 82.31     The local community-based contractors shall collaborate and 
 82.32  coordinate efforts with other community organizations and 
 82.33  interested persons to provide school and community-wide 
 82.34  promotional activities that support and reinforce the message of 
 82.35  the MN ENABL curriculum. 
 82.36     (c) An evaluation component which evaluates the process and 
 83.1   the impact of the program. 
 83.2      The "process evaluation" must provide information to the 
 83.3   state on the breadth and scope of the program.  The evaluation 
 83.4   must identify program areas that might need modification and 
 83.5   identify local MN ENABL contractor strategies and procedures 
 83.6   which are particularly effective.  Contractors must keep 
 83.7   complete records on the demographics of clients served, number 
 83.8   of direct education sessions delivered and other appropriate 
 83.9   statistics, and must document exactly how the program was 
 83.10  implemented.  The commissioner may select contractor sites for 
 83.11  more in-depth case studies. 
 83.12     The "impact evaluation" must provide information to the 
 83.13  state on the impact of the different components of the MN ENABL 
 83.14  program and an assessment of the impact of the program on 
 83.15  adolescents' related sexual knowledge, attitudes, and 
 83.16  risk-taking behavior. 
 83.17     The commissioner shall compare the MN ENABL evaluation 
 83.18  information and data with similar evaluation data from other 
 83.19  states pursuing a similar adolescent pregnancy prevention 
 83.20  program modeled after ENABL and use the information to improve 
 83.21  MN ENABL and build on aspects of the program that have 
 83.22  demonstrated a delay in adolescent sexual involvement. 
 83.23     (d) A training component requiring the commissioner of 
 83.24  health, in consultation with the commissioner of children, 
 83.25  families, and learning, to provide comprehensive uniform 
 83.26  training to the local MN ENABL community-based local contractors 
 83.27  and the direct education program staff.  
 83.28     The local community-based contractors may use adolescent 
 83.29  leaders slightly older than the adolescents in the program to 
 83.30  impart the message to postpone sexual involvement provided: 
 83.31     (1) the contractor follows a protocol for adult 
 83.32  mentors/leaders and older adolescent leaders established by the 
 83.33  commissioner of health; 
 83.34     (2) the older adolescent leader is accompanied by an adult 
 83.35  leader; and 
 83.36     (3) the contractor uses the curriculum as directed and 
 84.1   required by the commissioner of the department of health to 
 84.2   implement this part of the program.  The commissioner of health 
 84.3   shall provide technical assistance to community-based local 
 84.4   contractors. 
 84.5      Sec. 34.  Minnesota Statutes 1998, section 148.5194, 
 84.6   subdivision 2, is amended to read: 
 84.7      Subd. 2.  [BIENNIAL REGISTRATION FEE.] The fee for initial 
 84.8   registration and biennial registration, temporary registration, 
 84.9   or renewal is $160 $200.  
 84.10     Sec. 35.  Minnesota Statutes 1998, section 148.5194, 
 84.11  subdivision 3, is amended to read: 
 84.12     Subd. 3.  [BIENNIAL REGISTRATION FEE FOR DUAL REGISTRATION 
 84.13  AS A SPEECH-LANGUAGE PATHOLOGIST AND AUDIOLOGIST.] The fee for 
 84.14  initial registration and biennial registration, temporary 
 84.15  registration, or renewal is $160 $200.  
 84.16     Sec. 36.  Minnesota Statutes 1998, section 148.5194, is 
 84.17  amended by adding a subdivision to read: 
 84.18     Subd. 3a.  [SURCHARGE FEE.] Notwithstanding section 
 84.19  16A.1285, subdivision 2, for a period of four years following 
 84.20  the effective date of this subdivision, an applicant for 
 84.21  registration or registration renewal must pay a surcharge fee of 
 84.22  $25 in addition to any other fees due upon registration or 
 84.23  registration renewal.  This subdivision expires June 30, 2003. 
 84.24     Sec. 37.  Minnesota Statutes 1998, section 148.5194, 
 84.25  subdivision 4, is amended to read: 
 84.26     Subd. 4.  [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 
 84.27  for late submission of a renewal application is $15 $45.  
 84.28     Sec. 38.  Minnesota Statutes 1998, section 256B.69, 
 84.29  subdivision 5c, is amended to read: 
 84.30     Subd. 5c.  [MEDICAL EDUCATION AND RESEARCH TRUST FUND.] (a) 
 84.31  Beginning in January 1999 and each year thereafter: 
 84.32     (1) the commissioner of human services shall transfer an 
 84.33  amount equal to the reduction in the prepaid medical assistance 
 84.34  and prepaid general assistance medical care payments resulting 
 84.35  from clause (2), excluding nursing facility and elderly waiver 
 84.36  payments, to the medical education and research trust fund 
 85.1   established under section 62J.69 62J.692; 
 85.2      (2) the county medical assistance and general assistance 
 85.3   medical care capitation base rate prior to plan specific 
 85.4   adjustments shall be reduced 6.3 percent for Hennepin county, 
 85.5   two percent for the remaining metropolitan counties, and 1.6 
 85.6   percent for nonmetropolitan Minnesota counties; and 
 85.7      (3) the amount calculated under clause (1) shall not be 
 85.8   adjusted for subsequent changes to the capitation payments for 
 85.9   periods already paid.  
 85.10     (b) This subdivision shall be effective upon approval of a 
 85.11  federal waiver which allows federal financial participation in 
 85.12  the medical education and research trust fund.  
 85.13     Sec. 39.  Minnesota Statutes 1998, section 326.40, 
 85.14  subdivision 2, is amended to read: 
 85.15     Subd. 2.  [MASTER PLUMBER'S LICENSE; BOND AND; INSURANCE 
 85.16  REQUIREMENTS.] The applicant for a master plumber license may 
 85.17  give bond to the state in the total penal sum of $2,000 
 85.18  conditioned upon the faithful and lawful performance of all work 
 85.19  entered upon within the state.  Any person contracting to do 
 85.20  plumbing work must give bond to the state in the amount of 
 85.21  $25,000 for all work entered into within the state.  The bond 
 85.22  shall be for the benefit of persons injured or suffering 
 85.23  financial loss by reason of failure of performance to comply 
 85.24  with the requirements of the plumbing code.  The term of the 
 85.25  bond shall be concurrent with the term of the license.  The A 
 85.26  bond given to the state shall be filed with the secretary of 
 85.27  state and shall be in lieu of all other license bonds to any 
 85.28  political subdivision required for plumbing work.  The bond 
 85.29  shall be written by a corporate surety licensed to do business 
 85.30  in the state. 
 85.31     In addition, each applicant for a master plumber license or 
 85.32  renewal thereof, may provide evidence of public liability 
 85.33  insurance, including products liability insurance with limits of 
 85.34  at least $50,000 per person and $100,000 per occurrence and 
 85.35  property damage insurance with limits of at least $10,000.  The 
 85.36  insurance shall be written by an insurer licensed to do business 
 86.1   in the state of Minnesota and each licensed master plumber shall 
 86.2   maintain on file with the state commissioner of health a 
 86.3   certificate evidencing the insurance providing that the 
 86.4   insurance shall not be canceled without the insurer first giving 
 86.5   15 days written notice to the commissioner.  The term of the 
 86.6   insurance shall be concurrent with the term of the license.  The 
 86.7   certificate shall be in lieu of all other certificates required 
 86.8   by any political subdivision for licensing purposes. 
 86.9      Sec. 40.  Minnesota Statutes 1998, section 326.40, 
 86.10  subdivision 4, is amended to read: 
 86.11     Subd. 4.  [ALTERNATIVE COMPLIANCE.] Compliance with the 
 86.12  local bond requirements of a locale within which work is to be 
 86.13  performed shall be deemed to satisfy the bond and insurance 
 86.14  requirements of subdivision 2, provided the local ordinance 
 86.15  requires at least a $25,000 bond. 
 86.16     Sec. 41.  Minnesota Statutes 1998, section 326.40, 
 86.17  subdivision 5, is amended to read: 
 86.18     Subd. 5.  [FEE.] The state commissioner of health may 
 86.19  charge each applicant for a master plumber license or for a 
 86.20  renewal of a master plumber license and an additional fee person 
 86.21  giving bond an annual bond filing fee commensurate with the cost 
 86.22  of administering the bond and insurance requirements of 
 86.23  subdivision 2. 
 86.24     Sec. 42.  [STUDY REGARDING THE EXPANSION OF PLUMBER 
 86.25  LICENSURE AND PLUMBING INSPECTION REQUIREMENTS.] 
 86.26     (a) The commissioner of health, in consultation with 
 86.27  representatives of the plumbing industry and other interested 
 86.28  individuals, shall study and make recommendations to the 
 86.29  legislature on the following issues: 
 86.30     (1) whether licensure requirements for plumbers should be 
 86.31  expanded to require all persons and firms working as master 
 86.32  plumbers or journeyman plumbers in any home rule city or 
 86.33  statutory city to be licensed by the commissioner; 
 86.34     (2) whether any modifications are necessary to the 
 86.35  education requirements for licensure for master plumbers and 
 86.36  journeyman plumbers; 
 87.1      (3) whether the commissioner may charge fees to fund the 
 87.2   hiring of inspectors and plan reviewers to inspect and review 
 87.3   all new plumbing installations, and the amounts of such fees; 
 87.4   and 
 87.5      (4) whether the commissioner's authority to inspect new 
 87.6   plumbing installations should be expanded to require inspections 
 87.7   of all new plumbing installations for new construction and 
 87.8   additions, regardless of location or the population of the city 
 87.9   or town in which the installation is located. 
 87.10     (b) These recommendations, and draft legislation if 
 87.11  appropriate, must be presented to the legislature by January 15, 
 87.12  2000.  
 87.13     Sec. 43.  [CASE STUDIES TO DEVELOP STANDARDS FOR AUTOPSY 
 87.14  PRACTICE IN SPECIAL CASES.] 
 87.15     Subdivision 1.  [CASE STUDIES.] (a) If a professional 
 87.16  association representing coroners and medical examiners in 
 87.17  Minnesota accepts a grant from the commissioner of health for 
 87.18  purposes of this section, it must comply with the terms of this 
 87.19  section.  A professional association representing coroners and 
 87.20  medical examiners in Minnesota may conduct a series of case 
 87.21  studies to examine cases in which performing autopsies are 
 87.22  controversial or in which autopsies are opposed by a decedent's 
 87.23  relative or friend based on the decedent's religious beliefs.  
 87.24  The cases to be examined may be cases in which it is not 
 87.25  immediately apparent that an autopsy is needed to determine the 
 87.26  person's cause of death but that, upon further investigation, 
 87.27  the coroner or medical examiner determines that an autopsy is 
 87.28  necessary to determine the cause of death and that the cause of 
 87.29  death must be determined.  Using these case studies, the 
 87.30  professional association may develop: 
 87.31     (1) guidelines for coroners and medical examiners regarding 
 87.32  when to perform autopsies in controversial situations or in 
 87.33  situations in which autopsies are opposed based on a decedent's 
 87.34  religious beliefs; and 
 87.35     (2) special autopsy methods and procedures, if appropriate, 
 87.36  for autopsies in controversial situations or situations in which 
 88.1   autopsies are opposed based on a decedent's religious beliefs. 
 88.2      (b) The professional association may conduct 12 case 
 88.3   studies or more for the purposes in paragraph (a).  Upon 
 88.4   completion of the case studies, the professional association may 
 88.5   disseminate the guidelines and procedures developed to all 
 88.6   coroners and medical examiners conducting autopsies in Minnesota.
 88.7      Subd. 2.  [REPORT TO LEGISLATURE.] The professional 
 88.8   association may report to the legislature by January 15, 2000, 
 88.9   on the results of the case studies, the guidelines developed for 
 88.10  autopsy practice, the special autopsy methods and procedures 
 88.11  developed, and efforts or plans to disseminate the guidelines 
 88.12  and procedures developed to coroners and medical examiners 
 88.13  conducting autopsies in Minnesota. 
 88.14     Subd. 3.  [DATA PRIVACY.] All records held by the 
 88.15  professional association for purposes of completing the case 
 88.16  studies must be held in confidence.  The guidelines for 
 88.17  autopsies and special autopsy methods and procedures that are 
 88.18  disseminated to coroners and medical examiners shall contain no 
 88.19  individually identifiable information. 
 88.20     Sec. 44.  [AMENDMENT TO RULES.] 
 88.21     The commissioner of health shall amend Minnesota Rules, 
 88.22  chapter 4730 to conform with Minnesota Statutes, section 
 88.23  144.121, subdivision 8.  The amendments required by this section 
 88.24  may be done in the manner specified in Minnesota Statutes, 
 88.25  section 14.388, under the authority of clause (3) of that 
 88.26  section.  Minnesota Statutes, section 14.386, paragraph (b), 
 88.27  does not apply to amendments to rules made under this section. 
 88.28     Sec. 45.  [REPEALER.] 
 88.29     (a) Minnesota Statutes 1998, sections 13.99, subdivision 
 88.30  19m; 62J.77; 62J.78; and 62J.79, are repealed. 
 88.31     (b) Minnesota Statutes 1998, sections 62J.69; 144.9507, 
 88.32  subdivision 4; 144.9511; and 145.46, are repealed. 
 88.33     (c) Laws 1998, chapter 407, article 2, section 104, is 
 88.34  repealed. 
 88.35     Sec. 46.  [EFFECTIVE DATE.] 
 88.36     (a) Sections 33 to 35 are effective January 1, 2000. 
 89.1      (b) Sections 16, 20 to 22, and 37 are effective the day 
 89.2   following final enactment. 
 89.3                              ARTICLE 3 
 89.4                            LONG-TERM CARE 
 89.5      Section 1.  Minnesota Statutes 1998, section 144A.073, 
 89.6   subdivision 5, is amended to read: 
 89.7      Subd. 5.  [REPLACEMENT RESTRICTIONS.] (a) Proposals 
 89.8   submitted or approved under this section involving replacement 
 89.9   must provide for replacement of the facility on the existing 
 89.10  site except as allowed in this subdivision.  
 89.11     (b) Facilities located in a metropolitan statistical area 
 89.12  other than the Minneapolis-St. Paul seven-county metropolitan 
 89.13  area may relocate to a site within the same census tract or a 
 89.14  contiguous census tract.  
 89.15     (c) Facilities located in the Minneapolis-St. Paul 
 89.16  seven-county metropolitan area may relocate to a site within the 
 89.17  same or contiguous health planning area as adopted in March 1982 
 89.18  by the metropolitan council.  
 89.19     (d) Facilities located outside a metropolitan statistical 
 89.20  area may relocate to a site within the same city or township, or 
 89.21  within a contiguous township.  
 89.22     (e) A facility relocated to a different site under 
 89.23  paragraph (b), (c), or (d) must not be relocated to a site more 
 89.24  than six miles from the existing site. 
 89.25     (f) The relocation of part of an existing first facility to 
 89.26  a second location, under paragraphs (d) and (e), may include the 
 89.27  relocation to the second location of up to four beds from part 
 89.28  of an existing third facility located in a township contiguous 
 89.29  to the location of the first facility.  The six-mile limit in 
 89.30  paragraph (e) does not apply to this relocation from the third 
 89.31  facility. 
 89.32     (g) For proposals approved on January 13, 1994, under this 
 89.33  section involving the replacement of 102 licensed and certified 
 89.34  beds, the relocation of the existing first facility to the 
 89.35  second and third locations new location under paragraphs (d) and 
 89.36  (e) may include the relocation of up to 50 percent of the 75 
 90.1   beds of the existing first facility to each of the locations.  
 90.2   The six-mile limit in paragraph (e) does not apply to this 
 90.3   relocation to the third location.  Notwithstanding subdivision 
 90.4   3, construction of this project may be commenced any time prior 
 90.5   to January 1, 1996. 
 90.6      Sec. 2.  Minnesota Statutes 1998, section 144A.10, is 
 90.7   amended by adding a subdivision to read: 
 90.8      Subd. 1a.  [TRAINING AND EDUCATION FOR NURSING FACILITY 
 90.9   PROVIDERS.] The commissioner of health must establish and 
 90.10  implement a prescribed process and program for providing 
 90.11  training and education to providers licensed by the department 
 90.12  of health, either by itself or in conjunction with the industry 
 90.13  trade associations, before using any new regulatory guideline, 
 90.14  regulation, interpretation, program letter or memorandum, or any 
 90.15  other materials used in surveyor training to survey licensed 
 90.16  providers.  The process should include, but is not limited to, 
 90.17  the following key components: 
 90.18     (1) facilitate the implementation of immediate revisions to 
 90.19  any course curriculum for nursing assistants which reflect any 
 90.20  new standard of care practice that has been adopted or 
 90.21  referenced by the health department concerning the issue in 
 90.22  question; 
 90.23     (2) conduct training of long-term care providers and health 
 90.24  department survey inspectors either jointly or during the same 
 90.25  time frame on the department's new expectations; and 
 90.26     (3) within available resources the commissioner shall 
 90.27  cooperate in the development of clinical standards, work with 
 90.28  vendors of supplies and services regarding hazards, and identify 
 90.29  research of interest to the long-term care community.  
 90.30     Sec. 3.  Minnesota Statutes 1998, section 144A.10, is 
 90.31  amended by adding a subdivision to read: 
 90.32     Subd. 11.  [DATA ON FOLLOW-UP SURVEYS.] (a) If requested, 
 90.33  and not prohibited by federal law, the commissioner shall make 
 90.34  available to the nursing home associations and the public 
 90.35  photocopies of statements of deficiencies and related letters 
 90.36  from the department pertaining to federal certification 
 91.1   surveys.  The commissioner may charge for the actual cost of 
 91.2   reproduction of these documents. 
 91.3      (b) The commissioner shall also make available on a 
 91.4   quarterly basis aggregate data for all statements of 
 91.5   deficiencies issued after federal certification follow-up 
 91.6   surveys related to surveys that were conducted in the quarter 
 91.7   prior to the immediately preceding quarter.  The data shall 
 91.8   include the number of facilities with deficiencies, the total 
 91.9   number of deficiencies, the number of facilities that did not 
 91.10  have any deficiencies, the number of facilities for which a 
 91.11  resurvey or follow-up survey was not performed, and the average 
 91.12  number of days between the follow-up or resurvey and the exit 
 91.13  date of the preceding survey. 
 91.14     Sec. 4.  Minnesota Statutes 1998, section 144A.10, is 
 91.15  amended by adding a subdivision to read: 
 91.16     Subd. 12.  [NURSE AIDE TRAINING WAIVERS.] Because any 
 91.17  disruption or delay in the training and registration of nurse 
 91.18  aides may reduce access to care in certified facilities, the 
 91.19  commissioner shall grant all possible waivers for the 
 91.20  continuation of an approved nurse aide training and competency 
 91.21  evaluation program or nurse aide training program or competency 
 91.22  evaluation program conducted by or on the site of any certified 
 91.23  nursing facility or skilled nursing facility that would 
 91.24  otherwise lose approval for the program or programs.  The 
 91.25  commissioner shall take into consideration the distance to other 
 91.26  training programs, the frequency of other training programs, and 
 91.27  the impact that the loss of the onsite training will have on the 
 91.28  nursing facility's ability to recruit and train nurse aides. 
 91.29     Sec. 5.  Minnesota Statutes 1998, section 144A.10, is 
 91.30  amended by adding a subdivision to read: 
 91.31     Subd. 13.  [IMMEDIATE JEOPARDY.] When conducting survey 
 91.32  certification and enforcement activities related to regular, 
 91.33  expanded, or extended surveys under Code of Federal Regulations, 
 91.34  title 42, part 488, the commissioner may not issue a finding of 
 91.35  immediate jeopardy unless the specific event or omission that 
 91.36  constitutes the violation of the requirements of participation 
 92.1   poses an imminent risk of life-threatening or serious injury to 
 92.2   a resident.  The commissioner may not issue any findings of 
 92.3   immediate jeopardy after the conclusion of a regular, expanded, 
 92.4   or extended survey unless the survey team identified the 
 92.5   deficient practice or practices that constitute immediate 
 92.6   jeopardy and the residents at risk prior to the close of the 
 92.7   exit conference. 
 92.8      Sec. 6.  Minnesota Statutes 1998, section 144A.10, is 
 92.9   amended by adding a subdivision to read: 
 92.10     Subd. 14.  [INFORMAL DISPUTE RESOLUTION.] The commissioner 
 92.11  shall respond in writing to a request from a nursing facility 
 92.12  certified under the federal Medicare and Medicaid programs for 
 92.13  an informal dispute resolution within 30 days of the exit date 
 92.14  of the facility's survey.  The commissioner's response shall 
 92.15  identify the commissioner's decision regarding the continuation 
 92.16  of each deficiency citation challenged by the nursing facility, 
 92.17  as well as a statement of any changes in findings, level of 
 92.18  severity or scope, and proposed remedies or sanctions for each 
 92.19  deficiency citation. 
 92.20     Sec. 7.  [144A.102] [USE OF CIVIL MONEY PENALTIES; WAIVER 
 92.21  FROM STATE AND FEDERAL RULES AND REGULATIONS.] 
 92.22     By January 2000, the commissioner of health shall work with 
 92.23  providers to examine state and federal rules and regulations 
 92.24  governing the provision of care in licensed nursing facilities 
 92.25  and apply for federal waivers and identify necessary changes in 
 92.26  state law to:  
 92.27     (1) allow the use of civil money penalties imposed upon 
 92.28  nursing facilities to abate any deficiencies identified in a 
 92.29  nursing facility's plan of correction; and 
 92.30     (2) stop the accrual of any fine imposed by the health 
 92.31  department when a follow-up inspection survey is not conducted 
 92.32  by the department within the regulatory deadline. 
 92.33     Sec. 8.  Minnesota Statutes 1998, section 144D.01, 
 92.34  subdivision 4, is amended to read: 
 92.35     Subd. 4.  [HOUSING WITH SERVICES ESTABLISHMENT OR 
 92.36  ESTABLISHMENT.] "Housing with services establishment" or 
 93.1   "establishment" means an establishment providing sleeping 
 93.2   accommodations to one or more adult residents, at least 80 
 93.3   percent of which are 55 years of age or older, and offering or 
 93.4   providing, for a fee, one or more regularly scheduled 
 93.5   health-related services or two or more regularly scheduled 
 93.6   supportive services, whether offered or provided directly by the 
 93.7   establishment or by another entity arranged for by the 
 93.8   establishment. 
 93.9      Housing with services establishment does not include: 
 93.10     (1) a nursing home licensed under chapter 144A; 
 93.11     (2) a hospital, certified boarding care home, or supervised 
 93.12  living facility licensed under sections 144.50 to 144.56; 
 93.13     (3) a board and lodging establishment licensed under 
 93.14  chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 
 93.15  9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 
 93.16  9530.4450, or under chapter 245B; 
 93.17     (4) a board and lodging establishment which serves as a 
 93.18  shelter for battered women or other similar purpose; 
 93.19     (5) a family adult foster care home licensed by the 
 93.20  department of human services; 
 93.21     (6) private homes in which the residents are related by 
 93.22  kinship, law, or affinity with the providers of services; 
 93.23     (7) residential settings for persons with mental 
 93.24  retardation or related conditions in which the services are 
 93.25  licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 
 93.26  applicable successor rules or laws; 
 93.27     (8) a home-sharing arrangement such as when an elderly or 
 93.28  disabled person or single-parent family makes lodging in a 
 93.29  private residence available to another person in exchange for 
 93.30  services or rent, or both; 
 93.31     (9) a duly organized condominium, cooperative, common 
 93.32  interest community, or owners' association of the foregoing 
 93.33  where at least 80 percent of the units that comprise the 
 93.34  condominium, cooperative, or common interest community are 
 93.35  occupied by individuals who are the owners, members, or 
 93.36  shareholders of the units; or 
 94.1      (10) services for persons with developmental disabilities 
 94.2   that are provided under a license according to Minnesota Rules, 
 94.3   parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 
 94.4   under chapter 245B. 
 94.5      Sec. 9.  Minnesota Statutes 1998, section 252.28, 
 94.6   subdivision 1, is amended to read: 
 94.7      Subdivision 1.  [DETERMINATIONS; REDETERMINATIONS.] In 
 94.8   conjunction with the appropriate county boards, the commissioner 
 94.9   of human services shall determine, and shall redetermine at 
 94.10  least every four years, the need, location, size, and program of 
 94.11  public and private residential services and day training and 
 94.12  habilitation services for persons with mental retardation or 
 94.13  related conditions.  This subdivision does not apply to 
 94.14  semi-independent living services and residential-based 
 94.15  habilitation services provided to four or fewer persons at a 
 94.16  single site funded as home and community-based services.  A 
 94.17  determination of need shall not be required for a change in 
 94.18  ownership.  
 94.19     Sec. 10.  [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 
 94.20     Subdivision 1.  [HOST COUNTY RESPONSIBILITY.] (a) For 
 94.21  purposes of this section, "local system needs planning" means 
 94.22  the determination of need for ICF/MR services by program type, 
 94.23  location, demographics, and size of licensed services for 
 94.24  persons with developmental disabilities or related conditions. 
 94.25     (b) This section does not apply to semi-independent living 
 94.26  services and residential-based habilitation services funded as 
 94.27  home and community-based services. 
 94.28     (c) In collaboration with the commissioner and ICF/MR 
 94.29  providers, counties shall complete a local system needs planning 
 94.30  process for each ICF/MR facility.  Counties shall evaluate the 
 94.31  preferences and needs of persons with developmental disabilities 
 94.32  to determine resource demands through a systematic assessment 
 94.33  and planning process by May 15, 2000, and by July 1 every two 
 94.34  years thereafter beginning in 2001. 
 94.35     (d) A local system needs planning process shall be 
 94.36  undertaken more frequently when the needs or preferences of 
 95.1   consumers change significantly to require reformation of the 
 95.2   resources available to persons with developmental disabilities. 
 95.3      (e) A local system needs plan shall be amended anytime 
 95.4   recommendations for modifications to existing ICF/MR services 
 95.5   are made to the host county, including recommendations for: 
 95.6      (1) closure; 
 95.7      (2) relocation of services; 
 95.8      (3) downsizing; 
 95.9      (4) rate adjustments exceeding 90 days duration to address 
 95.10  access; or 
 95.11     (5) modification of existing services for which a change in 
 95.12  the framework of service delivery is advocated. 
 95.13     Subd. 2.  [CONSUMER NEEDS AND PREFERENCES.] In conducting 
 95.14  the local system needs planning process, the host county must 
 95.15  use information from the individual service plans of persons for 
 95.16  whom the county is financially responsible and of persons from 
 95.17  other counties for whom the county has agreed to be the host 
 95.18  county.  The determination of services and supports offered 
 95.19  within the county shall be based on the preferences and needs of 
 95.20  consumers.  The host county shall also consider the community 
 95.21  social services plan, waiting lists, and other sources that 
 95.22  identify unmet needs for services.  A review of ICF/MR facility 
 95.23  licensing and certification surveys, substantiated maltreatment 
 95.24  reports, and established service standards shall be employed to 
 95.25  assess the performance of providers and shall be considered in 
 95.26  the county's recommendations.  Consumer satisfaction surveys may 
 95.27  also be considered in this process. 
 95.28     Subd. 3.  [RECOMMENDATIONS.] (a) Upon completion of the 
 95.29  local system needs planning assessment, the host county shall 
 95.30  make recommendations by May 15, 2000, and by July 1 every two 
 95.31  years thereafter beginning in 2001.  If no change is 
 95.32  recommended, a copy of the assessment along with corresponding 
 95.33  documentation shall be provided to the commissioner by July 1 
 95.34  prior to the contract year. 
 95.35     (b) Except as provided in section 252.292, subdivision 4, 
 95.36  recommendations regarding closures, relocations, or downsizings 
 96.1   that include a rate increase and recommendations regarding rate 
 96.2   adjustments exceeding 90 days shall be submitted to the 
 96.3   statewide advisory committee for review and determination, along 
 96.4   with the assessment, plan, and corresponding budget. 
 96.5      (c) Recommendations for closures, relocations, and 
 96.6   downsizings that do not include a rate increase and for 
 96.7   modification of existing services for which a change in the 
 96.8   framework of service delivery is necessary shall be provided to 
 96.9   the commissioner by July 1 prior to the contract year or at 
 96.10  least 90 days prior to the anticipated change, along with the 
 96.11  assessment and corresponding documentation. 
 96.12     Subd. 4.  [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 
 96.13  commissioner shall appoint a five-member statewide advisory 
 96.14  committee.  The advisory committee shall include representatives 
 96.15  of providers and counties and the commissioner or the 
 96.16  commissioner's designee. 
 96.17     (b) The criteria for ranking proposals, already developed 
 96.18  in 1997 by a task force authorized by the legislature, shall be 
 96.19  adopted and incorporated into the decision-making process.  
 96.20  Specific guidelines, including time frame for submission of 
 96.21  requests, shall be established and announced through the State 
 96.22  Register, and all requests shall be considered in comparison to 
 96.23  each other and the ranking criteria.  The advisory committee 
 96.24  shall review and recommend requests for facility rate 
 96.25  adjustments to address closures, downsizing, relocation, or 
 96.26  access needs within the county and shall forward recommendations 
 96.27  and documentation to the commissioner.  The committee shall 
 96.28  ensure that: 
 96.29     (1) applications are in compliance with applicable state 
 96.30  and federal law and with the state plan; and 
 96.31     (2) cost projections for the proposed service are within 
 96.32  fiscal limitations. 
 96.33     (c) The advisory committee shall review proposals and 
 96.34  submit recommendations to the commissioner within 60 days 
 96.35  following the published deadline for submission under 
 96.36  subdivision 5. 
 97.1      Subd. 5.  [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 
 97.2   collaboration with counties, providers, and the statewide 
 97.3   advisory committee, the commissioner shall ensure that services 
 97.4   recognize the preferences and needs of persons with 
 97.5   developmental disabilities and related conditions through a 
 97.6   recurring systemic review and assessment of ICF/MR facilities 
 97.7   within the state. 
 97.8      (b) The commissioner shall publish a notice in the State 
 97.9   Register twice each calendar year to announce the opportunity 
 97.10  for counties or providers to submit requests for rate 
 97.11  adjustments associated with plans for downsizing, relocation, 
 97.12  and closure of ICF/MR facilities. 
 97.13     (c) The commissioner shall designate funding parameters to 
 97.14  counties and to the statewide advisory committee for the overall 
 97.15  implementation of system needs within the fiscal resources 
 97.16  allocated by the legislature. 
 97.17     (d) The commissioner shall contract with ICF/MR providers.  
 97.18  The initial contracts shall cover the period from October 1, 
 97.19  2000, to December 31, 2001.  Subsequent contracts shall be for 
 97.20  two-year periods beginning January 1, 2002. 
 97.21     Sec. 11.  Minnesota Statutes 1998, section 252.291, is 
 97.22  amended by adding a subdivision to read: 
 97.23     Subd. 2a.  [EXCEPTION FOR LAKE OWASSO PROJECT.] (a) The 
 97.24  commissioner shall authorize and grant a license under chapter 
 97.25  245A to a new intermediate care facility for persons with mental 
 97.26  retardation effective January 1, 2000, under the following 
 97.27  circumstances: 
 97.28     (1) the new facility replaces an existing 64-bed 
 97.29  intermediate care facility for the mentally retarded located in 
 97.30  Ramsey county; 
 97.31     (2) the new facility is located upon a parcel of land 
 97.32  contiguous to the parcel upon which the existing 64-bed facility 
 97.33  is located; 
 97.34     (3) the new facility is comprised of no more than eight 
 97.35  twin home style buildings and an administration building; 
 97.36     (4) the total licensed bed capacity of the facility does 
 98.1   not exceed 64 beds; and 
 98.2      (5) the existing 64-bed facility is demolished. 
 98.3      (b) The medical assistance payment rate for the new 
 98.4   facility shall be the higher of the rate specified in paragraph 
 98.5   (c) or as otherwise provided by law. 
 98.6      (c) The new facility shall be considered a newly 
 98.7   established facility for rate setting purposes, and shall be 
 98.8   eligible for the investment per bed limit specified in section 
 98.9   256B.501, subdivision 11, paragraph (c), and the interest 
 98.10  expense limitation specified in section 256B.501, subdivision 
 98.11  11, paragraph (d).  Notwithstanding section 256B.5011, the newly 
 98.12  established facility's initial payment rate shall be set 
 98.13  according to Minnesota Rules, part 9553.0075, and shall not be 
 98.14  subject to the provisions of section 256B.501, subdivision 5b. 
 98.15     (d) During the construction of the new facility, Ramsey 
 98.16  county shall work with residents, families, and service 
 98.17  providers to explore all service options open to current 
 98.18  residents of the facility. 
 98.19     Sec. 12.  Minnesota Statutes 1998, section 256B.0911, 
 98.20  subdivision 6, is amended to read: 
 98.21     Subd. 6.  [PAYMENT FOR PREADMISSION SCREENING.] (a) The 
 98.22  total screening payment for each county must be paid monthly by 
 98.23  certified nursing facilities in the county.  The monthly amount 
 98.24  to be paid by each nursing facility for each fiscal year must be 
 98.25  determined by dividing the county's annual allocation for 
 98.26  screenings by 12 to determine the monthly payment and allocating 
 98.27  the monthly payment to each nursing facility based on the number 
 98.28  of licensed beds in the nursing facility. 
 98.29     (b) The commissioner shall include the total annual payment 
 98.30  for screening for each nursing facility according to section 
 98.31  256B.431, subdivision 2b, paragraph (g), or 256B.435. 
 98.32     (c) Payments for screening activities are available to the 
 98.33  county or counties to cover staff salaries and expenses to 
 98.34  provide the screening function.  The lead agency shall employ, 
 98.35  or contract with other agencies to employ, within the limits of 
 98.36  available funding, sufficient personnel to conduct the 
 99.1   preadmission screening activity while meeting the state's 
 99.2   long-term care outcomes and objectives as defined in section 
 99.3   256B.0917, subdivision 1.  The local agency shall be accountable 
 99.4   for meeting local objectives as approved by the commissioner in 
 99.5   the CSSA biennial plan. 
 99.6      (c) (d) Notwithstanding section 256B.0641, overpayments 
 99.7   attributable to payment of the screening costs under the medical 
 99.8   assistance program may not be recovered from a facility.  
 99.9      (d) (e) The commissioner of human services shall amend the 
 99.10  Minnesota medical assistance plan to include reimbursement for 
 99.11  the local screening teams. 
 99.12     Sec. 13.  Minnesota Statutes 1998, section 256B.0913, 
 99.13  subdivision 5, is amended to read: 
 99.14     Subd. 5.  [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 
 99.15  Alternative care funding may be used for payment of costs of: 
 99.16     (1) adult foster care; 
 99.17     (2) adult day care; 
 99.18     (3) home health aide; 
 99.19     (4) homemaker services; 
 99.20     (5) personal care; 
 99.21     (6) case management; 
 99.22     (7) respite care; 
 99.23     (8) assisted living; 
 99.24     (9) residential care services; 
 99.25     (10) care-related supplies and equipment; 
 99.26     (11) meals delivered to the home; 
 99.27     (12) transportation; 
 99.28     (13) skilled nursing; 
 99.29     (14) chore services; 
 99.30     (15) companion services; 
 99.31     (16) nutrition services; 
 99.32     (17) training for direct informal caregivers; and 
 99.33     (18) telemedicine devices to monitor recipients in their 
 99.34  own homes as an alternative to hospital care, nursing home care, 
 99.35  or home visits.; and 
 99.36     (19) other services including direct cash payments to 
100.1   clients, approved by the county agency, subject to the 
100.2   provisions of paragraph (m).  Total annual payments for other 
100.3   services for all clients within a county may not exceed either 
100.4   ten percent of that county's annual alternative care program 
100.5   base allocation or $5,000, whichever is greater.  In no case 
100.6   shall this amount exceed the county's total annual alternative 
100.7   care program base allocation. 
100.8      (b) The county agency must ensure that the funds are used 
100.9   only to supplement and not supplant services available through 
100.10  other public assistance or services programs. 
100.11     (c) Unless specified in statute, the service standards for 
100.12  alternative care services shall be the same as the service 
100.13  standards defined in the elderly waiver.  Except for the county 
100.14  agencies' approval of direct cash payments to clients, persons 
100.15  or agencies must be employed by or under a contract with the 
100.16  county agency or the public health nursing agency of the local 
100.17  board of health in order to receive funding under the 
100.18  alternative care program. 
100.19     (d) The adult foster care rate shall be considered a 
100.20  difficulty of care payment and shall not include room and 
100.21  board.  The adult foster care daily rate shall be negotiated 
100.22  between the county agency and the foster care provider.  The 
100.23  rate established under this section shall not exceed 75 percent 
100.24  of the state average monthly nursing home payment for the case 
100.25  mix classification to which the individual receiving foster care 
100.26  is assigned, and it must allow for other alternative care 
100.27  services to be authorized by the case manager. 
100.28     (e) Personal care services may be provided by a personal 
100.29  care provider organization.  A county agency may contract with a 
100.30  relative of the client to provide personal care services, but 
100.31  must ensure nursing supervision.  Covered personal care services 
100.32  defined in section 256B.0627, subdivision 4, must meet 
100.33  applicable standards in Minnesota Rules, part 9505.0335. 
100.34     (f) A county may use alternative care funds to purchase 
100.35  medical supplies and equipment without prior approval from the 
100.36  commissioner when:  (1) there is no other funding source; (2) 
101.1   the supplies and equipment are specified in the individual's 
101.2   care plan as medically necessary to enable the individual to 
101.3   remain in the community according to the criteria in Minnesota 
101.4   Rules, part 9505.0210, item A; and (3) the supplies and 
101.5   equipment represent an effective and appropriate use of 
101.6   alternative care funds.  A county may use alternative care funds 
101.7   to purchase supplies and equipment from a non-Medicaid certified 
101.8   vendor if the cost for the items is less than that of a Medicaid 
101.9   vendor.  A county is not required to contract with a provider of 
101.10  supplies and equipment if the monthly cost of the supplies and 
101.11  equipment is less than $250.  
101.12     (g) For purposes of this section, residential care services 
101.13  are services which are provided to individuals living in 
101.14  residential care homes.  Residential care homes are currently 
101.15  licensed as board and lodging establishments and are registered 
101.16  with the department of health as providing special services.  
101.17  Residential care services are defined as "supportive services" 
101.18  and "health-related services."  "Supportive services" means the 
101.19  provision of up to 24-hour supervision and oversight.  
101.20  Supportive services includes:  (1) transportation, when provided 
101.21  by the residential care center only; (2) socialization, when 
101.22  socialization is part of the plan of care, has specific goals 
101.23  and outcomes established, and is not diversional or recreational 
101.24  in nature; (3) assisting clients in setting up meetings and 
101.25  appointments; (4) assisting clients in setting up medical and 
101.26  social services; (5) providing assistance with personal laundry, 
101.27  such as carrying the client's laundry to the laundry room.  
101.28  Assistance with personal laundry does not include any laundry, 
101.29  such as bed linen, that is included in the room and board rate.  
101.30  Health-related services are limited to minimal assistance with 
101.31  dressing, grooming, and bathing and providing reminders to 
101.32  residents to take medications that are self-administered or 
101.33  providing storage for medications, if requested.  Individuals 
101.34  receiving residential care services cannot receive both personal 
101.35  care services and residential care services.  
101.36     (h) For the purposes of this section, "assisted living" 
102.1   refers to supportive services provided by a single vendor to 
102.2   clients who reside in the same apartment building of three or 
102.3   more units which are not subject to registration under chapter 
102.4   144D.  Assisted living services are defined as up to 24-hour 
102.5   supervision, and oversight, supportive services as defined in 
102.6   clause (1), individualized home care aide tasks as defined in 
102.7   clause (2), and individualized home management tasks as defined 
102.8   in clause (3) provided to residents of a residential center 
102.9   living in their units or apartments with a full kitchen and 
102.10  bathroom.  A full kitchen includes a stove, oven, refrigerator, 
102.11  food preparation counter space, and a kitchen utensil storage 
102.12  compartment.  Assisted living services must be provided by the 
102.13  management of the residential center or by providers under 
102.14  contract with the management or with the county. 
102.15     (1) Supportive services include:  
102.16     (i) socialization, when socialization is part of the plan 
102.17  of care, has specific goals and outcomes established, and is not 
102.18  diversional or recreational in nature; 
102.19     (ii) assisting clients in setting up meetings and 
102.20  appointments; and 
102.21     (iii) providing transportation, when provided by the 
102.22  residential center only.  
102.23     Individuals receiving assisted living services will not 
102.24  receive both assisted living services and homemaking or personal 
102.25  care services.  Individualized means services are chosen and 
102.26  designed specifically for each resident's needs, rather than 
102.27  provided or offered to all residents regardless of their 
102.28  illnesses, disabilities, or physical conditions.  
102.29     (2) Home care aide tasks means:  
102.30     (i) preparing modified diets, such as diabetic or low 
102.31  sodium diets; 
102.32     (ii) reminding residents to take regularly scheduled 
102.33  medications or to perform exercises; 
102.34     (iii) household chores in the presence of technically 
102.35  sophisticated medical equipment or episodes of acute illness or 
102.36  infectious disease; 
103.1      (iv) household chores when the resident's care requires the 
103.2   prevention of exposure to infectious disease or containment of 
103.3   infectious disease; and 
103.4      (v) assisting with dressing, oral hygiene, hair care, 
103.5   grooming, and bathing, if the resident is ambulatory, and if the 
103.6   resident has no serious acute illness or infectious disease.  
103.7   Oral hygiene means care of teeth, gums, and oral prosthetic 
103.8   devices.  
103.9      (3) Home management tasks means:  
103.10     (i) housekeeping; 
103.11     (ii) laundry; 
103.12     (iii) preparation of regular snacks and meals; and 
103.13     (iv) shopping.  
103.14     Assisted living services as defined in this section shall 
103.15  not be authorized in boarding and lodging establishments 
103.16  licensed according to sections 157.011 and 157.15 to 157.22. 
103.17     (i) For establishments registered under chapter 144D, 
103.18  assisted living services under this section means the services 
103.19  described and licensed under section 144A.4605. 
103.20     (j) For the purposes of this section, reimbursement for 
103.21  assisted living services and residential care services shall be 
103.22  a monthly rate negotiated and authorized by the county agency 
103.23  based on an individualized service plan for each resident. The 
103.24  rate shall not exceed the nonfederal share of the greater of 
103.25  either the statewide or any of the geographic groups' weighted 
103.26  average monthly medical assistance nursing facility payment rate 
103.27  of the case mix resident class to which the 180-day eligible 
103.28  client would be assigned under Minnesota Rules, parts 9549.0050 
103.29  to 9549.0059, unless the services are provided by a home care 
103.30  provider licensed by the department of health and are provided 
103.31  in a building that is registered as a housing with services 
103.32  establishment under chapter 144D and that provides 24-hour 
103.33  supervision. 
103.34     (k) For purposes of this section, companion services are 
103.35  defined as nonmedical care, supervision and oversight, provided 
103.36  to a functionally impaired adult.  Companions may assist the 
104.1   individual with such tasks as meal preparation, laundry and 
104.2   shopping, but do not perform these activities as discrete 
104.3   services.  The provision of companion services does not entail 
104.4   hands-on medical care.  Providers may also perform light 
104.5   housekeeping tasks which are incidental to the care and 
104.6   supervision of the recipient.  This service must be approved by 
104.7   the case manager as part of the care plan.  Companion services 
104.8   must be provided by individuals or nonprofit organizations who 
104.9   are under contract with the local agency to provide the 
104.10  service.  Any person related to the waiver recipient by blood, 
104.11  marriage or adoption cannot be reimbursed under this service.  
104.12  Persons providing companion services will be monitored by the 
104.13  case manager. 
104.14     (l) For purposes of this section, training for direct 
104.15  informal caregivers is defined as a classroom or home course of 
104.16  instruction which may include:  transfer and lifting skills, 
104.17  nutrition, personal and physical cares, home safety in a home 
104.18  environment, stress reduction and management, behavioral 
104.19  management, long-term care decision making, care coordination 
104.20  and family dynamics.  The training is provided to an informal 
104.21  unpaid caregiver of a 180-day eligible client which enables the 
104.22  caregiver to deliver care in a home setting with high levels of 
104.23  quality.  The training must be approved by the case manager as 
104.24  part of the individual care plan.  Individuals, agencies, and 
104.25  educational facilities which provide caregiver training and 
104.26  education will be monitored by the case manager. 
104.27     (m) A county agency may make payment from their alternative 
104.28  care program allocation for other services provided to an 
104.29  alternative care program recipient if those services prevent, 
104.30  shorten, or delay institutionalization.  These services may 
104.31  include direct cash payments to the recipient for the purpose of 
104.32  purchasing the recipient's services.  The following provisions 
104.33  apply to payments under this paragraph: 
104.34     (1) a cash payment to a client under this provision cannot 
104.35  exceed 80 percent of the monthly payment limit for that client 
104.36  as specified in subdivision 4, paragraph (a), clause (7); 
105.1      (2) a county may not approve any cash payment for a client 
105.2   who has been assessed as having a dependency in orientation, 
105.3   unless the client has an authorized representative under section 
105.4   256.476, subdivision 2, paragraph (g), or for a client who is 
105.5   concurrently receiving adult foster care, residential care, or 
105.6   assisted living services; 
105.7      (3) any service approved under this section must be a 
105.8   service which meets the purpose and goals of the program as 
105.9   listed in subdivision 1; 
105.10     (4) cash payments must also meet the criteria in section 
105.11  256.476, subdivision 4, paragraph (b), and recipients of cash 
105.12  grants must meet the requirements in section 256.476, 
105.13  subdivision 10; and 
105.14     (5) the county shall report client outcomes, services, and 
105.15  costs under this paragraph in a manner prescribed by the 
105.16  commissioner. 
105.17  Upon implementation of direct cash payments to clients under 
105.18  this section, any person determined eligible for the alternative 
105.19  care program who chooses a cash payment approved by the county 
105.20  agency shall receive the cash payment under this section and not 
105.21  under section 256.476 unless the person was receiving a consumer 
105.22  support grant under section 256.476 before implementation of 
105.23  direct cash payments under this section. 
105.24     Sec. 14.  Minnesota Statutes 1998, section 256B.0913, 
105.25  subdivision 10, is amended to read: 
105.26     Subd. 10.  [ALLOCATION FORMULA.] (a) The alternative care 
105.27  appropriation for fiscal years 1992 and beyond shall cover only 
105.28  180-day eligible clients. 
105.29     (b) Prior to July 1 of each year, the commissioner shall 
105.30  allocate to county agencies the state funds available for 
105.31  alternative care for persons eligible under subdivision 2.  The 
105.32  allocation for fiscal year 1992 shall be calculated using a base 
105.33  that is adjusted to exclude the medical assistance share of 
105.34  alternative care expenditures.  The adjusted base is calculated 
105.35  by multiplying each county's allocation for fiscal year 1991 by 
105.36  the percentage of county alternative care expenditures for 
106.1   180-day eligible clients.  The percentage is determined based on 
106.2   expenditures for services rendered in fiscal year 1989 or 
106.3   calendar year 1989, whichever is greater. 
106.4      (c) If the county expenditures for 180-day eligible clients 
106.5   are 95 percent or more of its adjusted base allocation, the 
106.6   allocation for the next fiscal year is 100 percent of the 
106.7   adjusted base, plus inflation to the extent that inflation is 
106.8   included in the state budget. 
106.9      (d) If the county expenditures for 180-day eligible clients 
106.10  are less than 95 percent of its adjusted base allocation, the 
106.11  allocation for the next fiscal year is the adjusted base 
106.12  allocation less the amount of unspent funds below the 95 percent 
106.13  level. 
106.14     (e) For fiscal year 1992 only, a county may receive an 
106.15  increased allocation if annualized service costs for the month 
106.16  of May 1991 for 180-day eligible clients are greater than the 
106.17  allocation otherwise determined.  A county may apply for this 
106.18  increase by reporting projected expenditures for May to the 
106.19  commissioner by June 1, 1991.  The amount of the allocation may 
106.20  exceed the amount calculated in paragraph (b).  The projected 
106.21  expenditures for May must be based on actual 180-day eligible 
106.22  client caseload and the individual cost of clients' care plans.  
106.23  If a county does not report its expenditures for May, the amount 
106.24  in paragraph (c) or (d) shall be used. 
106.25     (f) Calculations for paragraphs (c) and (d) are to be made 
106.26  as follows:  for each county, the determination of expenditures 
106.27  shall be based on payments for services rendered from April 1 
106.28  through March 31 in the base year, to the extent that claims 
106.29  have been submitted by June 1 of that year.  Calculations for 
106.30  paragraphs (c) and (d) must also include the funds transferred 
106.31  to the consumer support grant program for clients who have 
106.32  transferred to that program from April 1 through March 31 in the 
106.33  base year.  
106.34     (g) For the biennium ending June 30, 2001, the allocation 
106.35  of state funds to county agencies shall be calculated as 
106.36  described in paragraphs (c) and (d).  If the annual legislative 
107.1   appropriation for the alternative care program is inadequate to 
107.2   fund the combined county allocations for fiscal year 2000 or 
107.3   2001, the commissioner shall distribute to each county the 
107.4   entire annual appropriation as that county's percentage of the 
107.5   computed base as calculated in paragraph (f). 
107.6      Sec. 15.  Minnesota Statutes 1998, section 256B.0913, 
107.7   subdivision 12, is amended to read: 
107.8      Subd. 12.  [CLIENT PREMIUMS.] (a) A premium is required for 
107.9   all 180-day eligible clients to help pay for the cost of 
107.10  participating in the program.  The amount of the premium for the 
107.11  alternative care client shall be determined as follows: 
107.12     (1) when the alternative care client's income less 
107.13  recurring and predictable medical expenses is greater than the 
107.14  medical assistance income standard but less than 150 percent of 
107.15  the federal poverty guideline, and total assets are less than 
107.16  $6,000 $10,000, the fee is zero; 
107.17     (2) when the alternative care client's income less 
107.18  recurring and predictable medical expenses is greater than 150 
107.19  percent of the federal poverty guideline, and total assets are 
107.20  less than $6,000 $10,000, the fee is 25 percent of the cost of 
107.21  alternative care services or the difference between 150 percent 
107.22  of the federal poverty guideline and the client's income less 
107.23  recurring and predictable medical expenses, whichever is less; 
107.24  and 
107.25     (3) when the alternative care client's total assets are 
107.26  greater than $6,000 $10,000, the fee is 25 percent of the cost 
107.27  of alternative care services.  
107.28     For married persons, total assets are defined as the total 
107.29  marital assets less the estimated community spouse asset 
107.30  allowance, under section 256B.059, if applicable.  For married 
107.31  persons, total income is defined as the client's income less the 
107.32  monthly spousal allotment, under section 256B.058. 
107.33     All alternative care services except case management shall 
107.34  be included in the estimated costs for the purpose of 
107.35  determining 25 percent of the costs. 
107.36     The monthly premium shall be calculated based on the cost 
108.1   of the first full month of alternative care services and shall 
108.2   continue unaltered until the next reassessment is completed or 
108.3   at the end of 12 months, whichever comes first.  Premiums are 
108.4   due and payable each month alternative care services are 
108.5   received unless the actual cost of the services is less than the 
108.6   premium. 
108.7      (b) The fee shall be waived by the commissioner when: 
108.8      (1) a person who is residing in a nursing facility is 
108.9   receiving case management only; 
108.10     (2) a person is applying for medical assistance; 
108.11     (3) a married couple is requesting an asset assessment 
108.12  under the spousal impoverishment provisions; 
108.13     (4) a person is a medical assistance recipient, but has 
108.14  been approved for alternative care-funded assisted living 
108.15  services; 
108.16     (5) a person is found eligible for alternative care, but is 
108.17  not yet receiving alternative care services; or 
108.18     (6) a person's fee under paragraph (a) is less than $25. 
108.19     (c) The county agency must collect the premium from the 
108.20  client and forward the amounts collected to the commissioner in 
108.21  the manner and at the times prescribed by the commissioner.  
108.22  Money collected must be deposited in the general fund and is 
108.23  appropriated to the commissioner for the alternative care 
108.24  program.  The client must supply the county with the client's 
108.25  social security number at the time of application.  If a client 
108.26  fails or refuses to pay the premium due, the county shall supply 
108.27  the commissioner with the client's social security number and 
108.28  other information the commissioner requires to collect the 
108.29  premium from the client.  The commissioner shall collect unpaid 
108.30  premiums using the Revenue Recapture Act in chapter 270A and 
108.31  other methods available to the commissioner.  The commissioner 
108.32  may require counties to inform clients of the collection 
108.33  procedures that may be used by the state if a premium is not 
108.34  paid.  
108.35     (d) The commissioner shall begin to adopt emergency or 
108.36  permanent rules governing client premiums within 30 days after 
109.1   July 1, 1991, including criteria for determining when services 
109.2   to a client must be terminated due to failure to pay a premium.  
109.3      Sec. 16.  Minnesota Statutes 1998, section 256B.0913, 
109.4   subdivision 16, is amended to read: 
109.5      Subd. 16.  [CONVERSION OF ENROLLMENT.] Upon approval of the 
109.6   elderly waiver amendments described in section 256B.0915, 
109.7   subdivision 1d, persons currently receiving services shall have 
109.8   their eligibility for the elderly waiver program determined 
109.9   under section 256B.0915.  Persons currently receiving 
109.10  alternative care services whose income is under the special 
109.11  income standard according to Code of Federal Regulations, title 
109.12  42, section 435.236, who are eligible for the elderly waiver 
109.13  program shall be transferred to that program and shall receive 
109.14  priority access to elderly waiver slots for six months after 
109.15  implementation of this subdivision, except that persons whose 
109.16  income is above the maintenance needs amount described in 
109.17  section 256B.0915, subdivision 1d, paragraph (a), shall have the 
109.18  option of remaining in the alternative care program.  Persons 
109.19  currently enrolled in the alternative care program who are not 
109.20  eligible for the elderly waiver program shall continue to be 
109.21  eligible for the alternative care program as long as continuous 
109.22  eligibility is maintained.  Continued eligibility for the 
109.23  alternative care program shall be reviewed every six months.  
109.24  Persons who apply for the alternative care program after 
109.25  approval of the elderly waiver amendments in section 256B.0915, 
109.26  subdivision 1d, are not eligible for alternative care if they 
109.27  would qualify for the elderly waiver, with or without a 
109.28  spenddown.  Persons who apply for the alternative care program 
109.29  after approval of the elderly waiver amendments in section 
109.30  256B.0915, subdivision 1d, whose income is under the special 
109.31  income standard according to Code of Federal Regulations, title 
109.32  42, section 435.236, are not eligible for alternative care if 
109.33  they would qualify for the elderly waiver, except that persons 
109.34  whose income is above the maintenance needs amount described in 
109.35  section 256B.0915, subdivision 1d, paragraph (a), shall have the 
109.36  option of remaining in the alternative care program. 
110.1      Sec. 17.  Minnesota Statutes 1998, section 256B.431, 
110.2   subdivision 2i, is amended to read: 
110.3      Subd. 2i.  [OPERATING COSTS AFTER JULY 1, 1988.] (a)  
110.4   [OTHER OPERATING COST LIMITS.] For the rate year beginning July 
110.5   1, 1988, the commissioner shall increase the other operating 
110.6   cost limits established in Minnesota Rules, part 9549.0055, 
110.7   subpart 2, item E, to 110 percent of the median of the array of 
110.8   allowable historical other operating cost per diems and index 
110.9   these limits as in Minnesota Rules, part 9549.0056, subparts 3 
110.10  and 4.  The limits must be established in accordance with 
110.11  subdivision 2b, paragraph (d).  For rate years beginning on or 
110.12  after July 1, 1989, the adjusted other operating cost limits 
110.13  must be indexed as in Minnesota Rules, part 9549.0056, subparts 
110.14  3 and 4.  For the rate period beginning October 1, 1992, and for 
110.15  rate years beginning after June 30, 1993, the amount of the 
110.16  surcharge under section 256.9657, subdivision 1, shall be 
110.17  included in the plant operations and maintenance operating cost 
110.18  category.  The surcharge shall be an allowable cost for the 
110.19  purpose of establishing the payment rate. 
110.20     (b) [CARE-RELATED OPERATING COST LIMITS.] For the rate year 
110.21  beginning July 1, 1988, the commissioner shall increase the 
110.22  care-related operating cost limits established in Minnesota 
110.23  Rules, part 9549.0055, subpart 2, items A and B, to 125 percent 
110.24  of the median of the array of the allowable historical case mix 
110.25  operating cost standardized per diems and the allowable 
110.26  historical other care-related operating cost per diems and index 
110.27  those limits as in Minnesota Rules, part 9549.0056, subparts 1 
110.28  and 2.  The limits must be established in accordance with 
110.29  subdivision 2b, paragraph (d).  For rate years beginning on or 
110.30  after July 1, 1989, the adjusted care-related limits must be 
110.31  indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 
110.32     (c) [SALARY ADJUSTMENT PER DIEM.] Effective July 1, 1998, 
110.33  to June 30, 2000, the commissioner shall make available the 
110.34  salary adjustment per diem calculated in clause (1) or (2) to 
110.35  the total operating cost payment rate of each nursing facility 
110.36  reimbursed under this section or section 256B.434.  The salary 
111.1   adjustment per diem for each nursing facility must be determined 
111.2   as follows:  
111.3      (1) For each nursing facility that reports salaries for 
111.4   registered nurses, licensed practical nurses, and aides, 
111.5   orderlies and attendants separately, the commissioner shall 
111.6   determine the salary adjustment per diem by multiplying the 
111.7   total salaries, payroll taxes, and fringe benefits allowed in 
111.8   each operating cost category, except management fees and 
111.9   administrator and central office salaries and the related 
111.10  payroll taxes and fringe benefits, by 3.0 percent and then 
111.11  dividing the resulting amount by the nursing facility's actual 
111.12  resident days. 
111.13     (2) For each nursing facility that does not report salaries 
111.14  for registered nurses, licensed practical nurses, aides, 
111.15  orderlies, and attendants separately, the salary adjustment per 
111.16  diem is the weighted average salary adjustment per diem increase 
111.17  determined under clause (1).  
111.18     (3) A nursing facility may apply for the salary adjustment 
111.19  per diem calculated under clauses (1) and (2).  The application 
111.20  must be made to the commissioner and contain a plan by which the 
111.21  nursing facility will distribute the salary adjustment to 
111.22  employees of the nursing facility.  In order to apply for a 
111.23  salary adjustment, a nursing facility reimbursed under section 
111.24  256B.434, must report the information required by clause (1) or 
111.25  (2) in the application, in the manner specified by the 
111.26  commissioner.  For nursing facilities in which the employees are 
111.27  represented by an exclusive bargaining representative, an 
111.28  agreement negotiated and agreed to by the employer and the 
111.29  exclusive bargaining representative, after July 1, 1998, may 
111.30  constitute the plan for the salary distribution.  The 
111.31  commissioner shall review the plan to ensure that the salary 
111.32  adjustment per diem is used solely to increase the compensation 
111.33  of nursing home facility employees.  To be eligible, a facility 
111.34  must submit its plan for the salary distribution by December 31, 
111.35  1998.  If a facility's plan for salary distribution is effective 
111.36  for its employees after July 1, 1998, the salary adjustment cost 
112.1   per diem shall be effective the same date as its plan. 
112.2      (4) Additional costs incurred by nursing facilities as a 
112.3   result of this salary adjustment are not allowable costs for 
112.4   purposes of the September 30, 1998, cost report. 
112.5      (d)  [NEW BASE YEAR.] The commissioner shall establish new 
112.6   base years for both the reporting year ending September 30, 
112.7   1989, and the reporting year ending September 30, 1990.  In 
112.8   establishing new base years, the commissioner must take into 
112.9   account:  
112.10     (1) statutory changes made in geographic groups; 
112.11     (2) redefinitions of cost categories; and 
112.12     (3) reclassification, pass-through, or exemption of certain 
112.13  costs such as Public Employee Retirement Act contributions. 
112.14     (e) (d) [NEW BASE YEAR.] The commissioner shall establish a 
112.15  new base year for the reporting years ending September 30, 1991, 
112.16  and September 30, 1992.  In establishing a new base year, the 
112.17  commissioner must take into account:  
112.18     (1) statutory changes made in geographic groups; 
112.19     (2) redefinitions of cost categories; and 
112.20     (3) reclassification, pass-through, or exemption of certain 
112.21  costs. 
112.22     Sec. 18.  Minnesota Statutes 1998, section 256B.431, 
112.23  subdivision 17, is amended to read: 
112.24     Subd. 17.  [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 
112.25  (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 
112.26  for rate periods beginning on October 1, 1992, and for rate 
112.27  years beginning after June 30, 1993, a nursing facility that (1) 
112.28  has completed a construction project approved under section 
112.29  144A.071, subdivision 4a, clause (m); (2) has completed a 
112.30  construction project approved under section 144A.071, 
112.31  subdivision 4a, and effective after June 30, 1995; or (3) has 
112.32  completed a renovation, replacement, or upgrading project 
112.33  approved under the moratorium exception process in section 
112.34  144A.073 shall be reimbursed for costs directly identified to 
112.35  that project as provided in subdivision 16 and this subdivision. 
112.36     (b) Notwithstanding Minnesota Rules, part 9549.0060, 
113.1   subparts 5, item A, subitems (1) and (3), and 7, item D, 
113.2   allowable interest expense on debt shall include: 
113.3      (1) interest expense on debt related to the cost of 
113.4   purchasing or replacing depreciable equipment, excluding 
113.5   vehicles, not to exceed six percent of the total historical cost 
113.6   of the project; and 
113.7      (2) interest expense on debt related to financing or 
113.8   refinancing costs, including costs related to points, loan 
113.9   origination fees, financing charges, legal fees, and title 
113.10  searches; and issuance costs including bond discounts, bond 
113.11  counsel, underwriter's counsel, corporate counsel, printing, and 
113.12  financial forecasts.  Allowable debt related to items in this 
113.13  clause shall not exceed seven percent of the total historical 
113.14  cost of the project.  To the extent these costs are financed, 
113.15  the straight-line amortization of the costs in this clause is 
113.16  not an allowable cost; and 
113.17     (3) interest on debt incurred for the establishment of a 
113.18  debt reserve fund, net of the interest earned on the debt 
113.19  reserve fund. 
113.20     (c) Debt incurred for costs under paragraph (b) is not 
113.21  subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 
113.22  subitem (5) or (6). 
113.23     (d) The incremental increase in a nursing facility's rental 
113.24  rate, determined under Minnesota Rules, parts 9549.0010 to 
113.25  9549.0080, and this section, resulting from the acquisition of 
113.26  allowable capital assets, and allowable debt and interest 
113.27  expense under this subdivision shall be added to its 
113.28  property-related payment rate and shall be effective on the 
113.29  first day of the month following the month in which the 
113.30  moratorium project was completed. 
113.31     (e) Notwithstanding subdivision 3f, paragraph (a), for rate 
113.32  periods beginning on October 1, 1992, and for rate years 
113.33  beginning after June 30, 1993, the replacement-costs-new per bed 
113.34  limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 
113.35  item B, for a nursing facility that has completed a renovation, 
113.36  replacement, or upgrading project that has been approved under 
114.1   the moratorium exception process in section 144A.073, or that 
114.2   has completed an addition to or replacement of buildings, 
114.3   attached fixtures, or land improvements for which the total 
114.4   historical cost exceeds the lesser of $150,000 or ten percent of 
114.5   the most recent appraised value, must be $47,500 per licensed 
114.6   bed in multiple-bed rooms and $71,250 per licensed bed in a 
114.7   single-bed room.  These amounts must be adjusted annually as 
114.8   specified in subdivision 3f, paragraph (a), beginning January 1, 
114.9   1993. 
114.10     (f) A nursing facility that completes a project identified 
114.11  in this subdivision and, as of April 17, 1992, has not been 
114.12  mailed a rate notice with a special appraisal for a completed 
114.13  project, or completes a project after April 17, 1992, but before 
114.14  September 1, 1992, may elect either to request a special 
114.15  reappraisal with the corresponding adjustment to the 
114.16  property-related payment rate under the laws in effect on June 
114.17  30, 1992, or to submit their capital asset and debt information 
114.18  after that date and obtain the property-related payment rate 
114.19  adjustment under this section, but not both. 
114.20     (g) For purposes of this paragraph, a total replacement 
114.21  means the complete replacement of the nursing facility's 
114.22  physical plant through the construction of a new physical plant 
114.23  or the transfer of the nursing facility's license from one 
114.24  physical plant location to another.  For total replacement 
114.25  projects completed on or after July 1, 1992, the commissioner 
114.26  shall compute the incremental change in the nursing facility's 
114.27  rental per diem, for rate years beginning on or after July 1, 
114.28  1995, by replacing its appraised value, including the historical 
114.29  capital asset costs, and the capital debt and interest costs 
114.30  with the new nursing facility's allowable capital asset costs 
114.31  and the related allowable capital debt and interest costs.  If 
114.32  the new nursing facility has decreased its licensed capacity, 
114.33  the aggregate investment per bed limit in subdivision 3a, 
114.34  paragraph (d), shall apply.  If the new nursing facility has 
114.35  retained a portion of the original physical plant for nursing 
114.36  facility usage, then a portion of the appraised value prior to 
115.1   the replacement must be retained and included in the calculation 
115.2   of the incremental change in the nursing facility's rental per 
115.3   diem.  For purposes of this part, the original nursing facility 
115.4   means the nursing facility prior to the total replacement 
115.5   project.  The portion of the appraised value to be retained 
115.6   shall be calculated according to clauses (1) to (3): 
115.7      (1) The numerator of the allocation ratio shall be the 
115.8   square footage of the area in the original physical plant which 
115.9   is being retained for nursing facility usage. 
115.10     (2) The denominator of the allocation ratio shall be the 
115.11  total square footage of the original nursing facility physical 
115.12  plant. 
115.13     (3) Each component of the nursing facility's allowable 
115.14  appraised value prior to the total replacement project shall be 
115.15  multiplied by the allocation ratio developed by dividing clause 
115.16  (1) by clause (2). 
115.17     In the case of either type of total replacement as 
115.18  authorized under section 144A.071 or 144A.073, the provisions of 
115.19  this subdivision shall also apply.  For purposes of the 
115.20  moratorium exception authorized under section 144A.071, 
115.21  subdivision 4a, paragraph (s), if the total replacement involves 
115.22  the renovation and use of an existing health care facility 
115.23  physical plant, the new allowable capital asset costs and 
115.24  related debt and interest costs shall include first the 
115.25  allowable capital asset costs and related debt and interest 
115.26  costs of the renovation, to which shall be added the allowable 
115.27  capital asset costs of the existing physical plant prior to the 
115.28  renovation, and if reported by the facility, the related 
115.29  allowable capital debt and interest costs. 
115.30     (h) Notwithstanding Minnesota Rules, part 9549.0060, 
115.31  subpart 11, item C, subitem (2), for a total replacement, as 
115.32  defined in paragraph (g), authorized under section 144A.071 or 
115.33  144A.073 after July 1, 1999, the replacement-costs-new per bed 
115.34  limit shall be $74,280 per licensed bed in multiple-bed rooms, 
115.35  $92,850 per licensed bed in semiprivate rooms with a fixed 
115.36  partition separating the resident beds, and $111,420 per 
116.1   licensed bed in single rooms.  Minnesota Rules, part 9549.0060, 
116.2   subpart 11, item C, subitem (2), does not apply.  These amounts 
116.3   must be adjusted annually as specified in subdivision 3f, 
116.4   paragraph (a), beginning January 1, 2000.  
116.5      (i) For a total replacement, as defined in paragraph (g), 
116.6   authorized under section 144A.073 for a 96-bed nursing home in 
116.7   Carlton county, the replacement costs new per bed limit shall be 
116.8   $74,280 per licensed bed in multiple-bed rooms, $92,850 per 
116.9   licensed bed in semiprivate rooms with a fixed partition 
116.10  separating the resident's beds, and $111,420 per licensed bed in 
116.11  a single room.  Minnesota Rules, part 9549.0060, subpart 11, 
116.12  item C, subitem (2), does not apply.  The resulting maximum 
116.13  allowable replacement costs new multiplied by 1.25 shall 
116.14  constitute the project's dollar threshold for purposes of 
116.15  application of the limit set forth in section 144A.071, 
116.16  subdivision 2.  The commissioner of health may waive the 
116.17  requirements of section 144A.073, subdivision 3b, paragraph (b), 
116.18  clause (2), on the condition that the other requirements of that 
116.19  paragraph are met. 
116.20     Sec. 19.  Minnesota Statutes 1998, section 256B.431, 
116.21  subdivision 26, is amended to read: 
116.22     Subd. 26.  [CHANGES TO NURSING FACILITY REIMBURSEMENT 
116.23  BEGINNING JULY 1, 1997.] The nursing facility reimbursement 
116.24  changes in paragraphs (a) to (f) shall apply in the sequence 
116.25  specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 
116.26  this section, beginning July 1, 1997. 
116.27     (a) For rate years beginning on or after July 1, 1997, the 
116.28  commissioner shall limit a nursing facility's allowable 
116.29  operating per diem for each case mix category for each rate year.
116.30  The commissioner shall group nursing facilities into two groups, 
116.31  freestanding and nonfreestanding, within each geographic group, 
116.32  using their operating cost per diem for the case mix A 
116.33  classification.  A nonfreestanding nursing facility is a nursing 
116.34  facility whose other operating cost per diem is subject to the 
116.35  hospital attached, short length of stay, or the rule 80 limits.  
116.36  All other nursing facilities shall be considered freestanding 
117.1   nursing facilities.  The commissioner shall then array all 
117.2   nursing facilities in each grouping by their allowable case mix 
117.3   A operating cost per diem.  In calculating a nursing facility's 
117.4   operating cost per diem for this purpose, the commissioner shall 
117.5   exclude the raw food cost per diem related to providing special 
117.6   diets that are based on religious beliefs, as determined in 
117.7   subdivision 2b, paragraph (h).  For those nursing facilities in 
117.8   each grouping whose case mix A operating cost per diem: 
117.9      (1) is at or below the median of the array, the 
117.10  commissioner shall limit the nursing facility's allowable 
117.11  operating cost per diem for each case mix category to the lesser 
117.12  of the prior reporting year's allowable operating cost per diem 
117.13  as specified in Laws 1996, chapter 451, article 3, section 11, 
117.14  paragraph (h), plus the inflation factor as established in 
117.15  paragraph (d), clause (2), increased by two percentage points, 
117.16  or the current reporting year's corresponding allowable 
117.17  operating cost per diem; or 
117.18     (2) is above the median of the array, the commissioner 
117.19  shall limit the nursing facility's allowable operating cost per 
117.20  diem for each case mix category to the lesser of the prior 
117.21  reporting year's allowable operating cost per diem as specified 
117.22  in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 
117.23  plus the inflation factor as established in paragraph (d), 
117.24  clause (2), increased by one percentage point, or the current 
117.25  reporting year's corresponding allowable operating cost per diem.
117.26     For purposes of paragraph (a), if a nursing facility 
117.27  reports on its cost report a reduction in cost due to a refund 
117.28  or credit for a rate year beginning on or after July 1, 1998, 
117.29  the commissioner shall increase that facility's spend-up limit 
117.30  for the rate year following the current rate year by the amount 
117.31  of the cost reduction divided by its resident days for the 
117.32  reporting year preceding the rate year in which the adjustment 
117.33  is to be made. 
117.34     (b) For rate years beginning on or after July 1, 1997, the 
117.35  commissioner shall limit the allowable operating cost per diem 
117.36  for high cost nursing facilities.  After application of the 
118.1   limits in paragraph (a) to each nursing facility's operating 
118.2   cost per diem, the commissioner shall group nursing facilities 
118.3   into two groups, freestanding or nonfreestanding, within each 
118.4   geographic group.  A nonfreestanding nursing facility is a 
118.5   nursing facility whose other operating cost per diem are subject 
118.6   to hospital attached, short length of stay, or rule 80 limits.  
118.7   All other nursing facilities shall be considered freestanding 
118.8   nursing facilities.  The commissioner shall then array all 
118.9   nursing facilities within each grouping by their allowable case 
118.10  mix A operating cost per diem.  In calculating a nursing 
118.11  facility's operating cost per diem for this purpose, the 
118.12  commissioner shall exclude the raw food cost per diem related to 
118.13  providing special diets that are based on religious beliefs, as 
118.14  determined in subdivision 2b, paragraph (h).  For those nursing 
118.15  facilities in each grouping whose case mix A operating cost per 
118.16  diem exceeds 1.0 standard deviation above the median, the 
118.17  commissioner shall reduce their allowable operating cost per 
118.18  diem by three percent.  For those nursing facilities in each 
118.19  grouping whose case mix A operating cost per diem exceeds 0.5 
118.20  standard deviation above the median but is less than or equal to 
118.21  1.0 standard deviation above the median, the commissioner shall 
118.22  reduce their allowable operating cost per diem by two percent.  
118.23  However, in no case shall a nursing facility's operating cost 
118.24  per diem be reduced below its grouping's limit established at 
118.25  0.5 standard deviations above the median. 
118.26     (c) For rate years beginning on or after July 1, 1997, the 
118.27  commissioner shall determine a nursing facility's efficiency 
118.28  incentive by first computing the allowable difference, which is 
118.29  the lesser of $4.50 or the amount by which the facility's other 
118.30  operating cost limit exceeds its nonadjusted other operating 
118.31  cost per diem for that rate year.  The commissioner shall 
118.32  compute the efficiency incentive by: 
118.33     (1) subtracting the allowable difference from $4.50 and 
118.34  dividing the result by $4.50; 
118.35     (2) multiplying 0.20 by the ratio resulting from clause 
118.36  (1), and then; 
119.1      (3) adding 0.50 to the result from clause (2); and 
119.2      (4) multiplying the result from clause (3) times the 
119.3   allowable difference. 
119.4      The nursing facility's efficiency incentive payment shall 
119.5   be the lesser of $2.25 or the product obtained in clause (4). 
119.6      (d) For rate years beginning on or after July 1, 1997, the 
119.7   forecasted price index for a nursing facility's allowable 
119.8   operating cost per diem shall be determined under clauses (1) 
119.9   and (2) using the change in the Consumer Price Index-All Items 
119.10  (United States city average) (CPI-U) as forecasted by Data 
119.11  Resources, Inc.  The commissioner shall use the indices as 
119.12  forecasted in the fourth quarter of the calendar year preceding 
119.13  the rate year, subject to subdivision 2l, paragraph (c).  
119.14     (1) The CPI-U forecasted index for allowable operating cost 
119.15  per diem shall be based on the 21-month period from the midpoint 
119.16  of the nursing facility's reporting year to the midpoint of the 
119.17  rate year following the reporting year. 
119.18     (2) For rate years beginning on or after July 1, 1997, the 
119.19  forecasted index for operating cost limits referred to in 
119.20  subdivision 21, paragraph (b), shall be based on the CPI-U for 
119.21  the 12-month period between the midpoints of the two reporting 
119.22  years preceding the rate year. 
119.23     (e) After applying these provisions for the respective rate 
119.24  years, the commissioner shall index these allowable operating 
119.25  cost per diem by the inflation factor provided for in paragraph 
119.26  (d), clause (1), and add the nursing facility's efficiency 
119.27  incentive as computed in paragraph (c). 
119.28     (f) For rate years beginning on or after July 1, 1997, the 
119.29  total operating cost payment rates for a nursing facility shall 
119.30  be the greater of the total operating cost payment rates 
119.31  determined under this section or the total operating cost 
119.32  payment rates in effect on June 30, 1997, subject to rate 
119.33  adjustments due to field audit or rate appeal resolution.  This 
119.34  provision shall not apply to subsequent field audit adjustments 
119.35  of the nursing facility's operating cost rates for rate years 
119.36  beginning on or after July 1, 1997. 
120.1      (g) For the rate years beginning on July 1, 1997, July 1, 
120.2   1998, and July 1, 1999, a nursing facility licensed for 40 beds 
120.3   effective May 1, 1992, with a subsequent increase of 20 
120.4   Medicare/Medicaid certified beds, effective January 26, 1993, in 
120.5   accordance with an increase in licensure is exempt from 
120.6   paragraphs (a) and (b). 
120.7      (h) For a nursing facility whose construction project was 
120.8   authorized according to section 144A.073, subdivision 5, 
120.9   paragraph (g), the operating cost payment rates for the third 
120.10  new location shall be determined based on Minnesota Rules, part 
120.11  9549.0057.  The relocation allowed under section 144A.073, 
120.12  subdivision 5, paragraph (g), and the rate determination allowed 
120.13  under this paragraph must meet the cost neutrality requirements 
120.14  of section 144A.073, subdivision 3c.  Paragraphs (a) and (b) 
120.15  shall not apply until the second rate year after the settle-up 
120.16  cost report is filed.  Notwithstanding subdivision 2b, paragraph 
120.17  (g), real estate taxes and special assessments payable by 
120.18  the third new location, a 501(c)(3) nonprofit corporation, shall 
120.19  be included in the payment rates determined under this 
120.20  subdivision for all subsequent rate years. 
120.21     (i) For the rate year beginning July 1, 1997, the 
120.22  commissioner shall compute the payment rate for a nursing 
120.23  facility licensed for 94 beds on September 30, 1996, that 
120.24  applied in October 1993 for approval of a total replacement 
120.25  under the moratorium exception process in section 144A.073, and 
120.26  completed the approved replacement in June 1995, with other 
120.27  operating cost spend-up limit under paragraph (a), increased by 
120.28  $3.98, and after computing the facility's payment rate according 
120.29  to this section, the commissioner shall make a one-year positive 
120.30  rate adjustment of $3.19 for operating costs related to the 
120.31  newly constructed total replacement, without application of 
120.32  paragraphs (a) and (b).  The facility's per diem, before the 
120.33  $3.19 adjustment, shall be used as the prior reporting year's 
120.34  allowable operating cost per diem for payment rate calculation 
120.35  for the rate year beginning July 1, 1998.  A facility described 
120.36  in this paragraph is exempt from paragraph (b) for the rate 
121.1   years beginning July 1, 1997, and July 1, 1998. 
121.2      (j) For the purpose of applying the limit stated in 
121.3   paragraph (a), a nursing facility in Kandiyohi county licensed 
121.4   for 86 beds that was granted hospital-attached status on 
121.5   December 1, 1994, shall have the prior year's allowable 
121.6   care-related per diem increased by $3.207 and the prior year's 
121.7   other operating cost per diem increased by $4.777 before adding 
121.8   the inflation in paragraph (d), clause (2), for the rate year 
121.9   beginning on July 1, 1997. 
121.10     (k) For the purpose of applying the limit stated in 
121.11  paragraph (a), a 117 bed nursing facility located in Pine county 
121.12  shall have the prior year's allowable other operating cost per 
121.13  diem increased by $1.50 before adding the inflation in paragraph 
121.14  (d), clause (2), for the rate year beginning on July 1, 1997. 
121.15     (l) For the purpose of applying the limit under paragraph 
121.16  (a), a nursing facility in Hibbing licensed for 192 beds shall 
121.17  have the prior year's allowable other operating cost per diem 
121.18  increased by $2.67 before adding the inflation in paragraph (d), 
121.19  clause (2), for the rate year beginning July 1, 1997. 
121.20     Sec. 20.  Minnesota Statutes 1998, section 256B.431, is 
121.21  amended by adding a subdivision to read: 
121.22     Subd. 28.  [NURSING FACILITY RATE INCREASES BEGINNING JULY 
121.23  1, 1999, AND JULY 1, 2000.] (a) For the rate years beginning 
121.24  July 1, 1999, and July 1, 2000, the commissioner shall make 
121.25  available to each nursing facility reimbursed under this section 
121.26  or section 256B.434 an adjustment to the total operating payment 
121.27  rate.  For each facility, total operating costs shall be 
121.28  separated into costs that are compensation related and all other 
121.29  costs.  Compensation related costs include salaries, payroll 
121.30  taxes, and fringe benefits for all employees except management 
121.31  fees, the administrator, and central office staff. 
121.32     (b) For the rate year beginning July 1, 1999, the 
121.33  commissioner shall make available a rate increase for 
121.34  compensation related costs of 4.843 percent and a rate increase 
121.35  for all other operating costs of 3.446 percent. 
121.36     (c) For the rate year beginning July 1, 2000, the 
122.1   commissioner shall make available a rate increase for 
122.2   compensation related costs of 3.632 percent and a rate increase 
122.3   for all other operating costs of 2.585 percent. 
122.4      (d) The payment rate adjustment for each nursing facility 
122.5   must be determined under clause (1) or (2): 
122.6      (1) for each nursing facility that reports salaries for 
122.7   registered nurses, licensed practical nurses, aides, orderlies, 
122.8   and attendants separately, the commissioner shall determine the 
122.9   payment rate adjustment using the categories specified in 
122.10  paragraph (a) multiplied by the rate increases specified in 
122.11  paragraph (b) or (c), and then dividing the resulting amount by 
122.12  the nursing facility's actual resident days.  In determining the 
122.13  amount of a payment rate adjustment for a nursing facility 
122.14  reimbursed under section 256B.434, the commissioner shall 
122.15  determine the proportions of the facility's rates that are 
122.16  compensation related costs and all other operating costs based 
122.17  on the facility's most recent cost report; and 
122.18     (2) for each nursing facility that does not report salaries 
122.19  for registered nurses, licensed practical nurses, aides, 
122.20  orderlies, and attendants separately, the payment rate 
122.21  adjustment shall be computed using the facility's total 
122.22  operating costs, separated into the categories specified in 
122.23  paragraph (a) in proportion to the weighted average of all 
122.24  facilities determined under clause (1), multiplied by the rate 
122.25  increases specified in paragraph (b) or (c), and then dividing 
122.26  the resulting amount by the nursing facility's actual resident 
122.27  days. 
122.28     (e) A nursing facility may apply for the 
122.29  compensation-related payment rate adjustment calculated under 
122.30  this subdivision.  The application must be made to the 
122.31  commissioner and contain a plan by which the nursing facility 
122.32  will distribute the compensation-related portion of the payment 
122.33  rate adjustment to employees of the nursing facility.  For 
122.34  nursing facilities in which the employees are represented by an 
122.35  exclusive bargaining representative, an agreement negotiated and 
122.36  agreed to by the employer and the exclusive bargaining 
123.1   representative constitutes the plan.  The commissioner shall 
123.2   review the plan to ensure that the payment rate adjustment per 
123.3   diem is used as provided in paragraphs (a) to (c).  To be 
123.4   eligible, a facility must submit its plan for the compensation 
123.5   distribution by December 31 each year.  A facility may amend its 
123.6   plan for the second rate year by submitting a revised plan by 
123.7   December 31, 2000.  If a facility's plan for compensation 
123.8   distribution is effective for its employees after July 1 of the 
123.9   year that the funds are available, the payment rate adjustment 
123.10  per diem shall be effective the same date as its plan. 
123.11     (f) A copy of the approved distribution plan must be made 
123.12  available to all employees.  This must be done by giving each 
123.13  employee a copy or by posting it in an area of the nursing 
123.14  facility to which all employees have access.  If an employee 
123.15  does not receive the compensation adjustment described in their 
123.16  facility's approved plan and is unable to resolve the problem 
123.17  with the facility's management or through the employee's union 
123.18  representative, the employee may contact the commissioner at an 
123.19  address or phone number provided by the commissioner and 
123.20  included in the approved plan.  
123.21     (g) If the reimbursement system under section 256B.435 is 
123.22  not implemented until July 1, 2001, the salary adjustment per 
123.23  diem authorized in subdivision 2i, paragraph (c), shall continue 
123.24  until June 30, 2001.  
123.25     (h) For the rate year beginning July 1, 1999, the following 
123.26  nursing facilities shall be allowed a rate increase equal to 67 
123.27  percent of the rate increase that would be allowed if 
123.28  subdivision 26, paragraph (a), was not applied: 
123.29     (1) a nursing facility in Carver county licensed for 33 
123.30  nursing home beds and four boarding care beds; 
123.31     (2) a nursing facility in Faribault county licensed for 159 
123.32  nursing home beds on September 30, 1998; and 
123.33     (3) a nursing facility in Houston county licensed for 68 
123.34  nursing home beds on September 30, 1998. 
123.35     (i) For the rate year beginning July 1, 1999, the following 
123.36  nursing facilities shall be allowed a rate increase equal to 67 
124.1   percent of the rate increase that would be allowed if 
124.2   subdivision 26, paragraphs (a) and (b), were not applied: 
124.3      (1) a nursing facility in Chisago county licensed for 135 
124.4   nursing home beds on September 30, 1998; and 
124.5      (2) a nursing facility in Murray county licensed for 62 
124.6   nursing home beds on September 30, 1998. 
124.7      (j) For the rate year beginning July 1, 1999, a nursing 
124.8   facility in Hennepin county licensed for 134 beds on September 
124.9   30, 1998, shall: 
124.10     (1) have the prior year's allowable care-related per diem 
124.11  increased by $3.93 and the prior year's other operating cost per 
124.12  diem increased by $1.69 before adding the inflation in 
124.13  subdivision 26, paragraph (d), clause (2); and 
124.14     (2) be allowed a rate increase equal to 67 percent of the 
124.15  rate increase that would be allowed if subdivision 26, 
124.16  paragraphs (a) and (b), were not applied. 
124.17     Sec. 21.  Minnesota Statutes 1998, section 256B.434, 
124.18  subdivision 3, is amended to read: 
124.19     Subd. 3.  [DURATION AND TERMINATION OF CONTRACTS.] (a) 
124.20  Subject to available resources, the commissioner may begin to 
124.21  execute contracts with nursing facilities November 1, 1995. 
124.22     (b) All contracts entered into under this section are for a 
124.23  term of one year.  Either party may terminate a contract at any 
124.24  time without cause by providing 30 90 calendar days advance 
124.25  written notice to the other party.  The decision to terminate a 
124.26  contract is not appealable.  If neither party provides written 
124.27  notice of termination the contract shall be renegotiated for 
124.28  additional one-year terms, for up to a total of four consecutive 
124.29  one-year terms Notwithstanding section 16C.05, subdivision 2, 
124.30  paragraph (a), clause (5), the contract shall be renegotiated 
124.31  for additional one-year terms, unless either party provides 
124.32  written notice of termination.  The provisions of the contract 
124.33  shall be renegotiated annually by the parties prior to the 
124.34  expiration date of the contract.  The parties may voluntarily 
124.35  renegotiate the terms of the contract at any time by mutual 
124.36  agreement. 
125.1      (c) If a nursing facility fails to comply with the terms of 
125.2   a contract, the commissioner shall provide reasonable notice 
125.3   regarding the breach of contract and a reasonable opportunity 
125.4   for the facility to come into compliance.  If the facility fails 
125.5   to come into compliance or to remain in compliance, the 
125.6   commissioner may terminate the contract.  If a contract is 
125.7   terminated, the contract payment remains in effect for the 
125.8   remainder of the rate year in which the contract was terminated, 
125.9   but in all other respects the provisions of this section do not 
125.10  apply to that facility effective the date the contract is 
125.11  terminated.  The contract shall contain a provision governing 
125.12  the transition back to the cost-based reimbursement system 
125.13  established under section 256B.431, subdivision 25, and 
125.14  Minnesota Rules, parts 9549.0010 to 9549.0080.  A contract 
125.15  entered into under this section may be amended by mutual 
125.16  agreement of the parties. 
125.17     Sec. 22.  Minnesota Statutes 1998, section 256B.434, 
125.18  subdivision 4, is amended to read: 
125.19     Subd. 4.  [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 
125.20  nursing facilities which have their payment rates determined 
125.21  under this section rather than section 256B.431, subdivision 25, 
125.22  the commissioner shall establish a rate under this subdivision.  
125.23  The nursing facility must enter into a written contract with the 
125.24  commissioner. 
125.25     (b) A nursing facility's case mix payment rate for the 
125.26  first rate year of a facility's contract under this section is 
125.27  the payment rate the facility would have received under section 
125.28  256B.431, subdivision 25. 
125.29     (c) A nursing facility's case mix payment rates for the 
125.30  second and subsequent years of a facility's contract under this 
125.31  section are the previous rate year's contract payment rates plus 
125.32  an inflation adjustment.  The index for the inflation adjustment 
125.33  must be based on the change in the Consumer Price Index-All 
125.34  Items (United States City average) (CPI-U) forecasted by Data 
125.35  Resources, Inc., as forecasted in the fourth quarter of the 
125.36  calendar year preceding the rate year.  The inflation adjustment 
126.1   must be based on the 12-month period from the midpoint of the 
126.2   previous rate year to the midpoint of the rate year for which 
126.3   the rate is being determined.  For the rate years beginning on 
126.4   July 1, 1999, and July 1, 2000, this paragraph shall apply only 
126.5   to the property related payment rate.  In determining the amount 
126.6   of the property related payment rate adjustment under this 
126.7   paragraph, the commissioner shall determine the proportion of 
126.8   the facility's rates that are property related based on the 
126.9   facility's most recent cost report. 
126.10     (d) The commissioner shall develop additional 
126.11  incentive-based payments of up to five percent above the 
126.12  standard contract rate for achieving outcomes specified in each 
126.13  contract.  The specified facility-specific outcomes must be 
126.14  measurable and approved by the commissioner.  The commissioner 
126.15  may establish, for each contract, various levels of achievement 
126.16  within an outcome.  After the outcomes have been specified the 
126.17  commissioner shall assign various levels of payment associated 
126.18  with achieving the outcome.  Any incentive-based payment cancels 
126.19  if there is a termination of the contract.  In establishing the 
126.20  specified outcomes and related criteria the commissioner shall 
126.21  consider the following state policy objectives: 
126.22     (1) improved cost effectiveness and quality of life as 
126.23  measured by improved clinical outcomes; 
126.24     (2) successful diversion or discharge to community 
126.25  alternatives; 
126.26     (3) decreased acute care costs; 
126.27     (4) improved consumer satisfaction; 
126.28     (5) the achievement of quality; or 
126.29     (6) any additional outcomes proposed by a nursing facility 
126.30  that the commissioner finds desirable. 
126.31     Sec. 23.  Minnesota Statutes 1998, section 256B.434, is 
126.32  amended by adding a subdivision to read: 
126.33     Subd. 4a.  [FACILITY RATE INCREASES.] For the rate year 
126.34  beginning July 1, 1999, the nursing facilities described in 
126.35  clauses (1) to (5) shall receive the rate increases indicated.  
126.36  The increases provided under this subdivision shall be included 
127.1   in the facility's total payment rates for the purpose of 
127.2   determining future rates under this section or any other section:
127.3      (1) a nursing facility in Becker county licensed for 102 
127.4   nursing home beds on September 30, 1998, shall receive an 
127.5   increase of $1.30 in its case mix class A payment rate; an 
127.6   increase of $1.33 in its case mix class B payment rate; an 
127.7   increase of $1.36 in its case mix class C payment rate; an 
127.8   increase of $1.39 in its case mix class D payment rate; an 
127.9   increase of $1.42 in its case mix class E payment rate; an 
127.10  increase of $1.42 in its case mix class F payment rate; an 
127.11  increase of $1.45 in its case mix class G payment rate; an 
127.12  increase of $1.49 in its case mix class H payment rate; an 
127.13  increase of $1.51 in its case mix class I payment rate; an 
127.14  increase of $1.54 in its case mix class J payment rate; and an 
127.15  increase of $1.59 in its case mix class K payment rate; 
127.16     (2) a nursing facility in Chisago county licensed for 101 
127.17  nursing home beds on September 30, 1998, shall receive an 
127.18  increase of $3.67 in each case mix payment rate; 
127.19     (3) a nursing facility in Canby, licensed for 75 beds shall 
127.20  have its property-related per diem rate increased by $1.21.  
127.21  This increase shall be recognized in the facility's contract 
127.22  payment rate under this section; 
127.23     (4) a nursing facility in Golden Valley with all its beds 
127.24  licensed to provide residential rehabilitative services to young 
127.25  adults under Minnesota Rules, parts 9570.2000 to 9570.3400, 
127.26  shall have the payment rate computed according to this section 
127.27  increased by $14.83; and 
127.28     (5) a county-owned 130-bed nursing facility in Park Rapids 
127.29  shall have its per diem contract payment rate increased by $1.02 
127.30  for costs related to compliance with comparable worth 
127.31  requirements.  
127.32     Sec. 24.  Minnesota Statutes 1998, section 256B.434, 
127.33  subdivision 13, is amended to read: 
127.34     Subd. 13.  [PAYMENT SYSTEM REFORM ADVISORY COMMITTEE.] (a) 
127.35  The commissioner, in consultation with an advisory committee, 
127.36  shall study options for reforming the regulatory and 
128.1   reimbursement system for nursing facilities to reduce the level 
128.2   of regulation, reporting, and procedural requirements, and to 
128.3   provide greater flexibility and incentives to stimulate 
128.4   competition and innovation.  The advisory committee shall 
128.5   include, at a minimum, representatives from the long-term care 
128.6   provider community, the department of health, and consumers of 
128.7   long-term care services.  The advisory committee sunsets on June 
128.8   30, 1997.  Among other things, the commissioner shall consider 
128.9   the feasibility and desirability of changing from a 
128.10  certification requirement to an accreditation requirement for 
128.11  participation in the medical assistance program, options to 
128.12  encourage early discharge of short-term residents through the 
128.13  provision of intensive therapy, and further modifications needed 
128.14  in rate equalization.  The commissioner shall also include 
128.15  detailed recommendations for a permanent managed care payment 
128.16  system to replace the contractual alternative payment 
128.17  demonstration project authorized under this section.  The 
128.18  commissioner shall submit a report with findings and 
128.19  recommendations to the legislature by January 15, 1997. 
128.20     (b) If a permanent managed care payment system has not been 
128.21  enacted into law by July 1, 1997, the commissioner shall develop 
128.22  and implement a transition plan to enable nursing facilities 
128.23  under contract with the commissioner under this section to 
128.24  revert to the cost-based payment system at the expiration of the 
128.25  alternative payment demonstration project.  The commissioner 
128.26  shall include in the alternative payment demonstration project 
128.27  contracts entered into under this section a provision to permit 
128.28  an amendment to the contract to be made after July 1, 1997, 
128.29  governing the transition back to the cost-based payment system.  
128.30  The transition plan and contract amendments are not subject to 
128.31  rulemaking requirements.  
128.32     Sec. 25.  Minnesota Statutes 1998, section 256B.435, is 
128.33  amended to read: 
128.34     256B.435 [NURSING FACILITY REIMBURSEMENT SYSTEM EFFECTIVE 
128.35  JULY 1, 2000 2001.] 
128.36     Subdivision 1.  [IN GENERAL.] Effective July 1, 2000 2001, 
129.1   the commissioner shall implement a performance-based contracting 
129.2   system to replace the current method of setting operating cost 
129.3   payment rates under sections 256B.431 and 256B.434 and Minnesota 
129.4   Rules, parts 9549.0010 to 9549.0080.  Operating cost payment 
129.5   rates for newly established facilities under Minnesota Rules, 
129.6   part 9549.0057, shall be established using section 256B.431 and 
129.7   Minnesota Rules, parts 9549.0010 to 9549.0070.  A nursing 
129.8   facility in operation on May 1, 1998, with payment rates not 
129.9   established under section 256B.431 or 256B.434 on that date, is 
129.10  ineligible for this performance-based contracting system.  In 
129.11  determining prospective payment rates of nursing facility 
129.12  services, the commissioner shall distinguish between operating 
129.13  costs and property-related costs.  The commissioner of finance 
129.14  shall include an annual inflationary adjustment in operating 
129.15  costs for nursing facilities using the inflation factor 
129.16  specified in subdivision 3 and funding for incentive-based 
129.17  payments as a budget change request in each biennial detailed 
129.18  expenditure budget submitted to the legislature under section 
129.19  16A.11.  Property related payment rates, including real estate 
129.20  taxes and special assessments, shall be determined under section 
129.21  256B.431 or 256B.434 or under a new property-related 
129.22  reimbursement system, if one is implemented by the commissioner 
129.23  under subdivision 3.  The commissioner shall present additional 
129.24  recommendations for performance-based contracting for nursing 
129.25  facilities to the legislature by February 15, 2000, in the 
129.26  following specific areas: 
129.27     (1) development of an interim default payment mechanism for 
129.28  nursing facilities that do not respond to the state's request 
129.29  for proposal but wish to continue participation in the medical 
129.30  assistance program, and nursing facilities the state does not 
129.31  select in the request for proposal process, and nursing 
129.32  facilities whose contract has been canceled; 
129.33     (2) development of criteria for facilities to earn 
129.34  performance-based incentive payments based on relevant outcomes 
129.35  negotiated by nursing facilities and the commissioner and that 
129.36  recognize both continuous quality efforts and quality 
130.1   improvement; 
130.2      (3) development of criteria and a process under which 
130.3   nursing facilities can request rate adjustments for low base 
130.4   rates, geographic disparities, or other reasons; 
130.5      (4) development of a dispute resolution mechanism for 
130.6   nursing facilities that are denied a contract, denied incentive 
130.7   payments, or denied a rate adjustment; 
130.8      (5) development of a property payment system to address the 
130.9   capital needs of nursing facilities that will be funded with 
130.10  additional appropriations; 
130.11     (6) establishment of a transitional plan to move from dual 
130.12  assessment instruments to the federally mandated resident 
130.13  assessment system, whereby the financial impact for each 
130.14  facility would be budget neutral; 
130.15     (7) identification of net cost implications for facilities 
130.16  and to the department of preparing for and implementing 
130.17  performance-based contracting or any proposed alternative 
130.18  system; 
130.19     (8) identification of facility financial and statistical 
130.20  reporting requirements; and 
130.21     (9) identification of exemptions from current regulations 
130.22  and statutes applicable under performance-based contracting.  
130.23     Subd. 1a.  [REQUESTS FOR PROPOSALS.] (a) For nursing 
130.24  facilities with rates established under section 256B.434 on 
130.25  January 1, 2001, the commissioner shall renegotiate contracts 
130.26  without requiring a response to a request for proposal, 
130.27  notwithstanding the solicitation process described in chapter 
130.28  16C. 
130.29     (b) Prior to July 1, 2001, the commissioner shall publish 
130.30  in the State Register a request for proposals to provide nursing 
130.31  facility services according to this section.  The commissioner 
130.32  will consider proposals from all nursing facilities that have 
130.33  payment rates established under section 256B.431.  The 
130.34  commissioner must respond to all proposals in a timely manner. 
130.35     (c) In issuing a request for proposals, the commissioner 
130.36  may develop reasonable requirements which, in the judgment of 
131.1   the commissioner, are necessary to protect residents or ensure 
131.2   that the performance-based contracting system furthers the 
131.3   interests of the state of Minnesota.  The request for proposals 
131.4   may include, but need not be limited to: 
131.5      (1) a requirement that a nursing facility make reasonable 
131.6   efforts to maximize Medicare payments on behalf of eligible 
131.7   residents; 
131.8      (2) requirements designed to prevent inappropriate or 
131.9   illegal discrimination against residents enrolled in the medical 
131.10  assistance program as compared to private paying residents; 
131.11     (3) requirements designed to ensure that admissions to a 
131.12  nursing facility are appropriate and that reasonable efforts are 
131.13  made to place residents in home and community-based settings 
131.14  when appropriate; 
131.15     (4) a requirement to agree to participate in the 
131.16  development of data collection systems and outcome-based 
131.17  standards.  Among other requirements specified by the 
131.18  commissioner, each facility entering into a contract may be 
131.19  required to pay an annual fee not to exceed $1,000.  The 
131.20  commissioner must use revenue generated from the fees to 
131.21  contract with a qualified consultant or contractor to develop 
131.22  data collection systems and outcome-based contracting standards; 
131.23     (5) a requirement that Medicare-certified contractors agree 
131.24  to maintain Medicare cost reports and to submit them to the 
131.25  commissioner upon request, or at times specified by the 
131.26  commissioner; and that contractors that are not 
131.27  Medicare-certified agree to maintain a uniform cost report in a 
131.28  format established by the commissioner and to submit the report 
131.29  to the commissioner upon request, or at times specified by the 
131.30  commissioner; 
131.31     (6) a requirement that demonstrates willingness and ability 
131.32  to develop and maintain data collection and retrieval systems to 
131.33  measure outcomes; and 
131.34     (7) a requirement to provide all information and assurances 
131.35  required by the terms and conditions of the federal waiver or 
131.36  federal approval. 
132.1      (d) In addition to the information and assurances contained 
132.2   in the submitted proposals, the commissioner may consider the 
132.3   following criteria in developing the terms of the contract: 
132.4      (1) the facility's history of compliance with federal and 
132.5   state laws and rules.  A facility deemed to be in substantial 
132.6   compliance with federal and state laws and rules is eligible to 
132.7   respond to a request for proposals.  A facility's compliance 
132.8   history shall not be the sole determining factor in situations 
132.9   where the facility has been sold and the new owners have 
132.10  submitted a proposal; 
132.11     (2) whether the facility has a record of excessive 
132.12  licensure fines or sanctions or fraudulent cost reports; 
132.13     (3) the facility's financial history and solvency; and 
132.14     (4) other factors identified by the commissioner deemed 
132.15  relevant to developing the terms of the contract, including a 
132.16  determination that a contract with a particular facility is not 
132.17  in the best interests of the residents of the facility or the 
132.18  state of Minnesota. 
132.19     (e) Notwithstanding the requirements of the solicitation 
132.20  process described in chapter 16C, the commissioner may contract 
132.21  with nursing facilities established according to section 
132.22  144A.073 without issuing a request for proposals. 
132.23     (f) Notwithstanding subdivision 1, after July 1, 2001, the 
132.24  commissioner may contract with additional nursing facilities, 
132.25  according to requests for proposals. 
132.26     Subd. 2.  [CONTRACT PROVISIONS.] (a) The performance-based 
132.27  contract with each nursing facility must include provisions that:
132.28     (1) apply the resident case mix assessment provisions of 
132.29  Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 
132.30  another assessment system, with the goal of moving to a single 
132.31  assessment system; 
132.32     (2) monitor resident outcomes through various methods, such 
132.33  as quality indicators based on the minimum data set and other 
132.34  utilization and performance measures; 
132.35     (3) require the establishment and use of a continuous 
132.36  quality improvement process that integrates information from 
133.1   quality indicators and regular resident and family satisfaction 
133.2   interviews; 
133.3      (4) require annual reporting of facility statistical 
133.4   information, including resident days by case mix category, 
133.5   productive nursing hours, wages and benefits, and raw food costs 
133.6   for use by the commissioner in the development of facility 
133.7   profiles that include trends in payment and service utilization; 
133.8      (5) require from each nursing facility an annual certified 
133.9   audited financial statement consisting of a balance sheet, 
133.10  income and expense statements, and an opinion from either a 
133.11  licensed or certified public accountant, if a certified audit 
133.12  was prepared, or unaudited financial statements if no certified 
133.13  audit was prepared; and 
133.14     (6) specify the method for resolving disputes; and 
133.15     (7) establish additional requirements and penalties for 
133.16  nursing facilities not meeting the standards set forth in the 
133.17  performance-based contract. 
133.18     (b) The commissioner may develop additional incentive-based 
133.19  payments for achieving specified outcomes specified in each 
133.20  contract.  The specified facility-specific outcomes must be 
133.21  measurable and approved by the commissioner.  
133.22     (c) The commissioner may also contract with nursing 
133.23  facilities in other ways through requests for proposals, 
133.24  including contracts on a risk or nonrisk basis, with nursing 
133.25  facilities or consortia of nursing facilities, to provide 
133.26  comprehensive long-term care coverage on a premium or capitated 
133.27  basis. 
133.28     (d) The commissioner may negotiate different contract terms 
133.29  for different nursing facilities. 
133.30     Subd. 2a.  [DURATION AND TERMINATION OF CONTRACTS.] (a) All 
133.31  contracts entered into under this section are for a term of one 
133.32  year.  Either party may terminate this contract at any time 
133.33  without cause by providing 90 calendar days' advance written 
133.34  notice to the other party.  Notwithstanding section 16C.05, 
133.35  subdivisions 2, paragraph (a), and 5, if neither party provides 
133.36  written notice of termination, the contract shall be 
134.1   renegotiated for additional one-year terms or the terms of the 
134.2   existing contract will be extended for one year.  The provisions 
134.3   of the contract shall be renegotiated annually by the parties 
134.4   prior to the expiration date of the contract.  The parties may 
134.5   voluntarily renegotiate the terms of the contract at any time by 
134.6   mutual agreement. 
134.7      (b) If a nursing facility fails to comply with the terms of 
134.8   a contract, the commissioner shall provide reasonable notice 
134.9   regarding the breach of contract and a reasonable opportunity 
134.10  for the facility to come into compliance.  If the facility fails 
134.11  to come into compliance or to remain in compliance, the 
134.12  commissioner may terminate the contract.  If a contract is 
134.13  terminated, provisions of section 256B.48, subdivision 1a, shall 
134.14  apply. 
134.15     Subd. 3.  [PAYMENT RATE PROVISIONS.] (a) For rate years 
134.16  beginning on or after July 1, 2000 2001, within the limits of 
134.17  appropriations specifically for this purpose, the commissioner 
134.18  shall determine operating cost payment rates for each licensed 
134.19  and certified nursing facility by indexing its operating cost 
134.20  payment rates in effect on June 30, 2000 2001, for inflation.  
134.21  The inflation factor to be used must be based on the change in 
134.22  the Consumer Price Index-All Items, United States city average 
134.23  (CPI-U) as forecasted by Data Resources, Inc. in the fourth 
134.24  quarter preceding the rate year.  For rate years beginning on or 
134.25  after July 1, 2001, the inflation factor must be based on the 
134.26  change in the Employment Cost Index for Private Industry Workers 
134.27  - Total Compensation as forecasted by the commissioner of 
134.28  finance's national economic consultant, in the fourth quarter 
134.29  preceding the rate year.  The CPI-U forecasted index for 
134.30  operating cost payment rates shall be based on the 12-month 
134.31  period from the midpoint of the nursing facility's prior rate 
134.32  year to the midpoint of the rate year for which the operating 
134.33  payment rate is being determined.  The operating cost payment 
134.34  rate to be inflated shall be the total payment rate in effect on 
134.35  June 30, 2001, minus the portion determined to be the 
134.36  property-related payment rate, minus the per diem amount of the 
135.1   preadmission screening cost included in the nursing facility's 
135.2   last payment rate established under section 256B.431. 
135.3      (b) Beginning July 1, 2000, each nursing facility subject 
135.4   to a performance-based contract under this section shall choose 
135.5   one of two methods of payment for property-related costs: 
135.6      (1) the method established in section 256B.434; or 
135.7      (2) the method established in section 256B.431. 
135.8      Once the nursing facility has made the election in this 
135.9   paragraph, that election shall remain in effect for at least 
135.10  four years or until an alternative property payment system is 
135.11  developed.  A per diem amount for preadmission screening will be 
135.12  added onto the contract payment rates according to the method of 
135.13  distribution of county allocation described in section 
135.14  256B.0911, subdivision 6, paragraph (a). 
135.15     (c) For rate years beginning on or after July 1, 2000 2001, 
135.16  the commissioner may implement a new method of payment for 
135.17  property-related costs that addresses the capital needs of 
135.18  facilities.  Notwithstanding paragraph (b), The new property 
135.19  payment system or systems, if implemented, shall replace the 
135.20  current method methods of setting property payment rates under 
135.21  sections 256B.431 and 256B.434. 
135.22     Subd. 4.  [CONTRACT PAYMENT RATES; APPEALS.] If an appeal 
135.23  is pending concerning the cost-based payment rates that are the 
135.24  basis for the calculation of the payment rate under this 
135.25  section, the commissioner and the nursing facility may agree on 
135.26  an interim contract rate to be used until the appeal is 
135.27  resolved.  When the appeal is resolved, the contract rate must 
135.28  be adjusted retroactively according to the appeal decision. 
135.29     Subd. 5.  [CONSUMER PROTECTION.] In addition to complying 
135.30  with all applicable laws regarding consumer protection, as a 
135.31  condition of entering into a contract under this section, a 
135.32  nursing facility must agree to: 
135.33     (1) establish resident grievance procedures; 
135.34     (2) establish expedited grievance procedures to resolve 
135.35  complaints made by short-stay residents; and 
135.36     (3) make available to residents and families a copy of the 
136.1   performance-based contract and outcomes to be achieved. 
136.2      Subd. 6.  [CONTRACTS ARE VOLUNTARY.] Participation of 
136.3   nursing facilities in the medical assistance program is 
136.4   voluntary.  The terms and procedures governing the 
136.5   performance-based contract are determined under this section and 
136.6   through negotiations between the commissioner and nursing 
136.7   facilities.  
136.8      Subd. 7.  [FEDERAL REQUIREMENTS.] The commissioner shall 
136.9   implement the performance-based contracting system subject to 
136.10  any required federal waivers or approval and in a manner that is 
136.11  consistent with federal requirements.  If a provision of this 
136.12  section is inconsistent with a federal requirement, the federal 
136.13  requirement supersedes the inconsistent provision.  The 
136.14  commissioner shall seek federal approval and request waivers as 
136.15  necessary to implement this section. 
136.16     Sec. 26.  Minnesota Statutes 1998, section 256B.48, 
136.17  subdivision 1, is amended to read: 
136.18     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
136.19  is not eligible to receive medical assistance payments unless it 
136.20  refrains from all of the following: 
136.21     (a) Charging private paying residents rates for similar 
136.22  services which exceed those which are approved by the state 
136.23  agency for medical assistance recipients as determined by the 
136.24  prospective desk audit rate, except under the following 
136.25  circumstances:  the nursing facility may (1) charge private 
136.26  paying residents a higher rate for a private room, and (2) 
136.27  charge for special services which are not included in the daily 
136.28  rate if medical assistance residents are charged separately at 
136.29  the same rate for the same services in addition to the daily 
136.30  rate paid by the commissioner.  Services covered by the payment 
136.31  rate must be the same regardless of payment source.  Special 
136.32  services, if offered, must be available to all residents in all 
136.33  areas of the nursing facility and charged separately at the same 
136.34  rate.  Residents are free to select or decline special 
136.35  services.  Special services must not include services which must 
136.36  be provided by the nursing facility in order to comply with 
137.1   licensure or certification standards and that if not provided 
137.2   would result in a deficiency or violation by the nursing 
137.3   facility.  Services beyond those required to comply with 
137.4   licensure or certification standards must not be charged 
137.5   separately as a special service if they were included in the 
137.6   payment rate for the previous reporting year.  A nursing 
137.7   facility that charges a private paying resident a rate in 
137.8   violation of this clause is subject to an action by the state of 
137.9   Minnesota or any of its subdivisions or agencies for civil 
137.10  damages.  A private paying resident or the resident's legal 
137.11  representative has a cause of action for civil damages against a 
137.12  nursing facility that charges the resident rates in violation of 
137.13  this clause.  The damages awarded shall include three times the 
137.14  payments that result from the violation, together with costs and 
137.15  disbursements, including reasonable attorneys' fees or their 
137.16  equivalent.  A private paying resident or the resident's legal 
137.17  representative, the state, subdivision or agency, or a nursing 
137.18  facility may request a hearing to determine the allowed rate or 
137.19  rates at issue in the cause of action.  Within 15 calendar days 
137.20  after receiving a request for such a hearing, the commissioner 
137.21  shall request assignment of an administrative law judge under 
137.22  sections 14.48 to 14.56 to conduct the hearing as soon as 
137.23  possible or according to agreement by the parties.  The 
137.24  administrative law judge shall issue a report within 15 calendar 
137.25  days following the close of the hearing.  The prohibition set 
137.26  forth in this clause shall not apply to facilities licensed as 
137.27  boarding care facilities which are not certified as skilled or 
137.28  intermediate care facilities level I or II for reimbursement 
137.29  through medical assistance. 
137.30     (b) Requiring (1) Charging, soliciting, accepting, or 
137.31  receiving from an applicant for admission to the facility, or 
137.32  the guardian or conservator from anyone acting in behalf of the 
137.33  applicant, as a condition of admission, to pay expediting the 
137.34  admission, or as a requirement for the individual's continued 
137.35  stay, any fee or, deposit in excess of $100, gift, money, 
137.36  donation, or other consideration not otherwise required as 
138.1   payment under the state plan; 
138.2      (2) requiring an individual, or anyone acting in behalf of 
138.3   the individual, to loan any money to the nursing facility, or; 
138.4      (3) requiring an individual, or anyone acting in behalf of 
138.5   the individual, to promise to leave all or part of the 
138.6   applicant's individual's estate to the facility; or 
138.7      (4) requiring a third-party guarantee of payment to the 
138.8   facility as a condition of admission, expedited admission, or 
138.9   continued stay in the facility.  
138.10  Nothing in this paragraph would prohibit discharge for 
138.11  nonpayment of services in accordance with state and federal 
138.12  regulations. 
138.13     (c) Requiring any resident of the nursing facility to 
138.14  utilize a vendor of health care services chosen by the nursing 
138.15  facility. 
138.16     (d) Providing differential treatment on the basis of status 
138.17  with regard to public assistance.  
138.18     (e) Discriminating in admissions, services offered, or room 
138.19  assignment on the basis of status with regard to public 
138.20  assistance or refusal to purchase special services.  Admissions 
138.21  discrimination shall include, but is not limited to:  
138.22     (1) basing admissions decisions upon assurance by the 
138.23  applicant to the nursing facility, or the applicant's guardian 
138.24  or conservator, that the applicant is neither eligible for nor 
138.25  will seek public assistance for payment of nursing facility care 
138.26  costs; and 
138.27     (2) engaging in preferential selection from waiting lists 
138.28  based on an applicant's ability to pay privately or an 
138.29  applicant's refusal to pay for a special service. 
138.30     The collection and use by a nursing facility of financial 
138.31  information of any applicant pursuant to a preadmission 
138.32  screening program established by law shall not raise an 
138.33  inference that the nursing facility is utilizing that 
138.34  information for any purpose prohibited by this paragraph.  
138.35     (f) Requiring any vendor of medical care as defined by 
138.36  section 256B.02, subdivision 7, who is reimbursed by medical 
139.1   assistance under a separate fee schedule, to pay any amount 
139.2   based on utilization or service levels or any portion of the 
139.3   vendor's fee to the nursing facility except as payment for 
139.4   renting or leasing space or equipment or purchasing support 
139.5   services from the nursing facility as limited by section 
139.6   256B.433.  All agreements must be disclosed to the commissioner 
139.7   upon request of the commissioner.  Nursing facilities and 
139.8   vendors of ancillary services that are found to be in violation 
139.9   of this provision shall each be subject to an action by the 
139.10  state of Minnesota or any of its subdivisions or agencies for 
139.11  treble civil damages on the portion of the fee in excess of that 
139.12  allowed by this provision and section 256B.433.  Damages awarded 
139.13  must include three times the excess payments together with costs 
139.14  and disbursements including reasonable attorney's fees or their 
139.15  equivalent.  
139.16     (g) Refusing, for more than 24 hours, to accept a resident 
139.17  returning to the same bed or a bed certified for the same level 
139.18  of care, in accordance with a physician's order authorizing 
139.19  transfer, after receiving inpatient hospital services. 
139.20     The prohibitions set forth in clause (b) shall not apply to 
139.21  a retirement facility with more than 325 beds including at least 
139.22  150 licensed nursing facility beds and which:  
139.23     (1) is owned and operated by an organization tax-exempt 
139.24  under section 290.05, subdivision 1, clause (i); and 
139.25     (2) accounts for all of the applicant's assets which are 
139.26  required to be assigned to the facility so that only expenses 
139.27  for the cost of care of the applicant may be charged against the 
139.28  account; and 
139.29     (3) agrees in writing at the time of admission to the 
139.30  facility to permit the applicant, or the applicant's guardian, 
139.31  or conservator, to examine the records relating to the 
139.32  applicant's account upon request, and to receive an audited 
139.33  statement of the expenditures charged against the applicant's 
139.34  individual account upon request; and 
139.35     (4) agrees in writing at the time of admission to the 
139.36  facility to permit the applicant to withdraw from the facility 
140.1   at any time and to receive, upon withdrawal, the balance of the 
140.2   applicant's individual account. 
140.3      For a period not to exceed 180 days, the commissioner may 
140.4   continue to make medical assistance payments to a nursing 
140.5   facility or boarding care home which is in violation of this 
140.6   section if extreme hardship to the residents would result.  In 
140.7   these cases the commissioner shall issue an order requiring the 
140.8   nursing facility to correct the violation.  The nursing facility 
140.9   shall have 20 days from its receipt of the order to correct the 
140.10  violation.  If the violation is not corrected within the 20-day 
140.11  period the commissioner may reduce the payment rate to the 
140.12  nursing facility by up to 20 percent.  The amount of the payment 
140.13  rate reduction shall be related to the severity of the violation 
140.14  and shall remain in effect until the violation is corrected.  
140.15  The nursing facility or boarding care home may appeal the 
140.16  commissioner's action pursuant to the provisions of chapter 14 
140.17  pertaining to contested cases.  An appeal shall be considered 
140.18  timely if written notice of appeal is received by the 
140.19  commissioner within 20 days of notice of the commissioner's 
140.20  proposed action.  
140.21     In the event that the commissioner determines that a 
140.22  nursing facility is not eligible for reimbursement for a 
140.23  resident who is eligible for medical assistance, the 
140.24  commissioner may authorize the nursing facility to receive 
140.25  reimbursement on a temporary basis until the resident can be 
140.26  relocated to a participating nursing facility.  
140.27     Certified beds in facilities which do not allow medical 
140.28  assistance intake on July 1, 1984, or after shall be deemed to 
140.29  be decertified for purposes of section 144A.071 only.  
140.30     Sec. 27.  Minnesota Statutes 1998, section 256B.48, 
140.31  subdivision 1a, is amended to read: 
140.32     Subd. 1a.  [TERMINATION.] If a nursing facility terminates 
140.33  its participation in the medical assistance program, whether 
140.34  voluntarily or involuntarily, the commissioner may authorize the 
140.35  nursing facility to receive continued medical assistance 
140.36  reimbursement only on a temporary basis until medical assistance 
141.1   residents can be relocated to nursing facilities participating 
141.2   in the medical assistance program. 
141.3      Sec. 28.  Minnesota Statutes 1998, section 256B.48, 
141.4   subdivision 1b, is amended to read: 
141.5      Subd. 1b.  [EXCEPTION.] Notwithstanding any agreement 
141.6   between a nursing facility and the department of human services 
141.7   or the provisions of this section or section 256B.411, other 
141.8   than subdivision 1a, the commissioner may authorize continued 
141.9   medical assistance payments to a nursing facility which ceased 
141.10  intake of medical assistance recipients prior to July 1, 1983, 
141.11  and which charges private paying residents rates that exceed 
141.12  those permitted by subdivision 1, paragraph (a), for (i) 
141.13  residents who resided in the nursing facility before July 1, 
141.14  1983, or (ii)  residents for whom the commissioner or any 
141.15  predecessors of the commissioner granted a permanent individual 
141.16  waiver prior to October 1, 1983.  Nursing facilities seeking 
141.17  continued medical assistance payments under this subdivision 
141.18  shall make the reports required under subdivision 2, except that 
141.19  on or after December 31, 1985, the financial statements required 
141.20  need not be audited by or contain the opinion of a certified 
141.21  public accountant or licensed public accountant, but need only 
141.22  be reviewed by a certified public accountant or licensed public 
141.23  accountant.  In the event that the state is determined by the 
141.24  federal government to be no longer eligible for the federal 
141.25  share of medical assistance payments made to a nursing facility 
141.26  under this subdivision, the commissioner may cease medical 
141.27  assistance payments, under this subdivision, to that nursing 
141.28  facility.  Between October 1, 1992, and July 1, 1993, a facility 
141.29  governed by this subdivision may elect to resume full 
141.30  participation in the medical assistance program by agreeing to 
141.31  comply with all of the requirements of the medical assistance 
141.32  program, including the rate equalization law in subdivision 1, 
141.33  paragraph (a), and all other requirements established in law or 
141.34  rule, and to resume intake of new medical assistance recipients. 
141.35     Sec. 29.  Minnesota Statutes 1998, section 256B.48, 
141.36  subdivision 6, is amended to read: 
142.1      Subd. 6.  [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For 
142.2   purposes of this subdivision, "nursing facility" means a nursing 
142.3   facility that is certified as a skilled nursing facility or, 
142.4   after September 30, 1990, a nursing facility licensed under 
142.5   chapter 144A that is certified as a nursing facility.  
142.6      (b) [MEDICARE PARTICIPATION REQUIRED.] All nursing 
142.7   facilities shall participate in Medicare part A and part B 
142.8   unless, after submitting an application, Medicare certification 
142.9   is denied by the federal health care financing administration.  
142.10  Medicare review shall be conducted at the time of the annual 
142.11  medical assistance review.  Charges for Medicare-covered 
142.12  services provided to residents who are simultaneously eligible 
142.13  for medical assistance and Medicare must be billed to Medicare 
142.14  part A or part B before billing medical assistance.  Medical 
142.15  assistance may be billed only for charges not reimbursed by 
142.16  Medicare.  
142.17     (c) [UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a 
142.18  nursing facility satisfies the requirements of paragraph (b) 
142.19  if:  (1) at least 50 percent of the facility's beds that are 
142.20  licensed under section 144A and certified as skilled nursing 
142.21  beds under the medical assistance program are Medicare 
142.22  certified; or (2) if a nursing facility's beds are licensed 
142.23  under section 144A, and some are medical assistance certified as 
142.24  skilled nursing beds and others are medical assistance certified 
142.25  as intermediate care facility I beds, at least 50 percent of the 
142.26  facility's total skilled nursing beds and intermediate care 
142.27  facility I beds or 100 percent of its skilled nursing beds, 
142.28  whichever is less, are Medicare certified. 
142.29     (d) [AFTER SEPTEMBER 30, 1990.] After September 30, 1990, a 
142.30  nursing facility satisfies the requirements of paragraph (b) if 
142.31  at least 50 percent of the facility's beds certified as nursing 
142.32  facility beds under the medical assistance program are Medicare 
142.33  certified. 
142.34     (e) (d) [CONFLICT WITH MEDICARE DISTINCT PART 
142.35  REQUIREMENTS.] At the request of a facility, the commissioner of 
142.36  human services may reduce the 50 percent Medicare participation 
143.1   requirement in paragraphs paragraph (c) and (d) to no less than 
143.2   20 percent if the commissioner of health determines that, due to 
143.3   the facility's physical plant configuration, the facility cannot 
143.4   satisfy Medicare distinct part requirements at the 50 percent 
143.5   certification level.  To receive a reduction in the 
143.6   participation requirement, a facility must demonstrate that the 
143.7   reduction will not adversely affect access of Medicare-eligible 
143.8   residents to Medicare-certified beds. 
143.9      (f) (e) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 
143.10  may grant exceptions to the requirements of paragraph (b) for 
143.11  nursing facilities that are designated as institutions for 
143.12  mental disease. 
143.13     (g) (f) [NOTICE OF RIGHTS.] The commissioner shall inform 
143.14  recipients of their rights under this subdivision and section 
143.15  144.651, subdivision 29. 
143.16     Sec. 30.  Minnesota Statutes 1998, section 256B.50, 
143.17  subdivision 1e, is amended to read: 
143.18     Subd. 1e.  [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 
143.19  section 15.472, paragraph (a), for an issue appealed under 
143.20  subdivision 1, the prevailing party in a contested case 
143.21  proceeding or, if appealed, in subsequent judicial review, must 
143.22  be awarded reasonable attorney's fees and costs incurred in 
143.23  litigating the appeal, if the prevailing party shows that the 
143.24  position of the opposing party was not substantially justified.  
143.25  The procedures for awarding fees and costs set forth in section 
143.26  15.474 must be followed in determining the prevailing party's 
143.27  fees and costs except as otherwise provided in this 
143.28  subdivision.  For purposes of this subdivision, "costs" means 
143.29  subpoena fees and mileage, transcript costs, court reporter 
143.30  fees, witness fees, postage and delivery costs, photocopying and 
143.31  printing costs, amounts charged the commissioner by the office 
143.32  of administrative hearings, and direct administrative costs of 
143.33  the department; and "substantially justified" means that a 
143.34  position had a reasonable basis in law and fact, based on the 
143.35  totality of the circumstances prior to and during the contested 
143.36  case proceeding and subsequent review. 
144.1      (b) When an award is made to the department under this 
144.2   subdivision, attorney fees must be calculated at the cost to the 
144.3   department.  When an award is made to a provider under this 
144.4   subdivision, attorney fees must be calculated at the rate 
144.5   charged to the provider except that attorney fees awarded must 
144.6   be the lesser of the attorney's normal hourly fee or $100 per 
144.7   hour. 
144.8      (c) In contested case proceedings involving more than one 
144.9   issue, the administrative law judge shall determine what portion 
144.10  of each party's attorney fees and costs is related to the issue 
144.11  or issues on which it prevailed and for which it is entitled to 
144.12  an award.  In making that determination, the administrative law 
144.13  judge shall consider the amount of time spent on each issue, the 
144.14  precedential value of the issue, the complexity of the issue, 
144.15  and other factors deemed appropriate by the administrative law 
144.16  judge.  
144.17     (d) When the department prevails on an issue involving more 
144.18  than one provider, the administrative law judge shall allocate 
144.19  the total amount of any award for attorney fees and costs among 
144.20  the providers.  In determining the allocation, the 
144.21  administrative law judge shall consider each provider's monetary 
144.22  interest in the issue and other factors deemed appropriate by 
144.23  the administrative law judge.  
144.24     (e) Attorney fees and costs awarded to the department for 
144.25  proceedings under this subdivision must not be reported or 
144.26  treated as allowable costs on the provider's cost report.  
144.27     (f) Fees and costs awarded to a provider for proceedings 
144.28  under this subdivision must be reimbursed to them by reporting 
144.29  the amount of fees and costs awarded as allowable costs on the 
144.30  provider's cost report for the reporting year in which they were 
144.31  awarded.  Fees and costs reported pursuant to this subdivision 
144.32  must be included in the general and administrative cost category 
144.33  but are not subject to categorical or overall cost limitations 
144.34  established in rule or statute within 120 days of the final 
144.35  decision on the award of attorney fees and costs. 
144.36     (g) If the provider fails to pay the awarded attorney fees 
145.1   and costs within 120 days of the final decision on the award of 
145.2   attorney fees and costs, the department may collect the amount 
145.3   due through any method available to it for the collection of 
145.4   medical assistance overpayments to providers.  Interest charges 
145.5   must be assessed on balances outstanding after 120 days of the 
145.6   final decision on the award of attorney fees and costs.  The 
145.7   annual interest rate charged must be the rate charged by the 
145.8   commissioner of revenue for late payment of taxes that is in 
145.9   effect on the 121st day after the final decision on the award of 
145.10  attorney fees and costs.  
145.11     (h) Amounts collected by the commissioner pursuant to this 
145.12  subdivision must be deemed to be recoveries pursuant to section 
145.13  256.01, subdivision 2, clause (15). 
145.14     (i) This subdivision applies to all contested case 
145.15  proceedings set on for hearing by the commissioner on or after 
145.16  April 29, 1988, regardless of the date the appeal was filed. 
145.17     Sec. 31.  Minnesota Statutes 1998, section 256B.5011, 
145.18  subdivision 1, is amended to read: 
145.19     Subdivision 1.  [IN GENERAL.] Effective October 1, 2000, 
145.20  the commissioner shall implement a performance-based contracting 
145.21  system to replace the current method of setting total cost 
145.22  payment rates under section 256B.501 and Minnesota Rules, parts 
145.23  9553.0010 to 9553.0080.  In determining prospective payment 
145.24  rates of intermediate care facilities for persons with mental 
145.25  retardation or related conditions, the commissioner shall index 
145.26  each facility's total operating payment rate by an inflation 
145.27  factor as described in subdivision 3 section 256B.5012.  The 
145.28  commissioner of finance shall include annual inflation 
145.29  adjustments in operating costs for intermediate care facilities 
145.30  for persons with mental retardation and related conditions as a 
145.31  budget change request in each biennial detailed expenditure 
145.32  budget submitted to the legislature under section 16A.11. 
145.33     Sec. 32.  Minnesota Statutes 1998, section 256B.5011, 
145.34  subdivision 2, is amended to read: 
145.35     Subd. 2.  [CONTRACT PROVISIONS.] (a) The 
145.36  performance-based service contract with each intermediate care 
146.1   facility must include provisions for: 
146.2      (1) modifying payments when significant changes occur in 
146.3   the needs of the consumers; 
146.4      (2) monitoring service quality using performance indicators 
146.5   that measure consumer outcomes; 
146.6      (3) the establishment and use of continuous quality 
146.7   improvement processes using the results attained through service 
146.8   quality monitoring; 
146.9      (4) the annual reporting of facility statistical 
146.10  information on all supervisory personnel, direct care personnel, 
146.11  specialized support personnel, hours, wages and benefits, 
146.12  staff-to-consumer ratios, and staffing patterns 
146.13     (3) appropriate and necessary statistical information 
146.14  required by the commissioner; 
146.15     (5) (4) annual aggregate facility financial information or 
146.16  an annual certified audited financial statement, including a 
146.17  balance sheet and income and expense statements for each 
146.18  facility, if a certified audit was prepared; and 
146.19     (6) (5) additional requirements and penalties for 
146.20  intermediate care facilities not meeting the standards set forth 
146.21  in the performance-based service contract. 
146.22     (b) The commissioner shall recommend to the legislature by 
146.23  January 15, 2000, whether the contract should include service 
146.24  quality monitoring that may utilize performance indicators that 
146.25  measure consumer and program outcomes.  Performance measurement 
146.26  shall not increase or duplicate regulatory requirements. 
146.27     Sec. 33.  [256B.5012] [ICF/MR PAYMENT SYSTEM 
146.28  IMPLEMENTATION.] 
146.29     Subdivision 1.  [TOTAL PAYMENT RATE.] The total payment 
146.30  rate effective October 1, 2000, for existing ICF/MR facilities 
146.31  is the total of the operating payment rate and the property 
146.32  payment rate plus inflation factors as defined in this section.  
146.33  The initial rate year shall run from October 1, 2000, through 
146.34  December 31, 2001.  Subsequent rate years shall run from January 
146.35  1 through December 31 beginning in the year 2002. 
146.36     Subd. 2.  [OPERATING PAYMENT RATE.] (a) The operating 
147.1   payment rate equals the facility's total payment rate in effect 
147.2   on September 30, 2000, minus the property rate.  The operating 
147.3   payment rate includes the special operating rate and the 
147.4   efficiency incentive in effect as of September 30, 2000.  Within 
147.5   the limits of appropriations specifically for this purpose, the 
147.6   operating payment shall be increased for each rate year by the 
147.7   annual percentage change in the Employment Cost Index for 
147.8   Private Industry Workers - Total Compensation, as forecasted by 
147.9   the commissioner of finance's economic consultant, in the second 
147.10  quarter of the calendar year preceding the start of each rate 
147.11  year.  In the case of the initial rate year beginning October 1, 
147.12  2000, and continuing through December 31, 2001, the percentage 
147.13  change shall be based on the percentage change in the Employment 
147.14  Cost Index for Private Industry Workers - Total Compensation for 
147.15  the 15-month period beginning October 1, 2000, as forecast by 
147.16  Data Resources, Inc., in the first quarter of 2000. 
147.17     (b) Effective October 1, 2000, the operating payment rate 
147.18  shall be adjusted to reflect an occupancy rate equal to 100 
147.19  percent of the facility's capacity days as of September 30, 2000.
147.20     Subd. 3.  [PROPERTY PAYMENT RATE.] (a) The property payment 
147.21  rate effective October 1, 2000, is based on the facility's 
147.22  modified property payment rate in effect on September 30, 2000.  
147.23  The modified property payment rate is the actual property 
147.24  payment rate exclusive of the effect of gains or losses on 
147.25  disposal of capital assets or adjustments for excess 
147.26  depreciation claims.  Effective October 1, 2000, a facility 
147.27  minimum property rate of $8.13 shall be applied to all existing 
147.28  ICF/MR facilities.  Facilities with a modified property payment 
147.29  rate effective September 30, 2000, which is below the minimum 
147.30  property rate shall receive an increase effective October 1, 
147.31  2000, equal to the difference between the minimum property 
147.32  payment rate and the modified property payment rate in effect as 
147.33  of September 30, 2000.  Facilities with a modified property 
147.34  payment rate at or above the minimum property payment rate 
147.35  effective September 30, 2000, shall receive the modified 
147.36  property payment rate effective October 1, 2000. 
148.1      (b) Within the limits of appropriations specifically for 
148.2   this purpose, facility property payment rates shall be increased 
148.3   annually for inflation, effective January 1, 2002.  The increase 
148.4   shall be based on each facility's property payment rate in 
148.5   effect on September 30, 2000.  Modified property payment rates 
148.6   effective September 30, 2000, shall be arrayed from highest to 
148.7   lowest before applying the minimum property payment rate in 
148.8   paragraph (a).  For modified property payment rates at the 90th 
148.9   percentile or above, the annual inflation increase shall be 
148.10  zero.  For modified property payment rates below the 90th 
148.11  percentile but equal to or above the 75th percentile, the annual 
148.12  inflation increase shall be one percent.  For modified property 
148.13  payment rates below the 75th percentile, the annual inflation 
148.14  increase shall be two percent.  
148.15     Sec. 34.  [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 
148.16     Subdivision 1.  [VARIABLE RATE ADJUSTMENTS.] When there is 
148.17  a documented increase in the resource needs of a current ICF/MR 
148.18  recipient or recipients, or a person is admitted to a facility 
148.19  who requires additional resources, the county of financial 
148.20  responsibility may approve an enhanced rate for one or more 
148.21  persons in the facility.  Resource needs directly attributable 
148.22  to an individual that may be considered under the variable rate 
148.23  adjustment include increased direct staff hours and other 
148.24  specialized services, equipment, and human resources.  The 
148.25  guidelines in paragraphs (a) to (d) apply for the payment rate 
148.26  adjustments under this section. 
148.27     (a) All persons must be screened according to section 
148.28  256B.092, subdivisions 7 and 8, prior to implementation of the 
148.29  new payment system and annually thereafter.  Screening data 
148.30  shall be analyzed to develop broad profiles of the functional 
148.31  characteristics of recipients.  Three components shall be used 
148.32  to distinguish recipients based on the following broad profiles: 
148.33     (1) functional ability to care for and maintain one's own 
148.34  basic needs; 
148.35     (2) the intensity of any aggressive or destructive 
148.36  behavior; and 
149.1      (3) any history of obstructive behavior in combination with 
149.2   a diagnosis of psychosis or neurosis.  
149.3      The profile groups shall be used to link resource needs to 
149.4   funding.  The resource profile shall determine the level of 
149.5   funding that may be authorized by the county.  The county of 
149.6   financial responsibility may approve a rate adjustment for an 
149.7   individual.  The commissioner shall recommend to the legislature 
149.8   by January 15, 2000, a methodology using the profile groups to 
149.9   determine variable rates.  The variable rate must be applied to 
149.10  expenses related to increased direct staff hours and other 
149.11  specialized services, equipment, and human resources.  This 
149.12  variable rate component plus the facility's current operating 
149.13  payment rate equals the individual's total operating payment 
149.14  rate. 
149.15     (b) A recipient must be screened by the county of financial 
149.16  responsibility using the developmental disabilities screening 
149.17  document completed immediately prior to approval of a variable 
149.18  rate by the county.  A comparison of the updated screening and 
149.19  the previous screening must demonstrate an increase in resource 
149.20  needs. 
149.21     (c) Rate adjustments projected to exceed the authorized 
149.22  funding level associated with the person's profile must be 
149.23  submitted to the commissioner. 
149.24     (d) The new rate approved through this process shall not be 
149.25  averaged across all persons living at a facility but shall be an 
149.26  individual rate.  The county of financial responsibility must 
149.27  indicate the projected length of time that the additional 
149.28  funding may be needed by the individual.  The need to continue 
149.29  an individual variable rate must be reviewed at the end of the 
149.30  anticipated duration of need but at least annually through the 
149.31  completion of the developmental disabilities screening document. 
149.32     Subd. 2.  [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 
149.33  payment rates may be adjusted by the host county, with 
149.34  authorization from a statewide advisory committee, if, through 
149.35  the local system needs planning process, it is determined that a 
149.36  need exists to amend the package of purchased services with a 
150.1   resulting increase or decrease in costs.  Except as provided in 
150.2   section 252.292, subdivision 4, if a provider demonstrates that 
150.3   the loss of revenues caused by the downsizing or closure of a 
150.4   facility cannot be absorbed by the facility based on current 
150.5   operations, the host county or the provider may submit a request 
150.6   to the statewide advisory committee for a facility base rate 
150.7   adjustment. 
150.8      Subd. 3.  [RELOCATION.] (a) Property rates for all 
150.9   facilities relocated after December 31, 1997, and up to and 
150.10  including October 1, 2000, shall have the full annual costs of 
150.11  relocation included in their October 1, 2000, property rate.  
150.12  The property rate for the relocated home is subject to the costs 
150.13  that were allowable under Minnesota Rules, chapter 9553, and the 
150.14  investment per bed limitation for newly constructed or newly 
150.15  established class B facilities.  
150.16     (b) In ensuing years, all relocated homes shall be subject 
150.17  to the investment per bed limit for newly constructed or newly 
150.18  established class B facilities under section 256B.501, 
150.19  subdivision 11.  The limits shall be adjusted on January 1 of 
150.20  each year by the percentage increase in the construction index 
150.21  published by the Bureau of Economic Analysis of the United 
150.22  States Department of Commerce in the Survey of Current Business 
150.23  Statistics in October of the previous two years.  Facilities 
150.24  that are relocated within the investment per bed limit may be 
150.25  approved by the statewide advisory committee.  Costs for 
150.26  relocation of a facility that exceed the investment per bed 
150.27  limit must be absorbed by the facility. 
150.28     (c) The payment rate shall take effect when the new 
150.29  facility is licensed and certified by the commissioner of 
150.30  health.  Rates for facilities that are relocated after December 
150.31  31, 1997, through October 1, 2000, shall be adjusted to reflect 
150.32  the full inclusion of the relocation costs, subject to the 
150.33  investment per bed limit in paragraph (b).  The investment per 
150.34  bed limit calculated rate for the year in which the facility was 
150.35  relocated shall be the investment per bed limit used. 
150.36     Subd. 4.  [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 
151.1   AND ACCESS.] If a facility is operating at less than 100 percent 
151.2   occupancy on September 30, 2000, or if a recipient is discharged 
151.3   from a facility, the commissioner shall adjust the total payment 
151.4   rate for up to 90 days for the remaining recipients.  This 
151.5   mechanism shall not be used to pay for hospital or therapeutic 
151.6   leave days beyond the maximums allowed.  Facility payment 
151.7   adjustments exceeding 90 days to address a demonstrated need for 
151.8   access must be submitted to the statewide advisory committee 
151.9   with a local system needs assessment, plan, and budget for 
151.10  review and recommendation. 
151.11     Sec. 35.  [256B.5014] [FINANCIAL REPORTING.] 
151.12     All facilities shall maintain financial records and shall 
151.13  provide annual income and expense reports to the commissioner of 
151.14  human services on a form prescribed by the commissioner no later 
151.15  than April 30 of each year in order to receive medical 
151.16  assistance payments.  The reports for the reporting year ending 
151.17  December 31 must include: 
151.18     (1) salaries and related expenses, including program 
151.19  salaries, administrative salaries, other salaries, payroll 
151.20  taxes, and fringe benefits; 
151.21     (2) general operating expenses, including supplies, 
151.22  training, repairs, purchased services and consultants, 
151.23  utilities, food, licenses and fees, real estate taxes, 
151.24  insurance, and working capital interest; 
151.25     (3) property related costs, including depreciation, capital 
151.26  debt interest, rent, and leases; and 
151.27     (4) total annual resident days. 
151.28     Sec. 36.  [256B.5015] [PASS-THROUGH OF TRAINING AND 
151.29  HABILITATION SERVICES COSTS.] 
151.30     Training and habilitation services costs shall be paid as a 
151.31  pass-through payment at the lowest rate paid for the comparable 
151.32  services at that site under sections 252.40 to 252.46.  The 
151.33  pass-through payments for training and habilitation services 
151.34  shall be paid separately by the commissioner and shall not be 
151.35  included in the computation of the total payment rate. 
151.36     Sec. 37.  Minnesota Statutes 1998, section 256B.69, 
152.1   subdivision 6a, is amended to read: 
152.2      Subd. 6a.  [NURSING HOME SERVICES.] (a) Notwithstanding 
152.3   Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 
152.4   days of nursing facility services as defined in section 
152.5   256B.0625, subdivision 2, which are provided in a nursing 
152.6   facility certified by the Minnesota department of health for 
152.7   services provided and eligible for payment under Medicaid, shall 
152.8   be covered under the prepaid medical assistance program for 
152.9   individuals who are not residing in a nursing facility at the 
152.10  time of enrollment in the prepaid medical assistance program.  
152.11  Liability for coverage of nursing facility services by a 
152.12  participating health plan is limited to 365 days for any person 
152.13  enrolled under the prepaid medical assistance program. 
152.14     (b) For individuals enrolled in the Minnesota senior health 
152.15  options project authorized under subdivision 23, nursing 
152.16  facility services shall be covered according to the terms and 
152.17  conditions of the federal waiver agreement governing that 
152.18  demonstration project. 
152.19     Sec. 38.  Minnesota Statutes 1998, section 256B.69, 
152.20  subdivision 6b, is amended to read: 
152.21     Subd. 6b.  [ELDERLY HOME AND COMMUNITY-BASED WAIVER 
152.22  SERVICES.] Notwithstanding Minnesota Rules, part 9500.1457, 
152.23  subpart 1, item C, elderly waiver services shall be covered 
152.24  under the prepaid medical assistance program for all individuals 
152.25  who are eligible according to section 256B.0915.  (a) For 
152.26  individuals enrolled in the Minnesota senior health options 
152.27  project authorized under subdivision 23, elderly waiver services 
152.28  shall be covered according to the terms and conditions of the 
152.29  federal waiver agreement governing that demonstration project. 
152.30     (b) For individuals under age 65 with physical disabilities 
152.31  but without a primary diagnosis of mental illness or 
152.32  developmental disabilities, except for related conditions, 
152.33  enrolled in the Minnesota senior health options project 
152.34  authorized under subdivision 23, home and community-based waiver 
152.35  services shall be covered according to the terms and conditions 
152.36  of the federal agreement governing that demonstration project. 
153.1      Sec. 39.  Minnesota Statutes 1998, section 256I.04, 
153.2   subdivision 3, is amended to read: 
153.3      Subd. 3.  [MORATORIUM ON THE DEVELOPMENT OF GROUP 
153.4   RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 
153.5   into agreements for new group residential housing beds with 
153.6   total rates in excess of the MSA equivalent rate except:  (1) 
153.7   for group residential housing establishments meeting the 
153.8   requirements of subdivision 2a, clause (2) with department 
153.9   approval; (2) for group residential housing establishments 
153.10  licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 
153.11  provided the facility is needed to meet the census reduction 
153.12  targets for persons with mental retardation or related 
153.13  conditions at regional treatment centers; (3) to ensure 
153.14  compliance with the federal Omnibus Budget Reconciliation Act 
153.15  alternative disposition plan requirements for inappropriately 
153.16  placed persons with mental retardation or related conditions or 
153.17  mental illness; (4) up to 80 beds in a single, specialized 
153.18  facility located in Hennepin county that will provide housing 
153.19  for chronic inebriates who are repetitive users of 
153.20  detoxification centers and are refused placement in emergency 
153.21  shelters because of their state of intoxication, and planning 
153.22  for the specialized facility must have been initiated before 
153.23  July 1, 1991, in anticipation of receiving a grant from the 
153.24  housing finance agency under section 462A.05, subdivision 20a, 
153.25  paragraph (b); or (5) notwithstanding the provisions of 
153.26  subdivision 2a, for up to 190 supportive housing units in Anoka, 
153.27  Dakota, Hennepin, or Ramsey county for homeless adults with a 
153.28  mental illness, a history of substance abuse, or human 
153.29  immunodeficiency virus or acquired immunodeficiency syndrome.  
153.30  For purposes of this section, "homeless adult" means a person 
153.31  who is living on the street or in a shelter or discharged from a 
153.32  regional treatment center, community hospital, or residential 
153.33  treatment program and has no appropriate housing available and 
153.34  lacks the resources and support necessary to access appropriate 
153.35  housing.  At least 70 percent of the supportive housing units 
153.36  must serve homeless adults with mental illness, substance abuse 
154.1   problems, or human immunodeficiency virus or acquired 
154.2   immunodeficiency syndrome who are about to be or, within the 
154.3   previous six months, has been discharged from a regional 
154.4   treatment center, or a state-contracted psychiatric bed in a 
154.5   community hospital, or a residential mental health or chemical 
154.6   dependency treatment program.  If a person meets the 
154.7   requirements of subdivision 1, paragraph (a), and receives a 
154.8   federal or state housing subsidy, the group residential housing 
154.9   rate for that person is limited to the supplementary rate under 
154.10  section 256I.05, subdivision 1a, and is determined by 
154.11  subtracting the amount of the person's countable income that 
154.12  exceeds the MSA equivalent rate from the group residential 
154.13  housing supplementary rate.  A resident in a demonstration 
154.14  project site who no longer participates in the demonstration 
154.15  program shall retain eligibility for a group residential housing 
154.16  payment in an amount determined under section 256I.06, 
154.17  subdivision 8, using the MSA equivalent rate.  Service funding 
154.18  under section 256I.05, subdivision 1a, will end June 30, 1997, 
154.19  if federal matching funds are available and the services can be 
154.20  provided through a managed care entity.  If federal matching 
154.21  funds are not available, then service funding will continue 
154.22  under section 256I.05, subdivision 1a.; or (6) for group 
154.23  residential housing beds in settings meeting the requirements of 
154.24  subdivision 2a, clauses (1) and (3), which are used exclusively 
154.25  for recipients receiving home and community-based waiver 
154.26  services under sections 256B.0915, 256B.092, subdivision 5, 
154.27  256B.093, and 256B.49, and who resided in a nursing facility for 
154.28  the six months immediately prior to the month of entry into the 
154.29  group residential housing setting.  The group residential 
154.30  housing rate for these beds must be set so that the monthly 
154.31  group residential housing payment for an individual occupying 
154.32  the bed when combined with the nonfederal share of services 
154.33  delivered under the waiver for that person does not exceed the 
154.34  nonfederal share of the monthly medical assistance payment made 
154.35  for the person to the nursing facility in which the person 
154.36  resided prior to entry into the group residential housing 
155.1   establishment.  The rate may not exceed the MSA equivalent rate 
155.2   plus $426.37 for any case. 
155.3      (b) A county agency may enter into a group residential 
155.4   housing agreement for beds with rates in excess of the MSA 
155.5   equivalent rate in addition to those currently covered under a 
155.6   group residential housing agreement if the additional beds are 
155.7   only a replacement of beds with rates in excess of the MSA 
155.8   equivalent rate which have been made available due to closure of 
155.9   a setting, a change of licensure or certification which removes 
155.10  the beds from group residential housing payment, or as a result 
155.11  of the downsizing of a group residential housing setting.  The 
155.12  transfer of available beds from one county to another can only 
155.13  occur by the agreement of both counties. 
155.14     Sec. 40.  Minnesota Statutes 1998, section 256I.05, 
155.15  subdivision 1, is amended to read: 
155.16     Subdivision 1.  [MAXIMUM RATES.] Monthly room and board 
155.17  rates negotiated by a county agency for a recipient living in 
155.18  group residential housing must not exceed the MSA equivalent 
155.19  rate specified under section 256I.03, subdivision 5, with the 
155.20  exception that a county agency may negotiate a supplementary 
155.21  room and board rate that exceeds the MSA equivalent rate by up 
155.22  to $426.37 for recipients of waiver services under title XIX of 
155.23  the Social Security Act.  This exception is subject to the 
155.24  following conditions: 
155.25     (1) that the Secretary of Health and Human Services has not 
155.26  approved a state request to include room and board costs which 
155.27  exceed the MSA equivalent rate in an individual's set of waiver 
155.28  services under title XIX of the Social Security Act; or 
155.29     (2) that the Secretary of Health and Human Services has 
155.30  approved the inclusion of room and board costs which exceed the 
155.31  MSA equivalent rate, but in an amount that is insufficient to 
155.32  cover costs which are included in a group residential housing 
155.33  agreement in effect on June 30, 1994; and 
155.34     (3) the amount of the rate that is above the MSA equivalent 
155.35  rate has been approved by the commissioner the setting is 
155.36  licensed by the commissioner of human services under Minnesota 
156.1   Rules, parts 9555.5050 to 9555.6265; 
156.2      (2) the setting is not the primary residence of the license 
156.3   holder and in which the license holder is not the primary 
156.4   caregiver; and 
156.5      (3) the average supplementary room and board rate in a 
156.6   county for a calendar year may not exceed the average 
156.7   supplementary room and board rate for that county in effect on 
156.8   January 1, 2000.  For calendar years beginning on or after 
156.9   January 1, 2002, within the limits of appropriations 
156.10  specifically for this purpose, the commissioner shall increase 
156.11  each county's supplemental room and board rate average on an 
156.12  annual basis by a factor consisting of the percentage change in 
156.13  the Consumer Price Index-All items, United States city average 
156.14  (CPI-U) for that calendar year compared to the preceding 
156.15  calendar year as forecasted by Data Resources, Inc., in the 
156.16  third quarter of the preceding calendar year.  If a county has 
156.17  not negotiated supplementary room and board rates for any 
156.18  facilities located in the county as of January 1, 2000, or has 
156.19  an average supplemental room and board rate under $100 per 
156.20  person as of January 1, 2000, it may submit a supplementary room 
156.21  and board rate request with budget information for a facility to 
156.22  the commissioner for approval. 
156.23  The county agency may at any time negotiate a higher or lower 
156.24  room and board rate than the average supplementary room and 
156.25  board rate that would otherwise be paid under this subdivision. 
156.26     Sec. 41.  Minnesota Statutes 1998, section 256I.05, 
156.27  subdivision 1a, is amended to read: 
156.28     Subd. 1a.  [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 
156.29  the provisions of section 256I.04, subdivision 3, in addition to 
156.30  the room and board rate specified in subdivision 1, the county 
156.31  agency may negotiate a payment not to exceed $426.37 for other 
156.32  services necessary to provide room and board provided by the 
156.33  group residence if the residence is licensed by or registered by 
156.34  the department of health, or licensed by the department of human 
156.35  services to provide services in addition to room and board, and 
156.36  if the provider of services is not also concurrently receiving 
157.1   funding for services for a recipient under a home and 
157.2   community-based waiver under title XIX of the Social Security 
157.3   Act; or funding from the medical assistance program under 
157.4   section 256B.0627, subdivision 4, for personal care services for 
157.5   residents in the setting; or residing in a setting which 
157.6   receives funding under Minnesota Rules, parts 9535.2000 to 
157.7   9535.3000.  If funding is available for other necessary services 
157.8   through a home and community-based waiver, or personal care 
157.9   services under section 256B.0627, subdivision 4, then the GRH 
157.10  rate is limited to the rate set in subdivision 1.  Unless 
157.11  otherwise provided in law, in no case may the supplementary 
157.12  service rate plus the supplementary room and board rate exceed 
157.13  $426.37.  The registration and licensure requirement does not 
157.14  apply to establishments which are exempt from state licensure 
157.15  because they are located on Indian reservations and for which 
157.16  the tribe has prescribed health and safety requirements.  
157.17  Service payments under this section may be prohibited under 
157.18  rules to prevent the supplanting of federal funds with state 
157.19  funds.  The commissioner shall pursue the feasibility of 
157.20  obtaining the approval of the Secretary of Health and Human 
157.21  Services to provide home and community-based waiver services 
157.22  under title XIX of the Social Security Act for residents who are 
157.23  not eligible for an existing home and community-based waiver due 
157.24  to a primary diagnosis of mental illness or chemical dependency 
157.25  and shall apply for a waiver if it is determined to be 
157.26  cost-effective.  
157.27     (b) The commissioner is authorized to make cost-neutral 
157.28  transfers from the GRH fund for beds under this section to other 
157.29  funding programs administered by the department after 
157.30  consultation with the county or counties in which the affected 
157.31  beds are located.  The commissioner may also make cost-neutral 
157.32  transfers from the GRH fund to county human service agencies for 
157.33  beds permanently removed from the GRH census under a plan 
157.34  submitted by the county agency and approved by the 
157.35  commissioner.  The commissioner shall report the amount of any 
157.36  transfers under this provision annually to the legislature. 
158.1      (c) The provisions of paragraph (b) do not apply to a 
158.2   facility that has its reimbursement rate established under 
158.3   section 256B.431, subdivision 4, paragraph (c). 
158.4      Sec. 42.  Minnesota Statutes 1998, section 256I.05, is 
158.5   amended by adding a subdivision to read: 
158.6      Subd. 1e.  [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 
158.7   Notwithstanding the provisions of subdivisions 1a and 1c, 
158.8   beginning July 1, 1999, a county agency shall negotiate a 
158.9   supplementary rate in addition to the rate specified in 
158.10  subdivision 1, equal to 25 percent of the amount specified in 
158.11  subdivision 1a, for a group residential housing provider that: 
158.12     (1) is located in Hennepin county and has had a group 
158.13  residential housing contract with the county since June 1996; 
158.14     (2) operates in three separate locations a 56-bed facility, 
158.15  a 40-bed facility, and a 30-bed facility; and 
158.16     (3) serves a chemically dependent clientele, providing 24 
158.17  hours per day supervision and limiting a resident's maximum 
158.18  length of stay to 13 months out of a consecutive 24-month period.
158.19     Sec. 43.  Laws 1995, chapter 207, article 3, section 21, is 
158.20  amended to read: 
158.21     Sec. 21.  [FACILITY CERTIFICATION.] 
158.22     Notwithstanding Minnesota Statutes, section 252.291, 
158.23  subdivisions 1 and 2, the commissioner of health shall inspect 
158.24  to certify a large community-based facility currently licensed 
158.25  under Minnesota Rules, parts 9525.0215 to 9525.0355, for more 
158.26  than 16 beds and located in Northfield.  The facility may be 
158.27  certified for up to 44 beds.  The commissioner of health must 
158.28  inspect to certify the facility as soon as possible after the 
158.29  effective date of this section.  The commissioner of human 
158.30  services shall work with the facility and affected counties to 
158.31  relocate any current residents of the facility who do not meet 
158.32  the admission criteria for an ICF/MR.  Until January 1, 1999, in 
158.33  order to fund the ICF/MR services and relocations of current 
158.34  residents authorized, the commissioner of human services may 
158.35  transfer on a quarterly basis to the medical assistance account 
158.36  from each affected county's community social service allocation, 
159.1   an amount equal to the state share of medical assistance 
159.2   reimbursement for the residential and day habilitation services 
159.3   funded by medical assistance and provided to clients for whom 
159.4   the county is financially responsible.  After January 1, 1999, 
159.5   the commissioner of human services shall fund the services under 
159.6   the state medical assistance program and may transfer on a 
159.7   quarterly basis to the medical assistance account from each 
159.8   affected county's community social service allocation, an amount 
159.9   equal to one-half of the state share of medical assistance 
159.10  reimbursement for the residential and day habilitation services 
159.11  funded by medical assistance and provided to clients for whom 
159.12  the county is financially responsible.  For nonresidents of 
159.13  Minnesota seeking admission to the facility, Rice county shall 
159.14  be notified in order to assure that appropriate funding is 
159.15  guaranteed from their state or country of residence. 
159.16     Sec. 44.  [DEADLINE EXTENSION.] 
159.17     Notwithstanding Minnesota Statutes, section 144A.073, 
159.18  subdivision 3, the commissioner of health shall extend approval 
159.19  to May 31, 2000, for a total replacement of a 96-bed nursing 
159.20  home located in Carlton county previously approved under 
159.21  Minnesota Statutes, section 144A.073. 
159.22     Sec. 45.  [STATE LICENSURE CONFLICTS WITH FEDERAL 
159.23  REGULATIONS.] 
159.24     (a) Notwithstanding the provisions of Minnesota Rules, part 
159.25  4658.0520, an incontinent resident must be checked according to 
159.26  a specific time interval written in the resident's care plan.  
159.27  The resident's attending physician must authorize in writing any 
159.28  interval longer than two hours. 
159.29     (b) This section expires July 1, 2001. 
159.30     Sec. 46.  [GROUP RESIDENTIAL HOUSING STUDY.] 
159.31     The commissioner of human services shall submit to the 
159.32  legislature by February 15, 2000, a study of the cost of 
159.33  providing housing for individuals eligible for group residential 
159.34  housing payments and an analysis of the relationship of the 
159.35  costs to market rate housing costs in a representative number of 
159.36  regions in the state.  In preparing the study, the commissioner 
160.1   shall consult with representatives of affected industries, 
160.2   counties, and consumers. 
160.3      Sec. 47.  [ICF/MR SERVICE RECONFIGURATION PROJECT.] 
160.4      (a) The commissioner of human services may authorize a 
160.5   project to reconfigure two existing intermediate care facilities 
160.6   for persons with mental retardation or related conditions 
160.7   (ICFs/MR) located on the same campus in Carver county and 
160.8   totaling 60 licensed beds in one 46-bed facility and one 14-bed 
160.9   facility.  The reconfiguration project will involve the 
160.10  relocation of up to six beds to a six-bed ICF/MR.  The remaining 
160.11  two ICFs/MR shall consist of one 34-bed ICF/MR and one ten-bed 
160.12  ICF/MR. 
160.13     (b) The project shall include the development of 
160.14  alternative home and community-based services for individuals 
160.15  relocated from the existing facilities.  In conjunction with 
160.16  this project, two beds in the 34-bed facility shall be reserved 
160.17  for temporary care services for individuals receiving 
160.18  alternative home and community-based services.  The ICF/MR may 
160.19  seek county approval to modify its need determinations in order 
160.20  to serve fewer clients, or to provide additional beds for 
160.21  temporary care services. 
160.22     (c) The project must be approved by the commissioner under 
160.23  Minnesota Statutes, section 252.28, and must include criteria 
160.24  for determining how individuals are selected for alternative 
160.25  services and the use of a request for proposal process in 
160.26  selecting vendors for the alternative services.  The 
160.27  commissioner is authorized to develop the two additional beds 
160.28  required, and set aside waivered service slots as needed for 
160.29  individuals choosing alternative home and community-based 
160.30  services. 
160.31     (d) Upon approval of the project, the following additional 
160.32  conditions shall apply to rate setting: 
160.33     (1) the two existing facilities' aggregate 
160.34  investment-per-bed limits in effect before the downsizing shall 
160.35  be the investment-per-bed limit after the downsizing; 
160.36     (2) the ten-bed and the 34-bed facilities shall be eligible 
161.1   for a one-time rate adjustment to be negotiated with the 
161.2   commissioner taking into consideration estimated excess revenues 
161.3   available from the six-bed facility; 
161.4      (3) the relocated six-bed facility shall receive the 
161.5   payment rates established for the former 46-bed facility until 
161.6   each facility files a cost report for a period of five months or 
161.7   longer ending on December 31 following their opening and those 
161.8   reports are desk audited by the commissioner.  The two remaining 
161.9   facilities shall file their regularly scheduled annual cost 
161.10  reports; 
161.11     (4) all facilities are exempt from the spend-up and high 
161.12  cost limits in Minnesota Statutes, section 256B.501, subdivision 
161.13  5b, for the rate year following the first cost report submitted 
161.14  under clause (3); and 
161.15     (5) the maintenance limit for the 34-bed facility shall be 
161.16  established using the methodology in Minnesota Statutes, section 
161.17  256B.501, subdivision 5d.  The maintenance limit for the ten-bed 
161.18  facility shall be adjusted by the same ratio used to adjust the 
161.19  34-bed facility's maintenance limit. 
161.20     Sec. 48.  [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 
161.21     (a) For the rate year beginning October 1, 1999, the 
161.22  commissioner of human services shall exempt an intermediate care 
161.23  facility for persons with mental retardation from reductions to 
161.24  the payment rates under Minnesota Statutes, section 256B.501, 
161.25  subdivision 5b, paragraph (d), clause (6), if the facility: 
161.26     (1) has had a settle-up payment rate established in the 
161.27  reporting year preceding the rate year for the one-time rate 
161.28  adjustment; 
161.29     (2) is a newly established facility; 
161.30     (3) is an A to B conversion that has been converted under 
161.31  Minnesota Statutes, section 252.292, since rate year 1990; 
161.32     (4) has a payment rate subject to a community conversion 
161.33  project under Minnesota Statutes, section 252.292; 
161.34     (5) has a payment rate established under Minnesota 
161.35  Statutes, section 245A.12 or 245A.13; or 
161.36     (6) is a facility created by the relocation of more than 25 
162.1   percent of the capacity of a related facility during the 
162.2   reporting year. 
162.3      (b) Notwithstanding any contrary provision in Minnesota 
162.4   Statutes, section 256B.501, for the rate year beginning October 
162.5   1, 1999, the commissioner of human services shall, for purposes 
162.6   of the spend-up limit, array facilities within each grouping 
162.7   established under Minnesota Statutes, section 256B.501, 
162.8   subdivision 5b, paragraph (d), clause (4), by each facility's 
162.9   cost per resident day.  A facility's cost per resident day shall 
162.10  be determined by dividing its allowable historical general 
162.11  operating cost for the reporting year by the facility's resident 
162.12  days for the reporting year.  Facilities with a cost per 
162.13  resident day at or above the median shall be limited to the 
162.14  lesser of: 
162.15     (1) the current reporting year's cost per resident day; or 
162.16     (2) the prior report year's cost per resident day plus the 
162.17  inflation factor established under Minnesota Statutes, section 
162.18  256B.501, subdivision 3c, clause (2), increased by three 
162.19  percentage points.  In no case shall the amount of this 
162.20  reduction exceed:  (i) three percent for a facility with a 
162.21  licensed capacity greater than 16 beds; (ii) two percent for a 
162.22  facility with a licensed capacity of nine to 16 beds; and (iii) 
162.23  one percent for a facility with a licensed capacity of eight or 
162.24  fewer beds. 
162.25     (c) The commissioner shall not apply the limits established 
162.26  under Minnesota Statutes, section 256B.501, subdivision 5b, 
162.27  paragraph (d), clause (8), for the rate year beginning October 
162.28  1, 1999. 
162.29     (d) Notwithstanding paragraphs (b) and (c), the 
162.30  commissioner must utilize facility payment rates based on the 
162.31  laws in effect for October 1, 1998, payment rates and use the 
162.32  resulting allowable operating cost per diems as the basis for 
162.33  the spend-up limits for the rate year beginning October 1, 1999. 
162.34     Sec. 49.  [DEADLINE EXTENSION.] 
162.35     Notwithstanding Minnesota Statutes, section 144A.073, 
162.36  subdivision 3, the commissioner of health shall extend approval 
163.1   to May 31, 2000, for a total replacement of a 96-bed nursing 
163.2   home located in Carlton county previously approved under 
163.3   Minnesota Statutes, section 144A.073. 
163.4      Sec. 50.  [GROUP RESIDENTIAL HOUSING STUDY.] 
163.5      The commissioner of human services shall submit to the 
163.6   legislature by February 15, 2000, a study of the cost of 
163.7   providing housing for individuals eligible for group residential 
163.8   housing payments and an analysis of the relationship of the 
163.9   costs to market rate housing costs in a representative number of 
163.10  regions in the state.  In preparing the study, the commissioner 
163.11  shall consult with representatives of affected industries, 
163.12  counties, and consumers. 
163.13     Sec. 51.  [REPEALER.] 
163.14     (a) Minnesota Statutes 1998, sections 144.0723; and 
163.15  256B.5011, subdivision 3, are repealed. 
163.16     (b) Minnesota Statutes 1998, section 256B.434, subdivision 
163.17  17, is repealed effective July 1, 1999.  
163.18     (c) Minnesota Statutes 1998, section 256B.501, subdivision 
163.19  3g, is repealed effective October 1, 2000. 
163.20     (d) Laws 1997, chapter 203, article 4, section 55, is 
163.21  repealed. 
163.22     (e) Section 45 is repealed effective July 1, 2001. 
163.23     Sec. 52.  [EFFECTIVE DATE.] 
163.24     Sections 3 to 7 and 45 are effective the day following 
163.25  final enactment. 
163.26                             ARTICLE 4 
163.27                        HEALTH CARE PROGRAMS 
163.28     Section 1.  Minnesota Statutes 1998, section 62A.045, is 
163.29  amended to read: 
163.30     62A.045 [PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 
163.31  HEALTH PROGRAMS.] 
163.32     (a) No health plan issued or renewed to provide coverage to 
163.33  a Minnesota resident shall contain any provision denying or 
163.34  reducing benefits because services are rendered to a person who 
163.35  is eligible for or receiving medical benefits pursuant to title 
163.36  XIX of the Social Security Act (Medicaid) in this or any other 
164.1   state; chapter 256; 256B; or 256D or services pursuant to 
164.2   section 252.27; 256L.01 to 256L.10; 260.251, subdivision 1a; or 
164.3   393.07, subdivision 1 or 2.  No health carrier providing 
164.4   benefits under plans covered by this section shall use 
164.5   eligibility for medical programs named in this section as an 
164.6   underwriting guideline or reason for nonacceptance of the risk. 
164.7      (b) If payment for covered expenses has been made under 
164.8   state medical programs for health care items or services 
164.9   provided to an individual, and a third party has a legal 
164.10  liability to make payments, the rights of payment and appeal of 
164.11  an adverse coverage decision for the individual, or in the case 
164.12  of a child their responsible relative or caretaker, will be 
164.13  subrogated to the state and/or its authorized agent agency.  The 
164.14  state agency may assert its rights under this section within 
164.15  three years of the date the service was rendered.  For purposes 
164.16  of this section, "state agency" includes prepaid health plans 
164.17  under contract with the commissioner according to sections 
164.18  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
164.19  children's mental health collaboratives under section 245.493; 
164.20  demonstration projects for persons with disabilities under 
164.21  section 256B.77; nursing homes under the alternative payment 
164.22  demonstration project under section 256B.434; and county-based 
164.23  purchasing entities under section 256B.692.  
164.24     (c) Notwithstanding any law to the contrary, when a person 
164.25  covered by a health plan receives medical benefits according to 
164.26  any statute listed in this section, payment for covered services 
164.27  or notice of denial for services billed by the provider must be 
164.28  issued directly to the provider.  If a person was receiving 
164.29  medical benefits through the department of human services at the 
164.30  time a service was provided, the provider must indicate this 
164.31  benefit coverage on any claim forms submitted by the provider to 
164.32  the health carrier for those services.  If the commissioner of 
164.33  human services notifies the health carrier that the commissioner 
164.34  has made payments to the provider, payment for benefits or 
164.35  notices of denials issued by the health carrier must be issued 
164.36  directly to the commissioner.  Submission by the department to 
165.1   the health carrier of the claim on a department of human 
165.2   services claim form is proper notice and shall be considered 
165.3   proof of payment of the claim to the provider and supersedes any 
165.4   contract requirements of the health carrier relating to the form 
165.5   of submission.  Liability to the insured for coverage is 
165.6   satisfied to the extent that payments for those benefits are 
165.7   made by the health carrier to the provider or the commissioner 
165.8   as required by this section. 
165.9      (d) When a state agency has acquired the rights of an 
165.10  individual eligible for medical programs named in this section 
165.11  and has health benefits coverage through a health carrier, the 
165.12  health carrier shall not impose requirements that are different 
165.13  from requirements applicable to an agent or assignee of any 
165.14  other individual covered. 
165.15     (e) For the purpose of this section, health plan includes 
165.16  coverage offered by community integrated service networks, any 
165.17  plan governed under the federal Employee Retirement Income 
165.18  Security Act of 1974 (ERISA), United States Code, title 29, 
165.19  sections 1001 to 1461, and coverage offered under the exclusions 
165.20  listed in section 62A.011, subdivision 3, clauses (2), (6), (9), 
165.21  (10), and (12).  
165.22     Sec. 2.  Minnesota Statutes 1998, section 122A.09, 
165.23  subdivision 4, is amended to read: 
165.24     Subd. 4.  [LICENSE AND RULES.] (a) The board must adopt 
165.25  rules to license public school teachers and interns subject to 
165.26  chapter 14. 
165.27     (b) The board must adopt rules requiring a person to 
165.28  successfully complete a skills examination in reading, writing, 
165.29  and mathematics as a requirement for initial teacher licensure.  
165.30  Such rules must require college and universities offering a 
165.31  board approved teacher preparation program to provide remedial 
165.32  assistance to persons who did not achieve a qualifying score on 
165.33  the skills examination, including those for whom English is a 
165.34  second language. 
165.35     (c) The board must adopt rules to approve teacher 
165.36  preparation programs. 
166.1      (d) The board must provide the leadership and shall adopt 
166.2   rules for the redesign of teacher education programs to 
166.3   implement a research based, results-oriented curriculum that 
166.4   focuses on the skills teachers need in order to be effective.  
166.5   The board shall implement new systems of teacher preparation 
166.6   program evaluation to assure program effectiveness based on 
166.7   proficiency of graduates in demonstrating attainment of program 
166.8   outcomes. 
166.9      (e) The board must adopt rules requiring successful 
166.10  completion of an examination of general pedagogical knowledge 
166.11  and examinations of licensure-specific teaching skills.  The 
166.12  rules shall be effective on the dates determined by the board, 
166.13  but not later than July 1, 1999. 
166.14     (f) The board must adopt rules requiring teacher educators 
166.15  to work directly with elementary or secondary school teachers in 
166.16  elementary or secondary schools to obtain periodic exposure to 
166.17  the elementary or secondary teaching environment. 
166.18     (g) The board must grant licenses to interns and to 
166.19  candidates for initial licenses. 
166.20     (h) The board must design and implement an assessment 
166.21  system which requires a candidate for an initial license and 
166.22  first continuing license to demonstrate the abilities necessary 
166.23  to perform selected, representative teaching tasks at 
166.24  appropriate levels. 
166.25     (i) The board must receive recommendations from local 
166.26  committees as established by the board for the renewal of 
166.27  teaching licenses. 
166.28     (j) The board must grant life licenses to those who qualify 
166.29  according to requirements established by the board, and suspend 
166.30  or revoke licenses pursuant to sections 122A.20 and 214.10.  The 
166.31  board must not establish any expiration date for application for 
166.32  life licenses.  
166.33     (k) In adopting rules to license public school teachers who 
166.34  provide health-related services for disabled children, the board 
166.35  shall adopt rules consistent with license or registration 
166.36  requirements of the commissioner of health and the 
167.1   health-related boards who license personnel who perform similar 
167.2   services outside of the school. 
167.3      Sec. 3.  Minnesota Statutes 1998, section 125A.08, is 
167.4   amended to read: 
167.5      125A.08 [SCHOOL DISTRICT OBLIGATIONS.] 
167.6      (a) As defined in this section, to the extent required by 
167.7   federal law as of July 1, 1999 2000, every district must ensure 
167.8   the following: 
167.9      (1) all students with disabilities are provided the special 
167.10  instruction and services which are appropriate to their needs.  
167.11  Where the individual education plan team has determined 
167.12  appropriate goals and objectives based on the student's needs, 
167.13  including the extent to which the student can be included in the 
167.14  least restrictive environment, and where there are essentially 
167.15  equivalent and effective instruction, related services, or 
167.16  assistive technology devices available to meet the student's 
167.17  needs, cost to the district may be among the factors considered 
167.18  by the team in choosing how to provide the appropriate services, 
167.19  instruction, or devices that are to be made part of the 
167.20  student's individual education plan.  The individual education 
167.21  plan team shall consider and may authorize services covered by 
167.22  medical assistance according to section 256B.0625, subdivision 
167.23  26.  The student's needs and the special education instruction 
167.24  and services to be provided must be agreed upon through the 
167.25  development of an individual education plan.  The plan must 
167.26  address the student's need to develop skills to live and work as 
167.27  independently as possible within the community.  By grade 9 or 
167.28  age 14, the plan must address the student's needs for transition 
167.29  from secondary services to post-secondary education and 
167.30  training, employment, community participation, recreation, and 
167.31  leisure and home living.  In developing the plan, districts must 
167.32  inform parents of the full range of transitional goals and 
167.33  related services that should be considered.  The plan must 
167.34  include a statement of the needed transition services, including 
167.35  a statement of the interagency responsibilities or linkages or 
167.36  both before secondary services are concluded; 
168.1      (2) children with a disability under age five and their 
168.2   families are provided special instruction and services 
168.3   appropriate to the child's level of functioning and needs; 
168.4      (3) children with a disability and their parents or 
168.5   guardians are guaranteed procedural safeguards and the right to 
168.6   participate in decisions involving identification, assessment 
168.7   including assistive technology assessment, and educational 
168.8   placement of children with a disability; 
168.9      (4) eligibility and needs of children with a disability are 
168.10  determined by an initial assessment or reassessment, which may 
168.11  be completed using existing data under United States Code, title 
168.12  20, section 33, et seq.; 
168.13     (5) to the maximum extent appropriate, children with a 
168.14  disability, including those in public or private institutions or 
168.15  other care facilities, are educated with children who are not 
168.16  disabled, and that special classes, separate schooling, or other 
168.17  removal of children with a disability from the regular 
168.18  educational environment occurs only when and to the extent that 
168.19  the nature or severity of the disability is such that education 
168.20  in regular classes with the use of supplementary services cannot 
168.21  be achieved satisfactorily; 
168.22     (6) in accordance with recognized professional standards, 
168.23  testing and evaluation materials, and procedures used for the 
168.24  purposes of classification and placement of children with a 
168.25  disability are selected and administered so as not to be 
168.26  racially or culturally discriminatory; and 
168.27     (7) the rights of the child are protected when the parents 
168.28  or guardians are not known or not available, or the child is a 
168.29  ward of the state. 
168.30     (b) For paraprofessionals employed to work in programs for 
168.31  students with disabilities, the school board in each district 
168.32  shall ensure that: 
168.33     (1) before or immediately upon employment, each 
168.34  paraprofessional develops sufficient knowledge and skills in 
168.35  emergency procedures, building orientation, roles and 
168.36  responsibilities, confidentiality, vulnerability, and 
169.1   reportability, among other things, to begin meeting the needs of 
169.2   the students with whom the paraprofessional works; 
169.3      (2) annual training opportunities are available to enable 
169.4   the paraprofessional to continue to further develop the 
169.5   knowledge and skills that are specific to the students with whom 
169.6   the paraprofessional works, including understanding 
169.7   disabilities, following lesson plans, and implementing follow-up 
169.8   instructional procedures and activities; and 
169.9      (3) a districtwide process obligates each paraprofessional 
169.10  to work under the ongoing direction of a licensed teacher and, 
169.11  where appropriate and possible, the supervision of a school 
169.12  nurse. 
169.13     Sec. 4.  Minnesota Statutes 1998, section 125A.744, 
169.14  subdivision 3, is amended to read: 
169.15     Subd. 3.  [IMPLEMENTATION.] Consistent with section 
169.16  256B.0625, subdivision 26, school districts may enroll as 
169.17  medical assistance providers or subcontractors and bill the 
169.18  department of human services under the medical assistance fee 
169.19  for service claims processing system for special education 
169.20  services which are covered services under chapter 256B, which 
169.21  are provided in the school setting for a medical assistance 
169.22  recipient, and for whom the district has secured informed 
169.23  consent consistent with section 13.05, subdivision 4, paragraph 
169.24  (d), and section 256B.77, subdivision 2, paragraph (p), to bill 
169.25  for each type of covered service.  School districts shall be 
169.26  reimbursed by the commissioner of human services for the federal 
169.27  share of individual education plan health-related services that 
169.28  qualify for reimbursement by medical assistance, minus up to 
169.29  five percent retained by the commissioner of human services for 
169.30  administrative costs, not to exceed $350,000 per fiscal year.  
169.31  The commissioner may withhold up to five percent of each payment 
169.32  to a school district.  Following the end of each fiscal year, 
169.33  the commissioner shall settle up with each school district in 
169.34  order to ensure that collections from each district for 
169.35  departmental administrative costs are made on a pro rata basis 
169.36  according to federal earnings for these services in each 
170.1   district.  A school district is not eligible to enroll as a home 
170.2   care provider or a personal care provider organization for 
170.3   purposes of billing home care services under section 256B.0627 
170.4   until the commissioner of human services issues a bulletin 
170.5   instructing county public health nurses on how to assess for the 
170.6   needs of eligible recipients during school hours.  To use 
170.7   private duty nursing services or personal care services at 
170.8   school, the recipient or responsible party must provide written 
170.9   authorization in the care plan identifying the chosen provider 
170.10  and the daily amount of services to be used at school.  Medical 
170.11  assistance services for those enrolled in a prepaid health plan 
170.12  shall remain the responsibility of the contracted health plan 
170.13  subject to their network, credentialing, prior authorization, 
170.14  and determination of medical necessity criteria.  The 
170.15  commissioner of human services shall adjust payments to health 
170.16  plans to reflect increased costs incurred by health plans due to 
170.17  increased payments made to school districts or new payment or 
170.18  delivery arrangements developed by health plans in cooperation 
170.19  with school districts. 
170.20     Sec. 5.  Minnesota Statutes 1998, section 125A.76, 
170.21  subdivision 2, is amended to read: 
170.22     Subd. 2.  [SPECIAL EDUCATION BASE REVENUE.] (a) The special 
170.23  education base revenue equals the sum of the following amounts 
170.24  computed using base year data: 
170.25     (1) 68 percent of the salary of each essential person 
170.26  employed in the district's program for children with a 
170.27  disability during the fiscal year, not including the share of 
170.28  salaries for personnel providing health-related services counted 
170.29  in clause (8), whether the person is employed by one or more 
170.30  districts or a Minnesota correctional facility operating on a 
170.31  fee-for-service basis; 
170.32     (2) for the Minnesota state academy for the deaf or the 
170.33  Minnesota state academy for the blind, 68 percent of the salary 
170.34  of each instructional aide assigned to a child attending the 
170.35  academy, if that aide is required by the child's individual 
170.36  education plan; 
171.1      (3) for special instruction and services provided to any 
171.2   pupil by contracting with public, private, or voluntary agencies 
171.3   other than school districts, in place of special instruction and 
171.4   services provided by the district, 52 percent of the difference 
171.5   between the amount of the contract and the basic revenue of the 
171.6   district for that pupil for the fraction of the school day the 
171.7   pupil receives services under the contract; 
171.8      (4) for special instruction and services provided to any 
171.9   pupil by contracting for services with public, private, or 
171.10  voluntary agencies other than school districts, that are 
171.11  supplementary to a full educational program provided by the 
171.12  school district, 52 percent of the amount of the contract for 
171.13  that pupil; 
171.14     (5) for supplies and equipment purchased or rented for use 
171.15  in the instruction of children with a disability, not including 
171.16  the portion of the expenses for supplies and equipment used to 
171.17  provide health-related services counted in clause (8), an amount 
171.18  equal to 47 percent of the sum actually expended by the 
171.19  district, or a Minnesota correctional facility operating on a 
171.20  fee-for-service basis, but not to exceed an average of $47 in 
171.21  any one school year for each child with a disability receiving 
171.22  instruction; 
171.23     (6) for fiscal years 1997 and later, special education base 
171.24  revenue shall include amounts under clauses (1) to (5) for 
171.25  special education summer programs provided during the base year 
171.26  for that fiscal year; and 
171.27     (7) for fiscal years 1999 and later, the cost of providing 
171.28  transportation services for children with disabilities under 
171.29  section 123B.92, subdivision 1, paragraph (b), clause (4); and 
171.30     (8) for fiscal years 2001 and later, the cost of salaries, 
171.31  supplies and equipment, and other related costs actually 
171.32  expended by the district for the nonfederal share of medical 
171.33  assistance services according to section 256B.0625, subdivision 
171.34  26. 
171.35     (b) If requested by a school district operating a special 
171.36  education program during the base year for less than the full 
172.1   fiscal year, or a school district in which is located a 
172.2   Minnesota correctional facility operating on a fee-for-service 
172.3   basis for less than the full fiscal year, the commissioner may 
172.4   adjust the base revenue to reflect the expenditures that would 
172.5   have occurred during the base year had the program been operated 
172.6   for the full fiscal year. 
172.7      (c) Notwithstanding paragraphs (a) and (b), the portion of 
172.8   a school district's base revenue attributable to a Minnesota 
172.9   correctional facility operating on a fee-for-service basis 
172.10  during the facility's first year of operating on a 
172.11  fee-for-service basis shall be computed using current year data. 
172.12     Sec. 6.  [127A.11] [MONITOR MEDICAL ASSISTANCE SERVICES FOR 
172.13  DISABLED STUDENTS.] 
172.14     The commissioner of children, families, and learning, in 
172.15  cooperation with the commissioner of human services, shall 
172.16  monitor the costs of health-related, special education services 
172.17  provided by public schools. 
172.18     Sec. 7.  [214.045] [COORDINATION WITH BOARD OF TEACHING.] 
172.19     The commissioner of health and the health-related licensing 
172.20  boards must coordinate with the board of teaching when modifying 
172.21  licensure requirements for regulated persons in order to have 
172.22  consistent regulatory requirements for personnel who perform 
172.23  services in schools. 
172.24     Sec. 8.  [245.99] [ADULT MENTAL ILLNESS CRISIS HOUSING 
172.25  ASSISTANCE PROGRAM.] 
172.26     Subdivision 1.  [CREATION.] The adult mental illness crisis 
172.27  housing assistance program is established in the department of 
172.28  human services. 
172.29     Subd. 2.  [RENTAL ASSISTANCE.] The program shall pay up to 
172.30  90 days of housing assistance for persons with a serious and 
172.31  persistent mental illness who require inpatient or residential 
172.32  care for stabilization.  The commissioner of human services may 
172.33  extend the length of assistance on a case-by-case basis. 
172.34     Subd. 3.  [ELIGIBILITY.] Housing assistance under this 
172.35  section is available only to persons of low or moderate income 
172.36  as determined by the commissioner. 
173.1      Subd. 4.  [ADMINISTRATION.] The commissioner may contract 
173.2   with organizations or government units experienced in housing 
173.3   assistance to operate the program under this section. 
173.4      Sec. 9.  Minnesota Statutes 1998, section 245A.04, 
173.5   subdivision 3a, is amended to read: 
173.6      Subd. 3a.  [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 
173.7   STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 
173.8   commissioner shall notify the applicant or license holder and 
173.9   the individual who is the subject of the study, in writing or by 
173.10  electronic transmission, of the results of the study.  When the 
173.11  study is completed, a notice that the study was undertaken and 
173.12  completed shall be maintained in the personnel files of the 
173.13  program.  For studies on individuals pertaining to a license to 
173.14  provide family day care or group family day care, foster care 
173.15  for children in the provider's own home, or foster care or day 
173.16  care services for adults in the provider's own home, the 
173.17  commissioner is not required to provide a separate notice of the 
173.18  background study results to the individual who is the subject of 
173.19  the study unless the study results in a disqualification of the 
173.20  individual. 
173.21     The commissioner shall notify the individual studied if the 
173.22  information in the study indicates the individual is 
173.23  disqualified from direct contact with persons served by the 
173.24  program.  The commissioner shall disclose the information 
173.25  causing disqualification and instructions on how to request a 
173.26  reconsideration of the disqualification to the individual 
173.27  studied.  An applicant or license holder who is not the subject 
173.28  of the study shall be informed that the commissioner has found 
173.29  information that disqualifies the subject from direct contact 
173.30  with persons served by the program.  However, only the 
173.31  individual studied must be informed of the information contained 
173.32  in the subject's background study unless the only basis for the 
173.33  disqualification is failure to cooperate, the Data Practices Act 
173.34  provides for release of the information, or the individual 
173.35  studied authorizes the release of the information. 
173.36     (b) If the commissioner determines that the individual 
174.1   studied has a disqualifying characteristic, the commissioner 
174.2   shall review the information immediately available and make a 
174.3   determination as to the subject's immediate risk of harm to 
174.4   persons served by the program where the individual studied will 
174.5   have direct contact.  The commissioner shall consider all 
174.6   relevant information available, including the following factors 
174.7   in determining the immediate risk of harm:  the recency of the 
174.8   disqualifying characteristic; the recency of discharge from 
174.9   probation for the crimes; the number of disqualifying 
174.10  characteristics; the intrusiveness or violence of the 
174.11  disqualifying characteristic; the vulnerability of the victim 
174.12  involved in the disqualifying characteristic; and the similarity 
174.13  of the victim to the persons served by the program where the 
174.14  individual studied will have direct contact.  The commissioner 
174.15  may determine that the evaluation of the information immediately 
174.16  available gives the commissioner reason to believe one of the 
174.17  following: 
174.18     (1) The individual poses an imminent risk of harm to 
174.19  persons served by the program where the individual studied will 
174.20  have direct contact.  If the commissioner determines that an 
174.21  individual studied poses an imminent risk of harm to persons 
174.22  served by the program where the individual studied will have 
174.23  direct contact, the individual and the license holder must be 
174.24  sent a notice of disqualification.  The commissioner shall order 
174.25  the license holder to immediately remove the individual studied 
174.26  from direct contact.  The notice to the individual studied must 
174.27  include an explanation of the basis of this determination. 
174.28     (2) The individual poses a risk of harm requiring 
174.29  continuous supervision while providing direct contact services 
174.30  during the period in which the subject may request a 
174.31  reconsideration.  If the commissioner determines that an 
174.32  individual studied poses a risk of harm that requires continuous 
174.33  supervision, the individual and the license holder must be sent 
174.34  a notice of disqualification.  The commissioner shall order the 
174.35  license holder to immediately remove the individual studied from 
174.36  direct contact services or assure that the individual studied is 
175.1   within sight or hearing of another staff person when providing 
175.2   direct contact services during the period in which the 
175.3   individual may request a reconsideration of the 
175.4   disqualification.  If the individual studied does not submit a 
175.5   timely request for reconsideration, or the individual submits a 
175.6   timely request for reconsideration, but the disqualification is 
175.7   not set aside for that license holder, the license holder will 
175.8   be notified of the disqualification and ordered to immediately 
175.9   remove the individual from any position allowing direct contact 
175.10  with persons receiving services from the license holder. 
175.11     (3) The individual does not pose an imminent risk of harm 
175.12  or a risk of harm requiring continuous supervision while 
175.13  providing direct contact services during the period in which the 
175.14  subject may request a reconsideration.  If the commissioner 
175.15  determines that an individual studied does not pose a risk of 
175.16  harm that requires continuous supervision, only the individual 
175.17  must be sent a notice of disqualification.  The license holder 
175.18  must be sent a notice that more time is needed to complete the 
175.19  individual's background study.  If the individual studied 
175.20  submits a timely request for reconsideration, and if the 
175.21  disqualification is set aside for that license holder, the 
175.22  license holder will receive the same notification received by 
175.23  license holders in cases where the individual studied has no 
175.24  disqualifying characteristic.  If the individual studied does 
175.25  not submit a timely request for reconsideration, or the 
175.26  individual submits a timely request for reconsideration, but the 
175.27  disqualification is not set aside for that license holder, the 
175.28  license holder will be notified of the disqualification and 
175.29  ordered to immediately remove the individual from any position 
175.30  allowing direct contact with persons receiving services from the 
175.31  license holder.  
175.32     (c) County licensing agencies performing duties under this 
175.33  subdivision may develop an alternative system for determining 
175.34  the subject's immediate risk of harm to persons served by the 
175.35  program, providing the notices under paragraph (b), and 
175.36  documenting the action taken by the county licensing agency.  
176.1   Each county licensing agency's implementation of the alternative 
176.2   system is subject to approval by the commissioner.  
176.3   Notwithstanding this alternative system, county licensing 
176.4   agencies shall complete the requirements of paragraph (a). 
176.5      Sec. 10.  Minnesota Statutes 1998, section 245A.08, 
176.6   subdivision 5, is amended to read: 
176.7      Subd. 5.  [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 
176.8   considering the findings of fact, conclusions, and 
176.9   recommendations of the administrative law judge, the 
176.10  commissioner shall issue a final order.  The commissioner shall 
176.11  consider, but shall not be bound by, the recommendations of the 
176.12  administrative law judge.  The appellant must be notified of the 
176.13  commissioner's final order as required by chapter 14.  The 
176.14  notice must also contain information about the appellant's 
176.15  rights under chapter 14.  The institution of proceedings for 
176.16  judicial review of the commissioner's final order shall not stay 
176.17  the enforcement of the final order except as provided in section 
176.18  14.65.  A license holder and each controlling individual of a 
176.19  license holder whose license has been revoked because of 
176.20  noncompliance with applicable law or rule must not be granted a 
176.21  license for five years following the revocation.  An applicant 
176.22  whose application was denied must not be granted a license for 
176.23  two years following a denial, unless the applicant's subsequent 
176.24  application contains new information which constitutes a 
176.25  substantial change in the conditions that caused the previous 
176.26  denial. 
176.27     Sec. 11.  Minnesota Statutes 1998, section 245B.05, 
176.28  subdivision 7, is amended to read: 
176.29     Subd. 7.  [REPORTING INCIDENTS AND EMERGENCIES.] The 
176.30  license holder must report the following incidents to the 
176.31  consumer's legal representative, caregiver, and case manager 
176.32  within 24 hours of the occurrence, or within 24 hours of receipt 
176.33  of the information: 
176.34     (1) the death of a consumer; 
176.35     (2) any medical emergencies, unexpected serious illnesses, 
176.36  or accidents that require physician treatment or 
177.1   hospitalization; 
177.2      (3) a consumer's unauthorized absence; or 
177.3      (4) any fires and incidents involving a law enforcement 
177.4   agency. 
177.5      Death or serious injury of the consumer must also be 
177.6   reported to the commissioner department of human services 
177.7   licensing division and the ombudsman, as required under sections 
177.8   245.91 and 245.94, subdivision 2a. 
177.9      Sec. 12.  Minnesota Statutes 1998, section 245B.07, 
177.10  subdivision 5, is amended to read: 
177.11     Subd. 5.  [STAFF ORIENTATION.] (a) Within 60 days of hiring 
177.12  staff who provide direct service, the license holder must 
177.13  provide 30 hours of staff orientation.  Direct care staff must 
177.14  complete 15 of the 30 hours orientation before providing any 
177.15  unsupervised direct service to a consumer.  If the staff person 
177.16  has received orientation training from a license holder licensed 
177.17  under this chapter, or provides semi-independent living services 
177.18  only, the 15-hour requirement may be reduced to eight hours.  
177.19  The total orientation of 30 hours may be reduced to 15 hours if 
177.20  the staff person has previously received orientation training 
177.21  from a license holder licensed under this chapter. 
177.22     (b) The 30 hours of orientation must combine supervised 
177.23  on-the-job training with coverage of the following material: 
177.24     (1) review of the consumer's service plans and risk 
177.25  management plan to achieve an understanding of the consumer as a 
177.26  unique individual; 
177.27     (2) review and instruction on the license holder's policies 
177.28  and procedures, including their location and access; 
177.29     (3) emergency procedures; 
177.30     (4) explanation of specific job functions, including 
177.31  implementing objectives from the consumer's individual service 
177.32  plan; 
177.33     (5) explanation of responsibilities related to section 
177.34  245A.65; sections 626.556 and 626.557, governing maltreatment 
177.35  reporting and service planning for children and vulnerable 
177.36  adults; and section 245.825, governing use of aversive and 
178.1   deprivation procedures; 
178.2      (6) medication administration as it applies to the 
178.3   individual consumer, from a training curriculum developed by a 
178.4   health services professional described in section 245B.05, 
178.5   subdivision 5, and when the consumer meets the criteria of 
178.6   having overriding health care needs, then medication 
178.7   administration taught by a health services professional.  Staff 
178.8   may administer medications only after they demonstrate the 
178.9   ability, as defined in the license holder's medication 
178.10  administration policy and procedures.  Once a consumer with 
178.11  overriding health care needs is admitted, staff will be provided 
178.12  with remedial training as deemed necessary by the license holder 
178.13  and the health professional to meet the needs of that consumer. 
178.14     For purposes of this section, overriding health care needs 
178.15  means a health care condition that affects the service options 
178.16  available to the consumer because the condition requires: 
178.17     (i) specialized or intensive medical or nursing 
178.18  supervision; and 
178.19     (ii) nonmedical service providers to adapt their services 
178.20  to accommodate the health and safety needs of the consumer; 
178.21     (7) consumer rights; and 
178.22     (8) other topics necessary as determined by the consumer's 
178.23  individual service plan or other areas identified by the license 
178.24  holder. 
178.25     (c) The license holder must document each employee's 
178.26  orientation received. 
178.27     Sec. 13.  Minnesota Statutes 1998, section 245B.07, 
178.28  subdivision 8, is amended to read: 
178.29     Subd. 8.  [POLICIES AND PROCEDURES.] The license holder 
178.30  must develop and implement the policies and procedures in 
178.31  paragraphs (1) to (3). 
178.32     (1) policies and procedures that promote consumer health 
178.33  and safety by ensuring: 
178.34     (i) consumer safety in emergency situations as identified 
178.35  in section 245B.05, subdivision 7; 
178.36     (ii) consumer health through sanitary practices; 
179.1      (iii) safe transportation, when the license holder is 
179.2   responsible for transportation of consumers, with provisions for 
179.3   handling emergency situations; 
179.4      (iv) a system of recordkeeping for both individuals and the 
179.5   organization, for review of incidents and emergencies, and 
179.6   corrective action if needed; 
179.7      (v) a plan for responding to and reporting all emergencies, 
179.8   including deaths, medical emergencies, illnesses, accidents, 
179.9   missing consumers, fires, severe weather and natural disasters, 
179.10  bomb threats, and other threats; 
179.11     (vi) safe medication administration as identified in 
179.12  section 245B.05, subdivision 5, incorporating an observed skill 
179.13  assessment to ensure that staff demonstrate the ability to 
179.14  administer medications consistent with the license holder's 
179.15  policy and procedures; 
179.16     (vii) psychotropic medication monitoring when the consumer 
179.17  is prescribed a psychotropic medication, including the use of 
179.18  the psychotropic medication use checklist.  If the 
179.19  responsibility for implementing the psychotropic medication use 
179.20  checklist has not been assigned in the individual service plan 
179.21  and the consumer lives in a licensed site, the residential 
179.22  license holder shall be designated; and 
179.23     (viii) criteria for admission or service initiation 
179.24  developed by the license holder; 
179.25     (2) policies and procedures that protect consumer rights 
179.26  and privacy by ensuring: 
179.27     (i) consumer data privacy, in compliance with the Minnesota 
179.28  Data Practices Act, chapter 13; and 
179.29     (ii) that complaint procedures provide consumers with a 
179.30  simple process to bring grievances and consumers receive a 
179.31  response to the grievance within a reasonable time period.  The 
179.32  license holder must provide a copy of the program's grievance 
179.33  procedure and time lines for addressing grievances.  The 
179.34  program's grievance procedure must permit consumers served by 
179.35  the program and the authorized representatives to bring a 
179.36  grievance to the highest level of authority in the program; and 
180.1      (3) policies and procedures that promote continuity and 
180.2   quality of consumer supports by ensuring: 
180.3      (i) continuity of care and service coordination, including 
180.4   provisions for service termination, temporary service 
180.5   suspension, and efforts made by the license holder to coordinate 
180.6   services with other vendors who also provide support to the 
180.7   consumer.  The policy must include the following requirements: 
180.8      (A) the license holder must notify the consumer or 
180.9   consumer's legal representative and the consumer's case manager 
180.10  in writing of the intended termination or temporary service 
180.11  suspension and the consumer's right to seek a temporary order 
180.12  staying the termination or suspension of service according to 
180.13  the procedures in section 256.045, subdivision 4a or subdivision 
180.14  6, paragraph (c); 
180.15     (B) notice of the proposed termination of services, 
180.16  including those situations that began with a temporary service 
180.17  suspension, must be given at least 60 days before the proposed 
180.18  termination is to become effective, unless services are 
180.19  temporarily suspended according to the license holder's written 
180.20  temporary service suspension procedures, in which case notice 
180.21  must be given as soon as possible; 
180.22     (C) the license holder must provide information requested 
180.23  by the consumer or consumer's legal representative or case 
180.24  manager when services are temporarily suspended or upon notice 
180.25  of termination; 
180.26     (D) use of temporary service suspension procedures are 
180.27  restricted to situations in which the consumer's behavior causes 
180.28  immediate and serious danger to the health and safety of the 
180.29  individual or others; 
180.30     (E) prior to giving notice of service termination or 
180.31  temporary service suspension, the license holder must document 
180.32  actions taken to minimize or eliminate the need for service 
180.33  termination or temporary service suspension; and 
180.34     (F) during the period of temporary service suspension, the 
180.35  license holder will work with the appropriate county agency to 
180.36  develop reasonable alternatives to protect the individual and 
181.1   others; and 
181.2      (ii) quality services measured through a program evaluation 
181.3   process including regular evaluations of consumer satisfaction 
181.4   and sharing the results of the evaluations with the consumers 
181.5   and legal representatives. 
181.6      Sec. 14.  Minnesota Statutes 1998, section 245B.07, 
181.7   subdivision 10, is amended to read: 
181.8      Subd. 10.  [CONSUMER FUNDS.] (a) The license holder must 
181.9   ensure that consumers retain the use and availability of 
181.10  personal funds or property unless restrictions are justified in 
181.11  the consumer's individual service plan. 
181.12     (b) The license holder must ensure separation of resident 
181.13  consumer funds from funds of the license holder, the residential 
181.14  program, or program staff. 
181.15     (c) Whenever the license holder assists a consumer with the 
181.16  safekeeping of funds or other property, the license holder 
181.17  must have written authorization to do so by the consumer or the 
181.18  consumer's legal representative, and the case manager.  In 
181.19  addition, the license holder must: 
181.20     (1) document receipt and disbursement of the consumer's 
181.21  funds or the property, and include the signature of the 
181.22  consumer, conservator, or payee; 
181.23     (2) provide a statement at least quarterly itemizing 
181.24  annually survey, document, and implement the preferences of the 
181.25  consumer, consumer's legal representative, and the case manager 
181.26  for frequency of receiving a statement that itemizes receipts 
181.27  and disbursements of resident consumer funds or other property; 
181.28  and 
181.29     (3) return to the consumer upon the consumer's request, 
181.30  funds and property in the license holder's possession subject to 
181.31  restrictions in the consumer's individual service plan, as soon 
181.32  as possible, but no later than three working days after the date 
181.33  of the request. 
181.34     (d) License holders and program staff must not: 
181.35     (1) borrow money from a consumer; 
181.36     (2) purchase personal items from a consumer; 
182.1      (3) sell merchandise or personal services to a consumer; 
182.2      (4) require a resident consumer to purchase items for which 
182.3   the license holder is eligible for reimbursement; or 
182.4      (5) use resident consumer funds in a manner that would 
182.5   violate section 256B.04, or any rules promulgated under that 
182.6   section. 
182.7      Sec. 15.  Minnesota Statutes 1998, section 252.32, 
182.8   subdivision 3a, is amended to read: 
182.9      Subd. 3a.  [REPORTS AND ALLOCATIONS.] (a) The commissioner 
182.10  shall specify requirements for quarterly fiscal and annual 
182.11  program reports according to section 256.01, subdivision 2, 
182.12  paragraph (17).  Program reports shall include data which will 
182.13  enable the commissioner to evaluate program effectiveness and to 
182.14  audit compliance.  The commissioner shall reimburse county costs 
182.15  on a quarterly basis. 
182.16     (b) Beginning January 1, 1998, The commissioner shall 
182.17  allocate state funds made available under this section to county 
182.18  social service agencies on a calendar year basis.  The 
182.19  commissioner shall allocate to each county first in amounts 
182.20  equal to each county's guaranteed floor as described in clause 
182.21  (1), and second, any remaining funds, after the allocation of 
182.22  funds to the newly participating counties as provided for in 
182.23  clause (3), shall be allocated in proportion to each county's 
182.24  total number of families receiving a grant on July 1 of the most 
182.25  recent calendar year will be allocated to county agencies to 
182.26  support children in their family homes.  
182.27     (1) Each county's guaranteed floor shall be calculated as 
182.28  follows:  
182.29     (i) 95 percent of the county's allocation received in the 
182.30  preceding calendar year.  For the calendar year 1998 allocation, 
182.31  the preceding calendar year shall be considered to be double the 
182.32  six-month allocation as provided in clause (2); 
182.33     (ii) when the amount of funds available for allocation is 
182.34  less than the amount available in the preceding year, each 
182.35  county's previous year allocation shall be reduced in proportion 
182.36  to the reduction in statewide funding, for the purpose of 
183.1   establishing the guaranteed floor.  
183.2      (2) For the period July 1, 1997, to December 31, 1997, the 
183.3   commissioner shall allocate to each county an amount equal to 
183.4   the actual, state approved grants issued to the families for the 
183.5   month of January 1997, multiplied by six.  This six-month 
183.6   allocation shall be combined with the calendar year 1998 
183.7   allocation and be administered as an 18-month allocation.  
183.8      (3) At the commissioner's discretion, funds may be 
183.9   allocated to any nonparticipating county that requests an 
183.10  allocation under this section.  Allocations to newly 
183.11  participating counties are dependent upon the availability of 
183.12  funds, as determined by the actual expenditure amount of the 
183.13  participating counties for the most recently completed calendar 
183.14  year.  
183.15     (4) The commissioner shall regularly review the use of 
183.16  family support fund allocations by county.  The commissioner may 
183.17  reallocate unexpended or unencumbered money at any time to those 
183.18  counties that have a demonstrated need for additional funding.  
183.19     (c) County allocations under this section will be adjusted 
183.20  for transfers that occur according to section 256.476 or when 
183.21  the county of financial responsibility changes according to 
183.22  chapter 256G for eligible recipients. 
183.23     Sec. 16.  Minnesota Statutes 1998, section 256.015, 
183.24  subdivision 1, is amended to read: 
183.25     Subdivision 1.  [STATE AGENCY HAS LIEN.] When the state 
183.26  agency provides, pays for, or becomes liable for medical care or 
183.27  furnishes subsistence or other payments to a person, the agency 
183.28  shall have a lien for the cost of the care and payments on any 
183.29  and all causes of action or recovery rights under any policy, 
183.30  plan, or contract providing benefits for health care or injury 
183.31  which accrue to the person to whom the care or payments were 
183.32  furnished, or to the person's legal representatives, as a result 
183.33  of the occurrence that necessitated the medical care, 
183.34  subsistence, or other payments.  For purposes of this section, 
183.35  "state agency" includes authorized agents of the state agency 
183.36  prepaid health plans under contract with the commissioner 
184.1   according to sections 256B.69, 256D.03, subdivision 4, paragraph 
184.2   (d), and 256L.12; children's mental health collaboratives under 
184.3   section 245.493; demonstration projects for persons with 
184.4   disabilities under section 256B.77; nursing homes under the 
184.5   alternative payment demonstration project under section 
184.6   256B.434; and county-based purchasing entities under section 
184.7   256B.692. 
184.8      Sec. 17.  Minnesota Statutes 1998, section 256.015, 
184.9   subdivision 3, is amended to read: 
184.10     Subd. 3.  [PROSECUTOR.] The attorney general, or the 
184.11  appropriate county attorney acting at the direction of the 
184.12  attorney general, shall represent the state agency commissioner 
184.13  to enforce the lien created under this section or, if no action 
184.14  has been brought, may initiate and prosecute an independent 
184.15  action on behalf of the state agency commissioner against a 
184.16  person, firm, or corporation that may be liable to the person to 
184.17  whom the care or payment was furnished. 
184.18     Any prepaid health plan providing services under sections 
184.19  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
184.20  children's mental health collaboratives under section 245.493; 
184.21  demonstration projects for persons with disabilities under 
184.22  section 256B.77; nursing homes under the alternative payment 
184.23  demonstration project under section 256B.434; or the 
184.24  county-based purchasing entity providing services under section 
184.25  256B.692 may retain legal representation to enforce their lien 
184.26  created under this section or, if no action has been brought, 
184.27  may initiate and prosecute an independent action on their behalf 
184.28  against a person, firm, or corporation that may be liable to the 
184.29  person to whom the care or payment was furnished.  
184.30     Sec. 18.  [256.028] [TAX REBATES.] 
184.31     Any federal or state tax rebate received by a recipient of 
184.32  a public assistance program shall not be counted as income or as 
184.33  an asset for purposes of any of the public assistance programs 
184.34  under this chapter or any other chapter, including, but not 
184.35  limited to, chapter 256B, 256D, 256E, 256I, 256J, or 256L to the 
184.36  extent permitted under federal law. 
185.1      Sec. 19.  Minnesota Statutes 1998, section 256.955, 
185.2   subdivision 3, is amended to read: 
185.3      Subd. 3.  [PRESCRIPTION DRUG COVERAGE.] Coverage under the 
185.4   program is limited to prescription drugs covered under the 
185.5   medical assistance program as described in section 256B.0625, 
185.6   subdivision 13, subject to a maximum deductible of $300 
185.7   annually, except drugs cleared by the FDA shall be available to 
185.8   qualified senior citizens enrolled in the program without 
185.9   restriction when prescribed for medically accepted indication as 
185.10  defined in the federal rebate program under section 1927 of 
185.11  title XIX of the federal Social Security Act.  Coverage under 
185.12  the program shall be limited to those prescription drugs that: 
185.13     (1) are covered under the medical assistance program as 
185.14  described in section 256B.0625, subdivision 13; and 
185.15     (2) are provided by manufacturers that have fully executed 
185.16  senior drug rebate agreements with the commissioner and comply 
185.17  with such agreements. 
185.18     Sec. 20.  Minnesota Statutes 1998, section 256.955, 
185.19  subdivision 4, is amended to read: 
185.20     Subd. 4.  [APPLICATION PROCEDURES AND COORDINATION WITH 
185.21  MEDICAL ASSISTANCE.] Applications and information on the program 
185.22  must be made available at county social service agencies, health 
185.23  care provider offices, and agencies and organizations serving 
185.24  senior citizens.  Senior citizens shall submit applications and 
185.25  any information specified by the commissioner as being necessary 
185.26  to verify eligibility directly to the county social service 
185.27  agencies:  
185.28     (1) beginning January 1, 1999, the county social service 
185.29  agency shall determine medical assistance spenddown eligibility 
185.30  of individuals who qualify for the senior citizen drug program 
185.31  of individuals; and 
185.32     (2) program payments will be used to reduce the spenddown 
185.33  obligations of individuals who are determined to be eligible for 
185.34  medical assistance with a spenddown as defined in section 
185.35  256B.056, subdivision 5. 
185.36  Seniors who are eligible for medical assistance with a spenddown 
186.1   shall be financially responsible for the deductible amount up to 
186.2   the satisfaction of the spenddown.  No deductible applies once 
186.3   the spenddown has been met.  Payments to providers for 
186.4   prescription drugs for persons eligible under this subdivision 
186.5   shall be reduced by the deductible.  
186.6      County social service agencies shall determine an 
186.7   applicant's eligibility for the program within 30 days from the 
186.8   date the application is received.  Eligibility begins the month 
186.9   after approval. 
186.10     Sec. 21.  Minnesota Statutes 1998, section 256.955, 
186.11  subdivision 7, is amended to read: 
186.12     Subd. 7.  [COST SHARING.] (a) Enrollees shall pay an annual 
186.13  premium of $120. 
186.14     (b) Program enrollees must satisfy a $300 $420 annual 
186.15  deductible, based upon expenditures for prescription drugs, to 
186.16  be paid as follows: 
186.17     (1) $25 monthly deductible for persons with a monthly 
186.18  spenddown; or 
186.19     (2) $150 biannual deductible for persons with a six-month 
186.20  spenddown in $35 monthly increments. 
186.21     Sec. 22.  Minnesota Statutes 1998, section 256.955, 
186.22  subdivision 8, is amended to read: 
186.23     Subd. 8.  [REPORT.] The commissioner shall annually report 
186.24  to the legislature on the senior citizen drug program.  The 
186.25  report must include demographic information on enrollees, 
186.26  per-prescription expenditures, total program expenditures, 
186.27  hospital and nursing home costs avoided by enrollees, any 
186.28  savings to medical assistance and Medicare resulting from the 
186.29  provision of prescription drug coverage under Medicare by health 
186.30  maintenance organizations, other public and private options for 
186.31  drug assistance to the senior population, any hardships caused 
186.32  by the annual premium and deductible, and any recommendations 
186.33  for changes in the senior drug program. 
186.34     Sec. 23.  Minnesota Statutes 1998, section 256.955, 
186.35  subdivision 9, is amended to read: 
186.36     Subd. 9.  [PROGRAM LIMITATION.] The commissioner shall 
187.1   administer the senior drug program so that the costs total no 
187.2   more than funds appropriated plus the drug rebate proceeds.  
187.3   Senior drug program rebate revenues are appropriated to the 
187.4   commissioner and shall be expended to augment funding of the 
187.5   senior drug program.  New enrollment shall cease if the 
187.6   commissioner determines that, given current enrollment, costs of 
187.7   the program will exceed appropriated funds and rebate proceeds.  
187.8   This section shall be repealed upon federal approval of the 
187.9   waiver to allow the commissioner to provide prescription drug 
187.10  coverage for qualified Medicare beneficiaries whose income is 
187.11  less than 150 percent of the federal poverty guidelines. 
187.12     Sec. 24.  Minnesota Statutes 1998, section 256.9685, 
187.13  subdivision 1a, is amended to read: 
187.14     Subd. 1a.  [ADMINISTRATIVE RECONSIDERATION.] 
187.15  Notwithstanding sections 256B.04, subdivision 15, and 256D.03, 
187.16  subdivision 7, the commissioner shall establish an 
187.17  administrative reconsideration process for appeals of inpatient 
187.18  hospital services determined to be medically unnecessary.  A 
187.19  physician or hospital may request a reconsideration of the 
187.20  decision that inpatient hospital services are not medically 
187.21  necessary by submitting a written request for review to the 
187.22  commissioner within 30 days after receiving notice of the 
187.23  decision.  The reconsideration process shall take place prior to 
187.24  the procedures of subdivision 1b and shall be conducted by 
187.25  physicians that are independent of the case under 
187.26  reconsideration.  A majority decision by the physicians is 
187.27  necessary to make a determination that the services were not 
187.28  medically necessary.  
187.29     Sec. 25.  Minnesota Statutes 1998, section 256.969, 
187.30  subdivision 1, is amended to read: 
187.31     Subdivision 1.  [HOSPITAL COST INDEX.] (a) The hospital 
187.32  cost index shall be the change in the Consumer Price Index-All 
187.33  Items (United States city average) (CPI-U) forecasted by Data 
187.34  Resources, Inc.  The commissioner shall use the indices as 
187.35  forecasted in the third quarter of the calendar year prior to 
187.36  the rate year.  The hospital cost index may be used to adjust 
188.1   the base year operating payment rate through the rate year on an 
188.2   annually compounded basis.  
188.3      (b) For fiscal years beginning on or after July 1, 1993, 
188.4   the commissioner of human services shall not provide automatic 
188.5   annual inflation adjustments for hospital payment rates under 
188.6   medical assistance, nor under general assistance medical care, 
188.7   except that the inflation adjustments under paragraph (a) for 
188.8   medical assistance, excluding general assistance medical care, 
188.9   shall apply through calendar year 1999 2001.  The index for 
188.10  calendar year 2000 shall be reduced 2.5 percentage points to 
188.11  recover overprojections of the index from 1994 to 1996.  The 
188.12  commissioner of finance shall include as a budget change request 
188.13  in each biennial detailed expenditure budget submitted to the 
188.14  legislature under section 16A.11 annual adjustments in hospital 
188.15  payment rates under medical assistance and general assistance 
188.16  medical care, based upon the hospital cost index. 
188.17     Sec. 26.  Minnesota Statutes 1998, section 256B.04, 
188.18  subdivision 16, is amended to read: 
188.19     Subd. 16.  [PERSONAL CARE SERVICES.] (a) Notwithstanding 
188.20  any contrary language in this paragraph, the commissioner of 
188.21  human services and the commissioner of health shall jointly 
188.22  promulgate rules to be applied to the licensure of personal care 
188.23  services provided under the medical assistance program.  The 
188.24  rules shall consider standards for personal care services that 
188.25  are based on the World Institute on Disability's recommendations 
188.26  regarding personal care services.  These rules shall at a 
188.27  minimum consider the standards and requirements adopted by the 
188.28  commissioner of health under section 144A.45, which the 
188.29  commissioner of human services determines are applicable to the 
188.30  provision of personal care services, in addition to other 
188.31  standards or modifications which the commissioner of human 
188.32  services determines are appropriate. 
188.33     The commissioner of human services shall establish an 
188.34  advisory group including personal care consumers and providers 
188.35  to provide advice regarding which standards or modifications 
188.36  should be adopted.  The advisory group membership must include 
189.1   not less than 15 members, of which at least 60 percent must be 
189.2   consumers of personal care services and representatives of 
189.3   recipients with various disabilities and diagnoses and ages.  At 
189.4   least 51 percent of the members of the advisory group must be 
189.5   recipients of personal care. 
189.6      The commissioner of human services may contract with the 
189.7   commissioner of health to enforce the jointly promulgated 
189.8   licensure rules for personal care service providers. 
189.9      Prior to final promulgation of the joint rule the 
189.10  commissioner of human services shall report preliminary findings 
189.11  along with any comments of the advisory group and a plan for 
189.12  monitoring and enforcement by the department of health to the 
189.13  legislature by February 15, 1992. 
189.14     Limits on the extent of personal care services that may be 
189.15  provided to an individual must be based on the 
189.16  cost-effectiveness of the services in relation to the costs of 
189.17  inpatient hospital care, nursing home care, and other available 
189.18  types of care.  The rules must provide, at a minimum:  
189.19     (1) that agencies be selected to contract with or employ 
189.20  and train staff to provide and supervise the provision of 
189.21  personal care services; 
189.22     (2) that agencies employ or contract with a qualified 
189.23  applicant that a qualified recipient proposes to the agency as 
189.24  the recipient's choice of assistant; 
189.25     (3) that agencies bill the medical assistance program for a 
189.26  personal care service by a personal care assistant and 
189.27  supervision by the registered nurse a qualified professional 
189.28  supervising the personal care assistant unless the recipient 
189.29  selects the fiscal agent option under section 256B.0627, 
189.30  subdivision 10; 
189.31     (4) that agencies establish a grievance mechanism; and 
189.32     (5) that agencies have a quality assurance program.  
189.33     (b) The commissioner may waive the requirement for the 
189.34  provision of personal care services through an agency in a 
189.35  particular county, when there are less than two agencies 
189.36  providing services in that county and shall waive the 
190.1   requirement for personal care assistants required to join an 
190.2   agency for the first time during 1993 when personal care 
190.3   services are provided under a relative hardship waiver under 
190.4   section 256B.0627, subdivision 4, paragraph (b), clause (7), and 
190.5   at least two agencies providing personal care services have 
190.6   refused to employ or contract with the independent personal care 
190.7   assistant. 
190.8      Sec. 27.  Minnesota Statutes 1998, section 256B.04, is 
190.9   amended by adding a subdivision to read: 
190.10     Subd. 19.  [PERFORMANCE DATA REPORTING UNIT.] The 
190.11  commissioner of human services shall establish a performance 
190.12  data reporting unit that serves counties and the state.  The 
190.13  department shall support this unit and provide technical 
190.14  assistance and access to the data warehouse.  The performance 
190.15  data reporting unit, which will operate within the department's 
190.16  central office and consist of both county and department staff, 
190.17  shall provide performance data reports to individual counties, 
190.18  share expertise from counties and the department perspective, 
190.19  and participate in joint planning to link with county databases 
190.20  and other county data sources in order to provide information on 
190.21  services provided to public clients from state, federal, and 
190.22  county funding sources.  The performance data reporting unit 
190.23  shall provide counties both individual and group summary level 
190.24  standard or unique reports on health care eligibility and 
190.25  services provided to clients for whom they have financial 
190.26  responsibility. 
190.27     Sec. 28.  Minnesota Statutes 1998, section 256B.042, 
190.28  subdivision 1, is amended to read: 
190.29     Subdivision 1.  [LIEN FOR COST OF CARE.] When the state 
190.30  agency provides, pays for, or becomes liable for medical care, 
190.31  it shall have a lien for the cost of the care upon any and all 
190.32  causes of action or recovery rights under any policy, plan, or 
190.33  contract providing benefits for health care or injury, which 
190.34  accrue to the person to whom the care was furnished, or to the 
190.35  person's legal representatives, as a result of the illness or 
190.36  injuries which necessitated the medical care.  For purposes of 
191.1   this section, "state agency" includes prepaid health plans under 
191.2   contract with the commissioner according to sections 256B.69, 
191.3   256D.03, subdivision 4, paragraph (d), and 256L.12; children's 
191.4   mental health collaboratives under section 245.493; 
191.5   demonstration projects for persons with disabilities under 
191.6   section 256B.77; nursing facilities under the alternative 
191.7   payment demonstration project under section 256B.434; and 
191.8   county-based purchasing entities under section 256B.692.  
191.9      Sec. 29.  Minnesota Statutes 1998, section 256B.042, 
191.10  subdivision 2, is amended to read: 
191.11     Subd. 2.  [LIEN ENFORCEMENT.] (a) The state agency may 
191.12  perfect and enforce its lien by following the procedures set 
191.13  forth in sections 514.69, 514.70 and 514.71, and its verified 
191.14  lien statement shall be filed with the appropriate court 
191.15  administrator in the county of financial responsibility.  The 
191.16  verified lien statement shall contain the following:  the name 
191.17  and address of the person to whom medical care was furnished, 
191.18  the date of injury, the name and address of the vendor or 
191.19  vendors furnishing medical care, the dates of the service, the 
191.20  amount claimed to be due for the care, and, to the best of the 
191.21  state agency's knowledge, the names and addresses of all 
191.22  persons, firms, or corporations claimed to be liable for damages 
191.23  arising from the injuries.  This section shall not affect the 
191.24  priority of any attorney's lien.  
191.25     (b) The state agency is not subject to any limitations 
191.26  period referred to in section 514.69 or 514.71 and has one year 
191.27  from the date notice is first received by it under subdivision 
191.28  4, paragraph (c), even if the notice is untimely, or one year 
191.29  from the date medical bills are first paid by the state agency, 
191.30  whichever is later, to file its verified lien statement.  The 
191.31  state agency may commence an action to enforce the lien within 
191.32  one year of (1) the date the notice required by subdivision 4, 
191.33  paragraph (c), is received or (2) the date the recipient's cause 
191.34  of action is concluded by judgment, award, settlement, or 
191.35  otherwise, whichever is later.  For purposes of this section, 
191.36  "state agency" includes authorized agents of the state agency. 
192.1      (c) If the notice required in subdivision 4 is not provided 
192.2   by any of the parties to the claim at any stage of the claim, 
192.3   the state agency will have one year from the date the state 
192.4   agency learns of the lack of notice to commence an action.  If 
192.5   amounts on the claim or cause of action are paid and the amount 
192.6   required to be paid to the state agency under subdivision 5, is 
192.7   not paid to the state agency, the state agency may commence an 
192.8   action to recover on the lien against any or all of the parties 
192.9   or entities which have either paid or received the payments. 
192.10     Sec. 30.  Minnesota Statutes 1998, section 256B.042, 
192.11  subdivision 3, is amended to read: 
192.12     Subd. 3.  The attorney general, or the appropriate county 
192.13  attorney acting at the direction of the attorney general, shall 
192.14  represent the state agency commissioner to enforce the lien 
192.15  created under this section or, if no action has been brought, 
192.16  may initiate and prosecute an independent action on behalf of 
192.17  the state agency commissioner against a person, firm, or 
192.18  corporation that may be liable to the person to whom the care 
192.19  was furnished. 
192.20     Any prepaid health plan providing services under sections 
192.21  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
192.22  children's mental health collaboratives under section 245.493; 
192.23  demonstration projects for persons with disabilities under 
192.24  section 256B.77; nursing homes under the alternative payment 
192.25  demonstration project under section 256B.434; or the 
192.26  county-based purchasing entity providing services under section 
192.27  256B.692 may retain legal representation to enforce their lien 
192.28  created under this section or, if no action has been brought, 
192.29  may initiate and prosecute an independent action on their behalf 
192.30  against a person, firm, or corporation that may be liable to the 
192.31  person to whom the care or payment was furnished.  
192.32     Sec. 31.  Minnesota Statutes 1998, section 256B.055, 
192.33  subdivision 3a, is amended to read: 
192.34     Subd. 3a.  [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 
192.35  AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 
192.36  MFIP-S is implemented in counties, medical assistance may be 
193.1   paid for a person receiving public assistance under the MFIP-S 
193.2   program. 
193.3      (b) Beginning January 1, 1998, medical assistance may be 
193.4   paid for a person who would have been eligible for public 
193.5   assistance under the income and resource standards and 
193.6   deprivation requirements, or who would have been eligible but 
193.7   for excess income or assets, under the state's AFDC plan in 
193.8   effect as of July 16, 1996, as required by the Personal 
193.9   Responsibility and Work Opportunity Reconciliation Act of 1996 
193.10  (PRWORA), Public Law Number 104-193. 
193.11     Sec. 32.  Minnesota Statutes 1998, section 256B.056, 
193.12  subdivision 4, is amended to read: 
193.13     Subd. 4.  [INCOME.] To be eligible for medical assistance, 
193.14  a person eligible under section 256B.055, subdivision 7, not 
193.15  receiving supplemental security income program payments, and 
193.16  families and children may have an income up to 133-1/3 percent 
193.17  of the AFDC income standard in effect under the July 16, 1996, 
193.18  AFDC state plan.  For rate years beginning on or after July 1, 
193.19  1999, the commissioner shall consider increasing Effective July 
193.20  1, 2000, the base AFDC standard in effect on July 16, 1996, by 
193.21  an amount equal to the percent change in the Consumer Price 
193.22  Index for all urban consumers for the previous October compared 
193.23  to one year earlier shall be increased by three percent.  
193.24  Effective January 1, 2000, and each successive January, 
193.25  recipients of supplemental security income may have an income up 
193.26  to the supplemental security income standard in effect on that 
193.27  date.  In computing income to determine eligibility of persons 
193.28  who are not residents of long-term care facilities, the 
193.29  commissioner shall disregard increases in income as required by 
193.30  Public Law Numbers 94-566, section 503; 99-272; and 99-509.  
193.31  Veterans aid and attendance benefits and Veterans Administration 
193.32  unusual medical expense payments are considered income to the 
193.33  recipient. 
193.34     Sec. 33.  Minnesota Statutes 1998, section 256B.057, 
193.35  subdivision 3, is amended to read: 
193.36     Subd. 3.  [QUALIFIED MEDICARE BENEFICIARIES.] A person who 
194.1   is entitled to Part A Medicare benefits, whose income is equal 
194.2   to or less than 85 100 percent of the federal poverty 
194.3   guidelines, and whose assets are no more than twice the asset 
194.4   limit used to determine eligibility for the supplemental 
194.5   security income program, is eligible for medical assistance 
194.6   reimbursement of Part A and Part B premiums, Part A and Part B 
194.7   coinsurance and deductibles, and cost-effective premiums for 
194.8   enrollment with a health maintenance organization or a 
194.9   competitive medical plan under section 1876 of the Social 
194.10  Security Act.  The income limit shall be increased to 90 percent 
194.11  of the federal poverty guidelines on January 1, 1990; and to 100 
194.12  percent on January 1, 1991.  Reimbursement of the Medicare 
194.13  coinsurance and deductibles, when added to the amount paid by 
194.14  Medicare, must not exceed the total rate the provider would have 
194.15  received for the same service or services if the person were a 
194.16  medical assistance recipient with Medicare coverage.  Increases 
194.17  in benefits under Title II of the Social Security Act shall not 
194.18  be counted as income for purposes of this subdivision until the 
194.19  first day of the second full month following publication of the 
194.20  change in the federal poverty guidelines. 
194.21     Sec. 34.  Minnesota Statutes 1998, section 256B.057, is 
194.22  amended by adding a subdivision to read: 
194.23     Subd. 9.  [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 
194.24  assistance may be paid for a person who is employed and who: 
194.25     (1) meets the definition of disabled under the supplemental 
194.26  security income program; 
194.27     (2) meets the asset limits in paragraph (b); and 
194.28     (3) pays a premium, if required, under paragraph (c).  
194.29  Any spousal income or assets shall be disregarded for purposes 
194.30  of eligibility and premium determinations. 
194.31     (b) For purposes of determining eligibility under this 
194.32  subdivision, a person's assets must not exceed $20,000, 
194.33  excluding: 
194.34     (1) all assets excluded under section 256B.056; 
194.35     (2) retirement accounts, including individual accounts, 
194.36  401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 
195.1      (3) medical expense accounts set up through the person's 
195.2   employer. 
195.3      (c) A person whose earned and unearned income is greater 
195.4   than 200 percent of federal poverty guidelines for the 
195.5   applicable family size must pay a premium to be eligible for 
195.6   medical assistance.  The premium shall be equal to ten percent 
195.7   of the person's gross earned and unearned income above 200 
195.8   percent of federal poverty guidelines for the applicable family 
195.9   size up to the cost of coverage. 
195.10     (d) A person's eligibility and premium shall be determined 
195.11  by the local county agency.  Premiums must be paid to the 
195.12  commissioner.  All premiums are dedicated to the commissioner. 
195.13     (e) Any required premium shall be determined at application 
195.14  and redetermined annually at recertification or when a change in 
195.15  income of family size occurs. 
195.16     (f) Premium payment is due upon notification from the 
195.17  commissioner of the premium amount required.  Premiums may be 
195.18  paid in installments at the discretion of the commissioner. 
195.19     (g) Nonpayment of the premium shall result in denial or 
195.20  termination of medical assistance unless the person demonstrates 
195.21  good cause for nonpayment.  Good cause exists if the 
195.22  requirements specified in Minnesota Rules, part 9506.0040, 
195.23  subpart 7, items B to D, are met.  Nonpayment shall include 
195.24  payment with a returned, refused, or dishonored instrument.  The 
195.25  commissioner may require a guaranteed form of payment as the 
195.26  only means to replace a returned, refused, or dishonored 
195.27  instrument. 
195.28     Sec. 35.  Minnesota Statutes 1998, section 256B.0575, is 
195.29  amended to read: 
195.30     256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 
195.31  PERSONS.] 
195.32     When an institutionalized person is determined eligible for 
195.33  medical assistance, the income that exceeds the deductions in 
195.34  paragraphs (a) and (b) must be applied to the cost of 
195.35  institutional care.  
195.36     (a) The following amounts must be deducted from the 
196.1   institutionalized person's income in the following order: 
196.2      (1) the personal needs allowance under section 256B.35 or, 
196.3   for a veteran who does not have a spouse or child, or a 
196.4   surviving spouse of a veteran having no child, the amount of an 
196.5   improved pension received from the veteran's administration not 
196.6   exceeding $90 per month; 
196.7      (2) the personal allowance for disabled individuals under 
196.8   section 256B.36; 
196.9      (3) if the institutionalized person has a legally appointed 
196.10  guardian or conservator, five percent of the recipient's gross 
196.11  monthly income up to $100 as reimbursement for guardianship or 
196.12  conservatorship services; 
196.13     (4) a monthly income allowance determined under section 
196.14  256B.058, subdivision 2, but only to the extent income of the 
196.15  institutionalized spouse is made available to the community 
196.16  spouse; 
196.17     (5) a monthly allowance for children under age 18 which, 
196.18  together with the net income of the children, would provide 
196.19  income equal to the medical assistance standard for families and 
196.20  children according to section 256B.056, subdivision 4, for a 
196.21  family size that includes only the minor children.  This 
196.22  deduction applies only if the children do not live with the 
196.23  community spouse and only to the extent that the deduction is 
196.24  not included in the personal needs allowance under section 
196.25  256B.35, subdivision 1, as child support garnished under a court 
196.26  order; 
196.27     (6) a monthly family allowance for other family members, 
196.28  equal to one-third of the difference between 122 percent of the 
196.29  federal poverty guidelines and the monthly income for that 
196.30  family member; 
196.31     (7) reparations payments made by the Federal Republic of 
196.32  Germany and reparations payments made by the Netherlands for 
196.33  victims of Nazi persecution between 1940 and 1945; and 
196.34     (8) all other exclusions from income for institutionalized 
196.35  persons as mandated by federal law; and 
196.36     (9) amounts for reasonable expenses incurred for necessary 
197.1   medical or remedial care for the institutionalized spouse that 
197.2   are not medical assistance covered expenses and that are not 
197.3   subject to payment by a third party.  
197.4      For purposes of clause (6), "other family member" means a 
197.5   person who resides with the community spouse and who is a minor 
197.6   or dependent child, dependent parent, or dependent sibling of 
197.7   either spouse.  "Dependent" means a person who could be claimed 
197.8   as a dependent for federal income tax purposes under the 
197.9   Internal Revenue Code. 
197.10     (b) Income shall be allocated to an institutionalized 
197.11  person for a period of up to three calendar months, in an amount 
197.12  equal to the medical assistance standard for a family size of 
197.13  one if:  
197.14     (1) a physician certifies that the person is expected to 
197.15  reside in the long-term care facility for three calendar months 
197.16  or less; 
197.17     (2) if the person has expenses of maintaining a residence 
197.18  in the community; and 
197.19     (3) if one of the following circumstances apply:  
197.20     (i) the person was not living together with a spouse or a 
197.21  family member as defined in paragraph (a) when the person 
197.22  entered a long-term care facility; or 
197.23     (ii) the person and the person's spouse become 
197.24  institutionalized on the same date, in which case the allocation 
197.25  shall be applied to the income of one of the spouses.  
197.26  For purposes of this paragraph, a person is determined to be 
197.27  residing in a licensed nursing home, regional treatment center, 
197.28  or medical institution if the person is expected to remain for a 
197.29  period of one full calendar month or more. 
197.30     Sec. 36.  Minnesota Statutes 1998, section 256B.061, is 
197.31  amended to read: 
197.32     256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 
197.33     (a) If any individual has been determined to be eligible 
197.34  for medical assistance, it will be made available for care and 
197.35  services included under the plan and furnished in or after the 
197.36  third month before the month in which the individual made 
198.1   application for such assistance, if such individual was, or upon 
198.2   application would have been, eligible for medical assistance at 
198.3   the time the care and services were furnished.  The commissioner 
198.4   may limit, restrict, or suspend the eligibility of an individual 
198.5   for up to one year upon that individual's conviction of a 
198.6   criminal offense related to application for or receipt of 
198.7   medical assistance benefits. 
198.8      (b) On the basis of information provided on the completed 
198.9   application, an applicant who meets the following criteria shall 
198.10  be determined eligible beginning in the month of application: 
198.11     (1) whose gross income is less than 90 percent of the 
198.12  applicable income standard; 
198.13     (2) whose total liquid assets are less than 90 percent of 
198.14  the asset limit; 
198.15     (3) does not reside in a long-term care facility; and 
198.16     (4) meets all other eligibility requirements. 
198.17  The applicant must provide all required verifications within 30 
198.18  days' notice of the eligibility determination or eligibility 
198.19  shall be terminated. 
198.20     Sec. 37.  Minnesota Statutes 1998, section 256B.0625, is 
198.21  amended by adding a subdivision to read: 
198.22     Subd. 3b.  [TELEMEDICINE CONSULTATIONS.] (a) Medical 
198.23  assistance covers telemedicine consultations.  Telemedicine 
198.24  consultations must be made via two-way, interactive video or 
198.25  store-and-forward technology.  Store-and-forward technology 
198.26  includes telemedicine consultations that do not occur in real 
198.27  time via synchronous transmissions, and that do not require a 
198.28  face-to-face encounter with the patient for all or any part of 
198.29  any such telemedicine consultation.  The patient record must 
198.30  include a written opinion from the consulting physician 
198.31  providing the telemedicine consultation.  A communication 
198.32  between two physicians that consists solely of a telephone 
198.33  conversation is not a telemedicine consultation.  Coverage is 
198.34  limited to three telemedicine consultations per recipient per 
198.35  calendar week.  Telemedicine consultations shall be paid at the 
198.36  full allowable rate. 
199.1      (b) This subdivision expires July 1, 2001.  
199.2      Sec. 38.  Minnesota Statutes 1998, section 256B.0625, 
199.3   subdivision 6a, is amended to read: 
199.4      Subd. 6a.  [HOME HEALTH SERVICES.] Home health services are 
199.5   those services specified in Minnesota Rules, part 9505.0290. 
199.6   Medical assistance covers home health services at a recipient's 
199.7   home residence.  Medical assistance does not cover home health 
199.8   services for residents of a hospital, nursing facility, or 
199.9   intermediate care facility, or a health care facility licensed 
199.10  by the commissioner of health, unless the program is funded 
199.11  under a home and community-based services waiver or unless the 
199.12  commissioner of human services has prior authorized skilled 
199.13  nurse visits for less than 90 days for a resident at an 
199.14  intermediate care facility for persons with mental retardation, 
199.15  to prevent an admission to a hospital or nursing facility or 
199.16  unless a resident who is otherwise eligible is on leave from the 
199.17  facility and the facility either pays for the home health 
199.18  services or forgoes the facility per diem for the leave days 
199.19  that home health services are used.  Home health services must 
199.20  be provided by a Medicare certified home health agency.  All 
199.21  nursing and home health aide services must be provided according 
199.22  to section 256B.0627. 
199.23     Sec. 39.  Minnesota Statutes 1998, section 256B.0625, 
199.24  subdivision 8, is amended to read: 
199.25     Subd. 8.  [PHYSICAL THERAPY.] Medical assistance covers 
199.26  physical therapy and related services, including specialized 
199.27  maintenance therapy.  Services provided by a physical therapy 
199.28  assistant shall be reimbursed at the same rate as services 
199.29  performed by a physical therapist when the services of the 
199.30  physical therapy assistant are provided under the direction of a 
199.31  physical therapist who is on the premises.  Services provided by 
199.32  a physical therapy assistant that are provided under the 
199.33  direction of a physical therapist who is not on the premises 
199.34  shall be reimbursed at 65 percent of the physical therapist rate.
199.35     Sec. 40.  Minnesota Statutes 1998, section 256B.0625, 
199.36  subdivision 8a, is amended to read: 
200.1      Subd. 8a.  [OCCUPATIONAL THERAPY.] Medical assistance 
200.2   covers occupational therapy and related services, including 
200.3   specialized maintenance therapy.  Services provided by an 
200.4   occupational therapy assistant shall be reimbursed at the same 
200.5   rate as services performed by an occupational therapist when the 
200.6   services of the occupational therapy assistant are provided 
200.7   under the direction of the occupational therapist who is on the 
200.8   premises.  Services provided by an occupational therapy 
200.9   assistant that are provided under the direction of an 
200.10  occupational therapist who is not on the premises shall be 
200.11  reimbursed at 65 percent of the occupational therapist rate. 
200.12     Sec. 41.  Minnesota Statutes 1998, section 256B.0625, is 
200.13  amended by adding a subdivision to read: 
200.14     Subd. 8b.  [SPEECH LANGUAGE PATHOLOGY SERVICES.] Medical 
200.15  assistance covers speech language pathology and related 
200.16  services, including specialized maintenance therapy. 
200.17     Sec. 42.  Minnesota Statutes 1998, section 256B.0625, is 
200.18  amended by adding a subdivision to read: 
200.19     Subd. 8c.  [CARE MANAGEMENT; REHABILITATION SERVICES.] (a) 
200.20  Effective July 1, 1999, one-time thresholds shall replace annual 
200.21  thresholds for provision of rehabilitation services described in 
200.22  subdivisions 8, 8a, and 8b.  The one-time thresholds will be the 
200.23  same in amount and description as the thresholds prescribed by 
200.24  the department of human services health care programs provider 
200.25  manual for calendar year 1997, except they will not be renewed 
200.26  annually, and they will include sensory skills and cognitive 
200.27  training skills. 
200.28     (b) A care management approach for authorization of 
200.29  services beyond the threshold shall be instituted in conjunction 
200.30  with the one-time thresholds.  The care management approach 
200.31  shall require the provider and the department rehabilitation 
200.32  reviewer to work together directly through written 
200.33  communication, or telephone communication when appropriate, to 
200.34  establish a medically necessary care management plan. 
200.35  Authorization for rehabilitation services shall include approval 
200.36  for up to 12 months of services at a time without additional 
201.1   documentation from the provider during the extended period, when 
201.2   the rehabilitation services are medically necessary due to an 
201.3   ongoing health condition. 
201.4      (c) The commissioner shall implement an expedited five-day 
201.5   turnaround time to review authorization requests for recipients 
201.6   who need emergency rehabilitation services and who have 
201.7   exhausted their one-time threshold limit for those services. 
201.8      Sec. 43.  Minnesota Statutes 1998, section 256B.0625, 
201.9   subdivision 13, is amended to read: 
201.10     Subd. 13.  [DRUGS.] (a) Medical assistance covers drugs, 
201.11  except for fertility drugs when specifically used to enhance 
201.12  fertility, if prescribed by a licensed practitioner and 
201.13  dispensed by a licensed pharmacist, by a physician enrolled in 
201.14  the medical assistance program as a dispensing physician, or by 
201.15  a physician or a nurse practitioner employed by or under 
201.16  contract with a community health board as defined in section 
201.17  145A.02, subdivision 5, for the purposes of communicable disease 
201.18  control.  The commissioner, after receiving recommendations from 
201.19  professional medical associations and professional pharmacist 
201.20  associations, shall designate a formulary committee to advise 
201.21  the commissioner on the names of drugs for which payment is 
201.22  made, recommend a system for reimbursing providers on a set fee 
201.23  or charge basis rather than the present system, and develop 
201.24  methods encouraging use of generic drugs when they are less 
201.25  expensive and equally effective as trademark drugs.  The 
201.26  formulary committee shall consist of nine members, four of whom 
201.27  shall be physicians who are not employed by the department of 
201.28  human services, and a majority of whose practice is for persons 
201.29  paying privately or through health insurance, three of whom 
201.30  shall be pharmacists who are not employed by the department of 
201.31  human services, and a majority of whose practice is for persons 
201.32  paying privately or through health insurance, a consumer 
201.33  representative, and a nursing home representative.  Committee 
201.34  members shall serve three-year terms and shall serve without 
201.35  compensation.  Members may be reappointed once.  
201.36     (b) The commissioner shall establish a drug formulary.  Its 
202.1   establishment and publication shall not be subject to the 
202.2   requirements of the Administrative Procedure Act, but the 
202.3   formulary committee shall review and comment on the formulary 
202.4   contents.  The formulary committee shall review and recommend 
202.5   drugs which require prior authorization.  The formulary 
202.6   committee may recommend drugs for prior authorization directly 
202.7   to the commissioner, as long as opportunity for public input is 
202.8   provided.  Prior authorization may be requested by the 
202.9   commissioner based on medical and clinical criteria before 
202.10  certain drugs are eligible for payment.  Before a drug may be 
202.11  considered for prior authorization at the request of the 
202.12  commissioner:  
202.13     (1) the drug formulary committee must develop criteria to 
202.14  be used for identifying drugs; the development of these criteria 
202.15  is not subject to the requirements of chapter 14, but the 
202.16  formulary committee shall provide opportunity for public input 
202.17  in developing criteria; 
202.18     (2) the drug formulary committee must hold a public forum 
202.19  and receive public comment for an additional 15 days; and 
202.20     (3) the commissioner must provide information to the 
202.21  formulary committee on the impact that placing the drug on prior 
202.22  authorization will have on the quality of patient care and 
202.23  information regarding whether the drug is subject to clinical 
202.24  abuse or misuse.  Prior authorization may be required by the 
202.25  commissioner before certain formulary drugs are eligible for 
202.26  payment.  The formulary shall not include:  
202.27     (i) drugs or products for which there is no federal 
202.28  funding; 
202.29     (ii) over-the-counter drugs, except for antacids, 
202.30  acetaminophen, family planning products, aspirin, insulin, 
202.31  products for the treatment of lice, vitamins for adults with 
202.32  documented vitamin deficiencies, vitamins for children under the 
202.33  age of seven and pregnant or nursing women, and any other 
202.34  over-the-counter drug identified by the commissioner, in 
202.35  consultation with the drug formulary committee, as necessary, 
202.36  appropriate, and cost-effective for the treatment of certain 
203.1   specified chronic diseases, conditions or disorders, and this 
203.2   determination shall not be subject to the requirements of 
203.3   chapter 14; 
203.4      (iii) anorectics, except that medically necessary 
203.5   anorectics shall be covered for a recipient previously diagnosed 
203.6   as having pickwickian syndrome and currently diagnosed as having 
203.7   diabetes and being morbidly obese; 
203.8      (iv) drugs for which medical value has not been 
203.9   established; and 
203.10     (v) drugs from manufacturers who have not signed a rebate 
203.11  agreement with the Department of Health and Human Services 
203.12  pursuant to section 1927 of title XIX of the Social Security Act 
203.13  and who have not signed an agreement with the state for drugs 
203.14  purchased pursuant to the senior citizen drug program 
203.15  established under section 256.955. 
203.16     The commissioner shall publish conditions for prohibiting 
203.17  payment for specific drugs after considering the formulary 
203.18  committee's recommendations.  
203.19     (c) The basis for determining the amount of payment shall 
203.20  be the lower of the actual acquisition costs of the drugs plus a 
203.21  fixed dispensing fee; the maximum allowable cost set by the 
203.22  federal government or by the commissioner plus the fixed 
203.23  dispensing fee; or the usual and customary price charged to the 
203.24  public.  The pharmacy dispensing fee shall be $3.65.  Actual 
203.25  acquisition cost includes quantity and other special discounts 
203.26  except time and cash discounts.  The actual acquisition cost of 
203.27  a drug shall be estimated by the commissioner, at average 
203.28  wholesale price minus nine percent.  The maximum allowable cost 
203.29  of a multisource drug may be set by the commissioner and it 
203.30  shall be comparable to, but no higher than, the maximum amount 
203.31  paid by other third-party payors in this state who have maximum 
203.32  allowable cost programs.  The commissioner shall set maximum 
203.33  allowable costs for multisource drugs that are not on the 
203.34  federal upper limit list as described in United States Code, 
203.35  title 42, chapter 7, section 1396r-8(e), the Social Security 
203.36  Act, and Code of Federal Regulations, title 42, part 447, 
204.1   section 447.332.  Establishment of the amount of payment for 
204.2   drugs shall not be subject to the requirements of the 
204.3   Administrative Procedure Act.  An additional dispensing fee of 
204.4   $.30 may be added to the dispensing fee paid to pharmacists for 
204.5   legend drug prescriptions dispensed to residents of long-term 
204.6   care facilities when a unit dose blister card system, approved 
204.7   by the department, is used.  Under this type of dispensing 
204.8   system, the pharmacist must dispense a 30-day supply of drug.  
204.9   The National Drug Code (NDC) from the drug container used to 
204.10  fill the blister card must be identified on the claim to the 
204.11  department.  The unit dose blister card containing the drug must 
204.12  meet the packaging standards set forth in Minnesota Rules, part 
204.13  6800.2700, that govern the return of unused drugs to the 
204.14  pharmacy for reuse.  The pharmacy provider will be required to 
204.15  credit the department for the actual acquisition cost of all 
204.16  unused drugs that are eligible for reuse.  Over-the-counter 
204.17  medications must be dispensed in the manufacturer's unopened 
204.18  package.  The commissioner may permit the drug clozapine to be 
204.19  dispensed in a quantity that is less than a 30-day supply.  
204.20  Whenever a generically equivalent product is available, payment 
204.21  shall be on the basis of the actual acquisition cost of the 
204.22  generic drug, unless the prescriber specifically indicates 
204.23  "dispense as written - brand necessary" on the prescription as 
204.24  required by section 151.21, subdivision 2. 
204.25     (d) For purposes of this subdivision, "multisource drugs" 
204.26  means covered outpatient drugs, excluding innovator multisource 
204.27  drugs for which there are two or more drug products, which: 
204.28     (1) are related as therapeutically equivalent under the 
204.29  Food and Drug Administration's most recent publication of 
204.30  "Approved Drug Products with Therapeutic Equivalence 
204.31  Evaluations"; 
204.32     (2) are pharmaceutically equivalent and bioequivalent as 
204.33  determined by the Food and Drug Administration; and 
204.34     (3) are sold or marketed in Minnesota. 
204.35  "Innovator multisource drug" means a multisource drug that was 
204.36  originally marketed under an original new drug application 
205.1   approved by the Food and Drug Administration. 
205.2      Sec. 44.  Minnesota Statutes 1998, section 256B.0625, 
205.3   subdivision 19c, is amended to read: 
205.4      Subd. 19c.  [PERSONAL CARE.] Medical assistance covers 
205.5   personal care services provided by an individual who is 
205.6   qualified to provide the services according to subdivision 19a 
205.7   and section 256B.0627, where the services are prescribed by a 
205.8   physician in accordance with a plan of treatment and are 
205.9   supervised by a registered nurse the recipient under the fiscal 
205.10  agent option according to section 256B.0627, subdivision 10, or 
205.11  a qualified professional.  "Qualified professional" means a 
205.12  mental health professional as defined in section 245.462, 
205.13  subdivision 18, or 245.4871, subdivision 26; or a registered 
205.14  nurse as defined in sections 148.171 to 148.285.  As part of the 
205.15  assessment, the county public health nurse will consult with the 
205.16  recipient or responsible party and identify the most appropriate 
205.17  person to provide supervision of the personal care assistant.  
205.18  The qualified professional shall perform the duties described in 
205.19  Minnesota Rules, part 9505.0335, subpart 4.  
205.20     Sec. 45.  Minnesota Statutes 1998, section 256B.0625, 
205.21  subdivision 26, is amended to read: 
205.22     Subd. 26.  [SPECIAL EDUCATION SERVICES.] (a) Medical 
205.23  assistance covers medical services identified in a recipient's 
205.24  individualized education plan and covered under the medical 
205.25  assistance state plan.  Covered services include occupational 
205.26  therapy, physical therapy, speech-language therapy, clinical 
205.27  psychological services, nursing services, school psychological 
205.28  services, school social work services, personal care assistants 
205.29  serving as management aides, assistive technology devices, 
205.30  transportation services, and other services covered under the 
205.31  medical assistance state plan.  Mental health services eligible 
205.32  for medical assistance reimbursement must be provided or 
205.33  coordinated through a children's mental health collaborative 
205.34  where a collaborative exists if the child is included in the 
205.35  collaborative operational target population.  The provision or 
205.36  coordination of services does not require that the individual 
206.1   education plan be developed by the collaborative. 
206.2      The services may be provided by a Minnesota school district 
206.3   that is enrolled as a medical assistance provider or its 
206.4   subcontractor, and only if the services meet all the 
206.5   requirements otherwise applicable if the service had been 
206.6   provided by a provider other than a school district, in the 
206.7   following areas:  medical necessity, physician's orders, 
206.8   documentation, personnel qualifications, and prior authorization 
206.9   requirements.  The nonfederal share of costs for services 
206.10  provided under this subdivision is the responsibility of the 
206.11  local school district as provided in section 125A.74.  Services 
206.12  listed in a child's individual education plan are eligible for 
206.13  medical assistance reimbursement only if those services meet 
206.14  criteria for federal financial participation under the Medicaid 
206.15  program.  
206.16     (b) Approval of health-related services for inclusion in 
206.17  the individual education plan does not require prior 
206.18  authorization for purposes of reimbursement under this chapter.  
206.19  The commissioner may require physician review and approval of 
206.20  the plan not more than once annually or upon any modification of 
206.21  the individual education plan that reflects a change in 
206.22  health-related services. 
206.23     (c) Services of a speech-language pathologist provided 
206.24  under this section are covered notwithstanding Minnesota Rules, 
206.25  part 9505.0390, subpart 1, item L, if the person: 
206.26     (1) holds a masters degree in speech-language pathology; 
206.27     (2) is licensed by the Minnesota board of teaching as an 
206.28  educational speech-language pathologist; and 
206.29     (3) either has a certificate of clinical competence from 
206.30  the American Speech and Hearing Association, has completed the 
206.31  equivalent educational requirements and work experience 
206.32  necessary for the certificate or has completed the academic 
206.33  program and is acquiring supervised work experience to qualify 
206.34  for the certificate. 
206.35     (d) Medical assistance coverage for medically necessary 
206.36  services provided under other subdivisions in this section may 
207.1   not be denied solely on the basis that the same or similar 
207.2   services are covered under this subdivision. 
207.3      (e) The commissioner shall develop and implement package 
207.4   rates, bundled rates, or per diem rates for special education 
207.5   services under which separately covered services are grouped 
207.6   together and billed as a unit in order to reduce administrative 
207.7   complexity.  
207.8      (f) The commissioner shall develop a cost-based payment 
207.9   structure for payment of these services.  
207.10     (g) Effective July 1, 2000, medical assistance services 
207.11  provided under an individual education plan or an individual 
207.12  family service plan by local school districts shall not count 
207.13  against medical assistance authorization thresholds for that 
207.14  child. 
207.15     Sec. 46.  Minnesota Statutes 1998, section 256B.0625, 
207.16  subdivision 28, is amended to read: 
207.17     Subd. 28.  [CERTIFIED NURSE PRACTITIONER SERVICES.] Medical 
207.18  assistance covers services performed by a certified pediatric 
207.19  nurse practitioner, a certified family nurse practitioner, a 
207.20  certified adult nurse practitioner, a certified 
207.21  obstetric/gynecological nurse practitioner, a certified neonatal 
207.22  nurse practitioner, or a certified geriatric nurse practitioner 
207.23  in independent practice, if:  
207.24     (1) the service provided on an inpatient basis is not 
207.25  included as part of the cost for inpatient services included in 
207.26  the operating payment rate; 
207.27     (2) the services are service is otherwise covered under 
207.28  this chapter as a physician service,; and if 
207.29     (3) the service is within the scope of practice of the 
207.30  nurse practitioner's license as a registered nurse, as defined 
207.31  in section 148.171. 
207.32     Sec. 47.  Minnesota Statutes 1998, section 256B.0625, 
207.33  subdivision 30, is amended to read: 
207.34     Subd. 30.  [OTHER CLINIC SERVICES.] (a) Medical assistance 
207.35  covers rural health clinic services, federally qualified health 
207.36  center services, nonprofit community health clinic services, 
208.1   public health clinic services, and the services of a clinic 
208.2   meeting the criteria established in rule by the commissioner.  
208.3   Rural health clinic services and federally qualified health 
208.4   center services mean services defined in United States Code, 
208.5   title 42, section 1396d(a)(2)(B) and (C).  Payment for rural 
208.6   health clinic and federally qualified health center services 
208.7   shall be made according to applicable federal law and regulation.
208.8      (b) A federally qualified health center that is beginning 
208.9   initial operation shall submit an estimate of budgeted costs and 
208.10  visits for the initial reporting period in the form and detail 
208.11  required by the commissioner.  A federally qualified health 
208.12  center that is already in operation shall submit an initial 
208.13  report using actual costs and visits for the initial reporting 
208.14  period.  Within 90 days of the end of its reporting period, a 
208.15  federally qualified health center shall submit, in the form and 
208.16  detail required by the commissioner, a report of its operations, 
208.17  including allowable costs actually incurred for the period and 
208.18  the actual number of visits for services furnished during the 
208.19  period, and other information required by the commissioner.  
208.20  Federally qualified health centers that file Medicare cost 
208.21  reports shall provide the commissioner with a copy of the most 
208.22  recent Medicare cost report filed with the Medicare program 
208.23  intermediary for the reporting year which support the costs 
208.24  claimed on their cost report to the state. 
208.25     (c) In order to continue cost-based payment under the 
208.26  medical assistance program according to paragraphs (a) and (b), 
208.27  a federally qualified health center or rural health clinic must 
208.28  apply for designation as an essential community provider within 
208.29  six months of final adoption of rules by the department of 
208.30  health according to section 62Q.19, subdivision 7.  For those 
208.31  federally qualified health centers and rural health clinics that 
208.32  have applied for essential community provider status within the 
208.33  six-month time prescribed, medical assistance payments will 
208.34  continue to be made according to paragraphs (a) and (b) for the 
208.35  first three years after application.  For federally qualified 
208.36  health centers and rural health clinics that either do not apply 
209.1   within the time specified above or who have had essential 
209.2   community provider status for three years, medical assistance 
209.3   payments for health services provided by these entities shall be 
209.4   according to the same rates and conditions applicable to the 
209.5   same service provided by health care providers that are not 
209.6   federally qualified health centers or rural health clinics.  
209.7   This paragraph takes effect only if the Minnesota health care 
209.8   reform waiver is approved by the federal government, and remains 
209.9   in effect for as long as the Minnesota health care reform waiver 
209.10  remains in effect.  When the waiver expires, this paragraph 
209.11  expires, and the commissioner of human services shall publish a 
209.12  notice in the State Register and notify the revisor of statutes. 
209.13     (d) Effective July 1, 1999, the provisions of paragraph (c) 
209.14  requiring a federally qualified health center or a rural health 
209.15  clinic to make application for an essential community provider 
209.16  designation in order to have cost-based payments made according 
209.17  to paragraphs (a) and (b) no longer apply. 
209.18     (e) Effective January 1, 2000, payments made according to 
209.19  paragraphs (a) and (b) shall be limited to the cost phase-out 
209.20  schedule of the Balanced Budget Act of 1997. 
209.21     Sec. 48.  Minnesota Statutes 1998, section 256B.0625, 
209.22  subdivision 32, is amended to read: 
209.23     Subd. 32.  [NUTRITIONAL PRODUCTS.] (a) Medical assistance 
209.24  covers nutritional products needed for nutritional 
209.25  supplementation because solid food or nutrients thereof cannot 
209.26  be properly absorbed by the body or needed for treatment of 
209.27  phenylketonuria, hyperlysinemia, maple syrup urine disease, a 
209.28  combined allergy to human milk, cow's milk, and soy formula, or 
209.29  any other childhood or adult diseases, conditions, or disorders 
209.30  identified by the commissioner as requiring a similarly 
209.31  necessary nutritional product.  Nutritional products needed for 
209.32  the treatment of a combined allergy to human milk, cow's milk, 
209.33  and soy formula require prior authorization.  Separate payment 
209.34  shall not be made for nutritional products for residents of 
209.35  long-term care facilities.  Payment for dietary requirements is 
209.36  a component of the per diem rate paid to these facilities. 
210.1      (b) The commissioner shall designate a nutritional 
210.2   supplementation products advisory committee to advise the 
210.3   commissioner on nutritional supplementation products for which 
210.4   payment is made.  The committee shall consist of nine members, 
210.5   one of whom shall be a physician, one of whom shall be a 
210.6   pharmacist, two of whom shall be registered dietitians, one of 
210.7   whom shall be a public health nurse, one of whom shall be a 
210.8   representative of a home health care agency, one of whom shall 
210.9   be a provider of long-term care services, and two of whom shall 
210.10  be consumers of nutritional supplementation products.  Committee 
210.11  members shall serve two-year terms and shall serve without 
210.12  compensation. 
210.13     (c) The advisory committee shall review and recommend 
210.14  nutritional supplementation products which require prior 
210.15  authorization.  The commissioner shall develop procedures for 
210.16  the operation of the advisory committee so that the advisory 
210.17  committee operates in a manner parallel to the drug formulary 
210.18  committee. 
210.19     Sec. 49.  Minnesota Statutes 1998, section 256B.0625, 
210.20  subdivision 35, is amended to read: 
210.21     Subd. 35.  [FAMILY COMMUNITY SUPPORT SERVICES.] Medical 
210.22  assistance covers family community support services as defined 
210.23  in section 245.4871, subdivision 17.  In addition to the 
210.24  provisions of section 245.4871, and to the extent authorized by 
210.25  rules promulgated by the state agency, medical assistance covers 
210.26  the following services as family community support services: 
210.27     (1) services identified in an individual treatment plan 
210.28  when provided by a trained mental health behavioral aide under 
210.29  the direction of a mental health practitioner or mental health 
210.30  professional; 
210.31     (2) mental health crisis intervention and crisis 
210.32  stabilization services provided outside of hospital inpatient 
210.33  settings; and 
210.34     (3) the therapeutic components of preschool and therapeutic 
210.35  camp programs. 
210.36     Sec. 50.  Minnesota Statutes 1998, section 256B.0627, 
211.1   subdivision 1, is amended to read: 
211.2      Subdivision 1.  [DEFINITION.] (a) "Assessment" means a 
211.3   review and evaluation of a recipient's need for home care 
211.4   services conducted in person.  Assessments for private duty 
211.5   nursing shall be conducted by a registered private duty nurse.  
211.6   Assessments for home health agency services shall be conducted 
211.7   by a home health agency nurse.  Assessments for personal 
211.8   care assistant services shall be conducted by the county public 
211.9   health nurse or a certified public health nurse under contract 
211.10  with the county.  An initial assessment for personal care 
211.11  services is conducted on individuals who are requesting personal 
211.12  care services or for those consumers who have never had a public 
211.13  health nurse assessment.  The initial A face-to-face assessment 
211.14  must include:  a face-to-face health status assessment and 
211.15  determination of baseline need, evaluation of service outcomes, 
211.16  collection of initial case data, identification of appropriate 
211.17  services and service plan development or modification, 
211.18  coordination of initial services, referrals and follow-up to 
211.19  appropriate payers and community resources, completion of 
211.20  required reports, obtaining service authorization, and consumer 
211.21  education.  A reassessment visit face-to-face assessment for 
211.22  personal care services is conducted on those recipients who have 
211.23  never had a county public health nurse assessment.  A 
211.24  face-to-face assessment must occur at least annually or when 
211.25  there is a significant change in consumer the recipient's 
211.26  condition and or when there is a change in the need for personal 
211.27  care assistant services.  The reassessment visit A service 
211.28  update may substitute for the annual face-to-face assessment 
211.29  when there is not a significant change in recipient condition or 
211.30  a change in the need for personal care assistant service.  A 
211.31  service update or review for temporary increase includes a 
211.32  review of initial baseline data, evaluation of service outcomes, 
211.33  redetermination of service need, modification of service plan 
211.34  and appropriate referrals, update of initial forms, obtaining 
211.35  service authorization, and on going consumer education.  
211.36  Assessments for medical assistance home care services for mental 
212.1   retardation or related conditions and alternative care services 
212.2   for developmentally disabled home and community-based waivered 
212.3   recipients may be conducted by the county public health nurse to 
212.4   ensure coordination and avoid duplication.  Assessments must be 
212.5   completed on forms provided by the commissioner within 30 days 
212.6   of a request for home care services by a recipient or 
212.7   responsible party. 
212.8      (b) "Care plan" means a written description of personal 
212.9   care assistant services developed by the agency nurse qualified 
212.10  professional with the recipient or responsible party to be used 
212.11  by the personal care assistant with a copy provided to the 
212.12  recipient or responsible party. 
212.13     (c) "Home care services" means a health service, determined 
212.14  by the commissioner as medically necessary, that is ordered by a 
212.15  physician and documented in a service plan that is reviewed by 
212.16  the physician at least once every 60 62 days for the provision 
212.17  of home health services, or private duty nursing, or at least 
212.18  once every 365 days for personal care.  Home care services are 
212.19  provided to the recipient at the recipient's residence that is a 
212.20  place other than a hospital or long-term care facility or as 
212.21  specified in section 256B.0625.  
212.22     (d) "Medically necessary" has the meaning given in 
212.23  Minnesota Rules, parts 9505.0170 to 9505.0475.  
212.24     (e) "Personal care assistant" means a person who:  (1) is 
212.25  at least 18 years old, except for persons 16 to 18 years of age 
212.26  who participated in a related school-based job training program 
212.27  or have completed a certified home health aide competency 
212.28  evaluation; (2) is able to effectively communicate with the 
212.29  recipient and personal care provider organization; (3) effective 
212.30  July 1, 1996, has completed one of the training requirements as 
212.31  specified in Minnesota Rules, part 9505.0335, subpart 3, items A 
212.32  to D; (4) has the ability to, and provides covered personal care 
212.33  services according to the recipient's care plan, responds 
212.34  appropriately to recipient needs, and reports changes in the 
212.35  recipient's condition to the supervising registered nurse 
212.36  qualified professional; (5) is not a consumer of personal care 
213.1   services; and (6) is subject to criminal background checks and 
213.2   procedures specified in section 245A.04.  An individual who has 
213.3   been convicted of a crime specified in Minnesota Rules, part 
213.4   4668.0020, subpart 14, or a comparable crime in another 
213.5   jurisdiction is disqualified from being a personal care 
213.6   assistant, unless the individual meets the rehabilitation 
213.7   criteria specified in Minnesota Rules, part 4668.0020, subpart 
213.8   15. 
213.9      (f) "Personal care provider organization" means an 
213.10  organization enrolled to provide personal care services under 
213.11  the medical assistance program that complies with the 
213.12  following:  (1) owners who have a five percent interest or more, 
213.13  and managerial officials are subject to a background study as 
213.14  provided in section 245A.04.  This applies to currently enrolled 
213.15  personal care provider organizations and those agencies seeking 
213.16  enrollment as a personal care provider organization.  An 
213.17  organization will be barred from enrollment if an owner or 
213.18  managerial official of the organization has been convicted of a 
213.19  crime specified in section 245A.04, or a comparable crime in 
213.20  another jurisdiction, unless the owner or managerial official 
213.21  meets the reconsideration criteria specified in section 245A.04; 
213.22  (2) the organization must maintain a surety bond and liability 
213.23  insurance throughout the duration of enrollment and provides 
213.24  proof thereof.  The insurer must notify the department of human 
213.25  services of the cancellation or lapse of policy; and (3) the 
213.26  organization must maintain documentation of services as 
213.27  specified in Minnesota Rules, part 9505.2175, subpart 7, as well 
213.28  as evidence of compliance with personal care assistant training 
213.29  requirements. 
213.30     (g) "Responsible party" means an individual residing with a 
213.31  recipient of personal care services who is capable of providing 
213.32  the supportive care necessary to assist the recipient to live in 
213.33  the community, is at least 18 years old, and is not a personal 
213.34  care assistant.  Responsible parties who are parents of minors 
213.35  or guardians of minors or incapacitated persons may delegate the 
213.36  responsibility to another adult during a temporary absence of at 
214.1   least 24 hours but not more than six months.  The person 
214.2   delegated as a responsible party must be able to meet the 
214.3   definition of responsible party, except that the delegated 
214.4   responsible party is required to reside with the recipient only 
214.5   while serving as the responsible party.  Foster care license 
214.6   holders may be designated the responsible party for residents of 
214.7   the foster care home if case management is provided as required 
214.8   in section 256B.0625, subdivision 19a.  For persons who, as of 
214.9   April 1, 1992, are sharing personal care services in order to 
214.10  obtain the availability of 24-hour coverage, an employee of the 
214.11  personal care provider organization may be designated as the 
214.12  responsible party if case management is provided as required in 
214.13  section 256B.0625, subdivision 19a. 
214.14     (h) "Service plan" means a written description of the 
214.15  services needed based on the assessment developed by the nurse 
214.16  who conducts the assessment together with the recipient or 
214.17  responsible party.  The service plan shall include a description 
214.18  of the covered home care services, frequency and duration of 
214.19  services, and expected outcomes and goals.  The recipient and 
214.20  the provider chosen by the recipient or responsible party must 
214.21  be given a copy of the completed service plan within 30 calendar 
214.22  days of the request for home care services by the recipient or 
214.23  responsible party. 
214.24     (i) "Skilled nurse visits" are provided in a recipient's 
214.25  residence under a plan of care or service plan that specifies a 
214.26  level of care which the nurse is qualified to provide.  These 
214.27  services are: 
214.28     (1) nursing services according to the written plan of care 
214.29  or service plan and accepted standards of medical and nursing 
214.30  practice in accordance with chapter 148; 
214.31     (2) services which due to the recipient's medical condition 
214.32  may only be safely and effectively provided by a registered 
214.33  nurse or a licensed practical nurse; 
214.34     (3) assessments performed only by a registered nurse; and 
214.35     (4) teaching and training the recipient, the recipient's 
214.36  family, or other caregivers requiring the skills of a registered 
215.1   nurse or licensed practical nurse.  
215.2      Sec. 51.  Minnesota Statutes 1998, section 256B.0627, 
215.3   subdivision 2, is amended to read: 
215.4      Subd. 2.  [SERVICES COVERED.] Home care services covered 
215.5   under this section include:  
215.6      (1) nursing services under section 256B.0625, subdivision 
215.7   6a; 
215.8      (2) private duty nursing services under section 256B.0625, 
215.9   subdivision 7; 
215.10     (3) home health aide services under section 256B.0625, 
215.11  subdivision 6a; 
215.12     (4) personal care services under section 256B.0625, 
215.13  subdivision 19a; 
215.14     (5) nursing supervision of personal care assistant services 
215.15  provided by a qualified professional under section 256B.0625, 
215.16  subdivision 19a; and 
215.17     (6) consulting professional of personal care assistant 
215.18  services under the fiscal agent option as specified in 
215.19  subdivision 10; 
215.20     (7) face-to-face assessments by county public health nurses 
215.21  for services under section 256B.0625, subdivision 19a; and 
215.22     (8) service updates and review of temporary increases for 
215.23  personal care assistant services by the county public health 
215.24  nurse for services under section 256B.0625, subdivision 19a. 
215.25     Sec. 52.  Minnesota Statutes 1998, section 256B.0627, 
215.26  subdivision 4, is amended to read: 
215.27     Subd. 4.  [PERSONAL CARE SERVICES.] (a) The personal care 
215.28  services that are eligible for payment are the following:  
215.29     (1) bowel and bladder care; 
215.30     (2) skin care to maintain the health of the skin; 
215.31     (3) repetitive maintenance range of motion, muscle 
215.32  strengthening exercises, and other tasks specific to maintaining 
215.33  a recipient's optimal level of function; 
215.34     (4) respiratory assistance; 
215.35     (5) transfers and ambulation; 
215.36     (6) bathing, grooming, and hairwashing necessary for 
216.1   personal hygiene; 
216.2      (7) turning and positioning; 
216.3      (8) assistance with furnishing medication that is 
216.4   self-administered; 
216.5      (9) application and maintenance of prosthetics and 
216.6   orthotics; 
216.7      (10) cleaning medical equipment; 
216.8      (11) dressing or undressing; 
216.9      (12) assistance with eating and meal preparation and 
216.10  necessary grocery shopping; 
216.11     (13) accompanying a recipient to obtain medical diagnosis 
216.12  or treatment; 
216.13     (14) assisting, monitoring, or prompting the recipient to 
216.14  complete the services in clauses (1) to (13); 
216.15     (15) redirection, monitoring, and observation that are 
216.16  medically necessary and an integral part of completing the 
216.17  personal care services described in clauses (1) to (14); 
216.18     (16) redirection and intervention for behavior, including 
216.19  observation and monitoring; 
216.20     (17) interventions for seizure disorders, including 
216.21  monitoring and observation if the recipient has had a seizure 
216.22  that requires intervention within the past three months; 
216.23     (18) tracheostomy suctioning using a clean procedure if the 
216.24  procedure is properly delegated by a registered nurse.  Before 
216.25  this procedure can be delegated to a personal care assistant, a 
216.26  registered nurse must determine that the tracheostomy suctioning 
216.27  can be accomplished utilizing a clean rather than a sterile 
216.28  procedure and must ensure that the personal care assistant has 
216.29  been taught the proper procedure; and 
216.30     (19) incidental household services that are an integral 
216.31  part of a personal care service described in clauses (1) to (18).
216.32  For purposes of this subdivision, monitoring and observation 
216.33  means watching for outward visible signs that are likely to 
216.34  occur and for which there is a covered personal care service or 
216.35  an appropriate personal care intervention.  For purposes of this 
216.36  subdivision, a clean procedure refers to a procedure that 
217.1   reduces the numbers of microorganisms or prevents or reduces the 
217.2   transmission of microorganisms from one person or place to 
217.3   another.  A clean procedure may be used beginning 14 days after 
217.4   insertion. 
217.5      (b) The personal care services that are not eligible for 
217.6   payment are the following:  
217.7      (1) services not ordered by the physician; 
217.8      (2) assessments by personal care provider organizations or 
217.9   by independently enrolled registered nurses; 
217.10     (3) services that are not in the service plan; 
217.11     (4) services provided by the recipient's spouse, legal 
217.12  guardian for an adult or child recipient, or parent of a 
217.13  recipient under age 18; 
217.14     (5) services provided by a foster care provider of a 
217.15  recipient who cannot direct the recipient's own care, unless 
217.16  monitored by a county or state case manager under section 
217.17  256B.0625, subdivision 19a; 
217.18     (6) services provided by the residential or program license 
217.19  holder in a residence for more than four persons; 
217.20     (7) services that are the responsibility of a residential 
217.21  or program license holder under the terms of a service agreement 
217.22  and administrative rules; 
217.23     (8) sterile procedures; 
217.24     (9) injections of fluids into veins, muscles, or skin; 
217.25     (10) services provided by parents of adult recipients, 
217.26  adult children, or adult siblings of the recipient, unless these 
217.27  relatives meet one of the following hardship criteria and the 
217.28  commissioner waives this requirement: 
217.29     (i) the relative resigns from a part-time or full-time job 
217.30  to provide personal care for the recipient; 
217.31     (ii) the relative goes from a full-time to a part-time job 
217.32  with less compensation to provide personal care for the 
217.33  recipient; 
217.34     (iii) the relative takes a leave of absence without pay to 
217.35  provide personal care for the recipient; 
217.36     (iv) the relative incurs substantial expenses by providing 
218.1   personal care for the recipient; or 
218.2      (v) because of labor conditions, special language needs, or 
218.3   intermittent hours of care needed, the relative is needed in 
218.4   order to provide an adequate number of qualified personal care 
218.5   assistants to meet the medical needs of the recipient; 
218.6      (11) homemaker services that are not an integral part of a 
218.7   personal care services; 
218.8      (12) home maintenance, or chore services; 
218.9      (13) services not specified under paragraph (a); and 
218.10     (14) services not authorized by the commissioner or the 
218.11  commissioner's designee. 
218.12     Sec. 53.  Minnesota Statutes 1998, section 256B.0627, 
218.13  subdivision 5, is amended to read: 
218.14     Subd. 5.  [LIMITATION ON PAYMENTS.] Medical assistance 
218.15  payments for home care services shall be limited according to 
218.16  this subdivision.  
218.17     (a)  [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 
218.18  recipient may receive the following home care services during a 
218.19  calendar year: 
218.20     (1) any initial assessment up to two face-to-face 
218.21  assessments to determine a recipient's need for personal care 
218.22  assistant services; 
218.23     (2) up to two reassessments per year one service update 
218.24  done to determine a recipient's need for personal care services; 
218.25  and 
218.26     (3) up to five skilled nurse visits.  
218.27     (b)  [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 
218.28  services above the limits in paragraph (a) must receive the 
218.29  commissioner's prior authorization, except when: 
218.30     (1) the home care services were required to treat an 
218.31  emergency medical condition that if not immediately treated 
218.32  could cause a recipient serious physical or mental disability, 
218.33  continuation of severe pain, or death.  The provider must 
218.34  request retroactive authorization no later than five working 
218.35  days after giving the initial service.  The provider must be 
218.36  able to substantiate the emergency by documentation such as 
219.1   reports, notes, and admission or discharge histories; 
219.2      (2) the home care services were provided on or after the 
219.3   date on which the recipient's eligibility began, but before the 
219.4   date on which the recipient was notified that the case was 
219.5   opened.  Authorization will be considered if the request is 
219.6   submitted by the provider within 20 working days of the date the 
219.7   recipient was notified that the case was opened; 
219.8      (3) a third-party payor for home care services has denied 
219.9   or adjusted a payment.  Authorization requests must be submitted 
219.10  by the provider within 20 working days of the notice of denial 
219.11  or adjustment.  A copy of the notice must be included with the 
219.12  request; 
219.13     (4) the commissioner has determined that a county or state 
219.14  human services agency has made an error; or 
219.15     (5) the professional nurse determines an immediate need for 
219.16  up to 40 skilled nursing or home health aide visits per calendar 
219.17  year and submits a request for authorization within 20 working 
219.18  days of the initial service date, and medical assistance is 
219.19  determined to be the appropriate payer. 
219.20     (c)  [RETROACTIVE AUTHORIZATION.] A request for retroactive 
219.21  authorization will be evaluated according to the same criteria 
219.22  applied to prior authorization requests.  
219.23     (d)  [ASSESSMENT AND SERVICE PLAN.] Assessments under 
219.24  section 256B.0627, subdivision 1, paragraph (a), shall be 
219.25  conducted initially, and at least annually thereafter, in person 
219.26  with the recipient and result in a completed service plan using 
219.27  forms specified by the commissioner.  Within 30 days of 
219.28  recipient or responsible party request for home care services, 
219.29  the assessment, the service plan, and other information 
219.30  necessary to determine medical necessity such as diagnostic or 
219.31  testing information, social or medical histories, and hospital 
219.32  or facility discharge summaries shall be submitted to the 
219.33  commissioner.  For personal care services: 
219.34     (1) The amount and type of service authorized based upon 
219.35  the assessment and service plan will follow the recipient if the 
219.36  recipient chooses to change providers.  
220.1      (2) If the recipient's medical need changes, the 
220.2   recipient's provider may assess the need for a change in service 
220.3   authorization and request the change from the county public 
220.4   health nurse.  Within 30 days of the request, the public health 
220.5   nurse will determine whether to request the change in services 
220.6   based upon the provider assessment, or conduct a home visit to 
220.7   assess the need and determine whether the change is appropriate. 
220.8      (3) To continue to receive personal care services after the 
220.9   first year, the recipient or the responsible party, in 
220.10  conjunction with the public health nurse, may complete a service 
220.11  update on forms developed by the commissioner according to 
220.12  criteria and procedures in subdivision 1.  The service update 
220.13  may substitute for the annual reassessment described in 
220.14  subdivision 1. 
220.15     (e)  [PRIOR AUTHORIZATION.] The commissioner, or the 
220.16  commissioner's designee, shall review the assessment, the 
220.17  service update, request for temporary services, service plan, 
220.18  and any additional information that is submitted.  The 
220.19  commissioner shall, within 30 days after receiving a complete 
220.20  request, assessment, and service plan, authorize home care 
220.21  services as follows:  
220.22     (1)  [HOME HEALTH SERVICES.] All home health services 
220.23  provided by a licensed nurse or a home health aide must be prior 
220.24  authorized by the commissioner or the commissioner's designee.  
220.25  Prior authorization must be based on medical necessity and 
220.26  cost-effectiveness when compared with other care options.  When 
220.27  home health services are used in combination with personal care 
220.28  and private duty nursing, the cost of all home care services 
220.29  shall be considered for cost-effectiveness.  The commissioner 
220.30  shall limit nurse and home health aide visits to no more than 
220.31  one visit each per day. 
220.32     (2)  [PERSONAL CARE SERVICES.] (i) All personal care 
220.33  services and registered nurse supervision by a qualified 
220.34  professional must be prior authorized by the commissioner or the 
220.35  commissioner's designee except for the assessments established 
220.36  in paragraph (a).  The amount of personal care services 
221.1   authorized must be based on the recipient's home care rating.  A 
221.2   child may not be found to be dependent in an activity of daily 
221.3   living if because of the child's age an adult would either 
221.4   perform the activity for the child or assist the child with the 
221.5   activity and the amount of assistance needed is similar to the 
221.6   assistance appropriate for a typical child of the same age.  
221.7   Based on medical necessity, the commissioner may authorize: 
221.8      (A) up to two times the average number of direct care hours 
221.9   provided in nursing facilities for the recipient's comparable 
221.10  case mix level; or 
221.11     (B) up to three times the average number of direct care 
221.12  hours provided in nursing facilities for recipients who have 
221.13  complex medical needs or are dependent in at least seven 
221.14  activities of daily living and need physical assistance with 
221.15  eating or have a neurological diagnosis; or 
221.16     (C) up to 60 percent of the average reimbursement rate, as 
221.17  of July 1, 1991, for care provided in a regional treatment 
221.18  center for recipients who have Level I behavior, plus any 
221.19  inflation adjustment as provided by the legislature for personal 
221.20  care service; or 
221.21     (D) up to the amount the commissioner would pay, as of July 
221.22  1, 1991, plus any inflation adjustment provided for home care 
221.23  services, for care provided in a regional treatment center for 
221.24  recipients referred to the commissioner by a regional treatment 
221.25  center preadmission evaluation team.  For purposes of this 
221.26  clause, home care services means all services provided in the 
221.27  home or community that would be included in the payment to a 
221.28  regional treatment center; or 
221.29     (E) up to the amount medical assistance would reimburse for 
221.30  facility care for recipients referred to the commissioner by a 
221.31  preadmission screening team established under section 256B.0911 
221.32  or 256B.092; and 
221.33     (F) a reasonable amount of time for the provision of 
221.34  nursing supervision by a qualified professional of personal care 
221.35  services.  
221.36     (ii) The number of direct care hours shall be determined 
222.1   according to the annual cost report submitted to the department 
222.2   by nursing facilities.  The average number of direct care hours, 
222.3   as established by May 1, 1992, shall be calculated and 
222.4   incorporated into the home care limits on July 1, 1992.  These 
222.5   limits shall be calculated to the nearest quarter hour. 
222.6      (iii) The home care rating shall be determined by the 
222.7   commissioner or the commissioner's designee based on information 
222.8   submitted to the commissioner by the county public health nurse 
222.9   on forms specified by the commissioner.  The home care rating 
222.10  shall be a combination of current assessment tools developed 
222.11  under sections 256B.0911 and 256B.501 with an addition for 
222.12  seizure activity that will assess the frequency and severity of 
222.13  seizure activity and with adjustments, additions, and 
222.14  clarifications that are necessary to reflect the needs and 
222.15  conditions of recipients who need home care including children 
222.16  and adults under 65 years of age.  The commissioner shall 
222.17  establish these forms and protocols under this section and shall 
222.18  use an advisory group, including representatives of recipients, 
222.19  providers, and counties, for consultation in establishing and 
222.20  revising the forms and protocols. 
222.21     (iv) A recipient shall qualify as having complex medical 
222.22  needs if the care required is difficult to perform and because 
222.23  of recipient's medical condition requires more time than 
222.24  community-based standards allow or requires more skill than 
222.25  would ordinarily be required and the recipient needs or has one 
222.26  or more of the following: 
222.27     (A) daily tube feedings; 
222.28     (B) daily parenteral therapy; 
222.29     (C) wound or decubiti care; 
222.30     (D) postural drainage, percussion, nebulizer treatments, 
222.31  suctioning, tracheotomy care, oxygen, mechanical ventilation; 
222.32     (E) catheterization; 
222.33     (F) ostomy care; 
222.34     (G) quadriplegia; or 
222.35     (H) other comparable medical conditions or treatments the 
222.36  commissioner determines would otherwise require institutional 
223.1   care.  
223.2      (v) A recipient shall qualify as having Level I behavior if 
223.3   there is reasonable supporting evidence that the recipient 
223.4   exhibits, or that without supervision, observation, or 
223.5   redirection would exhibit, one or more of the following 
223.6   behaviors that cause, or have the potential to cause: 
223.7      (A) injury to the recipient's own body; 
223.8      (B) physical injury to other people; or 
223.9      (C) destruction of property. 
223.10     (vi) Time authorized for personal care relating to Level I 
223.11  behavior in subclause (v), items (A) to (C), shall be based on 
223.12  the predictability, frequency, and amount of intervention 
223.13  required. 
223.14     (vii) A recipient shall qualify as having Level II behavior 
223.15  if the recipient exhibits on a daily basis one or more of the 
223.16  following behaviors that interfere with the completion of 
223.17  personal care services under subdivision 4, paragraph (a): 
223.18     (A) unusual or repetitive habits; 
223.19     (B) withdrawn behavior; or 
223.20     (C) offensive behavior. 
223.21     (viii) A recipient with a home care rating of Level II 
223.22  behavior in subclause (vii), items (A) to (C), shall be rated as 
223.23  comparable to a recipient with complex medical needs under 
223.24  subclause (iv).  If a recipient has both complex medical needs 
223.25  and Level II behavior, the home care rating shall be the next 
223.26  complex category up to the maximum rating under subclause (i), 
223.27  item (B). 
223.28     (3)  [PRIVATE DUTY NURSING SERVICES.] All private duty 
223.29  nursing services shall be prior authorized by the commissioner 
223.30  or the commissioner's designee.  Prior authorization for private 
223.31  duty nursing services shall be based on medical necessity and 
223.32  cost-effectiveness when compared with alternative care options.  
223.33  The commissioner may authorize medically necessary private duty 
223.34  nursing services in quarter-hour units when: 
223.35     (i) the recipient requires more individual and continuous 
223.36  care than can be provided during a nurse visit; or 
224.1      (ii) the cares are outside of the scope of services that 
224.2   can be provided by a home health aide or personal care assistant.
224.3      The commissioner may authorize: 
224.4      (A) up to two times the average amount of direct care hours 
224.5   provided in nursing facilities statewide for case mix 
224.6   classification "K" as established by the annual cost report 
224.7   submitted to the department by nursing facilities in May 1992; 
224.8      (B) private duty nursing in combination with other home 
224.9   care services up to the total cost allowed under clause (2); 
224.10     (C) up to 16 hours per day if the recipient requires more 
224.11  nursing than the maximum number of direct care hours as 
224.12  established in item (A) and the recipient meets the hospital 
224.13  admission criteria established under Minnesota Rules, parts 
224.14  9505.0500 to 9505.0540.  
224.15     The commissioner may authorize up to 16 hours per day of 
224.16  medically necessary private duty nursing services or up to 24 
224.17  hours per day of medically necessary private duty nursing 
224.18  services until such time as the commissioner is able to make a 
224.19  determination of eligibility for recipients who are 
224.20  cooperatively applying for home care services under the 
224.21  community alternative care program developed under section 
224.22  256B.49, or until it is determined by the appropriate regulatory 
224.23  agency that a health benefit plan is or is not required to pay 
224.24  for appropriate medically necessary health care services.  
224.25  Recipients or their representatives must cooperatively assist 
224.26  the commissioner in obtaining this determination.  Recipients 
224.27  who are eligible for the community alternative care program may 
224.28  not receive more hours of nursing under this section than would 
224.29  otherwise be authorized under section 256B.49. 
224.30     (4)  [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 
224.31  ventilator-dependent, the monthly medical assistance 
224.32  authorization for home care services shall not exceed what the 
224.33  commissioner would pay for care at the highest cost hospital 
224.34  designated as a long-term hospital under the Medicare program.  
224.35  For purposes of this clause, home care services means all 
224.36  services provided in the home that would be included in the 
225.1   payment for care at the long-term hospital.  
225.2   "Ventilator-dependent" means an individual who receives 
225.3   mechanical ventilation for life support at least six hours per 
225.4   day and is expected to be or has been dependent for at least 30 
225.5   consecutive days.  
225.6      (f)  [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 
225.7   or the commissioner's designee shall determine the time period 
225.8   for which a prior authorization shall be effective.  If the 
225.9   recipient continues to require home care services beyond the 
225.10  duration of the prior authorization, the home care provider must 
225.11  request a new prior authorization.  Under no circumstances, 
225.12  other than the exceptions in paragraph (b), shall a prior 
225.13  authorization be valid prior to the date the commissioner 
225.14  receives the request or for more than 12 months.  A recipient 
225.15  who appeals a reduction in previously authorized home care 
225.16  services may continue previously authorized services, other than 
225.17  temporary services under paragraph (h), pending an appeal under 
225.18  section 256.045.  The commissioner must provide a detailed 
225.19  explanation of why the authorized services are reduced in amount 
225.20  from those requested by the home care provider.  
225.21     (g)  [APPROVAL OF HOME CARE SERVICES.] The commissioner or 
225.22  the commissioner's designee shall determine the medical 
225.23  necessity of home care services, the level of caregiver 
225.24  according to subdivision 2, and the institutional comparison 
225.25  according to this subdivision, the cost-effectiveness of 
225.26  services, and the amount, scope, and duration of home care 
225.27  services reimbursable by medical assistance, based on the 
225.28  assessment, primary payer coverage determination information as 
225.29  required, the service plan, the recipient's age, the cost of 
225.30  services, the recipient's medical condition, and diagnosis or 
225.31  disability.  The commissioner may publish additional criteria 
225.32  for determining medical necessity according to section 256B.04. 
225.33     (h)  [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 
225.34  The agency nurse, the independently enrolled private duty nurse, 
225.35  or county public health nurse may request a temporary 
225.36  authorization for home care services by telephone.  The 
226.1   commissioner may approve a temporary level of home care services 
226.2   based on the assessment, and service or care plan information, 
226.3   and primary payer coverage determination information as required.
226.4   Authorization for a temporary level of home care services 
226.5   including nurse supervision is limited to the time specified by 
226.6   the commissioner, but shall not exceed 45 days, unless extended 
226.7   because the county public health nurse has not completed the 
226.8   required assessment and service plan, or the commissioner's 
226.9   determination has not been made.  The level of services 
226.10  authorized under this provision shall have no bearing on a 
226.11  future prior authorization. 
226.12     (i)  [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 
226.13  Home care services provided in an adult or child foster care 
226.14  setting must receive prior authorization by the department 
226.15  according to the limits established in paragraph (a). 
226.16     The commissioner may not authorize: 
226.17     (1) home care services that are the responsibility of the 
226.18  foster care provider under the terms of the foster care 
226.19  placement agreement and administrative rules.  Requests for home 
226.20  care services for recipients residing in a foster care setting 
226.21  must include the foster care placement agreement and 
226.22  determination of difficulty of care; 
226.23     (2) personal care services when the foster care license 
226.24  holder is also the personal care provider or personal care 
226.25  assistant unless the recipient can direct the recipient's own 
226.26  care, or case management is provided as required in section 
226.27  256B.0625, subdivision 19a; 
226.28     (3) personal care services when the responsible party is an 
226.29  employee of, or under contract with, or has any direct or 
226.30  indirect financial relationship with the personal care provider 
226.31  or personal care assistant, unless case management is provided 
226.32  as required in section 256B.0625, subdivision 19a; 
226.33     (4) home care services when the number of foster care 
226.34  residents is greater than four unless the county responsible for 
226.35  the recipient's foster placement made the placement prior to 
226.36  April 1, 1992, requests that home care services be provided, and 
227.1   case management is provided as required in section 256B.0625, 
227.2   subdivision 19a; or 
227.3      (5) home care services when combined with foster care 
227.4   payments, other than room and board payments that exceed the 
227.5   total amount that public funds would pay for the recipient's 
227.6   care in a medical institution. 
227.7      Sec. 54.  Minnesota Statutes 1998, section 256B.0627, 
227.8   subdivision 8, is amended to read: 
227.9      Subd. 8.  [SHARED PERSONAL CARE ASSISTANT SERVICES; SHARED 
227.10  CARE.] (a) Medical assistance payments for shared personal care 
227.11  assistance shared care services shall be limited according to 
227.12  this subdivision. 
227.13     (b) Recipients of personal care assistant services may 
227.14  share staff and the commissioner shall provide a rate system for 
227.15  shared personal care assistant services.  For two persons 
227.16  sharing care services, the rate paid to a provider shall not 
227.17  exceed 1-1/2 times the rate paid for serving a single 
227.18  individual, and for three persons sharing care services, the 
227.19  rate paid to a provider shall not exceed twice the rate paid for 
227.20  serving a single individual.  These rates apply only to 
227.21  situations in which all recipients were present and received 
227.22  shared care services on the date for which the service is 
227.23  billed.  No more than three persons may receive shared care 
227.24  services from a personal care assistant in a single setting. 
227.25     (c) Shared care service is the provision of personal care 
227.26  services by a personal care assistant to two or three recipients 
227.27  at the same time and in the same setting.  For the purposes of 
227.28  this subdivision, "setting" means: 
227.29     (1) the home or foster care home of one of the individual 
227.30  recipients; or 
227.31     (2) a child care program in which all recipients served by 
227.32  one personal care assistant are participating, which is licensed 
227.33  under chapter 245A or operated by a local school district or 
227.34  private school.  
227.35     The provisions of this subdivision do not apply when a 
227.36  personal care assistant is caring for multiple recipients in 
228.1   more than one setting. 
228.2      (d) The recipient or the recipient's responsible party, in 
228.3   conjunction with the county public health nurse, shall determine:
228.4      (1) whether shared care personal care assistant services is 
228.5   an appropriate option based on the individual needs and 
228.6   preferences of the recipient; and 
228.7      (2) the amount of shared care services allocated as part of 
228.8   the overall authorization of personal care services. 
228.9      The recipient or the responsible party, in conjunction with 
228.10  the supervising registered nurse qualified professional, shall 
228.11  approve arrange the setting, and grouping, and arrangement of 
228.12  shared care services based on the individual needs and 
228.13  preferences of the recipients.  Decisions on the selection of 
228.14  recipients to share care services must be based on the ages of 
228.15  the recipients, compatibility, and coordination of their care 
228.16  needs. 
228.17     (e) The following items must be considered by the recipient 
228.18  or the responsible party and the supervising nurse qualified 
228.19  professional, and documented in the recipient's care plan health 
228.20  service record: 
228.21     (1) the additional qualifications needed by the personal 
228.22  care assistant to provide care to several recipients in the same 
228.23  setting; 
228.24     (2) the additional training and supervision needed by the 
228.25  personal care assistant to ensure that the needs of the 
228.26  recipient are met appropriately and safely.  The provider must 
228.27  provide on-site supervision by a registered nurse qualified 
228.28  professional within the first 14 days of shared care services, 
228.29  and monthly thereafter; 
228.30     (3) the setting in which the shared care services will be 
228.31  provided; 
228.32     (4) the ongoing monitoring and evaluation of the 
228.33  effectiveness and appropriateness of the service and process 
228.34  used to make changes in service or setting; and 
228.35     (5) a contingency plan which accounts for absence of the 
228.36  recipient in a shared care services setting due to illness or 
229.1   other circumstances and staffing contingencies. 
229.2      (f) The provider must offer the recipient or the 
229.3   responsible party the option of shared or individual one-on-one 
229.4   personal care assistant care services.  The recipient or the 
229.5   responsible party can withdraw from participating in a shared 
229.6   care services arrangement at any time. 
229.7      (g) In addition to documentation requirements under 
229.8   Minnesota Rules, part 9505.2175, a personal care provider must 
229.9   meet documentation requirements for shared personal 
229.10  care assistant services and must document the following in the 
229.11  health service record for each individual recipient sharing care 
229.12  services: 
229.13     (1) authorization permission by the recipient or the 
229.14  recipient's responsible party, if any, for the maximum number of 
229.15  shared care services hours per week chosen by the recipient; 
229.16     (2) authorization permission by the recipient or the 
229.17  recipient's responsible party, if any, for personal 
229.18  care assistant services provided outside the recipient's 
229.19  residence; 
229.20     (3) authorization permission by the recipient or the 
229.21  recipient's responsible party, if any, for others to receive 
229.22  shared care services in the recipient's residence; 
229.23     (4) revocation by the recipient or the recipient's 
229.24  responsible party, if any, of the shared care service 
229.25  authorization, or the shared care service to be provided to 
229.26  others in the recipient's residence, or the shared care service 
229.27  to be provided outside the recipient's residence; 
229.28     (5) supervision of the shared care personal care assistant 
229.29  services by the supervisory nurse qualified professional, 
229.30  including the date, time of day, number of hours spent 
229.31  supervising the provision of shared care services, whether the 
229.32  supervision was face-to-face or another method of supervision, 
229.33  changes in the recipient's condition, shared care services 
229.34  scheduling issues and recommendations; 
229.35     (6) documentation by the personal care assistant qualified 
229.36  professional of telephone calls or other discussions with 
230.1   the supervisory nurse personal care assistant regarding services 
230.2   being provided to the recipient; and 
230.3      (7) daily documentation of the shared care services 
230.4   provided by each identified personal care assistant including: 
230.5      (i) the names of each recipient receiving shared care 
230.6   services together; 
230.7      (ii) the setting for the day's care shared services, 
230.8   including the starting and ending times that the recipient 
230.9   received shared care services; and 
230.10     (iii) notes by the personal care assistant regarding 
230.11  changes in the recipient's condition, problems that may arise 
230.12  from the sharing of care services, scheduling issues, care 
230.13  issues, and other notes as required by the supervising nurse 
230.14  qualified professional. 
230.15     (h) Unless otherwise provided in this subdivision, all 
230.16  other statutory and regulatory provisions relating to personal 
230.17  care services apply to shared care services. 
230.18     Nothing in this subdivision shall be construed to reduce 
230.19  the total number of hours authorized for an individual recipient.
230.20     Sec. 55.  Minnesota Statutes 1998, section 256B.0627, is 
230.21  amended by adding a subdivision to read: 
230.22     Subd. 9.  [FLEXIBLE USE OF PERSONAL CARE ASSISTANT 
230.23  HOURS.] (a) The commissioner may allow for the flexible use of 
230.24  personal care assistant hours.  "Flexible use" means the 
230.25  scheduled use of authorized hours of personal care assistant 
230.26  services, which vary within the length of the service 
230.27  authorization in order to more effectively meet the needs and 
230.28  schedule of the recipient.  Recipients may use their approved 
230.29  hours flexibly within the service authorization period for 
230.30  medically necessary covered services specified in the assessment 
230.31  required in subdivision 1.  The flexible use of authorized hours 
230.32  does not increase the total amount of authorized hours available 
230.33  to a recipient as determined under subdivision 5.  The 
230.34  commissioner shall not authorize additional personal care 
230.35  assistant services to supplement a service authorization that is 
230.36  exhausted before the end date under a flexible service use plan, 
231.1   unless the county public health nurse determines a change in 
231.2   condition and a need for increased services is established. 
231.3      (b) The recipient or responsible party, together with the 
231.4   county public health nurse, shall determine whether flexible use 
231.5   is an appropriate option based on the needs and preferences of 
231.6   the recipient or responsible party, and, if appropriate, must 
231.7   ensure that the allocation of hours covers the ongoing needs of 
231.8   the recipient over the entire service authorization period.  As 
231.9   part of the assessment and service planning process, the 
231.10  recipient or responsible party must work with the county public 
231.11  health nurse to develop a written month-to-month plan of the 
231.12  projected use of personal care assistant services that is part 
231.13  of the service plan and ensures that the: 
231.14     (1) health and safety needs of the recipient will be met; 
231.15     (2) total annual authorization will not exceed before the 
231.16  end date; and 
231.17     (3) how actual use of hours will be monitored.  
231.18     (c) If the actual use of personal care assistant service 
231.19  varies significantly from the use projected in the plan, the 
231.20  written plan must be promptly updated by the recipient or 
231.21  responsible party and the county public health nurse. 
231.22     (d) The recipient or responsible party, together with the 
231.23  provider, must work to monitor and document the use of 
231.24  authorized hours and ensure that a recipient is able to manage 
231.25  services effectively throughout the authorized period.  The 
231.26  provider must ensure that the month-to-month plan is 
231.27  incorporated into the care plan.  Upon request of the recipient 
231.28  or responsible party, the provider must furnish regular updates 
231.29  to the recipient or responsible party on the amount of personal 
231.30  care assistant services used.  
231.31     (e) The recipient or responsible party may revoke the 
231.32  authorization for flexible use of hours by notifying the 
231.33  provider and county public health nurse in writing. 
231.34     (f) If the requirements in paragraphs (a) to (e) have not 
231.35  substantially been met, the commissioner shall deny, revoke, or 
231.36  suspend the authorization to use authorized hours flexibly.  The 
232.1   recipient or responsible party may appeal the commissioner's 
232.2   action according to section 256.045.  The denial, revocation, or 
232.3   suspension to use the flexible hours option shall not affect the 
232.4   recipient's authorized level of personal care assistant services 
232.5   as determined under subdivision 5. 
232.6      Sec. 56.  Minnesota Statutes 1998, section 256B.0627, is 
232.7   amended by adding a subdivision to read: 
232.8      Subd. 10.  [FISCAL AGENT OPTION AVAILABLE FOR PERSONAL CARE 
232.9   ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that 
232.10  allows the recipient to: 
232.11     (1) use a fiscal agent instead of a personal care provider 
232.12  organization; 
232.13     (2) supervise the personal care assistant; and 
232.14     (3) use a consulting professional. 
232.15     The commissioner may allow a recipient of personal care 
232.16  assistant services to use a fiscal agent to assist the recipient 
232.17  in paying and accounting for medically necessary covered 
232.18  personal care assistant services authorized in subdivision 4 and 
232.19  within the payment parameters of subdivision 5.  Unless 
232.20  otherwise provided in this subdivision, all other statutory and 
232.21  regulatory provisions relating to personal care services apply 
232.22  to a recipient using the fiscal agent option. 
232.23     (b) The recipient or responsible party shall: 
232.24     (1) hire, and terminate the personal care assistant and 
232.25  consulting professional, with the fiscal agent; 
232.26     (2) recruit the personal care assistant and consulting 
232.27  professional and orient and train the personal care assistant in 
232.28  areas that do not require professional delegation as determined 
232.29  by the county public health nurse; 
232.30     (3) supervise and evaluate the personal care assistant in 
232.31  areas that do not require professional delegation as determined 
232.32  in the assessment; 
232.33     (4) cooperate with a consulting professional and implement 
232.34  recommendations pertaining to the health and safety of the 
232.35  recipient; 
232.36     (5) hire a qualified professional to train and supervise 
233.1   the performance of delegated tasks done by the personal care 
233.2   assistant; 
233.3      (6) monitor services and verify in writing the hours worked 
233.4   by the personal care assistant and the consulting professional; 
233.5      (7) develop and revise a care plan with assistance from a 
233.6   consulting professional; 
233.7      (8) verify and document the credentials of the consulting 
233.8   professional; and 
233.9      (9) enter into a written agreement, as specified in 
233.10  paragraph (f). 
233.11     (c) The duties of the fiscal agent shall be to: 
233.12     (1) bill the medical assistance program for personal care 
233.13  assistant and consulting professional services; 
233.14     (2) request and secure background checks on personal care 
233.15  assistants and consulting professionals according to section 
233.16  245A.04; 
233.17     (3) pay the personal care assistant and consulting 
233.18  professional based on actual hours of services provided; 
233.19     (4) withhold and pay all applicable federal and state 
233.20  taxes; 
233.21     (5) verify and document hours worked by the personal care 
233.22  assistant and consulting professional; 
233.23     (6) make the arrangements and pay unemployment insurance, 
233.24  taxes, workers' compensation, liability insurance, and other 
233.25  benefits, if any; 
233.26     (7) enroll in the medical assistance program as a fiscal 
233.27  agent; and 
233.28     (8) enter into a written agreement as specified in 
233.29  paragraph (f) before services are provided. 
233.30     (d) The fiscal agent: 
233.31     (1) may not be related to the recipient, consulting 
233.32  professional, or the personal care assistant; 
233.33     (2) must ensure arm's length transactions with the 
233.34  recipient and personal care assistant; and 
233.35     (3) shall be considered a joint employer of the personal 
233.36  care assistant and consulting professional to the extent 
234.1   specified in this section. 
234.2      The fiscal agent or owners of the entity that provides 
234.3   fiscal agent services under this subdivision must pass a 
234.4   criminal background check as required in section 256B.0627, 
234.5   subdivision 1, paragraph (e). 
234.6      (e) The consulting professional providing assistance to the 
234.7   recipient shall meet the qualifications specified in section 
234.8   256B.0625, subdivision 19c.  The consulting professional shall 
234.9   assist the recipient in developing and revising a plan to meet 
234.10  the recipient's assessed needs, and supervise the performance of 
234.11  delegated tasks, as determined by the public health nurse.  In 
234.12  performing this function, the consulting professional must visit 
234.13  the recipient in the recipient's home at least once annually.  
234.14  The consulting professional must report to the local county 
234.15  public health nurse concerns relating to the health and safety 
234.16  of the recipient, and any suspected abuse, neglect, or financial 
234.17  exploitation of the recipient to the appropriate authorities.  
234.18     (f) The fiscal agent, recipient or responsible party, 
234.19  personal care assistant, and consulting professional shall enter 
234.20  into a written agreement before services are started.  The 
234.21  agreement shall include: 
234.22     (1) the duties of the recipient, professional, personal 
234.23  care assistant, and fiscal agent based on paragraphs (a) to (e); 
234.24     (2) the salary and benefits for the personal care assistant 
234.25  and those providing professional consultation; 
234.26     (3) the administrative fee of the fiscal agent and services 
234.27  paid for with that fee, including background check fees; 
234.28     (4) procedures to respond to billing or payment complaints; 
234.29  and 
234.30     (5) procedures for hiring and terminating the personal care 
234.31  assistant and those providing professional consultation. 
234.32     (g) The rates paid for personal care services, professional 
234.33  assistance, and fiscal agency services under this subdivision 
234.34  shall be the same rates paid for personal care services and 
234.35  qualified professional services under subdivision 2 
234.36  respectively.  Except for the administrative fee of the fiscal 
235.1   agent specified in paragraph (f), the remainder of the rates 
235.2   paid to the fiscal agent must be used to pay for the salary and 
235.3   benefits for the personal care assistant or those providing 
235.4   professional consultation. 
235.5      (h) As part of the assessment defined in subdivision 1, the 
235.6   following conditions must be met to use or continue use of a 
235.7   fiscal agent: 
235.8      (1) the recipient must be able to direct the recipient's 
235.9   own care, or the responsible party for the recipient must be 
235.10  readily available to direct the care of the personal care 
235.11  assistant; 
235.12     (2) the recipient or responsible party must be 
235.13  knowledgeable of the health care needs of the recipient and be 
235.14  able to effectively communicate those needs; 
235.15     (3) a face-to-face assessment must be conducted by the 
235.16  local county public health nurse at least annually, or when 
235.17  there is a significant change in the recipient's condition or 
235.18  change in the need for personal care assistant services.  The 
235.19  county public health nurse shall determine the services that 
235.20  require professional delegation, if any, and the amount and 
235.21  frequency of related supervision; 
235.22     (4) the recipient cannot select the shared services option 
235.23  as specified in subdivision 8; and 
235.24     (5) parties must be in compliance with the written 
235.25  agreement specified in paragraph (f). 
235.26     (i) The commissioner shall deny, revoke, or suspend the 
235.27  authorization to use the fiscal agent option if: 
235.28     (1) it has been determined by the consulting professional 
235.29  or local county public health nurse that the use of this option 
235.30  jeopardizes the recipient's health and safety; 
235.31     (2) the parties have failed to comply with the written 
235.32  agreement specified in paragraph (f); or 
235.33     (3) the use of the option has led to abusive or fraudulent 
235.34  billing for personal care assistant services.  
235.35     The recipient or responsible party may appeal the 
235.36  commissioner's action according to section 256.045.  The denial, 
236.1   revocation, or suspension to use the fiscal agent option shall 
236.2   not affect the recipient's authorized level of personal care 
236.3   assistant services as determined in subdivision 5.  
236.4      Sec. 57.  Minnesota Statutes 1998, section 256B.0627, is 
236.5   amended by adding a subdivision to read: 
236.6      Subd. 11.  [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 
236.7   Medical assistance payments for shared private duty nursing 
236.8   services by a private duty nurse shall be limited according to 
236.9   this subdivision.  For the purposes of this section, "private 
236.10  duty nursing agency" means an agency licensed under chapter 144A 
236.11  to provide private duty nursing services. 
236.12     (b) Recipients of private duty nursing services may share 
236.13  nursing staff and the commissioner shall provide a rate 
236.14  methodology for shared private duty nursing.  For two persons 
236.15  sharing nursing care, the rate paid to a provider shall not 
236.16  exceed 1.5 times the nonwaivered private duty nursing rates paid 
236.17  for serving a single individual who is not ventilator dependent, 
236.18  by a registered nurse or licensed practical nurse.  These rates 
236.19  apply only to situations in which both recipients are present 
236.20  and receive shared private duty nursing care on the date for 
236.21  which the service is billed.  No more than two persons may 
236.22  receive shared private duty nursing services from a private duty 
236.23  nurse in a single setting. 
236.24     (c) Shared private duty nursing care is the provision of 
236.25  nursing services by a private duty nurse to two recipients at 
236.26  the same time and in the same setting.  For the purposes of this 
236.27  subdivision, "setting" means: 
236.28     (1) the home or foster care home of one of the individual 
236.29  recipients; or 
236.30     (2) a child care program licensed under chapter 245A or 
236.31  operated by a local school district or private school; or 
236.32     (3) an adult day care service licensed under chapter 245A. 
236.33     This subdivision does not apply when a private duty nurse 
236.34  is caring for multiple recipients in more than one setting. 
236.35     (d) The recipient or the recipient's legal representative, 
236.36  and the recipient's physician, in conjunction with the home 
237.1   health care agency, shall determine: 
237.2      (1) whether shared private duty nursing care is an 
237.3   appropriate option based on the individual needs and preferences 
237.4   of the recipient; and 
237.5      (2) the amount of shared private duty nursing services 
237.6   authorized as part of the overall authorization of nursing 
237.7   services. 
237.8      (e) The recipient or the recipient's legal representative, 
237.9   in conjunction with the private duty nursing agency, shall 
237.10  approve the setting, grouping, and arrangement of shared private 
237.11  duty nursing care based on the individual needs and preferences 
237.12  of the recipients.  Decisions on the selection of recipients to 
237.13  share services must be based on the ages of the recipients, 
237.14  compatibility, and coordination of their care needs. 
237.15     (f) The following items must be considered by the recipient 
237.16  or the recipient's legal representative and the private duty 
237.17  nursing agency, and documented in the recipient's health service 
237.18  record: 
237.19     (1) the additional training needed by the private duty 
237.20  nurse to provide care to several recipients in the same setting 
237.21  and to ensure that the needs of the recipients are met 
237.22  appropriately and safely; 
237.23     (2) the setting in which the shared private duty nursing 
237.24  care will be provided; 
237.25     (3) the ongoing monitoring and evaluation of the 
237.26  effectiveness and appropriateness of the service and process 
237.27  used to make changes in service or setting; 
237.28     (4) a contingency plan which accounts for absence of the 
237.29  recipient in a shared private duty nursing setting due to 
237.30  illness or other circumstances; 
237.31     (5) staffing backup contingencies in the event of employee 
237.32  illness or absence; and 
237.33     (6) arrangements for additional assistance to respond to 
237.34  urgent or emergency care needs of the recipients. 
237.35     (g) The provider must offer the recipient or responsible 
237.36  party the option of shared or one-on-one private duty nursing 
238.1   services.  The recipient or responsible party can withdraw from 
238.2   participating in a shared service arrangement at any time. 
238.3      (h) The private duty nursing agency must document the 
238.4   following in the health service record for each individual 
238.5   recipient sharing private duty nursing care: 
238.6      (1) permission by the recipient or the recipient's legal 
238.7   representative for the maximum number of shared nursing care 
238.8   hours per week chosen by the recipient; 
238.9      (2) permission by the recipient or the recipient's legal 
238.10  representative for shared private duty nursing services provided 
238.11  outside the recipient's residence; 
238.12     (3) permission by the recipient or the recipient's legal 
238.13  representative for others to receive shared private duty nursing 
238.14  services in the recipient's residence; 
238.15     (4) revocation by the recipient or the recipient's legal 
238.16  representative of the shared private duty nursing care 
238.17  authorization, or the shared care to be provided to others in 
238.18  the recipient's residence, or the shared private duty nursing 
238.19  services to be provided outside the recipient's residence; and 
238.20     (5) daily documentation of the shared private duty nursing 
238.21  services provided by each identified private duty nurse, 
238.22  including: 
238.23     (i) the names of each recipient receiving shared private 
238.24  duty nursing services together; 
238.25     (ii) the setting for the shared services, including the 
238.26  starting and ending times that the recipient received shared 
238.27  private duty nursing care; and 
238.28     (iii) notes by the private duty nurse regarding changes in 
238.29  the recipient's condition, problems that may arise from the 
238.30  sharing of private duty nursing services, and scheduling and 
238.31  care issues. 
238.32     (i) Unless otherwise provided in this subdivision, all 
238.33  other statutory and regulatory provisions relating to private 
238.34  duty nursing services apply to shared private duty nursing 
238.35  services. 
238.36     Nothing in this subdivision shall be construed to reduce 
239.1   the total number of private duty nursing hours authorized for an 
239.2   individual recipient under subdivision 5. 
239.3      Sec. 58.  Minnesota Statutes 1998, section 256B.0627, is 
239.4   amended by adding a subdivision to read: 
239.5      Subd. 12.  [PUBLIC HEALTH NURSE ASSESSMENT RATE.] (a) The 
239.6   reimbursement rates for public health nurse visits that relate 
239.7   to the provision of personal care services under this section 
239.8   and section 256B.0625, subdivision 19a, are: 
239.9      (i) $210.50 for a face-to-face assessment visit; 
239.10     (ii) $105.25 for each service update; and 
239.11     (iii) $105.25 for each request for a temporary service 
239.12  increase. 
239.13     (b) The rates specified in paragraph (a) must be adjusted 
239.14  to reflect provider rate increases for personal care assistant 
239.15  services that are approved by the legislature for the fiscal 
239.16  year ending June 30, 2000, and subsequent fiscal years.  Any 
239.17  requirements applied by the legislature to provider rate 
239.18  increases for personal care assistant services also apply to 
239.19  adjustments under this paragraph. 
239.20     Sec. 59.  Minnesota Statutes 1998, section 256B.0635, 
239.21  subdivision 3, is amended to read: 
239.22     Subd. 3.  [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 
239.23  OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.] Upon federal 
239.24  approval, Medical assistance is available to persons who 
239.25  received MFIP-S in at least three of the six months preceding 
239.26  the month in which the person opted opt to discontinue receiving 
239.27  MFIP-S cash assistance under section 256J.31, subdivision 12.  A 
239.28  person who is eligible for medical assistance under this section 
239.29  may receive medical assistance without reapplication as long as 
239.30  the person meets MFIP-S eligibility requirements, unless the 
239.31  assistance unit does not include a dependent child.  Medical 
239.32  assistance may be paid pursuant to subdivisions 1 and 2 for 
239.33  persons who are no longer eligible for MFIP-S due to increased 
239.34  employment or child support.  A person may be eligible for 
239.35  MinnesotaCare due to increased employment or child support, and 
239.36  as such must be informed of the option to transition onto 
240.1   MinnesotaCare. 
240.2      Sec. 60.  [256B.0914] [CONFLICTS OF INTEREST RELATED TO 
240.3   MEDICAID EXPENDITURES.] 
240.4      Subdivision 1.  [DEFINITIONS.] (a) "Contract" means a 
240.5   written, fully executed agreement for the purchase of goods and 
240.6   services involving a substantial expenditure of Medicaid 
240.7   funding.  A contract under a renewal period shall be considered 
240.8   a separate contract. 
240.9      (b) "Contractor bid or proposal information" means cost or 
240.10  pricing data, indirect costs, and proprietary information marked 
240.11  as such by the bidder in accordance with applicable law. 
240.12     (c) "Particular expenditure" means a substantial 
240.13  expenditure as defined below, for a specified term, involving 
240.14  specific parties.  The renewal of an existing contract for the 
240.15  substantial expenditure of Medicaid funds is considered a 
240.16  separate, particular expenditure from the original contract. 
240.17     (d) "Source selection information" means any of the 
240.18  following information prepared for use by the state, county, or 
240.19  independent contractor for the purpose of evaluating a bid or 
240.20  proposal to enter into a Medicaid procurement contract, if that 
240.21  information has not been previously made available to the public 
240.22  or disclosed publicly: 
240.23     (1) bid prices submitted in response to a solicitation for 
240.24  sealed bids, or lists of the bid prices before bid opening; 
240.25     (2) proposed costs or prices submitted in response to a 
240.26  solicitation, or lists of those proposed costs or prices; 
240.27     (3) source selection plans; 
240.28     (4) technical evaluations plans; 
240.29     (5) technical evaluations of proposals; 
240.30     (6) cost or price evaluation of proposals; 
240.31     (7) competitive range determinations that identify 
240.32  proposals that have a reasonable chance of being selected for 
240.33  award of a contract; 
240.34     (8) rankings of bids, proposals, or competitors; 
240.35     (9) the reports and evaluations of source selection panels, 
240.36  boards, or advisory councils; and 
241.1      (10) other information marked as "source selection 
241.2   information" based on a case-by-case determination by the head 
241.3   of the agency, contractor, designees, or the contracting officer 
241.4   that disclosure of the information would jeopardize the 
241.5   integrity or successful completion of the Medicaid procurement 
241.6   to which the information relates. 
241.7      (e) "Substantial expenditure" and "substantial amounts" 
241.8   mean a purchase of goods or services in excess of $10,000,000 in 
241.9   Medicaid funding under this chapter or chapter 256L. 
241.10     Subd. 2.  [APPLICABILITY.] (a) Unless provided otherwise, 
241.11  this section applies to:  
241.12     (1) any state or local officer, employee, or independent 
241.13  contractor who is responsible for the substantial expenditures 
241.14  of medical assistance or MinnesotaCare funding under this 
241.15  chapter or chapter 256L for which federal Medicaid matching 
241.16  funds are available; 
241.17     (2) any individual who formerly was such an officer, 
241.18  employee, or independent contractor; and 
241.19     (3) any partner of such a state or local officer, employee, 
241.20  or independent contractor. 
241.21     (b) This section is intended to meet the requirements of 
241.22  state participation in the Medicaid program at United States 
241.23  Code, title 42, sections 1396a(a)(4) and 1396u-2(d)(3), which 
241.24  require that states have in place restrictions against conflicts 
241.25  of interest in the Medicaid procurement process, that are at 
241.26  least as stringent as those in effect under United States Code, 
241.27  title 41, section 423, and title 18, sections 207 and 208, as 
241.28  they apply to federal employees. 
241.29     Subd. 3.  [DISCLOSURE OF PROCUREMENT INFORMATION.] A person 
241.30  described in subdivision 2 may not knowingly disclose contractor 
241.31  bid or proposal information, or source selection information 
241.32  before the award by the state, county, or independent contractor 
241.33  of a Medicaid procurement contract to which the information 
241.34  relates unless the disclosure is otherwise authorized by law.  
241.35  No person, other than as provided by law, shall knowingly obtain 
241.36  contractor bid or proposal information or source selection 
242.1   information before the award of a Medicaid procurement contract 
242.2   to which the information relates. 
242.3      Subd. 4.  [OFFERS OF EMPLOYMENT.] When a person described 
242.4   in subdivision 2, paragraph (a), is participating personally and 
242.5   substantially in a Medicaid procurement for a contract contacts 
242.6   or is contacted by a person who is a bidder or offeror in the 
242.7   same procurement regarding possible employment outside of the 
242.8   entity by which the person is currently employed, the person 
242.9   must:  
242.10     (1) report the contact in writing to the person's 
242.11  supervisor and employer's ethics officer; and 
242.12     (2) either: 
242.13     (i) reject the possibility of employment with the bidder or 
242.14  offeror; or 
242.15     (ii) be disqualified from further participation in the 
242.16  procurement until the bidder or offeror is no longer involved in 
242.17  that procurement, or all discussions with the bidder or offeror 
242.18  regarding possible employment have terminated without an 
242.19  arrangement for employment.  A bidder or offeror may not engage 
242.20  in employment discussions with an official who is subject to 
242.21  this subdivision, until the bidder or offeror is no longer 
242.22  involved in that procurement. 
242.23     Subd. 5.  [ACCEPTANCE OF COMPENSATION BY A FORMER 
242.24  OFFICIAL.] (a) A former official of the state or county, or a 
242.25  former independent contractor, described in subdivision 2 may 
242.26  not accept compensation from a Medicaid contractor of a 
242.27  substantial expenditure as an employee, officer, director, or 
242.28  consultant of the contractor within one year after the former 
242.29  official or independent contractor: 
242.30     (1) served as the procuring contracting officer, the source 
242.31  selection authority, a member of the source selection evaluation 
242.32  board, or the chief of a financial or technical evaluation team 
242.33  in a procurement in which the contractor was selected for award; 
242.34     (2) served as the program manager, deputy program manager, 
242.35  or administrative contracting officer for a contract awarded to 
242.36  the contractor; or 
243.1      (3) personally made decisions for the state, county, or 
243.2   independent contractor to: 
243.3      (i) award a contract, subcontract, modification of a 
243.4   contract or subcontract, or a task order or delivery order to 
243.5   the contractor; 
243.6      (ii) establish overhead or other rates applicable to a 
243.7   contract or contracts with the contractor; 
243.8      (iii) approve issuance of a contract payment or payments to 
243.9   the contractor; or 
243.10     (iv) pay or settle a claim with the contractor. 
243.11     (b) Paragraph (a) does not prohibit a former official of 
243.12  the state, county, or independent contractor from accepting 
243.13  compensation from any division or affiliate of a contractor not 
243.14  involved in the same or similar products or services as the 
243.15  division or affiliate of the contractor that is responsible for 
243.16  the contract referred to in paragraph (a), clause (1), (2), or 
243.17  (3). 
243.18     (c) A contractor shall not provide compensation to a former 
243.19  official knowing that the former official is accepting that 
243.20  compensation in violation of this subdivision. 
243.21     Subd. 6.  [PERMANENT RESTRICTIONS ON REPRESENTATION AND 
243.22  COMMUNICATION.] (a) A person described in subdivision 2, after 
243.23  termination of his or her service with state, county, or 
243.24  independent contractor, is permanently restricted from knowingly 
243.25  making, with the intent to influence, any communication to or 
243.26  appearance before an officer or employee of a department, 
243.27  agency, or court of the United States, the state of Minnesota 
243.28  and its counties in connection with a particular expenditure: 
243.29     (1) in which the United States, the state of Minnesota, or 
243.30  a Minnesota county is a party or has a direct and substantial 
243.31  interest; 
243.32     (2) in which the person participated personally and 
243.33  substantially as an officer, employee, or independent 
243.34  contractor; and 
243.35     (3) which involved a specific party or parties at the time 
243.36  of participation. 
244.1      (b) For purposes of this subdivision and subdivisions 7 and 
244.2   9, "participated" means an action taken through decision, 
244.3   approval, disapproval, recommendation, the rendering of advice, 
244.4   investigation, or other such action. 
244.5      Subd. 7.  [TWO-YEAR RESTRICTIONS ON REPRESENTATION AND 
244.6   COMMUNICATION.] No person described in subdivision 2, within two 
244.7   years after termination of service with the state, county, or 
244.8   independent contractor, shall knowingly make, with the intent to 
244.9   influence, any communication to or appearance before any officer 
244.10  or employee of any government department, agency, or court in 
244.11  connection with a particular expenditure: 
244.12     (1) in which the United States, the state of Minnesota, or 
244.13  a Minnesota county is a party or has a direct and substantial 
244.14  interest; 
244.15     (2) which the person knows or reasonably should know was 
244.16  actually pending under the official's responsibility as an 
244.17  officer, employee, or independent contractor within one year 
244.18  before the termination of the official's service with the state, 
244.19  county, or independent contractor; and 
244.20     (3) which involved a specific party or parties at the time 
244.21  the expenditure was pending. 
244.22     Subd. 8.  [EXCEPTIONS TO PERMANENT AND TWO-YEAR 
244.23  RESTRICTIONS ON REPRESENTATION AND COMMUNICATION.] Subdivisions 
244.24  6 and 7 do not apply to: 
244.25     (1) communications or representations made in carrying out 
244.26  official duties on behalf of the United States, the state of 
244.27  Minnesota or local government, or as an elected official of the 
244.28  state or local government; 
244.29     (2) communications made solely for the purpose of 
244.30  furnishing scientific or technological information; or 
244.31     (3) giving testimony under oath.  A person subject to 
244.32  subdivisions 6 and 7 may serve as an expert witness in that 
244.33  matter, without restriction, for the state, county, or 
244.34  independent contractor.  Under court order, a person subject to 
244.35  subdivisions 6 and 7 may serve as an expert witness for others.  
244.36  Otherwise, the person may not serve as an expert witness in that 
245.1   matter. 
245.2      Subd. 9.  [WAIVER.] The commissioner of human services, or 
245.3   the governor in the case of the commissioner, may grant a waiver 
245.4   of a restriction in subdivisions 6 and 7 if he or she determines 
245.5   that a waiver is in the public interest and that the services of 
245.6   the officer or employee are critically needed for the benefit of 
245.7   the state or county government. 
245.8      Subd. 10.  [ACTS AFFECTING A PERSONAL FINANCIAL 
245.9   INTEREST.] A person described in subdivision 2, paragraph (a), 
245.10  clause (1), who participates in a particular expenditure in 
245.11  which the person has knowledge or has a financial interest, is 
245.12  subject to the penalties in subdivision 12.  For purposes of 
245.13  this subdivision, "financial interest" also includes the 
245.14  financial interest of a spouse, minor child, general partner, 
245.15  organization in which the officer or employee is serving as an 
245.16  officer, director, trustee, general partner, or employee, or any 
245.17  person or organization with whom the individual is negotiating 
245.18  or has any arrangement concerning prospective employment. 
245.19     Subd. 11.  [EXCEPTIONS TO PROHIBITIONS REGARDING FINANCIAL 
245.20  INTEREST.] Subdivision 10 does not apply if: 
245.21     (1) the person first advises the person's supervisor and 
245.22  the employer's ethics officer regarding the nature and 
245.23  circumstances of the particular expenditure and makes full 
245.24  disclosure of the financial interest and receives in advance a 
245.25  written determination made by the commissioner of human 
245.26  services, or the governor in the case of the commissioner, that 
245.27  the interest is not so substantial as to likely affect the 
245.28  integrity of the services which the government may expect from 
245.29  the officer, employee, or independent contractor; 
245.30     (2) the financial interest is listed as an exemption at 
245.31  Code of Federal Regulations, title 5, sections 2640.201 to 
245.32  2640.203, as too remote or inconsequential to affect the 
245.33  integrity of the services of the office, employee, or 
245.34  independent contractor to which the requirement applies. 
245.35     Subd. 12.  [CRIMINAL PENALTIES.] (a) A person who violates 
245.36  subdivisions 3 to 5 for the purpose of either exchanging the 
246.1   information covered by this section for anything of value, or 
246.2   for obtaining or giving anyone a competitive advantage in the 
246.3   award of a Medicaid contract, may be sentenced to imprisonment 
246.4   for not more than five years or payment of a fine of not more 
246.5   than $50,000 for each violation, or the amount of compensation 
246.6   which the person received or offered for the prohibited conduct, 
246.7   whichever is greater, or both. 
246.8      (b) A person who violates a provision of subdivisions 6 to 
246.9   11 may be sentenced to imprisonment for not more than one year 
246.10  or payment of a fine of not more than $50,000 for each violation 
246.11  or the amount of compensation which the person received or 
246.12  offered for the prohibited conduct, whichever amount is greater, 
246.13  or both.  A person who willfully engages in conduct in violation 
246.14  of subdivisions 6 to 11 may be sentenced to imprisonment for not 
246.15  more than five years or to payment of fine of not more than 
246.16  $50,000 for each violation or the amount of compensation which 
246.17  the person received or offered for the prohibited conduct, 
246.18  whichever amount is greater, or both. 
246.19     (c) Nothing in this section precludes prosecution under 
246.20  other laws such as section 609.43. 
246.21     Subd. 13.  [CIVIL PENALTIES AND INJUNCTIVE RELIEF.] (a) The 
246.22  Minnesota attorney general may bring a civil action in Ramsey 
246.23  county district court against a person who violates this section.
246.24  Upon proof of such conduct by a preponderance of evidence, the 
246.25  person is subject to a civil penalty.  An individual who 
246.26  violates this section is subject to a civil penalty of not more 
246.27  than $50,000 for each violation plus twice the amount of 
246.28  compensation which the individual received or offered for the 
246.29  prohibited conduct.  An organization that violates this section 
246.30  is subject to a civil penalty of not more than $500,000 for each 
246.31  violation plus twice the amount of compensation which the 
246.32  organization received or offered for the prohibited conduct. 
246.33     (b) If the Minnesota attorney general has reason to believe 
246.34  that a person is engaging in conduct in violation of this 
246.35  section, the attorney general may petition the Ramsey county 
246.36  district court for an order prohibiting that person from 
247.1   engaging in such conduct.  The court may issue an order 
247.2   prohibiting that person from engaging in such conduct if the 
247.3   court finds that the conduct constitutes such a violation.  The 
247.4   filing of a petition under this subdivision does not preclude 
247.5   any other remedy which is available by law. 
247.6      Subd. 14.  [ADMINISTRATIVE ACTIONS.] (a) If a state agency, 
247.7   local agency, or independent contractor receives information 
247.8   that a contractor or a person has violated this section, the 
247.9   state agency, local agency, or independent contractor may: 
247.10     (1) cancel the procurement if a contract has not already 
247.11  been awarded; 
247.12     (2) rescind the contract; or 
247.13     (3) initiate suspension or debarment proceedings according 
247.14  to applicable state or federal law. 
247.15     (b) If the contract is rescinded, the state agency, local 
247.16  agency, or independent contractor is entitled to recover, in 
247.17  addition to any penalty prescribed by law, the amount expended 
247.18  under the contract. 
247.19     (c) This section does not: 
247.20     (1) restrict the disclosure of information to or from any 
247.21  person or class of persons authorized to receive that 
247.22  information; 
247.23     (2) restrict a contractor from disclosing the contractor's 
247.24  bid or proposal information or the recipient from receiving that 
247.25  information; 
247.26     (3) restrict the disclosure or receipt of information 
247.27  relating to a Medicaid procurement after it has been canceled by 
247.28  the state agency, county agency, or independent contractor 
247.29  before the contract award unless the agency or independent 
247.30  contractor plans to resume the procurement; or 
247.31     (4) limit the applicability of any requirements, sanctions, 
247.32  contract penalties, and remedies established under any other law 
247.33  or regulation. 
247.34     (d) No person may file a protest against the award or 
247.35  proposed award of a Medicaid contract alleging a violation of 
247.36  this section unless that person reported the information the 
248.1   person believes constitutes evidence of the offense to the 
248.2   applicable state agency, local agency, or independent contractor 
248.3   responsible for the procurement.  The report must be made no 
248.4   later than 14 days after the person first discovered the 
248.5   possible violation. 
248.6      Sec. 61.  Minnesota Statutes 1998, section 256B.0916, is 
248.7   amended to read: 
248.8      256B.0916 [EXPANSION OF HOME AND COMMUNITY-BASED SERVICES; 
248.9   MANAGEMENT AND ALLOCATION RESPONSIBILITIES.] 
248.10     (a) The commissioner shall expand availability of home and 
248.11  community-based services for persons with mental retardation and 
248.12  related conditions to the extent allowed by federal law and 
248.13  regulation and shall assist counties in transferring persons 
248.14  from semi-independent living services to home and 
248.15  community-based services.  The commissioner may transfer funds 
248.16  from the state semi-independent living services account 
248.17  available under section 252.275, subdivision 8, and state 
248.18  community social services aids available under section 256E.15 
248.19  to the medical assistance account to pay for the nonfederal 
248.20  share of nonresidential and residential home and community-based 
248.21  services authorized under section 256B.092 for persons 
248.22  transferring from semi-independent living services. 
248.23     (b) Upon federal approval, county boards are not 
248.24  responsible for funding semi-independent living services as a 
248.25  social service for those persons who have transferred to the 
248.26  home and community-based waiver program as a result of the 
248.27  expansion under this subdivision.  The county responsibility for 
248.28  those persons transferred shall be assumed under section 
248.29  256B.092.  Notwithstanding the provisions of section 252.275, 
248.30  the commissioner shall continue to allocate funds under that 
248.31  section for semi-independent living services and county boards 
248.32  shall continue to fund services under sections 256E.06 and 
248.33  256E.14 for those persons who cannot access home and 
248.34  community-based services under section 256B.092. 
248.35     (c) Eighty percent of the state funds made available to the 
248.36  commissioner under section 252.275 as a result of persons 
249.1   transferring from the semi-independent living services program 
249.2   to the home and community-based services program shall be used 
249.3   to fund additional persons in the semi-independent living 
249.4   services program. 
249.5      (d) Beginning August 1, 1998, the commissioner shall issue 
249.6   an annual report on the home and community-based waiver for 
249.7   persons with mental retardation or related conditions, that 
249.8   includes a list of the counties in which less than 95 percent of 
249.9   the allocation provided, excluding the county waivered services 
249.10  reserve, has been committed for two or more quarters during the 
249.11  previous state fiscal year.  For each listed county, the report 
249.12  shall include the amount of funds allocated but not used, the 
249.13  number and ages of individuals screened and waiting for 
249.14  services, the services needed, a description of the technical 
249.15  assistance provided by the commissioner to assist the counties 
249.16  in jointly planning with other counties in order to serve more 
249.17  persons, and additional actions which will be taken to serve 
249.18  those screened and waiting for services. 
249.19     Subdivision 1.  [REDUCTION OF WAITING LIST.] (a) The 
249.20  legislature recognizes that as of January 1, 1999, 3,300 persons 
249.21  with mental retardation or related conditions have been screened 
249.22  and determined eligible for the home and community-based waiver 
249.23  services program for persons with mental retardation or related 
249.24  conditions.  Many wait for several years before receiving 
249.25  service. 
249.26     (b) The waiting list for this program shall be reduced or 
249.27  eliminated by June 30, 2003.  In order to reduce the number of 
249.28  eligible persons waiting for identified services provided 
249.29  through the home and community-based waiver for persons with 
249.30  mental retardation or related conditions, funding shall be 
249.31  increased to add 100 additional eligible persons each year 
249.32  beyond the February 1999 medical assistance forecast. 
249.33     (c) The commissioner shall allocate resources in such a 
249.34  manner as to use all resources budgeted for the home and 
249.35  community-based waiver for persons with mental retardation or 
249.36  related conditions according to the priorities listed in 
250.1   subdivision 2, paragraph (b), and then to serve other persons on 
250.2   the waiting list.  Resources allocated for a fiscal year to 
250.3   serve persons affected by public and private sector ICF/MR 
250.4   closures, but not expected to be expended for that purpose, must 
250.5   be reallocated within that fiscal year to serve other persons on 
250.6   the waiting list, and the number of waiver diversion slots shall 
250.7   be adjusted accordingly. 
250.8      (d) For fiscal year 2001, at least one-half of the increase 
250.9   in funding over the previous year provided in the February 1999 
250.10  medical assistance forecast for the home and community-based 
250.11  waiver for persons with mental retardation and related 
250.12  conditions, including changes made by the 1999 legislature, must 
250.13  be used to serve persons who are not affected by public and 
250.14  private sector ICF/MR closures. 
250.15     Subd. 2.  [DISTRIBUTION OF FUNDS; PARTNERSHIPS.] (a) 
250.16  Beginning with fiscal year 2000, the commissioner shall 
250.17  distribute all funding available for home and community-based 
250.18  waiver services for persons with mental retardation or related 
250.19  conditions to individual counties or to groups of counties that 
250.20  form partnerships to jointly plan, administer, and authorize 
250.21  funding for eligible individuals.  The commissioner shall 
250.22  encourage counties to form partnerships that have a sufficient 
250.23  number of recipients and funding to adequately manage the risk 
250.24  and maximize use of available resources.  
250.25     (b) Counties must submit a request for funds and a plan for 
250.26  administering the program as required by the commissioner.  The 
250.27  plan must identify the number of clients to be served, their 
250.28  ages, and their priority listing based on: 
250.29     (1) requirements in Minnesota Rules, part 9525.1880; 
250.30     (2) unstable living situations due to the age or incapacity 
250.31  of the primary caregiver; 
250.32     (3) the need for services to avoid out-of-home placement of 
250.33  children; and 
250.34     (4) the need to serve persons affected by private sector 
250.35  ICF/MR closures. 
250.36  The plan must also identify changes made to improve services to 
251.1   eligible persons and to improve program management. 
251.2      (c) In allocating resources to counties, priority must be 
251.3   given to groups of counties that form partnerships to jointly 
251.4   plan, administer, and authorize funding for eligible individuals 
251.5   and to counties determined by the commissioner to have 
251.6   sufficient waiver capacity to maximize resource use. 
251.7      (d) Within 30 days after receiving the county request for 
251.8   funds and plans, the commissioner shall provide a written 
251.9   response to the plan that includes the level of resources 
251.10  available to serve additional persons. 
251.11     (e) Counties are eligible to receive medical assistance 
251.12  administrative reimbursement for administrative costs under 
251.13  criteria established by the commissioner.  
251.14     Subd. 3.  [FAILURE TO DEVELOP PARTNERSHIPS OR SUBMIT A 
251.15  PLAN.] (a) By October 1 of each year the commissioner shall 
251.16  notify the county board if any county determined by the 
251.17  commissioner to have insufficient capacity to maximize use of 
251.18  available resources fails to develop a partnership with other 
251.19  counties or fails to submit a plan as required in subdivision 
251.20  2.  The commissioner shall provide needed technical assistance 
251.21  to a county or group of counties that fails to form a 
251.22  partnership or submit a plan.  If a county has not joined a 
251.23  county partnership or submitted a plan within 30 days following 
251.24  the notice by the commissioner of its failure, the commissioner 
251.25  shall require and assist that county to develop a plan or 
251.26  contract with another county or group of counties to plan and 
251.27  administer the waiver services program in that county. 
251.28     (b) Counties may request technical assistance, management 
251.29  information, and administrative support from the commissioner at 
251.30  any time.  The commissioner shall respond to county requests 
251.31  within 30 days.  Priority shall be given to activities that 
251.32  support the administrative needs of newly formed county 
251.33  partnerships. 
251.34     Subd. 4.  [ALLOWED RESERVE.] Counties or groups of counties 
251.35  participating in partnerships that have submitted a plan under 
251.36  this section may develop an allowed reserve amount to meet 
252.1   crises and other unmet needs of current home and community-based 
252.2   waiver recipients.  The amount of the allowed reserve shall be a 
252.3   county specific amount based upon documented past experience and 
252.4   projected need for the coming year described in an allowed 
252.5   reserve plan submitted for approval to the commissioner with the 
252.6   allocation request for the fiscal year. 
252.7      Subd. 5.  [PRIORITIES FOR REASSIGNMENT OF RESOURCES AND 
252.8   APPROVAL OF INCREASED CAPACITY.] In order to maximize the number 
252.9   of persons served with waiver funds, the commissioner shall 
252.10  monitor county utilization of allocated resources and, as 
252.11  appropriate, reassign resources not utilized and approve 
252.12  increased capacity within available county allocations.  
252.13  Priority consideration for reassignment of resources and 
252.14  approval of increased capacity shall be given to counties with 
252.15  sufficient capacity and counties that form partnerships.  In 
252.16  addition to the priorities listed in Minnesota Rules, part 
252.17  9525.1880, the commissioner shall also give priority 
252.18  consideration to persons whose living situations are unstable 
252.19  due to the age or incapacity of the primary caregiver and to 
252.20  children to avoid out-of-home placement. 
252.21     Subd. 6.  [WAIVER REQUEST.] (a) The commissioner shall 
252.22  submit to the federal Health Care Financing Administration by 
252.23  September 1, 1999, a request for a waiver to include an option 
252.24  that would allow waiver service recipients to directly receive 
252.25  95 percent of the funds that would be allocated to individuals 
252.26  based on written county criteria and procedures approved by the 
252.27  commissioner for the purchase of services to meet their 
252.28  long-term care needs.  The waiver request must include a 
252.29  provision requiring recipients who receive funds directly to 
252.30  provide to the commissioner annually, a description of the type 
252.31  of services used, the amount paid for the services purchased, 
252.32  and the amount of unspent funds. 
252.33     (b) The commissioner, in cooperation with county 
252.34  representatives, waiver service providers, recipients, 
252.35  recipients' families, legal guardians, and advocacy groups, 
252.36  shall develop criteria for: 
253.1      (1) eligibility to receive funding directly; 
253.2      (2) determination of the amount of funds made available to 
253.3   each eligible person based on need; and 
253.4      (3) the accountability required of persons directly 
253.5   receiving funds. 
253.6      (c) If this waiver is approved and implemented, any unspent 
253.7   money from the waiver services allocation, including the five 
253.8   percent not directly allocated to recipients and any unspent 
253.9   portion of the money that is directly allocated, shall be used 
253.10  to meet the needs of other eligible persons waiting for services 
253.11  funded through the waiver. 
253.12     (d) The commissioner, in consultation with county social 
253.13  services agencies, waiver services providers, recipients, 
253.14  recipients' families, legal guardians, and advocacy groups shall 
253.15  evaluate the effectiveness of this option within two years of 
253.16  its implementation. 
253.17     Subd. 7.  [ANNUAL REPORT BY COMMISSIONER.] Beginning 
253.18  October 1, 1999, and each October 1 thereafter, the commissioner 
253.19  shall issue an annual report on county and state use of 
253.20  available resources for the home and community-based waiver for 
253.21  persons with mental retardation or related conditions.  For each 
253.22  county or county partnership, the report shall include: 
253.23     (1) the amount of funds allocated but not used; 
253.24     (2) the county specific allowed reserve amount approved and 
253.25  used; 
253.26     (3) the number, ages and living situations of individuals 
253.27  screened and waiting for services; 
253.28     (4) the urgency of need for services to begin within one, 
253.29  two, or more than two years for each individual; 
253.30     (5) the services needed; 
253.31     (6) the number of additional persons served by approval of 
253.32  increased capacity within existing allocations; 
253.33     (7) results of action by the commissioner to streamline 
253.34  administrative requirements and improve county resource 
253.35  management; and 
253.36     (8) additional action that would decrease the number of 
254.1   those eligible and waiting for waivered services. 
254.2   The commissioner shall specify intended outcomes for the program 
254.3   and the degree to which these specified outcomes are attained. 
254.4      (e) Subd. 8.  [FINANCIAL INFORMATION BY COUNTY.] The 
254.5   commissioner shall make available to interested parties, upon 
254.6   request, financial information by county including the amount of 
254.7   resources allocated for the home and community-based waiver for 
254.8   persons with mental retardation and related conditions, the 
254.9   resources committed, the number of persons screened and waiting 
254.10  for services, the type of services requested by those waiting, 
254.11  and the amount of allocated resources not committed. 
254.12     Subd. 9.  [LEGAL REPRESENTATIVE PARTICIPATION 
254.13  EXCEPTION.] The commissioner, in cooperation with 
254.14  representatives of counties, service providers, service 
254.15  recipients, family members, legal representatives and advocates, 
254.16  shall develop criteria to allow legal representatives to be 
254.17  reimbursed for providing specific support services to meet the 
254.18  person's needs when a plan which assures health and safety has 
254.19  been agreed upon and carried out by the legal representative, 
254.20  the person, and the county.  Legal representatives providing 
254.21  support under consumer-directed community support services 
254.22  pursuant to section 256B.092, subdivision 4, or the consumer 
254.23  support grant program pursuant to section 256B.092, subdivision 
254.24  7, shall not be considered to have a direct or indirect service 
254.25  provider interest under section 256B.092, subdivision 7, if a 
254.26  health and safety plan which meets the criteria established has 
254.27  been agreed upon and implemented.  By October 1, 1999, the 
254.28  commissioner shall submit, for federal approval, amendments to 
254.29  allow legal representatives to provide supports and receive 
254.30  reimbursement under the consumer-directed community support 
254.31  services section of the home and community-based waiver plan. 
254.32     Sec. 62.  Minnesota Statutes 1998, section 256B.0917, 
254.33  subdivision 8, is amended to read: 
254.34     Subd. 8.  [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 
254.35  The organization awarded the contract under subdivision 7, shall 
254.36  develop and administer a grant program to establish or expand up 
255.1   to 27 33 community-based organizations that will implement 
255.2   living-at-home/block nurse programs that are designed to enable 
255.3   senior citizens to live as independently as possible in their 
255.4   homes and in their communities.  At least one-half of the 
255.5   programs must be in counties outside the seven-county 
255.6   metropolitan area.  Nonprofit organizations and units of local 
255.7   government are eligible to apply for grants to establish the 
255.8   community organizations that will implement living-at-home/block 
255.9   nurse programs.  In awarding grants, the organization awarded 
255.10  the contract under subdivision 7 shall give preference to 
255.11  nonprofit organizations and units of local government from 
255.12  communities that: 
255.13     (1) have high nursing home occupancy rates; 
255.14     (2) have a shortage of health care professionals; 
255.15     (3) are located in counties adjacent to, or are located in, 
255.16  counties with existing living-at-home/block nurse programs; and 
255.17     (4) meet other criteria established by LAH/BN, Inc., in 
255.18  consultation with the commissioner. 
255.19     (b) Grant applicants must also meet the following criteria: 
255.20     (1) the local community demonstrates a readiness to 
255.21  establish a community model of care, including the formation of 
255.22  a board of directors, advisory committee, or similar group, of 
255.23  which at least two-thirds is comprised of community citizens 
255.24  interested in community-based care for older persons; 
255.25     (2) the program has sponsorship by a credible, 
255.26  representative organization within the community; 
255.27     (3) the program has defined specific geographic boundaries 
255.28  and defined its organization, staffing and coordination/delivery 
255.29  of services; 
255.30     (4) the program demonstrates a team approach to 
255.31  coordination and care, ensuring that the older adult 
255.32  participants, their families, the formal and informal providers 
255.33  are all part of the effort to plan and provide services; and 
255.34     (5) the program provides assurances that all community 
255.35  resources and funding will be coordinated and that other funding 
255.36  sources will be maximized, including a person's own resources. 
256.1      (c) Grant applicants must provide a minimum of five percent 
256.2   of total estimated development costs from local community 
256.3   funding.  Grants shall be awarded for four-year periods, and the 
256.4   base amount shall not exceed $80,000 per applicant for the grant 
256.5   period.  The organization under contract may increase the grant 
256.6   amount for applicants from communities that have socioeconomic 
256.7   characteristics that indicate a higher level of need for 
256.8   assistance.  Subject to the availability of funding, grants and 
256.9   grant renewals awarded or entered into on or after July 1, 1997, 
256.10  shall be renewed by LAH/BN, Inc. every four years, unless 
256.11  LAH/BN, Inc. determines that the grant recipient has not 
256.12  satisfactorily operated the living-at-home/block nurse program 
256.13  in compliance with the requirements of paragraphs (b) and (d).  
256.14  Grants provided to living-at-home/block nurse programs under 
256.15  this paragraph may be used for both program development and the 
256.16  delivery of services. 
256.17     (d) Each living-at-home/block nurse program shall be 
256.18  designed by representatives of the communities being served to 
256.19  ensure that the program addresses the specific needs of the 
256.20  community residents.  The programs must be designed to: 
256.21     (1) incorporate the basic community, organizational, and 
256.22  service delivery principles of the living-at-home/block nurse 
256.23  program model; 
256.24     (2) provide senior citizens with registered nurse directed 
256.25  assessment, provision and coordination of health and personal 
256.26  care services on a sliding fee basis as an alternative to 
256.27  expensive nursing home care; 
256.28     (3) provide information, support services, homemaking 
256.29  services, counseling, and training for the client and family 
256.30  caregivers; 
256.31     (4) encourage the development and use of respite care, 
256.32  caregiver support, and in-home support programs, such as adult 
256.33  foster care and in-home adult day care; 
256.34     (5) encourage neighborhood residents and local 
256.35  organizations to collaborate in meeting the needs of senior 
256.36  citizens in their communities; 
257.1      (6) recruit, train, and direct the use of volunteers to 
257.2   provide informal services and other appropriate support to 
257.3   senior citizens and their caregivers; and 
257.4      (7) provide coordination and management of formal and 
257.5   informal services to senior citizens and their families using 
257.6   less expensive alternatives. 
257.7      Sec. 63.  Minnesota Statutes 1998, section 256B.0951, 
257.8   subdivision 1, is amended to read: 
257.9      Subdivision 1.  [MEMBERSHIP.] The region 10 quality 
257.10  assurance commission is established.  The commission consists of 
257.11  at least 13 14 but not more than 20 21 members as follows:  at 
257.12  least three but not more than five members representing advocacy 
257.13  organizations; at least three but not more than five members 
257.14  representing consumers, families, and their legal 
257.15  representatives; at least three but not more than five members 
257.16  representing service providers; and at least three but not more 
257.17  than five members representing counties; and the commissioner of 
257.18  human services or the commissioner's designee.  Initial 
257.19  membership of the commission shall be recruited and approved by 
257.20  the region 10 stakeholders group.  Prior to approving the 
257.21  commission's membership, the stakeholders group shall provide to 
257.22  the commissioner a list of the membership in the stakeholders 
257.23  group, as of February 1, 1997, a brief summary of meetings held 
257.24  by the group since July 1, 1996, and copies of any materials 
257.25  prepared by the group for public distribution.  The first 
257.26  commission shall establish membership guidelines for the 
257.27  transition and recruitment of membership for the commission's 
257.28  ongoing existence.  Members of the commission who do not receive 
257.29  a salary or wages from an employer for time spent on commission 
257.30  duties may receive a per diem payment when performing commission 
257.31  duties and functions.  All members may be reimbursed for 
257.32  expenses related to commission activities.  Notwithstanding the 
257.33  provisions of section 15.059, subdivision 5, the commission 
257.34  expires on June 30, 2001. 
257.35     Sec. 64.  Minnesota Statutes 1998, section 256B.0951, 
257.36  subdivision 3, is amended to read: 
258.1      Subd. 3.  [COMMISSION DUTIES.] (a) By October 1, 1997, the 
258.2   commission, in cooperation with the commissioners of human 
258.3   services and health, shall do the following:  (1) approve an 
258.4   alternative quality assurance licensing system based on the 
258.5   evaluation of outcomes; (2) approve measurable outcomes in the 
258.6   areas of health and safety, consumer evaluation, education and 
258.7   training, providers, and systems that shall be evaluated during 
258.8   the alternative licensing process; and (3) establish variable 
258.9   licensure periods not to exceed three years based on outcomes 
258.10  achieved.  For purposes of this subdivision, "outcome" means the 
258.11  behavior, action, or status of a person that can be observed or 
258.12  measured and can be reliably and validly determined. 
258.13     (b) By January 15, 1998, the commission shall approve, in 
258.14  cooperation with the commissioner of human services, a training 
258.15  program for members of the quality assurance teams established 
258.16  under section 256B.0952, subdivision 4. 
258.17     (c) The commission and the commissioner shall establish an 
258.18  ongoing review process for the alternative quality assurance 
258.19  licensing system.  The review shall take into account the 
258.20  comprehensive nature of the alternative system, which is 
258.21  designed to evaluate the broad spectrum of licensed and 
258.22  unlicensed entities that provide services to clients, as 
258.23  compared to the current licensing system.  
258.24     (d) The commission shall contract with an independent 
258.25  entity to conduct a financial review of the alternative quality 
258.26  assurance pilot project.  The review shall take into account the 
258.27  comprehensive nature of the alternative system, which is 
258.28  designed to evaluate the broad spectrum of licensed and 
258.29  unlicensed entities that provide services to clients, as 
258.30  compared to the current licensing system.  The review shall 
258.31  include an evaluation of possible budgetary savings within the 
258.32  department of human services as a result of implementation of 
258.33  the alternative quality assurance pilot project.  If a federal 
258.34  waiver is approved under subdivision 7, the financial review 
258.35  shall also evaluate possible savings within the department of 
258.36  health.  This review must be completed by December 15, 2000. 
259.1      (e) The commission shall submit a report to the legislature 
259.2   by January 15, 2001, on the results of the review process for 
259.3   the alternative quality assurance pilot project, a summary of 
259.4   the results of the independent financial review, and a 
259.5   recommendation on whether the pilot project should be extended 
259.6   beyond June 30, 2001. 
259.7      Sec. 65.  Minnesota Statutes 1998, section 256B.0955, is 
259.8   amended to read: 
259.9      256B.0955 [DUTIES OF THE COMMISSIONER OF HUMAN SERVICES.] 
259.10     (a) Effective July 1, 1998, the commissioner of human 
259.11  services shall delegate authority to perform licensing functions 
259.12  and activities, in accordance with section 245A.16, to counties 
259.13  participating in the alternative licensing system.  The 
259.14  commissioner shall not license or reimburse a facility, program, 
259.15  or service for persons with developmental disabilities in a 
259.16  county that participates in the alternative licensing system if 
259.17  the commissioner has received from the appropriate county 
259.18  notification that the facility, program, or service has been 
259.19  reviewed by a quality assurance team and has failed to qualify 
259.20  for licensure. 
259.21     (b) The commissioner may conduct random licensing 
259.22  inspections based on outcomes adopted under section 256B.0951 at 
259.23  facilities, programs, and services governed by the alternative 
259.24  licensing system.  The role of such random inspections shall be 
259.25  to verify that the alternative licensing system protects the 
259.26  safety and well-being of consumers and maintains the 
259.27  availability of high-quality services for persons with 
259.28  developmental disabilities.  
259.29     (c) The commissioner shall provide technical assistance and 
259.30  support or training to the alternative licensing system pilot 
259.31  project. 
259.32     (d) The commissioner and the commission shall establish an 
259.33  ongoing evaluation process for the alternative licensing system. 
259.34     (e) The commissioner shall contract with an independent 
259.35  entity to conduct a financial review of the alternative 
259.36  licensing system, including an evaluation of possible budgetary 
260.1   savings within the department of human services and the 
260.2   department of health as a result of implementation of the 
260.3   alternative quality assurance licensing system.  This review 
260.4   must be completed by December 15, 2000.  
260.5      (f) The commissioner and the commission shall submit a 
260.6   report to the legislature by January 15, 2001, on the results of 
260.7   the evaluation process of the alternative licensing system, a 
260.8   summary of the results of the independent financial review, and 
260.9   a recommendation on whether the pilot project should be extended 
260.10  beyond June 30, 2001. 
260.11     Sec. 66.  Minnesota Statutes 1998, section 256B.37, 
260.12  subdivision 2, is amended to read: 
260.13     Subd. 2.  [CIVIL ACTION FOR RECOVERY.] To recover under 
260.14  this section, the attorney general, or the appropriate county 
260.15  attorney, acting upon direction from the attorney general, may 
260.16  institute or join a civil action to enforce the subrogation 
260.17  rights of the commissioner established under this section.  
260.18     Any prepaid health plan providing services under sections 
260.19  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
260.20  children's mental health collaboratives under section 245.493; 
260.21  demonstration projects for persons with disabilities under 
260.22  section 256B.77; nursing homes under the alternative payment 
260.23  demonstration project under section 256B.434; or the 
260.24  county-based purchasing entity providing services under section 
260.25  256B.692 may retain legal representation to enforce the 
260.26  subrogation rights created under this section or, if no action 
260.27  has been brought, may initiate and prosecute an independent 
260.28  action on their behalf against a person, firm, or corporation 
260.29  that may be liable to the person to whom the care or payment was 
260.30  furnished.  
260.31     Sec. 67.  Minnesota Statutes 1998, section 256B.48, 
260.32  subdivision 1, is amended to read: 
260.33     Subdivision 1.  [PROHIBITED PRACTICES.] A nursing facility 
260.34  is not eligible to receive medical assistance payments unless it 
260.35  refrains from all of the following: 
260.36     (a) Charging private paying residents rates for similar 
261.1   services which exceed those which are approved by the state 
261.2   agency for medical assistance recipients as determined by the 
261.3   prospective desk audit rate, except under the following 
261.4   circumstances:  the nursing facility may (1) charge private 
261.5   paying residents a higher rate for a private room, and (2) 
261.6   charge for special services which are not included in the daily 
261.7   rate if medical assistance residents are charged separately at 
261.8   the same rate for the same services in addition to the daily 
261.9   rate paid by the commissioner.  Services covered by the payment 
261.10  rate must be the same regardless of payment source.  Special 
261.11  services, if offered, must be available to all residents in all 
261.12  areas of the nursing facility and charged separately at the same 
261.13  rate.  Residents are free to select or decline special 
261.14  services.  Special services must not include services which must 
261.15  be provided by the nursing facility in order to comply with 
261.16  licensure or certification standards and that if not provided 
261.17  would result in a deficiency or violation by the nursing 
261.18  facility.  Services beyond those required to comply with 
261.19  licensure or certification standards must not be charged 
261.20  separately as a special service if they were included in the 
261.21  payment rate for the previous reporting year.  A nursing 
261.22  facility that charges a private paying resident a rate in 
261.23  violation of this clause is subject to an action by the state of 
261.24  Minnesota or any of its subdivisions or agencies for civil 
261.25  damages.  A private paying resident or the resident's legal 
261.26  representative has a cause of action for civil damages against a 
261.27  nursing facility that charges the resident rates in violation of 
261.28  this clause.  The damages awarded shall include three times the 
261.29  payments that result from the violation, together with costs and 
261.30  disbursements, including reasonable attorneys' fees or their 
261.31  equivalent.  A private paying resident or the resident's legal 
261.32  representative, the state, subdivision or agency, or a nursing 
261.33  facility may request a hearing to determine the allowed rate or 
261.34  rates at issue in the cause of action.  Within 15 calendar days 
261.35  after receiving a request for such a hearing, the commissioner 
261.36  shall request assignment of an administrative law judge under 
262.1   sections 14.48 to 14.56 to conduct the hearing as soon as 
262.2   possible or according to agreement by the parties.  The 
262.3   administrative law judge shall issue a report within 15 calendar 
262.4   days following the close of the hearing.  The prohibition set 
262.5   forth in this clause shall not apply to facilities licensed as 
262.6   boarding care facilities which are not certified as skilled or 
262.7   intermediate care facilities level I or II for reimbursement 
262.8   through medical assistance. 
262.9      (b) Requiring an applicant for admission to the facility, 
262.10  or the guardian or conservator of the applicant, as a condition 
262.11  of admission, to pay any fee or deposit in excess of $100, loan 
262.12  any money to the nursing facility, or promise to leave all or 
262.13  part of the applicant's estate to the facility.  
262.14     (c) Requiring any resident of the nursing facility to 
262.15  utilize a vendor of health care services chosen by the nursing 
262.16  facility.  A nursing facility may require a resident to use 
262.17  pharmacies that utilize unit dose packing systems approved by 
262.18  the Minnesota board of pharmacy, and may require a resident to 
262.19  use pharmacies that are able to meet the federal regulations for 
262.20  safe and timely administration of medications such as systems 
262.21  with specific number of doses, prompt delivery of medications, 
262.22  or access to medications on a 24-hour basis.  Notwithstanding 
262.23  the provisions of this paragraph, nursing facilities shall not 
262.24  restrict a resident's choice of pharmacy because the pharmacy 
262.25  utilizes a specific system of unit dose drug packing. 
262.26     (d) Providing differential treatment on the basis of status 
262.27  with regard to public assistance.  
262.28     (e) Discriminating in admissions, services offered, or room 
262.29  assignment on the basis of status with regard to public 
262.30  assistance or refusal to purchase special services.  Admissions 
262.31  discrimination shall include, but is not limited to:  
262.32     (1) basing admissions decisions upon assurance by the 
262.33  applicant to the nursing facility, or the applicant's guardian 
262.34  or conservator, that the applicant is neither eligible for nor 
262.35  will seek public assistance for payment of nursing facility care 
262.36  costs; and 
263.1      (2) engaging in preferential selection from waiting lists 
263.2   based on an applicant's ability to pay privately or an 
263.3   applicant's refusal to pay for a special service. 
263.4      The collection and use by a nursing facility of financial 
263.5   information of any applicant pursuant to a preadmission 
263.6   screening program established by law shall not raise an 
263.7   inference that the nursing facility is utilizing that 
263.8   information for any purpose prohibited by this paragraph.  
263.9      (f) Requiring any vendor of medical care as defined by 
263.10  section 256B.02, subdivision 7, who is reimbursed by medical 
263.11  assistance under a separate fee schedule, to pay any amount 
263.12  based on utilization or service levels or any portion of the 
263.13  vendor's fee to the nursing facility except as payment for 
263.14  renting or leasing space or equipment or purchasing support 
263.15  services from the nursing facility as limited by section 
263.16  256B.433.  All agreements must be disclosed to the commissioner 
263.17  upon request of the commissioner.  Nursing facilities and 
263.18  vendors of ancillary services that are found to be in violation 
263.19  of this provision shall each be subject to an action by the 
263.20  state of Minnesota or any of its subdivisions or agencies for 
263.21  treble civil damages on the portion of the fee in excess of that 
263.22  allowed by this provision and section 256B.433.  Damages awarded 
263.23  must include three times the excess payments together with costs 
263.24  and disbursements including reasonable attorney's fees or their 
263.25  equivalent.  
263.26     (g) Refusing, for more than 24 hours, to accept a resident 
263.27  returning to the same bed or a bed certified for the same level 
263.28  of care, in accordance with a physician's order authorizing 
263.29  transfer, after receiving inpatient hospital services. 
263.30     The prohibitions set forth in clause (b) shall not apply to 
263.31  a retirement facility with more than 325 beds including at least 
263.32  150 licensed nursing facility beds and which:  
263.33     (1) is owned and operated by an organization tax-exempt 
263.34  under section 290.05, subdivision 1, clause (i); and 
263.35     (2) accounts for all of the applicant's assets which are 
263.36  required to be assigned to the facility so that only expenses 
264.1   for the cost of care of the applicant may be charged against the 
264.2   account; and 
264.3      (3) agrees in writing at the time of admission to the 
264.4   facility to permit the applicant, or the applicant's guardian, 
264.5   or conservator, to examine the records relating to the 
264.6   applicant's account upon request, and to receive an audited 
264.7   statement of the expenditures charged against the applicant's 
264.8   individual account upon request; and 
264.9      (4) agrees in writing at the time of admission to the 
264.10  facility to permit the applicant to withdraw from the facility 
264.11  at any time and to receive, upon withdrawal, the balance of the 
264.12  applicant's individual account. 
264.13     For a period not to exceed 180 days, the commissioner may 
264.14  continue to make medical assistance payments to a nursing 
264.15  facility or boarding care home which is in violation of this 
264.16  section if extreme hardship to the residents would result.  In 
264.17  these cases the commissioner shall issue an order requiring the 
264.18  nursing facility to correct the violation.  The nursing facility 
264.19  shall have 20 days from its receipt of the order to correct the 
264.20  violation.  If the violation is not corrected within the 20-day 
264.21  period the commissioner may reduce the payment rate to the 
264.22  nursing facility by up to 20 percent.  The amount of the payment 
264.23  rate reduction shall be related to the severity of the violation 
264.24  and shall remain in effect until the violation is corrected.  
264.25  The nursing facility or boarding care home may appeal the 
264.26  commissioner's action pursuant to the provisions of chapter 14 
264.27  pertaining to contested cases.  An appeal shall be considered 
264.28  timely if written notice of appeal is received by the 
264.29  commissioner within 20 days of notice of the commissioner's 
264.30  proposed action.  
264.31     In the event that the commissioner determines that a 
264.32  nursing facility is not eligible for reimbursement for a 
264.33  resident who is eligible for medical assistance, the 
264.34  commissioner may authorize the nursing facility to receive 
264.35  reimbursement on a temporary basis until the resident can be 
264.36  relocated to a participating nursing facility.  
265.1      Certified beds in facilities which do not allow medical 
265.2   assistance intake on July 1, 1984, or after shall be deemed to 
265.3   be decertified for purposes of section 144A.071 only. 
265.4      Sec. 68.  Minnesota Statutes 1998, section 256B.37, 
265.5   subdivision 2, is amended to read: 
265.6      Subd. 2.  [CIVIL ACTION FOR RECOVERY.] To recover under 
265.7   this section, the attorney general, or the appropriate county 
265.8   attorney, acting upon direction from the attorney general, may 
265.9   institute or join a civil action to enforce the subrogation 
265.10  rights of the commissioner established under this section.  
265.11     Any prepaid health plan providing services under sections 
265.12  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
265.13  children's mental health collaboratives under section 245.493; 
265.14  demonstration projects for persons with disabilities under 
265.15  section 256B.77; nursing homes under the alternative payment 
265.16  demonstration project under section 256B.434; or the 
265.17  county-based purchasing entity providing services under section 
265.18  256B.692 may retain legal representation to enforce the 
265.19  subrogation rights created under this section or, if no action 
265.20  has been brought, may initiate and prosecute an independent 
265.21  action on their behalf against a person, firm, or corporation 
265.22  that may be liable to the person to whom the care or payment was 
265.23  furnished.  
265.24     Sec. 69.  Minnesota Statutes 1998, section 256B.501, 
265.25  subdivision 8a, is amended to read: 
265.26     Subd. 8a.  [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 
265.27  CRISIS INTERVENTION SERVICES.] State-operated, Community-based 
265.28  crisis services provided in accordance with section 252.50, 
265.29  subdivision 7, to authorized by the commissioner or the 
265.30  commissioner's designee for a resident of an intermediate care 
265.31  facility for persons with mental retardation (ICF/MR) reimbursed 
265.32  under this section shall be paid by medical assistance in 
265.33  accordance with the paragraphs (a) to (h) (g). 
265.34     (a) "Crisis services" means the specialized services listed 
265.35  in clauses (1) to (3) provided to prevent the recipient from 
265.36  requiring placement in a more restrictive institutional setting 
266.1   such as an inpatient hospital or regional treatment center and 
266.2   to maintain the recipient in the present community setting. 
266.3      (1) The crisis services provider shall assess the 
266.4   recipient's behavior and environment to identify factors 
266.5   contributing to the crisis. 
266.6      (2) The crisis services provider shall develop a 
266.7   recipient-specific intervention plan in coordination with the 
266.8   service planning team and provide recommendations for revisions 
266.9   to the individual service plan if necessary to prevent or 
266.10  minimize the likelihood of future crisis situations.  The 
266.11  intervention plan shall include a transition plan to aid the 
266.12  recipient in returning to the community-based ICF/MR if the 
266.13  recipient is receiving residential crisis services.  
266.14     (3) The crisis services provider shall consult with and 
266.15  provide training and ongoing technical assistance to the 
266.16  recipient's service providers to aid in the implementation of 
266.17  the intervention plan and revisions to the individual service 
266.18  plan. 
266.19     (b) "Residential crisis services" means crisis services 
266.20  that are provided to a recipient admitted to the crisis services 
266.21  foster care setting an alternative, state-licensed site approved 
266.22  by the commissioner, because the ICF/MR receiving reimbursement 
266.23  under this section is not able, as determined by the 
266.24  commissioner, to provide the intervention and protection of the 
266.25  recipient and others living with the recipient that is necessary 
266.26  to prevent the recipient from requiring placement in a more 
266.27  restrictive institutional setting. 
266.28     (c) Residential crisis services providers must be licensed 
266.29  by maintain a license from the commissioner under section 
266.30  245A.03 to provide foster care, must exclusively provide for the 
266.31  residence when providing crisis services for short-term crisis 
266.32  intervention, and must not be located in a private residence. 
266.33     (d) Payment rates are determined annually for each crisis 
266.34  services provider based on cost of care for each provider as 
266.35  defined in section 246.50.  Interim payment rates are calculated 
266.36  on a per diem basis by dividing the projected cost of providing 
267.1   care by the projected number of contact days for the fiscal 
267.2   year, as estimated by the commissioner.  Final payment rates are 
267.3   calculated by dividing the actual cost of providing care by the 
267.4   actual number of contact days in the applicable fiscal 
267.5   year shall be established consistent with county negotiated 
267.6   crisis intervention services.  
267.7      (e) Payment shall be made for each contact day.  "Contact 
267.8   day" means any day in which the crisis services provider has 
267.9   face-to-face contact with the recipient or any of the 
267.10  recipient's medical assistance service providers for the purpose 
267.11  of providing crisis services as defined in paragraph (c). 
267.12     (f) Payment for residential crisis services is limited to 
267.13  21 days, unless an additional period is authorized by the 
267.14  commissioner or part of an approved regional plan.  The 
267.15  additional period may not exceed 21 days. 
267.16     (g) (f) Payment for crisis services shall be made only for 
267.17  services provided while the ICF/MR receiving reimbursement under 
267.18  this section: 
267.19     (1) has a shared services agreement with the crisis 
267.20  services provider in effect in accordance with under section 
267.21  246.57; and 
267.22     (2) has reassigned payment for the provision of the crisis 
267.23  services under this subdivision to the commissioner in 
267.24  accordance with Code of Federal Regulations, title 42, section 
267.25  447.10(e); and 
267.26     (3) has executed a cooperative agreement with the crisis 
267.27  services provider to implement the intervention plan and 
267.28  revisions to the individual service plan as necessary to prevent 
267.29  or minimize the likelihood of future crisis situations, to 
267.30  maintain the recipient in the present community setting, and to 
267.31  prevent the recipient from requiring a more restrictive 
267.32  institutional setting. 
267.33     (h) (g) Payment to the ICF/MR receiving reimbursement under 
267.34  this section shall be made for up to 18 therapeutic leave days 
267.35  during which the recipient is receiving residential crisis 
267.36  services, if the ICF/MR is otherwise eligible to receive payment 
268.1   for a therapeutic leave day under Minnesota Rules, part 
268.2   9505.0415.  Payment under this paragraph shall be terminated if 
268.3   the commissioner determines that the ICF/MR is not meeting the 
268.4   terms of the cooperative shared service agreement under 
268.5   paragraph (g) (f) or that the recipient will not return to the 
268.6   ICF/MR. 
268.7      Sec. 70.  Minnesota Statutes 1998, section 256B.69, 
268.8   subdivision 3a, is amended to read: 
268.9      Subd. 3a.  [COUNTY AUTHORITY.] (a) The commissioner, when 
268.10  implementing the general assistance medical care, or medical 
268.11  assistance prepayment program within a county, must include the 
268.12  county board in the process of development, approval, and 
268.13  issuance of the request for proposals to provide services to 
268.14  eligible individuals within the proposed county.  County boards 
268.15  must be given reasonable opportunity to make recommendations 
268.16  regarding the development, issuance, review of responses, and 
268.17  changes needed in the request for proposals.  The commissioner 
268.18  must provide county boards the opportunity to review each 
268.19  proposal based on the identification of community needs under 
268.20  chapters 145A and 256E and county advocacy activities.  If a 
268.21  county board finds that a proposal does not address certain 
268.22  community needs, the county board and commissioner shall 
268.23  continue efforts for improving the proposal and network prior to 
268.24  the approval of the contract.  The county board shall make 
268.25  recommendations regarding the approval of local networks and 
268.26  their operations to ensure adequate availability and access to 
268.27  covered services.  The provider or health plan must respond 
268.28  directly to county advocates and the state prepaid medical 
268.29  assistance ombudsperson regarding service delivery and must be 
268.30  accountable to the state regarding contracts with medical 
268.31  assistance and general assistance medical care funds.  The 
268.32  county board may recommend a maximum number of participating 
268.33  health plans after considering the size of the enrolling 
268.34  population; ensuring adequate access and capacity; considering 
268.35  the client and county administrative complexity; and considering 
268.36  the need to promote the viability of locally developed health 
269.1   plans.  The county board or a single entity representing a group 
269.2   of county boards and the commissioner shall mutually select 
269.3   health plans for participation at the time of initial 
269.4   implementation of the prepaid medical assistance program in that 
269.5   county or group of counties and at the time of contract renewal. 
269.6   The commissioner shall also seek input for contract requirements 
269.7   from the county or single entity representing a group of county 
269.8   boards at each contract renewal and incorporate those 
269.9   recommendations into the contract negotiation process.  The 
269.10  commissioner, in conjunction with the county board, shall 
269.11  actively seek to develop a mutually agreeable timetable prior to 
269.12  the development of the request for proposal, but counties must 
269.13  agree to initial enrollment beginning on or before January 1, 
269.14  1999, in either the prepaid medical assistance and general 
269.15  assistance medical care programs or county-based purchasing 
269.16  under section 256B.692.  At least 90 days before enrollment in 
269.17  the medical assistance and general assistance medical care 
269.18  prepaid programs begins in a county in which the prepaid 
269.19  programs have not been established, the commissioner shall 
269.20  provide a report to the chairs of senate and house committees 
269.21  having jurisdiction over state health care programs which 
269.22  verifies that the commissioner complied with the requirements 
269.23  for county involvement that are specified in this subdivision. 
269.24     (b) The commissioner shall seek a federal waiver to allow a 
269.25  fee-for-service plan option to MinnesotaCare enrollees.  The 
269.26  commissioner shall develop an increase of the premium fees 
269.27  required under section 256L.06 up to 20 percent of the premium 
269.28  fees for the enrollees who elect the fee-for-service option.  
269.29  Prior to implementation, the commissioner shall submit this fee 
269.30  schedule to the chair and ranking minority member of the senate 
269.31  health care committee, the senate health care and family 
269.32  services funding division, the house of representatives health 
269.33  and human services committee, and the house of representatives 
269.34  health and human services finance division. 
269.35     (c) At the option of the county board, the board may 
269.36  develop contract requirements related to the achievement of 
270.1   local public health goals to meet the health needs of medical 
270.2   assistance and general assistance medical care enrollees.  These 
270.3   requirements must be reasonably related to the performance of 
270.4   health plan functions and within the scope of the medical 
270.5   assistance and general assistance medical care benefit sets.  If 
270.6   the county board and the commissioner mutually agree to such 
270.7   requirements, the department shall include such requirements in 
270.8   all health plan contracts governing the prepaid medical 
270.9   assistance and general assistance medical care programs in that 
270.10  county at initial implementation of the program in that county 
270.11  and at the time of contract renewal.  The county board may 
270.12  participate in the enforcement of the contract provisions 
270.13  related to local public health goals. 
270.14     (d) For counties in which prepaid medical assistance and 
270.15  general assistance medical care programs have not been 
270.16  established, the commissioner shall not implement those programs 
270.17  if a county board submits acceptable and timely preliminary and 
270.18  final proposals under section 256B.692, until county-based 
270.19  purchasing is no longer operational in that county.  For 
270.20  counties in which prepaid medical assistance and general 
270.21  assistance medical care programs are in existence on or after 
270.22  September 1, 1997, the commissioner must terminate contracts 
270.23  with health plans according to section 256B.692, subdivision 5, 
270.24  if the county board submits and the commissioner accepts 
270.25  preliminary and final proposals according to that subdivision.  
270.26  The commissioner is not required to terminate contracts that 
270.27  begin on or after September 1, 1997, according to section 
270.28  256B.692 until two years have elapsed from the date of initial 
270.29  enrollment. 
270.30     (e) In the event that a county board or a single entity 
270.31  representing a group of county boards and the commissioner 
270.32  cannot reach agreement regarding:  (i) the selection of 
270.33  participating health plans in that county; (ii) contract 
270.34  requirements; or (iii) implementation and enforcement of county 
270.35  requirements including provisions regarding local public health 
270.36  goals, the commissioner shall resolve all disputes after taking 
271.1   into account the recommendations of a three-person mediation 
271.2   panel.  The panel shall be composed of one designee of the 
271.3   president of the association of Minnesota counties, one designee 
271.4   of the commissioner of human services, and one designee of the 
271.5   commissioner of health. 
271.6      (f) If a county which elects to implement county-based 
271.7   purchasing ceases to implement county-based purchasing, it is 
271.8   prohibited from assuming the responsibility of county-based 
271.9   purchasing for a period of five years from the date it 
271.10  discontinues purchasing. 
271.11     (g) Notwithstanding the requirement in this subdivision 
271.12  that a county must agree to initial enrollment on or before 
271.13  January 1, 1999, the commissioner shall grant a delay of up to 
271.14  nine months in the implementation of the county-based purchasing 
271.15  authorized in section 256B.692 until federal waiver authority 
271.16  and approval has been granted, if the county or group of 
271.17  counties has submitted a preliminary proposal for county-based 
271.18  purchasing by September 1, 1997, has not already implemented the 
271.19  prepaid medical assistance program before January 1, 1998, and 
271.20  has submitted a written request for the delay to the 
271.21  commissioner by July 1, 1998.  In order for the delay to be 
271.22  continued, the county or group of counties must also submit to 
271.23  the commissioner the following information by December 1, 1998.  
271.24  The information must: 
271.25     (1) identify the proposed date of implementation, not later 
271.26  than October 1, 1999 as determined under section 256B.692, 
271.27  subdivision 5; 
271.28     (2) include copies of the county board resolutions which 
271.29  demonstrate the continued commitment to the implementation of 
271.30  county-based purchasing by the proposed date.  County board 
271.31  authorization may remain contingent on the submission of a final 
271.32  proposal which meets the requirements of section 256B.692, 
271.33  subdivision 5, paragraph (b); 
271.34     (3) demonstrate actions taken for the establishment of a 
271.35  governance structure between the participating counties and 
271.36  describe how the fiduciary responsibilities of county-based 
272.1   purchasing will be allocated between the counties, if more than 
272.2   one county is involved in the proposal; 
272.3      (4) describe how the risk of a deficit will be managed in 
272.4   the event expenditures are greater than total capitation 
272.5   payments.  This description must identify how any of the 
272.6   following strategies will be used: 
272.7      (i) risk contracts with licensed health plans; 
272.8      (ii) risk arrangements with providers who are not licensed 
272.9   health plans; 
272.10     (iii) risk arrangements with other licensed insurance 
272.11  entities; and 
272.12     (iv) funding from other county resources; 
272.13     (5) include, if county-based purchasing will not contract 
272.14  with licensed health plans or provider networks, letters of 
272.15  interest from local providers in at least the categories of 
272.16  hospital, physician, mental health, and pharmacy which express 
272.17  interest in contracting for services.  These letters must 
272.18  recognize any risk transfer identified in clause (4), item (ii); 
272.19  and 
272.20     (6) describe the options being considered to obtain the 
272.21  administrative services required in section 256B.692, 
272.22  subdivision 3, clauses (3) and (5). 
272.23     (h) For counties which receive a delay under this 
272.24  subdivision, the final proposals required under section 
272.25  256B.692, subdivision 5, paragraph (b), must be submitted at 
272.26  least six months prior to the requested implementation date.  
272.27  Authority to implement county-based purchasing remains 
272.28  contingent on approval of the final proposal as required under 
272.29  section 256B.692. 
272.30     (i) If the commissioner is unable to provide 
272.31  county-specific, individual-level fee-for-service claims to 
272.32  counties by June 4, 1998, the commissioner shall grant a delay 
272.33  under paragraph (g) of up to 12 months in the implementation of 
272.34  county-based purchasing, and shall require implementation not 
272.35  later than January 1, 2000.  In order to receive an extension of 
272.36  the proposed date of implementation under this paragraph, a 
273.1   county or group of counties must submit a written request for 
273.2   the extension to the commissioner by August 1, 1998, must submit 
273.3   the information required under paragraph (g) by December 1, 
273.4   1998, and must submit a final proposal as provided under 
273.5   paragraph (h). 
273.6      (j) Notwithstanding other requirements of this subdivision, 
273.7   the commissioner shall not require the implementation of the 
273.8   county-based purchasing authorized in section 256B.692 until six 
273.9   months after federal waiver approval has been obtained for 
273.10  county-based purchasing, if the county or counties have 
273.11  submitted the final plan as required in section 256B.692, 
273.12  subdivision 5.  The commissioner shall allow the county or 
273.13  counties which submitted information under section 256B.692, 
273.14  subdivision 5, to submit supplemental or additional information 
273.15  which was not possible to submit by April 1, 1999.  A county or 
273.16  counties shall continue to submit the required information and 
273.17  substantive detail necessary to obtain a prompt response and 
273.18  waiver approval.  If amendments to the final plan are necessary 
273.19  due to the terms and conditions of the waiver approval, the 
273.20  commissioner shall allow the county or group of counties 60 days 
273.21  to make the necessary amendments to the final plan and shall not 
273.22  require implementation of the county-based purchasing until six 
273.23  months after the revised final plan has been submitted. 
273.24     Sec. 71.  Minnesota Statutes 1998, section 256B.69, is 
273.25  amended by adding a subdivision to read: 
273.26     Subd. 3b.  [PROVISION OF DATA TO COUNTY BOARDS.] The 
273.27  commissioner, in consultation with representatives of county 
273.28  boards of commissioners shall identify program information and 
273.29  data necessary on an ongoing basis for county boards to:  (1) 
273.30  make recommendations to the commissioner related to state 
273.31  purchasing under the prepaid medical assistance program; and (2) 
273.32  effectively administer county-based purchasing.  This 
273.33  information and data must include, but is not limited to, 
273.34  county-specific, individual-level fee-for-service and prepaid 
273.35  health plan claims information. 
273.36     Sec. 72.  Minnesota Statutes 1998, section 256B.69, is 
274.1   amended by adding a subdivision to read: 
274.2      Subd. 4b.  [INDIVIDUAL EDUCATION PLAN AND INDIVIDUALIZED 
274.3   FAMILY SERVICE PLAN SERVICES.] The commissioner shall amend the 
274.4   federal waiver allowing the state to separate out individual 
274.5   education plan and individualized family service plan services 
274.6   for children enrolled in the prepaid medical assistance program 
274.7   and the MinnesotaCare program.  Effective July 1, 1999, or upon 
274.8   federal approval, medical assistance coverage of eligible 
274.9   individual education plan and individualized family service plan 
274.10  services shall not be included in the capitated services for 
274.11  children enrolled in health plans through the prepaid medical 
274.12  assistance program and the MinnesotaCare program.  Upon federal 
274.13  approval, local school districts shall bill the commissioner for 
274.14  these services, and claims shall be paid on a fee-for-service 
274.15  basis. 
274.16     Sec. 73.  Minnesota Statutes 1998, section 256B.69, 
274.17  subdivision 5a, is amended to read: 
274.18     Subd. 5a.  [MANAGED CARE CONTRACTS.] Managed care contracts 
274.19  under this section, sections 256.9363, and 256D.03, shall be 
274.20  entered into or renewed on a calendar year basis beginning 
274.21  January 1, 1996.  Managed care contracts which were in effect on 
274.22  June 30, 1995, and set to renew on July 1, 1995, shall be 
274.23  renewed for the period July 1, 1995 through December 31, 1995 at 
274.24  the same terms that were in effect on June 30, 1995. 
274.25     A prepaid health plan providing covered health services for 
274.26  eligible persons pursuant to chapters 256B, 256D, and 256L, is 
274.27  responsible for complying with the terms of its contract with 
274.28  the commissioner.  Requirements applicable to managed care 
274.29  programs under chapters 256B, 256D, and 256L, established after 
274.30  the effective date of a contract with the commissioner take 
274.31  effect when the contract is next issued or renewed. 
274.32     Sec. 74.  Minnesota Statutes 1998, section 256B.69, 
274.33  subdivision 5b, is amended to read: 
274.34     Subd. 5b.  [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 
274.35  prepaid medical assistance and general assistance medical care 
274.36  program contract rates set by the commissioner under subdivision 
275.1   5 and effective on or after January 1, 1998, capitation rates 
275.2   for nonmetropolitan counties shall on a weighted average be no 
275.3   less than 88 percent of the capitation rates for metropolitan 
275.4   counties, excluding Hennepin county.  The commissioner shall 
275.5   make a pro rata adjustment in capitation rates paid to counties 
275.6   other than nonmetropolitan counties in order to make this 
275.7   provision budget neutral.  
275.8      (b) For prepaid medical assistance program contract rates 
275.9   set by the commissioner under subdivision 5 and effective on or 
275.10  after January 1, 2001, capitation rates for nonmetropolitan 
275.11  counties shall, on a weighted average, be no less than 89 
275.12  percent of the capitation rates for metropolitan counties, 
275.13  excluding Hennepin county. 
275.14     Sec. 75.  Minnesota Statutes 1998, section 256B.69, is 
275.15  amended by adding a subdivision to read: 
275.16     Subd. 5e.  [MEDICAL EDUCATION AND RESEARCH PAYMENTS.] For 
275.17  the calendar years 1999, 2000, and 2001, a hospital that 
275.18  participates in funding the federal share of the medical 
275.19  education and research trust fund payment under Laws 1998, 
275.20  chapter 407, article 1, section 3, shall not be held liable for 
275.21  any amounts attributable to this payment above the charge limit 
275.22  of section 256.969, subdivision 3a.  The commissioner of human 
275.23  services shall assume liability for any corresponding federal 
275.24  share of the payments above the charge limit. 
275.25     Sec. 76.  Minnesota Statutes 1998, section 256B.692, 
275.26  subdivision 2, is amended to read: 
275.27     Subd. 2.  [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 
275.28  Notwithstanding chapters 62D and 62N, a county that elects to 
275.29  purchase medical assistance and general assistance medical care 
275.30  in return for a fixed sum without regard to the frequency or 
275.31  extent of services furnished to any particular enrollee is not 
275.32  required to obtain a certificate of authority under chapter 62D 
275.33  or 62N.  The county board of commissioners is the governing body 
275.34  of a county-based purchasing program.  In a multicounty 
275.35  arrangement, the governing body is a joint powers board 
275.36  established under section 471.59.  
276.1      (b) A county that elects to purchase medical assistance and 
276.2   general assistance medical care services under this section must 
276.3   satisfy the commissioner of health that the requirements for 
276.4   assurance of consumer protection, provider protection, and 
276.5   fiscal solvency of chapter 62D, applicable to health maintenance 
276.6   organizations, or chapter 62N, applicable to community 
276.7   integrated service networks, will be met.  
276.8      (c) A county must also assure the commissioner of health 
276.9   that the requirements of sections 62J.041; 62J.48; 62J.71 to 
276.10  62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 
276.11  62Q, including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 
276.12  62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 
276.13  62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 
276.14  62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met.  
276.15     (d) All enforcement and rulemaking powers available under 
276.16  chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 
276.17  commissioner of health with respect to counties that purchase 
276.18  medical assistance and general assistance medical care services 
276.19  under this section.  
276.20     (e) The commissioner, in consultation with county 
276.21  government, shall develop administrative and financial reporting 
276.22  requirements for county-based purchasing programs relating to 
276.23  sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 
276.24  62N.31, and other sections as necessary, that are specific to 
276.25  county administrative, accounting, and reporting systems and 
276.26  consistent with other statutory requirements of counties.  
276.27     Sec. 77.  Minnesota Statutes 1998, section 256B.75, is 
276.28  amended to read: 
276.29     256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 
276.30     (a) For outpatient hospital facility fee payments for 
276.31  services rendered on or after October 1, 1992, the commissioner 
276.32  of human services shall pay the lower of (1) submitted charge, 
276.33  or (2) 32 percent above the rate in effect on June 30, 1992, 
276.34  except for those services for which there is a federal maximum 
276.35  allowable payment.  Effective for services rendered on or after 
276.36  January 1, 2000, payment rates for nonsurgical outpatient 
277.1   hospital facility fees and emergency room facility fees shall be 
277.2   increased by eight percent over the rates in effect on December 
277.3   31, 1999, except for those services for which there is a federal 
277.4   maximum allowable payment.  Services for which there is a 
277.5   federal maximum allowable payment shall be paid at the lower of 
277.6   (1) submitted charge, or (2) the federal maximum allowable 
277.7   payment.  Total aggregate payment for outpatient hospital 
277.8   facility fee services shall not exceed the Medicare upper 
277.9   limit.  If it is determined that a provision of this section 
277.10  conflicts with existing or future requirements of the United 
277.11  States government with respect to federal financial 
277.12  participation in medical assistance, the federal requirements 
277.13  prevail.  The commissioner may, in the aggregate, prospectively 
277.14  reduce payment rates to avoid reduced federal financial 
277.15  participation resulting from rates that are in excess of the 
277.16  Medicare upper limitations. 
277.17     (b) Notwithstanding paragraph (a), payment for outpatient, 
277.18  emergency, and ambulatory surgery hospital facility fee services 
277.19  for critical access hospitals designated under section 144.1483, 
277.20  clause (11), shall be paid on a cost-based payment system that 
277.21  is based on the cost-finding methods and allowable costs of the 
277.22  Medicare program. 
277.23     Sec. 78.  Minnesota Statutes 1998, section 256B.76, is 
277.24  amended to read: 
277.25     256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 
277.26     (a) The physician reimbursement increase provided in 
277.27  section 256B.74, subdivision 2, shall not be implemented.  
277.28  Effective for services rendered on or after October 1, 1992, the 
277.29  commissioner shall make payments for physician services as 
277.30  follows: 
277.31     (1) payment for level one Health Care Finance 
277.32  Administration's common procedural coding system (HCPCS) codes 
277.33  titled "office and other outpatient services," "preventive 
277.34  medicine new and established patient," "delivery, antepartum, 
277.35  and postpartum care," "critical care," Caesarean delivery and 
277.36  pharmacologic management provided to psychiatric patients, and 
278.1   HCPCS level three codes for enhanced services for prenatal high 
278.2   risk, shall be paid at the lower of (i) submitted charges, or 
278.3   (ii) 25 percent above the rate in effect on June 30, 1992.  If 
278.4   the rate on any procedure code within these categories is 
278.5   different than the rate that would have been paid under the 
278.6   methodology in section 256B.74, subdivision 2, then the larger 
278.7   rate shall be paid; 
278.8      (2) payments for all other services shall be paid at the 
278.9   lower of (i) submitted charges, or (ii) 15.4 percent above the 
278.10  rate in effect on June 30, 1992; and 
278.11     (3) all physician rates shall be converted from the 50th 
278.12  percentile of 1982 to the 50th percentile of 1989, less the 
278.13  percent in aggregate necessary to equal the above increases 
278.14  except that payment rates for home health agency services shall 
278.15  be the rates in effect on September 30, 1992.; 
278.16     (4) effective for services rendered on or after January 1, 
278.17  2000, payment rates for physician and professional services 
278.18  shall be increased by three percent over the rates in effect on 
278.19  December 31, 1999, except for home health agency and family 
278.20  planning agency services; and 
278.21     (5) the increases in clause (4) shall be implemented 
278.22  January 1, 2000, for managed care. 
278.23     (b) The dental reimbursement increase provided in section 
278.24  256B.74, subdivision 5, shall not be implemented.  Effective for 
278.25  services rendered on or after October 1, 1992, the commissioner 
278.26  shall make payments for dental services as follows: 
278.27     (1) dental services shall be paid at the lower of (i) 
278.28  submitted charges, or (ii) 25 percent above the rate in effect 
278.29  on June 30, 1992; and 
278.30     (2) dental rates shall be converted from the 50th 
278.31  percentile of 1982 to the 50th percentile of 1989, less the 
278.32  percent in aggregate necessary to equal the above increases.; 
278.33     (3) effective for services rendered on or after January 1, 
278.34  2000, payment rates for dental services shall be increased by 
278.35  three percent over the rates in effect on December 31, 1999; 
278.36     (4) the commissioner shall award grants to community 
279.1   clinics or other nonprofit community organizations, political 
279.2   subdivisions, professional associations, or other organizations 
279.3   that demonstrate the ability to provide dental services 
279.4   effectively to public program recipients.  Grants may be used to 
279.5   fund the costs related to coordinating access for recipients, 
279.6   developing and implementing patient care criteria, upgrading or 
279.7   establishing new facilities, acquiring furnishings or equipment, 
279.8   recruiting new providers, or other development costs that will 
279.9   improve access to dental care in a region.  In awarding grants, 
279.10  the commissioner shall give priority to applicants that plan to 
279.11  serve areas of the state in which the number of dental providers 
279.12  is not currently sufficient to meet the needs of recipients of 
279.13  public programs or uninsured individuals.  The commissioner 
279.14  shall consider the following in awarding the grants:  (i) 
279.15  potential to successfully increase access to an underserved 
279.16  population; (ii) the ability to raise matching funds; (iii) the 
279.17  long-term viability of the project to improve access beyond the 
279.18  period of initial funding; (iv) the efficiency in the use of the 
279.19  funding; and (v) the experience of the proposers in providing 
279.20  services to the target population. 
279.21     The commissioner shall monitor the grants and may terminate 
279.22  a grant if the grantee does not increase dental access for 
279.23  public program recipients.  The commissioner shall consider 
279.24  grants for the following: 
279.25     (i) implementation of new programs or continued expansion 
279.26  of current access programs that have demonstrated success in 
279.27  providing dental services in underserved areas; 
279.28     (ii) a pilot program for utilizing hygienists outside of a 
279.29  traditional dental office to provide dental hygiene services; 
279.30  and 
279.31     (iii) a program that organizes a network of volunteer 
279.32  dentists, establishes a system to refer eligible individuals to 
279.33  volunteer dentists, and through that network provides donated 
279.34  dental care services to public program recipients or uninsured 
279.35  individuals. 
279.36     (5) beginning October 1, 1999, the payment for tooth 
280.1   sealants and fluoride treatments shall be the lower of (i) 
280.2   submitted charge, or (ii) 80 percent of median 1997 charges; and 
280.3      (6) the increases listed in clauses (3) and (5) shall be 
280.4   implemented January 1, 2000, for managed care. 
280.5      (c) An entity that operates both a Medicare certified 
280.6   comprehensive outpatient rehabilitation facility and a facility 
280.7   which was certified prior to January 1, 1993, that is licensed 
280.8   under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 
280.9   whom at least 33 percent of the clients receiving rehabilitation 
280.10  services in the most recent calendar year are medical assistance 
280.11  recipients, shall be reimbursed by the commissioner for 
280.12  rehabilitation services at rates that are 38 percent greater 
280.13  than the maximum reimbursement rate allowed under paragraph (a), 
280.14  clause (2), when those services are (1) provided within the 
280.15  comprehensive outpatient rehabilitation facility and (2) 
280.16  provided to residents of nursing facilities owned by the entity. 
280.17     Sec. 79.  [256B.765] [PROVIDER RATE INCREASES.] 
280.18     (a) Effective July 1, 2001, within the limits of 
280.19  appropriations specifically for this purpose, the commissioner 
280.20  shall provide an annual inflation adjustment for the providers 
280.21  listed in paragraph (c).  The index for the inflation adjustment 
280.22  must be based on the change in the Employment Cost Index for 
280.23  Private Industry Workers - Total Compensation forecasted by Data 
280.24  Resources, Inc., as forecasted in the fourth quarter of the 
280.25  calendar year preceding the fiscal year.  The commissioner shall 
280.26  increase reimbursement or allocation rates by the percentage of 
280.27  this adjustment, and county boards shall adjust provider 
280.28  contracts as needed. 
280.29     (b) The commissioner of finance shall include an annual 
280.30  inflationary adjustment in reimbursement rates for the providers 
280.31  listed in paragraph (c) using the inflation factor specified in 
280.32  paragraph (a) as a budget change request in each biennial 
280.33  detailed expenditure budget submitted to the legislature under 
280.34  section 16A.11. 
280.35     (c) The annual adjustment under paragraph (a) shall be 
280.36  provided for home and community-based waiver services for 
281.1   persons with mental retardation or related conditions under 
281.2   section 256B.501; home and community-based waiver services for 
281.3   the elderly under section 256B.0915; waivered services under 
281.4   community alternatives for disabled individuals under section 
281.5   256B.49; community alternative care waivered services under 
281.6   section 256B.49; traumatic brain injury waivered services under 
281.7   section 256B.49; nursing services and home health services under 
281.8   section 256B.0625, subdivision 6a; personal care services and 
281.9   nursing supervision of personal care services under section 
281.10  256B.0625, subdivision 19a; private duty nursing services under 
281.11  section 256B.0625, subdivision 7; day training and habilitation 
281.12  services for adults with mental retardation or related 
281.13  conditions under sections 252.40 to 252.46; physical therapy 
281.14  services under sections 256B.0625, subdivision 8, and 256D.03, 
281.15  subdivision 4; occupational therapy services under sections 
281.16  256B.0625, subdivision 8a, and 256D.03, subdivision 4; 
281.17  speech-language therapy services under section 256D.03, 
281.18  subdivision 4, and Minnesota Rules, part 9505.0390; respiratory 
281.19  therapy services under section 256D.03, subdivision 4, and 
281.20  Minnesota Rules, part 9505.0295; alternative care services under 
281.21  section 256B.0913; adult residential program grants under 
281.22  Minnesota Rules, parts 9535.2000 to 9535.3000; adult and family 
281.23  community support grants under Minnesota Rules, parts 9535.1700 
281.24  to 9535.1760; semi-independent living services under section 
281.25  252.275 including SILS funding under county social services 
281.26  grants formerly funded under chapter 256I; and community support 
281.27  services for deaf and hard-of-hearing adults with mental illness 
281.28  who use or wish to use sign language as their primary means of 
281.29  communication. 
281.30     Sec. 80.  Minnesota Statutes 1998, section 256B.77, 
281.31  subdivision 7a, is amended to read: 
281.32     Subd. 7a.  [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 
281.33  for the demonstration project as provided in this subdivision. 
281.34     (b) "Eligible individuals" means those persons living in 
281.35  the demonstration site who are eligible for medical assistance 
281.36  and are disabled based on a disability determination under 
282.1   section 256B.055, subdivisions 7 and 12, or who are eligible for 
282.2   medical assistance and have been diagnosed as having: 
282.3      (1) serious and persistent mental illness as defined in 
282.4   section 245.462, subdivision 20; 
282.5      (2) severe emotional disturbance as defined in section 
282.6   245.487 245.4871, subdivision 6; or 
282.7      (3) mental retardation, or being a mentally retarded person 
282.8   as defined in section 252A.02, or a related condition as defined 
282.9   in section 252.27, subdivision 1a. 
282.10  Other individuals may be included at the option of the county 
282.11  authority based on agreement with the commissioner. 
282.12     (c) Eligible individuals residing on a federally recognized 
282.13  Indian reservation may be excluded from participation in the 
282.14  demonstration project at the discretion of the tribal government 
282.15  based on agreement with the commissioner, in consultation with 
282.16  the county authority. 
282.17     (d) Eligible individuals include individuals in excluded 
282.18  time status, as defined in chapter 256G.  Enrollees in excluded 
282.19  time at the time of enrollment shall remain in excluded time 
282.20  status as long as they live in the demonstration site and shall 
282.21  be eligible for 90 days after placement outside the 
282.22  demonstration site if they move to excluded time status in a 
282.23  county within Minnesota other than their county of financial 
282.24  responsibility. 
282.25     (e) (d) A person who is a sexual psychopathic personality 
282.26  as defined in section 253B.02, subdivision 18a, or a sexually 
282.27  dangerous person as defined in section 253B.02, subdivision 18b, 
282.28  is excluded from enrollment in the demonstration project. 
282.29     Sec. 81.  Minnesota Statutes 1998, section 256B.77, is 
282.30  amended by adding a subdivision to read: 
282.31     Subd. 7b.  [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 
282.32  or after July 1, 1999, for American Indian recipients of medical 
282.33  assistance who are required to enroll with a county 
282.34  administrative entity or service delivery organization under 
282.35  subdivision 7, medical assistance shall cover health care 
282.36  services provided at American Indian health services facilities 
283.1   and facilities operated by a tribe or tribal organization under 
283.2   funding authorized by United States Code, title 25, sections 
283.3   450f to 450n, or title III of the Indian Self-Determination and 
283.4   Education Assistance Act, Public Law Number 93-638, if those 
283.5   services would otherwise be covered under section 256B.0625.  
283.6   Payments for services provided under this subdivision shall be 
283.7   made on a fee-for-service basis, and may, at the option of the 
283.8   tribe or tribal organization, be made according to rates 
283.9   authorized under sections 256.969, subdivision 16, and 
283.10  256B.0625, subdivision 34.  Implementation of this purchasing 
283.11  model is contingent on federal approval. 
283.12     (b) The commissioner of human services, in consultation 
283.13  with tribal governments, shall develop a plan for tribes to 
283.14  assist in the enrollment process for American Indian recipients 
283.15  enrolled in the demonstration project for people with 
283.16  disabilities under this section.  This plan also shall address 
283.17  how tribes will be included in ensuring the coordination of care 
283.18  for American Indian recipients between Indian health service or 
283.19  tribal providers and other providers. 
283.20     (c) For purposes of this subdivision, "American Indian" has 
283.21  the meaning given to persons to whom services will be provided 
283.22  for in Code of Federal Regulations, title 42, section 36.12. 
283.23     Sec. 82.  Minnesota Statutes 1998, section 256B.77, 
283.24  subdivision 8, is amended to read: 
283.25     Subd. 8.  [RESPONSIBILITIES OF THE COUNTY ADMINISTRATIVE 
283.26  ENTITY.] (a) The county administrative entity shall meet the 
283.27  requirements of this subdivision, unless the county authority or 
283.28  the commissioner, with written approval of the county authority, 
283.29  enters into a service delivery contract with a service delivery 
283.30  organization for any or all of the requirements contained in 
283.31  this subdivision. 
283.32     (b) The county administrative entity shall enroll eligible 
283.33  individuals regardless of health or disability status. 
283.34     (c) The county administrative entity shall provide all 
283.35  enrollees timely access to the medical assistance benefit set.  
283.36  Alternative services and additional services are available to 
284.1   enrollees at the option of the county administrative entity and 
284.2   may be provided if specified in the personal support plan.  
284.3   County authorities are not required to seek prior authorization 
284.4   from the department as required by the laws and rules governing 
284.5   medical assistance. 
284.6      (d) The county administrative entity shall cover necessary 
284.7   services as a result of an emergency without prior 
284.8   authorization, even if the services were rendered outside of the 
284.9   provider network. 
284.10     (e) The county administrative entity shall authorize 
284.11  necessary and appropriate services when needed and requested by 
284.12  the enrollee or the enrollee's legal representative in response 
284.13  to an urgent situation.  Enrollees shall have 24-hour access to 
284.14  urgent care services coordinated by experienced disability 
284.15  providers who have information about enrollees' needs and 
284.16  conditions. 
284.17     (f) The county administrative entity shall accept the 
284.18  capitation payment from the commissioner in return for the 
284.19  provision of services for enrollees. 
284.20     (g) The county administrative entity shall maintain 
284.21  internal grievance and complaint procedures, including an 
284.22  expedited informal complaint process in which the county 
284.23  administrative entity must respond to verbal complaints within 
284.24  ten calendar days, and a formal grievance process, in which the 
284.25  county administrative entity must respond to written complaints 
284.26  within 30 calendar days. 
284.27     (h) The county administrative entity shall provide a 
284.28  certificate of coverage, upon enrollment, to each enrollee and 
284.29  the enrollee's legal representative, if any, which describes the 
284.30  benefits covered by the county administrative entity, any 
284.31  limitations on those benefits, and information about providers 
284.32  and the service delivery network.  This information must also be 
284.33  made available to prospective enrollees.  This certificate must 
284.34  be approved by the commissioner. 
284.35     (i) The county administrative entity shall present evidence 
284.36  of an expedited process to approve exceptions to benefits, 
285.1   provider network restrictions, and other plan limitations under 
285.2   appropriate circumstances. 
285.3      (j) The county administrative entity shall provide 
285.4   enrollees or their legal representatives with written notice of 
285.5   their appeal rights under subdivision 16, and of ombudsman and 
285.6   advocacy programs under subdivisions 13 and 14, at the following 
285.7   times:  upon enrollment, upon submission of a written complaint, 
285.8   when a service is reduced, denied, or terminated, or when 
285.9   renewal of authorization for ongoing service is refused. 
285.10     (k) The county administrative entity shall determine 
285.11  immediate needs, including services, support, and assessments, 
285.12  within 30 calendar days of after enrollment, or within a shorter 
285.13  time frame if specified in the intergovernmental contract. 
285.14     (l) The county administrative entity shall assess the need 
285.15  for services of new enrollees within 60 calendar days of after 
285.16  enrollment, or within a shorter time frame if specified in the 
285.17  intergovernmental contract, and periodically reassess the need 
285.18  for services for all enrollees. 
285.19     (m) The county administrative entity shall ensure the 
285.20  development of a personal support plan for each person within 60 
285.21  calendar days of enrollment, or within a shorter time frame if 
285.22  specified in the intergovernmental contract, unless otherwise 
285.23  agreed to by the enrollee and the enrollee's legal 
285.24  representative, if any.  Until a personal support plan is 
285.25  developed and agreed to by the enrollee, enrollees must have 
285.26  access to the same amount, type, setting, duration, and 
285.27  frequency of covered services that they had at the time of 
285.28  enrollment unless other covered services are needed.  For an 
285.29  enrollee who is not receiving covered services at the time of 
285.30  enrollment and for enrollees whose personal support plan is 
285.31  being revised, access to the medical assistance benefit set must 
285.32  be assured until a personal support plan is developed or 
285.33  revised.  If an enrollee chooses not to develop a personal 
285.34  support plan, the enrollee will be subject to the network and 
285.35  prior authorization requirements of the county administrative 
285.36  entity or service delivery organization 60 days after 
286.1   enrollment.  An enrollee can choose to have a personal support 
286.2   plan developed at any time.  The personal support plan must be 
286.3   based on choices, preferences, and assessed needs and strengths 
286.4   of the enrollee.  The service coordinator shall develop the 
286.5   personal support plan, in consultation with the enrollee or the 
286.6   enrollee's legal representative and other individuals requested 
286.7   by the enrollee.  The personal support plan must be updated as 
286.8   needed or as requested by the enrollee.  Enrollees may choose 
286.9   not to have a personal support plan. 
286.10     (n) The county administrative entity shall ensure timely 
286.11  authorization, arrangement, and continuity of needed and covered 
286.12  supports and services. 
286.13     (o) The county administrative entity shall offer service 
286.14  coordination that fulfills the responsibilities under 
286.15  subdivision 12 and is appropriate to the enrollee's needs, 
286.16  choices, and preferences, including a choice of service 
286.17  coordinator. 
286.18     (p) The county administrative entity shall contract with 
286.19  schools and other agencies as appropriate to provide otherwise 
286.20  covered medically necessary medical assistance services as 
286.21  described in an enrollee's individual family support plan, as 
286.22  described in sections 125A.26 to 125A.48, or individual 
286.23  education plan, as described in chapter 125A. 
286.24     (q) The county administrative entity shall develop and 
286.25  implement strategies, based on consultation with affected 
286.26  groups, to respect diversity and ensure culturally competent 
286.27  service delivery in a manner that promotes the physical, social, 
286.28  psychological, and spiritual well-being of enrollees and 
286.29  preserves the dignity of individuals, families, and their 
286.30  communities. 
286.31     (r) When an enrollee changes county authorities, county 
286.32  administrative entities shall ensure coordination with the 
286.33  entity that is assuming responsibility for administering the 
286.34  medical assistance benefit set to ensure continuity of supports 
286.35  and services for the enrollee. 
286.36     (s) The county administrative entity shall comply with 
287.1   additional requirements as specified in the intergovernmental 
287.2   contract.  
287.3      (t) To the extent that alternatives are approved under 
287.4   subdivision 17, county administrative entities must provide for 
287.5   the health and safety of enrollees and protect the rights to 
287.6   privacy and to provide informed consent. 
287.7      Sec. 83.  Minnesota Statutes 1998, section 256B.77, 
287.8   subdivision 10, is amended to read: 
287.9      Subd. 10.  [CAPITATION PAYMENT.] (a) The commissioner shall 
287.10  pay a capitation payment to the county authority and, when 
287.11  applicable under subdivision 6, paragraph (a), to the service 
287.12  delivery organization for each medical assistance eligible 
287.13  enrollee.  The commissioner shall develop capitation payment 
287.14  rates for the initial contract period for each demonstration 
287.15  site in consultation with an independent actuary, to ensure that 
287.16  the cost of services under the demonstration project does not 
287.17  exceed the estimated cost for medical assistance services for 
287.18  the covered population under the fee-for-service system for the 
287.19  demonstration period.  For each year of the demonstration 
287.20  project, the capitation payment rate shall be based on 96 
287.21  percent of the projected per person costs that would otherwise 
287.22  have been paid under medical assistance fee-for-service during 
287.23  each of those years.  Rates shall be adjusted within the limits 
287.24  of the available risk adjustment technology, as mandated by 
287.25  section 62Q.03.  In addition, the commissioner shall implement 
287.26  appropriate risk and savings sharing provisions with county 
287.27  administrative entities and, when applicable under subdivision 
287.28  6, paragraph (a), service delivery organizations within the 
287.29  projected budget limits.  Capitation rates shall be adjusted, at 
287.30  least annually, to include any rate increases and payments for 
287.31  expanded or newly covered services for eligible individuals.  
287.32  The initial demonstration project rate shall include an amount 
287.33  in addition to the fee-for-service payments to adjust for 
287.34  underutilization of dental services.  Any savings beyond those 
287.35  allowed for the county authority, county administrative entity, 
287.36  or service delivery organization shall be first used to meet the 
288.1   unmet needs of eligible individuals.  Payments to providers 
288.2   participating in the project are exempt from the requirements of 
288.3   sections 256.966 and 256B.03, subdivision 2. 
288.4      (b) The commissioner shall monitor and evaluate annually 
288.5   the effect of the discount on consumers, the county authority, 
288.6   and providers of disability services.  Findings shall be 
288.7   reported and recommendations made, as appropriate, to ensure 
288.8   that the discount effect does not adversely affect the ability 
288.9   of the county administrative entity or providers of services to 
288.10  provide appropriate services to eligible individuals, and does 
288.11  not result in cost shifting of eligible individuals to the 
288.12  county authority. 
288.13     (c) For risk-sharing to occur under this subdivision, the 
288.14  aggregate fee-for-service cost of covered services provided by 
288.15  the county administrative entity under this section must exceed 
288.16  the aggregate sum of capitation payments made to the county 
288.17  administrative entity under this section.  The county authority 
288.18  is required to maintain its current level of nonmedical 
288.19  assistance spending on enrollees.  If the county authority 
288.20  spends less in nonmedical assistance dollars on enrollees than 
288.21  it spent the year prior to the contract year, the amount of 
288.22  underspending shall be deducted from the aggregate 
288.23  fee-for-service cost of covered services.  The commissioner 
288.24  shall then compare the fee-for-service costs and capitation 
288.25  payments related to the services provided for the term of this 
288.26  contract.  The commissioner shall base its calculation of the 
288.27  fee-for-service costs on application of the medical assistance 
288.28  fee schedule to services identified on the county administrative 
288.29  entity's encounter claims submitted to the commissioner.  The 
288.30  aggregate fee-for-service cost shall not include any third-party 
288.31  recoveries or cost-avoided amounts. 
288.32     If the commissioner finds that the aggregate 
288.33  fee-for-service cost is greater than the sum of the capitation 
288.34  payments, the commissioner shall settle according to the 
288.35  following schedule: 
288.36     (1) For the first contract year for each project, the 
289.1   commissioner shall pay the county administrative entity 50 
289.2   percent of the difference between the sum of the capitation 
289.3   payments and 100 percent of projected fee-for-service costs.  
289.4   For aggregate fee-for-service costs in excess of 100 percent of 
289.5   projected fee-for-service costs, the commissioner shall pay 250 
289.6   percent of the difference between the aggregate fee-for-service 
289.7   cost and the projected fee-for-service cost, up to 104 percent 
289.8   of the projected fee-for-service costs.  The county 
289.9   administrative entity shall be responsible for all costs in 
289.10  excess of 104 percent of projected fee-for-service costs. 
289.11     (2) For the second contract year for each project, the 
289.12  commissioner shall pay the county administrative entity 37.5 
289.13  percent of the difference between the sum of the capitation 
289.14  payments and 100 percent of projected fee-for-service costs.  
289.15  The county administrative entity shall be responsible for all 
289.16  costs in excess of 100 percent of projected fee-for-service 
289.17  costs. 
289.18     (3) For the third contract year for each project, the 
289.19  commissioner shall pay the county administrative entity 25 
289.20  percent of the difference between the sum of the capitation 
289.21  payments and 100 percent of projected fee-for-service costs.  
289.22  The county administrative entity shall be responsible for all 
289.23  costs in excess of 100 percent of projected fee-for-service 
289.24  costs. 
289.25     (4) For the fourth and subsequent contract years for each 
289.26  project, the county administrative entity shall be responsible 
289.27  for all costs in excess of the capitation payments. 
289.28     (d) In addition to other payments under this subdivision, 
289.29  the commissioner may increase payments by up to 0.25 percent of 
289.30  the projected per person costs that would otherwise have been 
289.31  paid under medical assistance fee-for-service.  The commissioner 
289.32  may make the increased payments to: 
289.33     (1) offset rate increases for regional treatment services 
289.34  under subdivision 22 which are higher than was expected by the 
289.35  commissioner when the capitation was set at 96 percent; and 
289.36     (2) implement incentives to encourage appropriate, high 
290.1   quality, efficient services. 
290.2      Sec. 84.  Minnesota Statutes 1998, section 256B.77, 
290.3   subdivision 14, is amended to read: 
290.4      Subd. 14.  [EXTERNAL ADVOCACY.] In addition to ombudsman 
290.5   services, enrollees shall have access to advocacy services on a 
290.6   local or regional basis.  The purpose of external advocacy 
290.7   includes providing individual advocacy services for enrollees 
290.8   who have complaints or grievances with the county administrative 
290.9   entity, service delivery organization, or a service provider; 
290.10  assisting enrollees to understand the service delivery system 
290.11  and select providers and, if applicable, a service delivery 
290.12  organization; and understand and exercise their rights as an 
290.13  enrollee.  External advocacy contractors must demonstrate that 
290.14  they have the expertise to advocate on behalf of all categories 
290.15  of eligible individuals and are independent of the commissioner, 
290.16  county authority, county administrative entity, service delivery 
290.17  organization, or any service provider within the demonstration 
290.18  project.  
290.19     These advocacy services shall be provided through the 
290.20  ombudsman for mental health and mental retardation directly, or 
290.21  under contract with private, nonprofit organizations, with 
290.22  funding provided through the demonstration project.  The funding 
290.23  shall be provided annually to the ombudsman's office based on 
290.24  0.1 percent of the projected per person costs that would 
290.25  otherwise have been paid under medical assistance 
290.26  fee-for-service during those years.  Funding for external 
290.27  advocacy shall be provided for each year of the demonstration 
290.28  period through general fund appropriations.  This funding is in 
290.29  addition to the capitation payment available under subdivision 
290.30  10. 
290.31     Sec. 85.  Minnesota Statutes 1998, section 256B.77, is 
290.32  amended by adding a subdivision to read: 
290.33     Subd. 27.  [SERVICE COORDINATION TRANSITION.] Demonstration 
290.34  sites designated under subdivision 5, with the permission of an 
290.35  eligible individual, may implement the provisions of subdivision 
290.36  12 beginning 60 calendar days prior to an individual's 
291.1   enrollment.  This implementation may occur prior to the 
291.2   enrollment of eligible individuals, but is restricted to 
291.3   eligible individuals. 
291.4      Sec. 86.  Minnesota Statutes 1998, section 256D.03, 
291.5   subdivision 3, is amended to read: 
291.6      Subd. 3.  [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 
291.7   (a) General assistance medical care may be paid for any person 
291.8   who is not eligible for medical assistance under chapter 256B, 
291.9   including eligibility for medical assistance based on a 
291.10  spenddown of excess income according to section 256B.056, 
291.11  subdivision 5, or MinnesotaCare as defined in paragraph (b), 
291.12  except as provided in paragraph (c); and: 
291.13     (1) who is receiving assistance under section 256D.05, 
291.14  except for families with children who are eligible under 
291.15  Minnesota family investment program-statewide (MFIP-S), who is 
291.16  having a payment made on the person's behalf under sections 
291.17  256I.01 to 256I.06, or who resides in group residential housing 
291.18  as defined in chapter 256I and can meet a spenddown using the 
291.19  cost of remedial services received through group residential 
291.20  housing; or 
291.21     (2)(i) who is a resident of Minnesota; and whose equity in 
291.22  assets is not in excess of $1,000 per assistance unit.  Exempt 
291.23  assets, the reduction of excess assets, and the waiver of excess 
291.24  assets must conform to the medical assistance program in chapter 
291.25  256B, with the following exception:  the maximum amount of 
291.26  undistributed funds in a trust that could be distributed to or 
291.27  on behalf of the beneficiary by the trustee, assuming the full 
291.28  exercise of the trustee's discretion under the terms of the 
291.29  trust, must be applied toward the asset maximum; and 
291.30     (ii) who has countable income not in excess of the 
291.31  assistance standards established in section 256B.056, 
291.32  subdivision 4, or whose excess income is spent down according to 
291.33  section 256B.056, subdivision 5, using a six-month budget 
291.34  period.  The method for calculating earned income disregards and 
291.35  deductions for a person who resides with a dependent child under 
291.36  age 21 shall follow section 256B.056, subdivision 1a.  However, 
292.1   if a disregard of $30 and one-third of the remainder has been 
292.2   applied to the wage earner's income, the disregard shall not be 
292.3   applied again until the wage earner's income has not been 
292.4   considered in an eligibility determination for general 
292.5   assistance, general assistance medical care, medical assistance, 
292.6   or MFIP-S for 12 consecutive months.  The earned income and work 
292.7   expense deductions for a person who does not reside with a 
292.8   dependent child under age 21 shall be the same as the method 
292.9   used to determine eligibility for a person under section 
292.10  256D.06, subdivision 1, except the disregard of the first $50 of 
292.11  earned income is not allowed; 
292.12     (3) who would be eligible for medical assistance except 
292.13  that the person resides in a facility that is determined by the 
292.14  commissioner or the federal Health Care Financing Administration 
292.15  to be an institution for mental diseases; or 
292.16     (4) who is ineligible for medical assistance under chapter 
292.17  256B or general assistance medical care under any other 
292.18  provision of this section, and is receiving care and 
292.19  rehabilitation services from a nonprofit center established to 
292.20  serve victims of torture.  These individuals are eligible for 
292.21  general assistance medical care only for the period during which 
292.22  they are receiving services from the center.  During this period 
292.23  of eligibility, individuals eligible under this clause shall not 
292.24  be required to participate in prepaid general assistance medical 
292.25  care.  
292.26     (b) Beginning January 1, 2000, applicants or recipients who 
292.27  meet all eligibility requirements of MinnesotaCare as defined in 
292.28  sections 256L.01 to 256L.16, and are: 
292.29     (i) adults with dependent children under 21 whose gross 
292.30  family income is equal to or less than 275 percent of the 
292.31  federal poverty guidelines; or 
292.32     (ii) adults without children with earned income and whose 
292.33  family gross income is between 75 percent of the federal poverty 
292.34  guidelines and the amount set by section 256L.04, subdivision 7, 
292.35  shall be terminated from general assistance medical care upon 
292.36  enrollment in MinnesotaCare. 
293.1      (c) For services rendered on or after July 1, 1997, 
293.2   eligibility is limited to one month prior to application if the 
293.3   person is determined eligible in the prior month.  A 
293.4   redetermination of eligibility must occur every 12 months.  
293.5   Beginning January 1, 2000, Minnesota health care program 
293.6   applications completed by recipients and applicants who are 
293.7   persons described in paragraph (b), may be returned to the 
293.8   county agency to be forwarded to the department of human 
293.9   services or sent directly to the department of human services 
293.10  for enrollment in MinnesotaCare.  If all other eligibility 
293.11  requirements of this subdivision are met, eligibility for 
293.12  general assistance medical care shall be available in any month 
293.13  during which a MinnesotaCare eligibility determination and 
293.14  enrollment are pending.  Upon notification of eligibility for 
293.15  MinnesotaCare, notice of termination for eligibility for general 
293.16  assistance medical care shall be sent to an applicant or 
293.17  recipient.  If all other eligibility requirements of this 
293.18  subdivision are met, eligibility for general assistance medical 
293.19  care shall be available until enrollment in MinnesotaCare 
293.20  subject to the provisions of paragraph (e). 
293.21     (d) The date of an initial Minnesota health care program 
293.22  application necessary to begin a determination of eligibility 
293.23  shall be the date the applicant has provided a name, address, 
293.24  and social security number, signed and dated, to the county 
293.25  agency or the department of human services.  If the applicant is 
293.26  unable to provide an initial application when health care is 
293.27  delivered due to a medical condition or disability, a health 
293.28  care provider may act on the person's behalf to complete the 
293.29  initial application.  The applicant must complete the remainder 
293.30  of the application and provide necessary verification before 
293.31  eligibility can be determined.  The county agency must assist 
293.32  the applicant in obtaining verification if necessary.  On the 
293.33  basis of information provided on the completed application, an 
293.34  applicant who meets the following criteria shall be determined 
293.35  eligible beginning in the month of application: 
293.36     (1) has gross income less than 90 percent of the applicable 
294.1   income standard; 
294.2      (2) has liquid assets that total within $300 of the asset 
294.3   standard; 
294.4      (3) does not reside in a long-term care facility; and 
294.5      (4) meets all other eligibility requirements. 
294.6   The applicant must provide all required verifications within 30 
294.7   days' notice of the eligibility determination or eligibility 
294.8   shall be terminated. 
294.9      (e) County agencies are authorized to use all automated 
294.10  databases containing information regarding recipients' or 
294.11  applicants' income in order to determine eligibility for general 
294.12  assistance medical care or MinnesotaCare.  Such use shall be 
294.13  considered sufficient in order to determine eligibility and 
294.14  premium payments by the county agency. 
294.15     (f) General assistance medical care is not available for a 
294.16  person in a correctional facility unless the person is detained 
294.17  by law for less than one year in a county correctional or 
294.18  detention facility as a person accused or convicted of a crime, 
294.19  or admitted as an inpatient to a hospital on a criminal hold 
294.20  order, and the person is a recipient of general assistance 
294.21  medical care at the time the person is detained by law or 
294.22  admitted on a criminal hold order and as long as the person 
294.23  continues to meet other eligibility requirements of this 
294.24  subdivision.  
294.25     (g) General assistance medical care is not available for 
294.26  applicants or recipients who do not cooperate with the county 
294.27  agency to meet the requirements of medical assistance.  General 
294.28  assistance medical care is limited to payment of emergency 
294.29  services only for applicants or recipients as described in 
294.30  paragraph (b), whose MinnesotaCare coverage is denied or 
294.31  terminated for nonpayment of premiums as required by sections 
294.32  256L.06 and 256L.07.  
294.33     (h) In determining the amount of assets of an individual, 
294.34  there shall be included any asset or interest in an asset, 
294.35  including an asset excluded under paragraph (a), that was given 
294.36  away, sold, or disposed of for less than fair market value 
295.1   within the 60 months preceding application for general 
295.2   assistance medical care or during the period of eligibility.  
295.3   Any transfer described in this paragraph shall be presumed to 
295.4   have been for the purpose of establishing eligibility for 
295.5   general assistance medical care, unless the individual furnishes 
295.6   convincing evidence to establish that the transaction was 
295.7   exclusively for another purpose.  For purposes of this 
295.8   paragraph, the value of the asset or interest shall be the fair 
295.9   market value at the time it was given away, sold, or disposed 
295.10  of, less the amount of compensation received.  For any 
295.11  uncompensated transfer, the number of months of ineligibility, 
295.12  including partial months, shall be calculated by dividing the 
295.13  uncompensated transfer amount by the average monthly per person 
295.14  payment made by the medical assistance program to skilled 
295.15  nursing facilities for the previous calendar year.  The 
295.16  individual shall remain ineligible until this fixed period has 
295.17  expired.  The period of ineligibility may exceed 30 months, and 
295.18  a reapplication for benefits after 30 months from the date of 
295.19  the transfer shall not result in eligibility unless and until 
295.20  the period of ineligibility has expired.  The period of 
295.21  ineligibility begins in the month the transfer was reported to 
295.22  the county agency, or if the transfer was not reported, the 
295.23  month in which the county agency discovered the transfer, 
295.24  whichever comes first.  For applicants, the period of 
295.25  ineligibility begins on the date of the first approved 
295.26  application. 
295.27     (i) When determining eligibility for any state benefits 
295.28  under this subdivision, the income and resources of all 
295.29  noncitizens shall be deemed to include their sponsor's income 
295.30  and resources as defined in the Personal Responsibility and Work 
295.31  Opportunity Reconciliation Act of 1996, title IV, Public Law 
295.32  Number 104-193, sections 421 and 422, and subsequently set out 
295.33  in federal rules. 
295.34     (j)(1) An undocumented noncitizen or a nonimmigrant is 
295.35  ineligible for general assistance medical care other than 
295.36  emergency services.  For purposes of this subdivision, a 
296.1   nonimmigrant is an individual in one or more of the classes 
296.2   listed in United States Code, title 8, section 1101(a)(15), and 
296.3   an undocumented noncitizen is an individual who resides in the 
296.4   United States without the approval or acquiescence of the 
296.5   Immigration and Naturalization Service. 
296.6      (2) This paragraph does not apply to a child under age 18, 
296.7   to a Cuban or Haitian entrant as defined in Public Law Number 
296.8   96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 
296.9   aged, blind, or disabled as defined in Code of Federal 
296.10  Regulations, title 42, sections 435.520, 435.530, 435.531, 
296.11  435.540, and 435.541, or effective October 1, 1998, to an 
296.12  individual eligible for general assistance medical care under 
296.13  paragraph (a), clause (4), who cooperates with the Immigration 
296.14  and Naturalization Service to pursue any applicable immigration 
296.15  status, including citizenship, that would qualify the individual 
296.16  for medical assistance with federal financial participation. 
296.17     (3) For purposes of this paragraph, "emergency services" 
296.18  has the meaning given in Code of Federal Regulations, title 42, 
296.19  section 440.255(b)(1), except that it also means services 
296.20  rendered because of suspected or actual pesticide poisoning. 
296.21     (k) Notwithstanding any other provision of law, a 
296.22  noncitizen who is ineligible for medical assistance due to the 
296.23  deeming of a sponsor's income and resources, is ineligible for 
296.24  general assistance medical care. 
296.25     Sec. 87.  Minnesota Statutes 1998, section 256D.03, 
296.26  subdivision 4, is amended to read: 
296.27     Subd. 4.  [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 
296.28  For a person who is eligible under subdivision 3, paragraph (a), 
296.29  clause (3), general assistance medical care covers, except as 
296.30  provided in paragraph (c): 
296.31     (1) inpatient hospital services; 
296.32     (2) outpatient hospital services; 
296.33     (3) services provided by Medicare certified rehabilitation 
296.34  agencies; 
296.35     (4) prescription drugs and other products recommended 
296.36  through the process established in section 256B.0625, 
297.1   subdivision 13; 
297.2      (5) equipment necessary to administer insulin and 
297.3   diagnostic supplies and equipment for diabetics to monitor blood 
297.4   sugar level; 
297.5      (6) eyeglasses and eye examinations provided by a physician 
297.6   or optometrist; 
297.7      (7) hearing aids; 
297.8      (8) prosthetic devices; 
297.9      (9) laboratory and X-ray services; 
297.10     (10) physician's services; 
297.11     (11) medical transportation; 
297.12     (12) chiropractic services as covered under the medical 
297.13  assistance program; 
297.14     (13) podiatric services; 
297.15     (14) dental services; 
297.16     (15) outpatient services provided by a mental health center 
297.17  or clinic that is under contract with the county board and is 
297.18  established under section 245.62; 
297.19     (16) day treatment services for mental illness provided 
297.20  under contract with the county board; 
297.21     (17) prescribed medications for persons who have been 
297.22  diagnosed as mentally ill as necessary to prevent more 
297.23  restrictive institutionalization; 
297.24     (18) psychological services, medical supplies and 
297.25  equipment, and Medicare premiums, coinsurance and deductible 
297.26  payments; 
297.27     (19) medical equipment not specifically listed in this 
297.28  paragraph when the use of the equipment will prevent the need 
297.29  for costlier services that are reimbursable under this 
297.30  subdivision; 
297.31     (20) services performed by a certified pediatric nurse 
297.32  practitioner, a certified family nurse practitioner, a certified 
297.33  adult nurse practitioner, a certified obstetric/gynecological 
297.34  nurse practitioner, a certified neonatal nurse practitioner, or 
297.35  a certified geriatric nurse practitioner in independent 
297.36  practice, if (1) the services are service is otherwise covered 
298.1   under this chapter as a physician service, (2) a service 
298.2   provided on an inpatient basis is not included as part of the 
298.3   cost for inpatient services included in the operating payment 
298.4   rate, and if (3) the service is within the scope of practice of 
298.5   the nurse practitioner's license as a registered nurse, as 
298.6   defined in section 148.171; and 
298.7      (21) services of a certified public health nurse or a 
298.8   registered nurse practicing in a public health nursing clinic 
298.9   that is a department of, or that operates under the direct 
298.10  authority of, a unit of government, if the service is within the 
298.11  scope of practice of the public health nurse's license as a 
298.12  registered nurse, as defined in section 148.171; and 
298.13     (22) telemedicine consultations, to the extent they are 
298.14  covered under section 256B.0625, subdivision 3b.  
298.15     (b) Except as provided in paragraph (c), for a recipient 
298.16  who is eligible under subdivision 3, paragraph (a), clause (1) 
298.17  or (2), general assistance medical care covers the services 
298.18  listed in paragraph (a) with the exception of special 
298.19  transportation services. 
298.20     (c) Gender reassignment surgery and related services are 
298.21  not covered services under this subdivision unless the 
298.22  individual began receiving gender reassignment services prior to 
298.23  July 1, 1995.  
298.24     (d) In order to contain costs, the commissioner of human 
298.25  services shall select vendors of medical care who can provide 
298.26  the most economical care consistent with high medical standards 
298.27  and shall where possible contract with organizations on a 
298.28  prepaid capitation basis to provide these services.  The 
298.29  commissioner shall consider proposals by counties and vendors 
298.30  for prepaid health plans, competitive bidding programs, block 
298.31  grants, or other vendor payment mechanisms designed to provide 
298.32  services in an economical manner or to control utilization, with 
298.33  safeguards to ensure that necessary services are provided.  
298.34  Before implementing prepaid programs in counties with a county 
298.35  operated or affiliated public teaching hospital or a hospital or 
298.36  clinic operated by the University of Minnesota, the commissioner 
299.1   shall consider the risks the prepaid program creates for the 
299.2   hospital and allow the county or hospital the opportunity to 
299.3   participate in the program in a manner that reflects the risk of 
299.4   adverse selection and the nature of the patients served by the 
299.5   hospital, provided the terms of participation in the program are 
299.6   competitive with the terms of other participants considering the 
299.7   nature of the population served.  Payment for services provided 
299.8   pursuant to this subdivision shall be as provided to medical 
299.9   assistance vendors of these services under sections 256B.02, 
299.10  subdivision 8, and 256B.0625.  For payments made during fiscal 
299.11  year 1990 and later years, the commissioner shall consult with 
299.12  an independent actuary in establishing prepayment rates, but 
299.13  shall retain final control over the rate methodology.  
299.14  Notwithstanding the provisions of subdivision 3, an individual 
299.15  who becomes ineligible for general assistance medical care 
299.16  because of failure to submit income reports or recertification 
299.17  forms in a timely manner, shall remain enrolled in the prepaid 
299.18  health plan and shall remain eligible for general assistance 
299.19  medical care coverage through the last day of the month in which 
299.20  the enrollee became ineligible for general assistance medical 
299.21  care. 
299.22     (e) The commissioner of human services may reduce payments 
299.23  provided under sections 256D.01 to 256D.21 and 261.23 in order 
299.24  to remain within the amount appropriated for general assistance 
299.25  medical care, within the following restrictions: 
299.26     (i) For the period July 1, 1985 to December 31, 1985, 
299.27  reductions below the cost per service unit allowable under 
299.28  section 256.966, are permitted only as follows:  payments for 
299.29  inpatient and outpatient hospital care provided in response to a 
299.30  primary diagnosis of chemical dependency or mental illness may 
299.31  be reduced no more than 30 percent; payments for all other 
299.32  inpatient hospital care may be reduced no more than 20 percent.  
299.33  Reductions below the payments allowable under general assistance 
299.34  medical care for the remaining general assistance medical care 
299.35  services allowable under this subdivision may be reduced no more 
299.36  than ten percent. 
300.1      (ii) For the period January 1, 1986 to December 31, 1986, 
300.2   reductions below the cost per service unit allowable under 
300.3   section 256.966 are permitted only as follows:  payments for 
300.4   inpatient and outpatient hospital care provided in response to a 
300.5   primary diagnosis of chemical dependency or mental illness may 
300.6   be reduced no more than 20 percent; payments for all other 
300.7   inpatient hospital care may be reduced no more than 15 percent.  
300.8   Reductions below the payments allowable under general assistance 
300.9   medical care for the remaining general assistance medical care 
300.10  services allowable under this subdivision may be reduced no more 
300.11  than five percent. 
300.12     (iii) For the period January 1, 1987 to June 30, 1987, 
300.13  reductions below the cost per service unit allowable under 
300.14  section 256.966 are permitted only as follows:  payments for 
300.15  inpatient and outpatient hospital care provided in response to a 
300.16  primary diagnosis of chemical dependency or mental illness may 
300.17  be reduced no more than 15 percent; payments for all other 
300.18  inpatient hospital care may be reduced no more than ten 
300.19  percent.  Reductions below the payments allowable under medical 
300.20  assistance for the remaining general assistance medical care 
300.21  services allowable under this subdivision may be reduced no more 
300.22  than five percent.  
300.23     (iv) For the period July 1, 1987 to June 30, 1988, 
300.24  reductions below the cost per service unit allowable under 
300.25  section 256.966 are permitted only as follows:  payments for 
300.26  inpatient and outpatient hospital care provided in response to a 
300.27  primary diagnosis of chemical dependency or mental illness may 
300.28  be reduced no more than 15 percent; payments for all other 
300.29  inpatient hospital care may be reduced no more than five percent.
300.30  Reductions below the payments allowable under medical assistance 
300.31  for the remaining general assistance medical care services 
300.32  allowable under this subdivision may be reduced no more than 
300.33  five percent. 
300.34     (v) For the period July 1, 1988 to June 30, 1989, 
300.35  reductions below the cost per service unit allowable under 
300.36  section 256.966 are permitted only as follows:  payments for 
301.1   inpatient and outpatient hospital care provided in response to a 
301.2   primary diagnosis of chemical dependency or mental illness may 
301.3   be reduced no more than 15 percent; payments for all other 
301.4   inpatient hospital care may not be reduced.  Reductions below 
301.5   the payments allowable under medical assistance for the 
301.6   remaining general assistance medical care services allowable 
301.7   under this subdivision may be reduced no more than five percent. 
301.8      (f) There shall be no copayment required of any recipient 
301.9   of benefits for any services provided under this subdivision.  A 
301.10  hospital receiving a reduced payment as a result of this section 
301.11  may apply the unpaid balance toward satisfaction of the 
301.12  hospital's bad debts. 
301.13     (g) Any county may, from its own resources, provide medical 
301.14  payments for which state payments are not made. 
301.15     (h) Chemical dependency services that are reimbursed under 
301.16  chapter 254B must not be reimbursed under general assistance 
301.17  medical care. 
301.18     (i) The maximum payment for new vendors enrolled in the 
301.19  general assistance medical care program after the base year 
301.20  shall be determined from the average usual and customary charge 
301.21  of the same vendor type enrolled in the base year. 
301.22     (j) The conditions of payment for services under this 
301.23  subdivision are the same as the conditions specified in rules 
301.24  adopted under chapter 256B governing the medical assistance 
301.25  program, unless otherwise provided by statute or rule. 
301.26     Sec. 88.  Minnesota Statutes 1998, section 256D.03, 
301.27  subdivision 8, is amended to read: 
301.28     Subd. 8.  [PRIVATE INSURANCE POLICIES.] (a) Private 
301.29  accident and health care coverage for medical services is 
301.30  primary coverage and must be exhausted before general assistance 
301.31  medical care is paid.  When a person who is otherwise eligible 
301.32  for general assistance medical care has private accident or 
301.33  health care coverage, including a prepaid health plan, the 
301.34  private health care benefits available to the person must be 
301.35  used first and to the fullest extent.  General assistance 
301.36  medical care payment will not be made when either covered 
302.1   charges are paid in full by a third party or the provider has an 
302.2   agreement to accept payment for less than charges as payment in 
302.3   full.  Payment for patients that are simultaneously covered by 
302.4   general assistance medical care and a liable third party other 
302.5   than Medicare will be determined as the lesser of clauses (1) to 
302.6   (3): 
302.7      (1) the patient liability according to the provider/insurer 
302.8   agreement; 
302.9      (2) covered charges minus the third party payment amount; 
302.10  or 
302.11     (3) the general assistance medical care rate minus the 
302.12  third party payment amount. 
302.13  A negative difference will not be implemented. 
302.14     (b) When a parent or a person with an obligation of support 
302.15  has enrolled in a prepaid health care plan under section 
302.16  518.171, subdivision 1, the commissioner of human services shall 
302.17  limit the recipient of general assistance medical care to the 
302.18  benefits payable under that prepaid health care plan to the 
302.19  extent that services available under general assistance medical 
302.20  care are also available under the prepaid health care plan.  
302.21     (c) Upon furnishing general assistance medical care or 
302.22  general assistance to any person having private accident or 
302.23  health care coverage, or having a cause of action arising out of 
302.24  an occurrence that necessitated the payment of assistance, the 
302.25  state agency shall be subrogated, to the extent of the cost of 
302.26  medical care, subsistence, or other payments furnished, to any 
302.27  rights the person may have under the terms of the coverage or 
302.28  under the cause of action.  For purposes of this subdivision, 
302.29  "state agency" includes prepaid health plans under contract with 
302.30  the commissioner according to sections 256B.69, 256D.03, 
302.31  subdivision 4, paragraph (d), and 256L.12; children's mental 
302.32  health collaboratives under section 245.493; demonstration 
302.33  projects for persons with disabilities under section 256B.77; 
302.34  nursing homes under the alternative payment demonstration 
302.35  project under section 256B.434; and county-based purchasing 
302.36  entities under section 256B.692. 
303.1      This right of subrogation includes all portions of the 
303.2   cause of action, notwithstanding any settlement allocation or 
303.3   apportionment that purports to dispose of portions of the cause 
303.4   of action not subject to subrogation.  
303.5      (d) To recover under this section, the attorney general or 
303.6   the appropriate county attorney, acting upon direction from the 
303.7   attorney general, may institute or join a civil action to 
303.8   enforce the subrogation rights the commissioner established 
303.9   under this section.  
303.10     Any prepaid health plan providing services under sections 
303.11  256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 
303.12  children's mental health collaboratives under section 245.493; 
303.13  demonstration projects for persons with disabilities under 
303.14  section 256B.77; nursing homes under the alternative payment 
303.15  demonstration project under section 256B.434; or the 
303.16  county-based purchasing entity providing services under section 
303.17  256B.692 may retain legal representation to enforce the 
303.18  subrogation rights created under this section or, if no action 
303.19  has been brought, may initiate and prosecute an independent 
303.20  action on their behalf against a person, firm, or corporation 
303.21  that may be liable to the person to whom the care or payment was 
303.22  furnished. 
303.23     (e) The state agency must be given notice of monetary 
303.24  claims against a person, firm, or corporation that may be liable 
303.25  in damages, or otherwise obligated to pay part or all of the 
303.26  costs related to an injury when the state agency has paid or 
303.27  become liable for the cost of care or payments related to the 
303.28  injury.  Notice must be given as follows:  
303.29     (i) Applicants for general assistance or general assistance 
303.30  medical care shall notify the state or county agency of any 
303.31  possible claims when they submit the application.  Recipients of 
303.32  general assistance or general assistance medical care shall 
303.33  notify the state or county agency of any possible claims when 
303.34  those claims arise.  
303.35     (ii) A person providing medical care services to a 
303.36  recipient of general assistance medical care shall notify the 
304.1   state agency when the person has reason to believe that a third 
304.2   party may be liable for payment of the cost of medical care.  
304.3      (iii) A person who is party to a claim upon which the state 
304.4   agency may be entitled to subrogation under this section shall 
304.5   notify the state agency of its potential subrogation claim 
304.6   before filing a claim, commencing an action, or negotiating a 
304.7   settlement.  A person who is a party to a claim includes the 
304.8   plaintiff, the defendants, and any other party to the cause of 
304.9   action. 
304.10     Notice given to the county agency is not sufficient to meet 
304.11  the requirements of paragraphs (b) and (c).  
304.12     (f) Upon any judgment, award, or settlement of a cause of 
304.13  action, or any part of it, upon which the state agency has a 
304.14  subrogation right, including compensation for liquidated, 
304.15  unliquidated, or other damages, reasonable costs of collection, 
304.16  including attorney fees, must be deducted first.  The full 
304.17  amount of general assistance or general assistance medical care 
304.18  paid to or on behalf of the person as a result of the injury 
304.19  must be deducted next and paid to the state agency.  The rest 
304.20  must be paid to the public assistance recipient or other 
304.21  plaintiff.  The plaintiff, however, must receive at least 
304.22  one-third of the net recovery after attorney fees and collection 
304.23  costs. 
304.24     Sec. 89.  Minnesota Statutes 1998, section 256L.03, 
304.25  subdivision 5, is amended to read: 
304.26     Subd. 5.  [COPAYMENTS AND COINSURANCE.] (a) The 
304.27  MinnesotaCare benefit plan shall include the following 
304.28  copayments and coinsurance requirements for all enrollees except 
304.29  parents and relative caretakers of children under the age of 21 
304.30  in households with income at or below 175 percent of the federal 
304.31  poverty guidelines and pregnant women and children under the age 
304.32  of 21:  
304.33     (1) ten percent of the paid charges for inpatient hospital 
304.34  services for adult enrollees, subject to an annual inpatient 
304.35  out-of-pocket maximum of $1,000 per individual and $3,000 per 
304.36  family; 
305.1      (2) $3 per prescription for adult enrollees; 
305.2      (3) $25 for eyeglasses for adult enrollees; and 
305.3      (4) effective July 1, 1998, 50 percent of the 
305.4   fee-for-service rate for adult dental care services other than 
305.5   preventive care services for persons eligible under section 
305.6   256L.04, subdivisions 1 to 7, with income equal to or less than 
305.7   175 percent of the federal poverty guidelines. 
305.8      The exceptions described in this paragraph shall only be 
305.9   implemented if required to obtain federal Medicaid funding for 
305.10  these individuals and shall expire July 1, 2000. 
305.11     (b) Effective July 1, 1997, adult enrollees with family 
305.12  gross income that exceeds 175 percent of the federal poverty 
305.13  guidelines and who are not pregnant shall be financially 
305.14  responsible for the coinsurance amount and amounts which exceed 
305.15  the $10,000 inpatient hospital benefit limit. 
305.16     (c) When a MinnesotaCare enrollee becomes a member of a 
305.17  prepaid health plan, or changes from one prepaid health plan to 
305.18  another during a calendar year, any charges submitted towards 
305.19  the $10,000 annual inpatient benefit limit, and any 
305.20  out-of-pocket expenses incurred by the enrollee for inpatient 
305.21  services, that were submitted or incurred prior to enrollment, 
305.22  or prior to the change in health plans, shall be disregarded. 
305.23     Sec. 90.  Minnesota Statutes 1998, section 256L.03, 
305.24  subdivision 6, is amended to read: 
305.25     Subd. 6.  [LIEN.] When the state agency provides, pays for, 
305.26  or becomes liable for covered health services, the agency shall 
305.27  have a lien for the cost of the covered health services upon any 
305.28  and all causes of action accruing to the enrollee, or to the 
305.29  enrollee's legal representatives, as a result of the occurrence 
305.30  that necessitated the payment for the covered health services.  
305.31  All liens under this section shall be subject to the provisions 
305.32  of section 256.015.  For purposes of this subdivision, "state 
305.33  agency" includes authorized agents of the state agency prepaid 
305.34  health plans under contract with the commissioner according to 
305.35  sections 256B.69, 256D.03, subdivision 4, paragraph (d), and 
305.36  256L.12; and county-based purchasing entities under section 
306.1   256B.692. 
306.2      Sec. 91.  Minnesota Statutes 1998, section 256L.04, 
306.3   subdivision 2, is amended to read: 
306.4      Subd. 2.  [COOPERATION IN ESTABLISHING THIRD-PARTY 
306.5   LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 
306.6   eligible for MinnesotaCare, individuals and families must 
306.7   cooperate with the state agency to identify potentially liable 
306.8   third-party payers and assist the state in obtaining third-party 
306.9   payments.  "Cooperation" includes, but is not limited to, 
306.10  identifying any third party who may be liable for care and 
306.11  services provided under MinnesotaCare to the enrollee, providing 
306.12  relevant information to assist the state in pursuing a 
306.13  potentially liable third party, and completing forms necessary 
306.14  to recover third-party payments. 
306.15     (b) A parent, guardian, relative caretaker, or child 
306.16  enrolled in the MinnesotaCare program must cooperate with the 
306.17  department of human services and the local agency in 
306.18  establishing the paternity of an enrolled child and in obtaining 
306.19  medical care support and payments for the child and any other 
306.20  person for whom the person can legally assign rights, in 
306.21  accordance with applicable laws and rules governing the medical 
306.22  assistance program.  A child shall not be ineligible for or 
306.23  disenrolled from the MinnesotaCare program solely because the 
306.24  child's parent, relative caretaker, or guardian fails to 
306.25  cooperate in establishing paternity or obtaining medical support.
306.26     Sec. 92.  Minnesota Statutes 1998, section 256L.04, 
306.27  subdivision 8, is amended to read: 
306.28     Subd. 8.  [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 
306.29  ASSISTANCE.] (a) Individuals who receive supplemental security 
306.30  income or retirement, survivors, or disability benefits due to a 
306.31  disability, or other disability-based pension, who qualify under 
306.32  subdivision 7, but who are potentially eligible for medical 
306.33  assistance without a spenddown shall be allowed to enroll in 
306.34  MinnesotaCare for a period of 60 days, so long as the applicant 
306.35  meets all other conditions of eligibility.  The commissioner 
306.36  shall identify and refer the applications of such individuals to 
307.1   their county social service agency.  The county and the 
307.2   commissioner shall cooperate to ensure that the individuals 
307.3   obtain medical assistance coverage for any months for which they 
307.4   are eligible. 
307.5      (b) The enrollee must cooperate with the county social 
307.6   service agency in determining medical assistance eligibility 
307.7   within the 60-day enrollment period.  Enrollees who do not 
307.8   cooperate with medical assistance within the 60-day enrollment 
307.9   period shall be disenrolled from the plan within one calendar 
307.10  month.  Persons disenrolled for nonapplication for medical 
307.11  assistance may not reenroll until they have obtained a medical 
307.12  assistance eligibility determination.  Persons disenrolled for 
307.13  noncooperation with medical assistance may not reenroll until 
307.14  they have cooperated with the county agency and have obtained a 
307.15  medical assistance eligibility determination. 
307.16     (c) Beginning January 1, 2000, counties that choose to 
307.17  become MinnesotaCare enrollment sites shall consider 
307.18  MinnesotaCare applications of individuals described in paragraph 
307.19  (a) to also be applications for medical assistance and shall 
307.20  first determine whether medical assistance eligibility exists.  
307.21  Adults with children with family income under 175 percent of the 
307.22  federal poverty guidelines for the applicable family size, 
307.23  pregnant women, and children who qualify under subdivision 1 
307.24  Applicants who are potentially eligible for medical assistance 
307.25  without a spenddown, except for those described in paragraph 
307.26  (a), may choose to enroll in either MinnesotaCare or medical 
307.27  assistance. 
307.28     (d) The commissioner shall redetermine provider payments 
307.29  made under MinnesotaCare to the appropriate medical assistance 
307.30  payments for those enrollees who subsequently become eligible 
307.31  for medical assistance. 
307.32     Sec. 93.  Minnesota Statutes 1998, section 256L.04, 
307.33  subdivision 11, is amended to read: 
307.34     Subd. 11.  [MINNESOTACARE OUTREACH.] (a) The commissioner 
307.35  shall award grants to public or private organizations to provide 
307.36  information on the importance of maintaining insurance coverage 
308.1   and on how to obtain coverage through the MinnesotaCare program 
308.2   in areas of the state with high uninsured populations.  
308.3      (b) In awarding the grants, the commissioner shall consider 
308.4   the following: 
308.5      (1) geographic areas and populations with high uninsured 
308.6   rates; 
308.7      (2) the ability to raise matching funds; and 
308.8      (3) the ability to contact or serve eligible populations. 
308.9      The commissioner shall monitor the grants and may terminate 
308.10  a grant if the outreach effort does not increase the 
308.11  MinnesotaCare program enrollment in medical assistance, general 
308.12  assistance medical care, or the MinnesotaCare program. 
308.13     Sec. 94.  Minnesota Statutes 1998, section 256L.04, 
308.14  subdivision 13, is amended to read: 
308.15     Subd. 13.  [FAMILIES WITH GRANDPARENTS, RELATIVE 
308.16  CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 
308.17  January 1, 1999, in families that include a grandparent, 
308.18  relative caretaker as defined in the medical assistance program, 
308.19  foster parent, or legal guardian, the grandparent, relative 
308.20  caretaker, foster parent, or legal guardian may apply as a 
308.21  family or may apply separately for the children.  If the 
308.22  caretaker applies separately for the children, only the 
308.23  children's income is counted and the provisions of subdivision 
308.24  1, paragraph (b), do not apply.  If the grandparent, relative 
308.25  caretaker, foster parent, or legal guardian applies with the 
308.26  children, their income is included in the gross family income 
308.27  for determining eligibility and premium amount. 
308.28     Sec. 95.  Minnesota Statutes 1998, section 256L.05, is 
308.29  amended by adding a subdivision to read: 
308.30     Subd. 3c.  [RETROACTIVE COVERAGE.] Notwithstanding 
308.31  subdivision 3, the effective date of coverage shall be the first 
308.32  day of the month following termination from medical assistance 
308.33  or general assistance medical care for families and individuals 
308.34  who are eligible for MinnesotaCare and who submitted a written 
308.35  request for retroactive MinnesotaCare coverage with a completed 
308.36  application within 30 days of the mailing of notification of 
309.1   termination from medical assistance or general assistance 
309.2   medical care.  The applicant must provide all required 
309.3   verifications within 30 days of the written request for 
309.4   verification.  For retroactive coverage, premiums must be paid 
309.5   in full for any retroactive month, current month, and next month 
309.6   within 30 days of the premium billing. 
309.7      Sec. 96.  Minnesota Statutes 1998, section 256L.05, 
309.8   subdivision 4, is amended to read: 
309.9      Subd. 4.  [APPLICATION PROCESSING.] The commissioner of 
309.10  human services shall determine an applicant's eligibility for 
309.11  MinnesotaCare no more than 30 days from the date that the 
309.12  application is received by the department of human services.  
309.13  Beginning January 1, 2000, this requirement also applies to 
309.14  local county human services agencies that determine eligibility 
309.15  for MinnesotaCare.  Once annually at application or 
309.16  reenrollment, to prevent processing delays, applicants or 
309.17  enrollees who, from the information provided on the application, 
309.18  appear to meet eligibility requirements shall be enrolled upon 
309.19  timely payment of premiums.  The enrollee must provide all 
309.20  required verifications within 30 days of enrollment notification 
309.21  of the eligibility determination or coverage from the program 
309.22  shall be terminated.  Enrollees who are determined to be 
309.23  ineligible when verifications are provided shall be disenrolled 
309.24  from the program. 
309.25     Sec. 97.  Minnesota Statutes 1998, section 256L.06, 
309.26  subdivision 3, is amended to read: 
309.27     Subd. 3.  [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 
309.28  Premiums are dedicated to the commissioner for MinnesotaCare. 
309.29     (b) The commissioner shall develop and implement procedures 
309.30  to:  (1) require enrollees to report changes in income; (2) 
309.31  adjust sliding scale premium payments, based upon changes in 
309.32  enrollee income; and (3) disenroll enrollees from MinnesotaCare 
309.33  for failure to pay required premiums.  Beginning July 1, 1998, 
309.34  Failure to pay includes payment with a dishonored check and, a 
309.35  returned automatic bank withdrawal, or a refused credit card or 
309.36  debit card payment.  The commissioner may demand a guaranteed 
310.1   form of payment, including a cashier's check or a money order, 
310.2   as the only means to replace a dishonored check, returned, or 
310.3   refused payment. 
310.4      (c) Premiums are calculated on a calendar month basis and 
310.5   may be paid on a monthly, quarterly, or annual basis, with the 
310.6   first payment due upon notice from the commissioner of the 
310.7   premium amount required.  The commissioner shall inform 
310.8   applicants and enrollees of these premium payment options. 
310.9   Premium payment is required before enrollment is complete and to 
310.10  maintain eligibility in MinnesotaCare.  
310.11     (d) Nonpayment of the premium will result in disenrollment 
310.12  from the plan within one calendar month after the due date.  
310.13  Persons disenrolled for nonpayment or who voluntarily terminate 
310.14  coverage from the program may not reenroll until four calendar 
310.15  months have elapsed.  Persons disenrolled for nonpayment who pay 
310.16  all past due premiums as well as current premiums due, including 
310.17  premiums due for the period of disenrollment, within 20 days of 
310.18  disenrollment, shall be reenrolled retroactively to the first 
310.19  day of disenrollment.  Persons disenrolled for nonpayment or who 
310.20  voluntarily terminate coverage from the program may not reenroll 
310.21  for four calendar months unless the person demonstrates good 
310.22  cause for nonpayment.  Good cause does not exist if a person 
310.23  chooses to pay other family expenses instead of the premium.  
310.24  The commissioner shall define good cause in rule. 
310.25     Sec. 98.  Minnesota Statutes 1998, section 256L.07, is 
310.26  amended to read: 
310.27     256L.07 [ELIGIBILITY FOR SUBSIDIZED PREMIUMS BASED ON 
310.28  SLIDING SCALE MINNESOTACARE.] 
310.29     Subdivision 1.  [GENERAL REQUIREMENTS.] (a) Children 
310.30  enrolled in the original children's health plan as of September 
310.31  30, 1992, children who enrolled in the MinnesotaCare program 
310.32  after September 30, 1992, pursuant to Laws 1992, chapter 549, 
310.33  article 4, section 17, and children who have family gross 
310.34  incomes that are equal to or less than 150 percent of the 
310.35  federal poverty guidelines are eligible for subsidized premium 
310.36  payments without meeting the requirements of subdivision 2, as 
311.1   long as they maintain continuous coverage in the MinnesotaCare 
311.2   program or medical assistance.  Children who apply for 
311.3   MinnesotaCare on or after the implementation date of the 
311.4   employer-subsidized health coverage program as described in Laws 
311.5   1998, chapter 407, article 5, section 45, who have family gross 
311.6   incomes that are equal to or less than 150 percent of the 
311.7   federal poverty guidelines, must meet the requirements of 
311.8   subdivision 2 to be eligible for MinnesotaCare. 
311.9      (b) Families enrolled in MinnesotaCare under section 
311.10  256L.04, subdivision 1, whose income increases above 275 percent 
311.11  of the federal poverty guidelines, are no longer eligible for 
311.12  the program and shall be disenrolled by the commissioner.  
311.13  Individuals enrolled in MinnesotaCare under section 256L.04, 
311.14  subdivision 7, whose income increases above 175 percent of the 
311.15  federal poverty guidelines are no longer eligible for the 
311.16  program and shall be disenrolled by the commissioner.  For 
311.17  persons disenrolled under this subdivision, MinnesotaCare 
311.18  coverage terminates the last day of the calendar month following 
311.19  the month in which the commissioner determines that the income 
311.20  of a family or individual, determined over a four-month period 
311.21  as required by section 256L.15, subdivision 2, exceeds program 
311.22  income limits.  
311.23     (c) Notwithstanding paragraph (b), individuals and families 
311.24  may remain enrolled in MinnesotaCare if ten percent of their 
311.25  annual income is less than the annual premium for a policy with 
311.26  a $500 deductible available through the Minnesota comprehensive 
311.27  health association.  Individuals and families who are no longer 
311.28  eligible for MinnesotaCare under this subdivision shall be given 
311.29  an 18-month notice period from the date that ineligibility is 
311.30  determined before disenrollment.  
311.31     Subd. 2.  [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 
311.32  COVERAGE.] (a) To be eligible for subsidized premium payments 
311.33  based on a sliding scale, a family or individual must not have 
311.34  access to subsidized health coverage through an employer and 
311.35  must not have had access to employer-subsidized coverage through 
311.36  a current employer for 18 months prior to application or 
312.1   reapplication.  A family or individual whose employer-subsidized 
312.2   coverage is lost due to an employer terminating health care 
312.3   coverage as an employee benefit during the previous 18 months is 
312.4   not eligible.  
312.5      (b) For purposes of this requirement, subsidized health 
312.6   coverage means health coverage for which the employer pays at 
312.7   least 50 percent of the cost of coverage for the employee or 
312.8   dependent, or a higher percentage as specified by the 
312.9   commissioner.  Children are eligible for employer-subsidized 
312.10  coverage through either parent, including the noncustodial 
312.11  parent.  The commissioner must treat employer contributions to 
312.12  Internal Revenue Code Section 125 plans and any other employer 
312.13  benefits intended to pay health care costs as qualified employer 
312.14  subsidies toward the cost of health coverage for employees for 
312.15  purposes of this subdivision. 
312.16     Subd. 3.  [OTHER HEALTH COVERAGE.] (a) Families and 
312.17  individuals enrolled in the MinnesotaCare program must have no 
312.18  health coverage while enrolled or for at least four months prior 
312.19  to application and renewal.  Children enrolled in the original 
312.20  children's health plan and children in families with income 
312.21  equal to or less than 150 percent of the federal poverty 
312.22  guidelines, who have other health insurance, are eligible if the 
312.23  other health coverage meets the requirements of Minnesota Rules, 
312.24  part 9506.0020, subpart 3, item B. coverage: 
312.25     (1) lacks two or more of the following: 
312.26     (i) basic hospital insurance; 
312.27     (ii) medical-surgical insurance; 
312.28     (iii) prescription drug coverage; 
312.29     (iv) dental coverage; or 
312.30     (v) vision coverage; 
312.31     (2) requires a deductible of $100 or more per person per 
312.32  year; or 
312.33     (3) lacks coverage because the child has exceeded the 
312.34  maximum coverage for a particular diagnosis or the policy 
312.35  excludes a particular diagnosis. 
312.36     The commissioner may change this eligibility criterion for 
313.1   sliding scale premiums in order to remain within the limits of 
313.2   available appropriations.  The requirement of no health coverage 
313.3   does not apply to newborns. 
313.4      (b) For purposes of this section, Medical assistance, 
313.5   general assistance medical care, and civilian health and medical 
313.6   program of the uniformed service, CHAMPUS, are not considered 
313.7   insurance or health coverage for purposes of the four-month 
313.8   requirement described in this subdivision. 
313.9      (c) For purposes of this section subdivision, Medicare Part 
313.10  A or B coverage under title XVIII of the Social Security Act, 
313.11  United States Code, title 42, sections 1395c to 1395w-4, is 
313.12  considered health coverage.  An applicant or enrollee may not 
313.13  refuse Medicare coverage to establish eligibility for 
313.14  MinnesotaCare. 
313.15     (d) Applicants who were recipients of medical assistance or 
313.16  general assistance medical care within one month of application 
313.17  must meet the provisions of this subdivision and subdivision 2. 
313.18     Subd. 4.  [FAMILIES WITH CHILDREN IN NEED OF CHEMICAL 
313.19  DEPENDENCY TREATMENT.] Premiums for families with children when 
313.20  a parent has been determined to be in need of chemical 
313.21  dependency treatment pursuant to an assessment conducted by the 
313.22  county under section 626.556, subdivision 10, or a case plan 
313.23  under section 257.071 or 260.191, subdivision 1e, who are 
313.24  eligible for MinnesotaCare under section 256L.04, subdivision 1, 
313.25  may be paid by the county of residence of the person in need of 
313.26  treatment for one year from the date the family is determined to 
313.27  be eligible or if the family is currently enrolled in 
313.28  MinnesotaCare from the date the person is determined to be in 
313.29  need of chemical dependency treatment.  Upon renewal, the family 
313.30  is responsible for any premiums owed under section 256L.15.  If 
313.31  the family is not currently enrolled in MinnesotaCare, the local 
313.32  county human services agency shall determine whether the family 
313.33  appears to meet the eligibility requirements and shall assist 
313.34  the family in applying for the MinnesotaCare program. 
313.35     Sec. 99.  Minnesota Statutes 1998, section 256L.15, 
313.36  subdivision 1, is amended to read: 
314.1      Subdivision 1.  [PREMIUM DETERMINATION.] Families with 
314.2   children and individuals shall pay a premium determined 
314.3   according to a sliding fee based on the cost of coverage as a 
314.4   percentage of the family's gross family income.  Pregnant women 
314.5   and children under age two are exempt from the provisions of 
314.6   section 256L.06, subdivision 3, paragraph (b), clause (3), 
314.7   requiring disenrollment for failure to pay premiums.  For 
314.8   pregnant women, this exemption continues until the first day of 
314.9   the month following the 60th day postpartum.  Women who remain 
314.10  enrolled during pregnancy or the postpartum period, despite 
314.11  nonpayment of premiums, shall be disenrolled on the first of the 
314.12  month following the 60th day postpartum for the penalty period 
314.13  that otherwise applies under section 256L.06, unless they begin 
314.14  paying premiums. 
314.15     Sec. 100.  Minnesota Statutes 1998, section 256L.15, 
314.16  subdivision 1b, is amended to read: 
314.17     Subd. 1b.  [PAYMENTS NONREFUNDABLE.] Only MinnesotaCare 
314.18  premiums are not refundable paid for future months of coverage 
314.19  for which a health plan capitation fee has not been paid may be 
314.20  refunded. 
314.21     Sec. 101.  Minnesota Statutes 1998, section 256L.15, 
314.22  subdivision 2, is amended to read: 
314.23     Subd. 2.  [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 
314.24  GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 
314.25  establish a sliding fee scale to determine the percentage of 
314.26  gross individual or family income that households at different 
314.27  income levels must pay to obtain coverage through the 
314.28  MinnesotaCare program.  The sliding fee scale must be based on 
314.29  the enrollee's gross individual or family income during the 
314.30  previous four months.  The sliding fee scale must contain 
314.31  separate tables based on enrollment of one, two, or three or 
314.32  more persons.  The sliding fee scale begins with a premium of 
314.33  1.5 percent of gross individual or family income for individuals 
314.34  or families with incomes below the limits for the medical 
314.35  assistance program for families and children in effect on 
314.36  January 1, 1999, and proceeds through the following evenly 
315.1   spaced steps:  1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 
315.2   percent.  These percentages are matched to evenly spaced income 
315.3   steps ranging from the medical assistance income limit for 
315.4   families and children in effect on January 1, 1999, to 275 
315.5   percent of the federal poverty guidelines for the applicable 
315.6   family size, up to a family size of five.  The sliding fee scale 
315.7   for a family of five must be used for families of more than 
315.8   five.  The sliding fee scale and percentages are not subject to 
315.9   the provisions of chapter 14.  If a family or individual reports 
315.10  increased income after enrollment, premiums shall not be 
315.11  adjusted until eligibility renewal. 
315.12     (b) Enrolled individuals and families whose gross annual 
315.13  income increases above 275 percent of the federal poverty 
315.14  guideline shall pay the maximum premium.  The maximum premium is 
315.15  defined as a base charge for one, two, or three or more 
315.16  enrollees so that if all MinnesotaCare cases paid the maximum 
315.17  premium, the total revenue would equal the total cost of 
315.18  MinnesotaCare medical coverage and administration.  In this 
315.19  calculation, administrative costs shall be assumed to equal ten 
315.20  percent of the total.  The costs of medical coverage for 
315.21  pregnant women and children under age two and the enrollees in 
315.22  these groups shall be excluded from the total.  The maximum 
315.23  premium for two enrollees shall be twice the maximum premium for 
315.24  one, and the maximum premium for three or more enrollees shall 
315.25  be three times the maximum premium for one. 
315.26     Sec. 102.  Minnesota Statutes 1998, section 626.556, 
315.27  subdivision 10i, is amended to read: 
315.28     Subd. 10i.  [ADMINISTRATIVE RECONSIDERATION OF FINAL 
315.29  DETERMINATION OF MALTREATMENT.] (a) An individual or facility 
315.30  that the commissioner or a local social service agency 
315.31  determines has maltreated a child, or the child's designee, 
315.32  regardless of the determination, who contests the investigating 
315.33  agency's final determination regarding maltreatment, may request 
315.34  the investigating agency to reconsider its final determination 
315.35  regarding maltreatment.  The request for reconsideration must be 
315.36  submitted in writing to the investigating agency within 15 
316.1   calendar days after receipt of notice of the final determination 
316.2   regarding maltreatment.  
316.3      (b) If the investigating agency denies the request or fails 
316.4   to act upon the request within 15 calendar days after receiving 
316.5   the request for reconsideration, the person or facility entitled 
316.6   to a fair hearing under section 256.045 may submit to the 
316.7   commissioner of human services a written request for a hearing 
316.8   under that section. 
316.9      (c) If, as a result of the reconsideration, the 
316.10  investigating agency changes the final determination of 
316.11  maltreatment, that agency shall notify the parties specified in 
316.12  subdivisions 10b, 10d, and 10f. 
316.13     (d) If an individual or facility contests the investigating 
316.14  agency's final determination regarding maltreatment by 
316.15  requesting a fair hearing under section 256.045, the 
316.16  commissioner of human services shall assure that the hearing is 
316.17  conducted and a decision is reached within 90 days of receipt of 
316.18  the request for a hearing.  The time for action on the decision 
316.19  may be extended for as many days as the hearing is postponed or 
316.20  the record is held open for the benefit of either party. 
316.21     Sec. 103.  Laws 1995, chapter 178, article 2, section 46, 
316.22  subdivision 10, is amended to read: 
316.23     Subd. 10.  [ADDITIONAL WAIVER REQUEST FOR EMPLOYED DISABLED 
316.24  PERSONS.] The commissioner shall seek a federal waiver in order 
316.25  to implement a work incentive for disabled persons eligible for 
316.26  medical assistance who are not residents of long-term care 
316.27  facilities when determining their eligibility for medical 
316.28  assistance.  The waiver shall request authorization to establish 
316.29  a medical assistance earned income disregard for employed 
316.30  disabled persons who, but for earned income, are eligible for 
316.31  SSDI and who receive require personal care assistance under the 
316.32  Medical Assistance Program.  The disregard shall be equivalent 
316.33  to the threshold amount applied to persons who qualify under 
316.34  section 1619(b) of the Social Security Act, except that when a 
316.35  disabled person's earned income reaches the maximum income 
316.36  permitted at the threshold under section 1619(b), the person 
317.1   shall retain medical assistance eligibility and must contribute 
317.2   to the costs of medical care on a sliding fee basis. 
317.3      Sec. 104.  Laws 1997, chapter 225, article 4, section 4, is 
317.4   amended to read: 
317.5      Sec. 4.  [SENIOR DRUG PROGRAM.] 
317.6      The commissioner shall administer the senior drug program 
317.7   so that the costs to the state total no more than $4,000,000 
317.8   plus the amount of the rebate.  The commissioner is authorized 
317.9   to discontinue enrollment in order to meet this level of funding.
317.10     The commissioner shall report to the legislature the 
317.11  estimated costs of the senior drug program without funding 
317.12  caps.  The report shall be included as part of the November and 
317.13  February forecasts. 
317.14     The commissioner of finance shall annually reimburse the 
317.15  general fund with health care access funds for the estimated 
317.16  increased costs in the QMB/SLMB program directly associated with 
317.17  the senior drug program.  This reimbursement shall sunset June 
317.18  30, 2001. 
317.19     Sec. 105.  [CHARITY CARE DATA COLLECTION.] 
317.20     The commissioner of health shall determine a definition for 
317.21  charity care and bad debt that distinguishes these two terms for 
317.22  inpatient and ambulatory care.  The commissioner shall use these 
317.23  definitions as a basis for collecting data on uncompensated care 
317.24  in hospitals, surgical centers, and health care clinics located 
317.25  in Minnesota.  
317.26     Sec. 106.  [MINNESOTACARE APPLICATION SIMPLIFICATION.] 
317.27     The commissioner of human services shall develop a one page 
317.28  preapplication form for the MinnesotaCare program and may 
317.29  develop a pilot project that involves using this form in 
317.30  community health clinics, community health offices, and 
317.31  disproportionate share hospitals to determine the feasibility of 
317.32  using a one page application form for MinnesotaCare.  As part of 
317.33  this pilot project, the commissioner shall track the number of 
317.34  individuals determined to be eligible from the preapplication 
317.35  form, the number determined to be eligible upon the completion 
317.36  of the full application, and for families with children the cost 
318.1   of providing the care to those found eligible. 
318.2      Sec. 107.  [EXPANSION OF SPECIAL EDUCATION SERVICES.] 
318.3      The commissioner of human services shall examine 
318.4   opportunities to expand the scope of providers eligible for 
318.5   reimbursement for medical assistance services listed in a 
318.6   child's individual education plan based on state and federal 
318.7   requirements for provider qualifications.  The commissioner 
318.8   shall complete these activities, in consultation with the 
318.9   commissioner of children, families, and learning, by December 
318.10  1999 and seek necessary federal approval. 
318.11     Sec. 108.  [HOME-BASED MENTAL HEALTH SERVICES.] 
318.12     By January 1, 2000, the commissioner of human services 
318.13  shall amend Minnesota Rules under the expedited process of 
318.14  Minnesota Statutes, section 14.389, to effect the following 
318.15  changes: 
318.16     (1) amend Minnesota Rules, part 9505.0324, subpart 2, to 
318.17  permit a county board to contract with any agency qualified 
318.18  under Minnesota Rules, part 9505.0324, subparts 4 and 5, as an 
318.19  eligible provider of home-based mental health services; 
318.20     (2) amend Minnesota Rules, part 9505.0324, subpart 2, to 
318.21  permit children's mental health collaboratives approved by the 
318.22  children's cabinet under Minnesota Statutes, section 245.493, to 
318.23  provide or to contract with any agency qualified under Minnesota 
318.24  Rules, part 9505.0324, subparts 4 and 5, as an eligible provider 
318.25  of home-based mental health services. 
318.26     Sec. 109.  [MEDICARE SUPPLEMENTAL COVERAGE FOR LOW-INCOME 
318.27  SENIORS.] 
318.28     The commissioner of health, in consultation with the 
318.29  commissioners of human services and commerce, shall study the 
318.30  extent and type of Medicare supplemental coverage for low-income 
318.31  seniors.  The commissioner shall also study the qualified 
318.32  Medicare beneficiaries eligible under Minnesota Statutes, 
318.33  section 256B.057, subdivision 3, in terms of developing a 
318.34  comprehensive set of services to supplement Medicare that these 
318.35  individuals may need to ensure independence and control of their 
318.36  lives.  The commissioner shall make recommendations on the 
319.1   cost-effectiveness of expanding the benefits offered to 
319.2   qualified Medicare beneficiaries including the feasibility of 
319.3   the state providing health care coverage options to low-income 
319.4   seniors that would provide a comprehensive set of services and 
319.5   would build on existing or new Medicare products.  The 
319.6   commissioner shall also study the fiscal impact of mandating 
319.7   coverage for Medicare supplemental products to include long-term 
319.8   care services, including home health services, homemaker 
319.9   services, and nursing facilities services and the fiscal 
319.10  implications of the state paying the premiums for this coverage 
319.11  for low-income seniors, including potential savings to the 
319.12  medical assistance program.  The commissioner shall report to 
319.13  the legislature on the findings of the study with any 
319.14  recommendations by January 15, 2000. 
319.15     Sec. 110.  [PROGRAMS FOR SENIOR CITIZENS.] 
319.16     The commissioner of human services shall study the 
319.17  eligibility criteria of and benefits provided to persons age 65 
319.18  and over through the array of cash assistance and health care 
319.19  programs administered by the department, and the extent to which 
319.20  these programs can be combined, simplified, or coordinated to 
319.21  reduce administrative costs and improve access.  The 
319.22  commissioner shall also study potential barriers to enrollment 
319.23  for low-income seniors who would otherwise deplete resources 
319.24  necessary to maintain independent community living.  At a 
319.25  minimum, the study must include an evaluation of asset 
319.26  requirements and enrollment sites.  The commissioner shall 
319.27  report study findings and recommendations to the legislature by 
319.28  June 30, 2001. 
319.29     Sec. 111.  [AMENDING MEDICAL ASSISTANCE RULES.] 
319.30     By January 1, 2001, the commissioner of human services 
319.31  shall amend Minnesota Rules, parts 9505.0323; 9505.0324; 
319.32  9505.0326; and 9505.0327, as necessary to implement the changes 
319.33  outlined in Minnesota Statutes, section 256B.0625, subdivision 
319.34  35. 
319.35     Sec. 112.  [REQUEST FOR WAIVER.] 
319.36     By October 1, 1999, the commissioner of human services or 
320.1   health shall request a waiver from the federal Department of 
320.2   Health and Human Services to implement Minnesota Statutes, 
320.3   256B.0951, subdivision 7. 
320.4      Sec. 113.  [DENTAL ACCESS STUDY.] 
320.5      The commissioner of human services, in consultation with 
320.6   the commissioner of health, dental care providers, 
320.7   representatives of community clinics, client advocacy groups, 
320.8   and counties, shall review the dental access problem, evaluate 
320.9   the effects of the dental access initiatives adopted by the 1999 
320.10  legislature, and make recommendations on other actions that 
320.11  could improve dental access for public program recipients.  The 
320.12  commissioner shall present a progress report to the legislature 
320.13  by January 15, 2000, and shall present a final report to the 
320.14  legislature by January 15, 2001. 
320.15     Sec. 114.  [REPORT ON RATE SETTING AND RISK ADJUSTMENT.] 
320.16     The commissioner of human services shall report to the 
320.17  legislature, by January 15, 2000, on the current rate setting 
320.18  process for state prepaid health care programs, rate setting and 
320.19  risk adjustment methods in other states, and the results of the 
320.20  application of risk adjustment on a trial basis in Minnesota for 
320.21  calendar year 1999.  The report must also present an analysis of 
320.22  the feasibility of requiring prepaid health plans to report 
320.23  vendor costs rather than charges, an analysis of capitation rate 
320.24  equalization for MinnesotaCare and the prepaid medical 
320.25  assistance program, an analysis of the fiscal impact on state 
320.26  and county government of repealing Minnesota Statutes 1998, 
320.27  section 256B.69, subdivision 5d, and recommendations for 
320.28  providing actuarial and market analyses related to setting 
320.29  prepaid health plan rates to the legislature on a timely basis 
320.30  that would allow this information to be used in the 
320.31  appropriations process. 
320.32     Sec. 115.  [REPORT ON PREPAID MEDICAL ASSISTANCE PROGRAM.] 
320.33     The commissioner of human services shall present 
320.34  recommendations to the legislature, by December 15, 1999, on 
320.35  methods for implementing county board authority under the 
320.36  prepaid medical assistance program.  
321.1      Sec. 116.  [PHYSICIAN AND PROFESSIONAL SERVICES PAYMENT 
321.2   METHODOLOGY CONVERSION.] 
321.3      The commissioner of human services shall submit a proposal 
321.4   to the legislature by January 15, 2000, detailing the medical 
321.5   assistance physician and professional services payment 
321.6   methodology conversion to resource based relative value scale. 
321.7      Sec. 117.  [RECOMMENDATIONS FOR DEFINITION OF SPECIALIZED 
321.8   MAINTENANCE THERAPY.] 
321.9      The commissioner of human services shall develop 
321.10  recommendations for definitions of specialized maintenance 
321.11  therapy for each type of covered therapy, in consultation with 
321.12  representatives of professional therapy associations, providers 
321.13  who work with patients who need long-term specialized 
321.14  maintenance therapy, and patient advocates.  The commissioner 
321.15  shall provide the recommended definitions to the chairs of the 
321.16  house health and human services finance committee and the senate 
321.17  health and family security budget division, by November 15, 1999.
321.18     Sec. 118.  [DENTAL HYGIENIST DEMONSTRATION PROJECT.] 
321.19     (a) The commissioner of human services may develop 
321.20  demonstration projects utilizing dental hygienists outside a 
321.21  traditional dental office to provide dental hygiene services to 
321.22  limited access patients.  Notwithstanding Minnesota Statutes, 
321.23  section 150A.10, subdivision 1, a licensed dental hygienist may 
321.24  provide screening services, education, prophylaxis, and 
321.25  application of topical fluorides under general supervision as 
321.26  defined in Minnesota Rules, part 3100.0100, subpart 21, without 
321.27  the patient being first examined by a licensed dentist.  
321.28  Services under this section must be authorized by a licensed 
321.29  dentist and must be performed by a licensed dental hygienist and 
321.30  may be performed at a location other than the usual place of 
321.31  practice of the dentist or dental hygienist.  For purposes of 
321.32  this section, "limited access patient" means a patient who the 
321.33  commissioner determines is unable to receive regular dental 
321.34  services in a dental office due to age, disability, or 
321.35  geographic location.  
321.36     (b) The commissioner shall report to the legislature by 
322.1   January 15, 2001, on whether this demonstration project has been 
322.2   effective in improving access to dental services for limited 
322.3   access patients. 
322.4      Sec. 119.  [REPORTS ON ALTERNATIVE RESOURCE ALLOCATION 
322.5   METHODS AND PARENTS OF MINORS.] 
322.6      (a) The commissioner of human services shall consider and 
322.7   evaluate administrative methods other than the current resource 
322.8   allocation system for the home and community-based waiver for 
322.9   persons with mental retardation and related conditions.  In 
322.10  developing the alternatives, the commissioner shall consult with 
322.11  county commissioners from large and small counties, county 
322.12  agencies, consumers, advocates, and providers.  The commissioner 
322.13  shall report to the chairs of the senate health and family 
322.14  security budget division and house health and human services 
322.15  finance committee by January 15, 2000. 
322.16     (b) By January 15, 2000, the commissioner of human services 
322.17  shall present recommendations to the legislature on the 
322.18  conditions under which parents of minors may be reimbursed for 
322.19  services, consistent with federal requirements, health and 
322.20  safety, the child's needs, and not supplanting typical parental 
322.21  responsibilities. 
322.22     Sec. 120.  [REPEALER.] 
322.23     Minnesota Statutes 1998, sections 256B.74, subdivisions 2 
322.24  and 5; and 462A.208, are repealed. 
322.25     Sec. 121.  [EFFECTIVE DATE.] 
322.26     (a) Sections 3, 5, 45, and 97 are effective July 1, 2000. 
322.27     (b) Section 56 is effective upon federal approval. 
322.28                             ARTICLE 5 
322.29                      STATE-OPERATED SERVICES;
322.30        CHEMICAL DEPENDENCY; MENTAL HEALTH; LAND CONVEYANCES
322.31     Section 1.  Minnesota Statutes 1998, section 16C.10, 
322.32  subdivision 5, is amended to read: 
322.33     Subd. 5.  [SPECIFIC PURCHASES.] The solicitation process 
322.34  described in this chapter is not required for acquisition of the 
322.35  following: 
322.36     (1) merchandise for resale purchased under policies 
323.1   determined by the commissioner; 
323.2      (2) farm and garden products which, as determined by the 
323.3   commissioner, may be purchased at the prevailing market price on 
323.4   the date of sale; 
323.5      (3) goods and services from the Minnesota correctional 
323.6   facilities; 
323.7      (4) goods and services from rehabilitation facilities and 
323.8   sheltered workshops that are certified by the commissioner of 
323.9   economic security; 
323.10     (5) goods and services for use by a community-based 
323.11  residential facility operated by the commissioner of human 
323.12  services; 
323.13     (6) goods purchased at auction or when submitting a sealed 
323.14  bid at auction provided that before authorizing such an action, 
323.15  the commissioner consult with the requesting agency to determine 
323.16  a fair and reasonable value for the goods considering factors 
323.17  including, but not limited to, costs associated with submitting 
323.18  a bid, travel, transportation, and storage.  This fair and 
323.19  reasonable value must represent the limit of the state's bid; 
323.20  and 
323.21     (7) utility services where no competition exists or where 
323.22  rates are fixed by law or ordinance. 
323.23     Sec. 2.  Minnesota Statutes 1998, section 245.462, 
323.24  subdivision 4, is amended to read: 
323.25     Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
323.26  "Case manager management service provider" means an individual a 
323.27  case manager or case manager associate employed by the county or 
323.28  other entity authorized by the county board to provide case 
323.29  management services specified in section 245.4711.  
323.30     A case manager must have a bachelor's degree in one of the 
323.31  behavioral sciences or related fields including, but not limited 
323.32  to, social work, psychology, or nursing from an accredited 
323.33  college or university and.  A case manager must have at least 
323.34  2,000 hours of supervised experience in the delivery of services 
323.35  to adults with mental illness, must be skilled in the process of 
323.36  identifying and assessing a wide range of client needs, and must 
324.1   be knowledgeable about local community resources and how to use 
324.2   those resources for the benefit of the client.  The case manager 
324.3   shall meet in person with a mental health professional at least 
324.4   once each month to obtain clinical supervision of the case 
324.5   manager's activities.  Case managers with a bachelor's degree 
324.6   but without 2,000 hours of supervised experience in the delivery 
324.7   of services to adults with mental illness must complete 40 hours 
324.8   of training approved by the commissioner of human services in 
324.9   case management skills and in the characteristics and needs of 
324.10  adults with serious and persistent mental illness and must 
324.11  receive clinical supervision regarding individual service 
324.12  delivery from a mental health professional at least once each 
324.13  week until the requirement of 2,000 hours of supervised 
324.14  experience is met.  
324.15     (b) Supervision for a case manager during the first year of 
324.16  service providing case management services shall be one hour per 
324.17  week of clinical supervision from a case management supervisor.  
324.18  After the first year, the case manager shall receive regular 
324.19  ongoing supervision totaling 38 hours per year, of which at 
324.20  least one hour per month must be clinical supervision regarding 
324.21  individual service delivery with a case management supervisor.  
324.22  The remainder may be provided by a case manager with two years 
324.23  of experience.  Group supervision may not constitute more than 
324.24  one-half of the required supervision hours.  Clinical 
324.25  supervision must be documented in the client record. 
324.26     (c) A case manager with a bachelor's degree who is not 
324.27  licensed, registered, or certified by a health-related licensing 
324.28  board must receive 30 hours of continuing education and training 
324.29  in mental illness and mental health services annually.  
324.30     (d) A case manager with a bachelor's degree but without 
324.31  2,000 hours of supervised experience described in paragraph (a), 
324.32  must complete 40 hours of training approved by the commissioner 
324.33  covering case management skills and the characteristics and 
324.34  needs of adults with serious and persistent mental illness.  
324.35     (e) Case managers without a bachelor's degree must meet one 
324.36  of the requirements in clauses (1) to (3):  
325.1      (1) have three or four years of experience as a case 
325.2   manager associate; 
325.3      (2) be a registered nurse without a bachelor's degree and 
325.4   have a combination of specialized training in psychiatry and 
325.5   work experience consisting of community interaction and 
325.6   involvement or community discharge planning in a mental health 
325.7   setting totaling three years; or 
325.8      (3) be a person who qualified as a case manager under the 
325.9   1998 department of human service federal waiver provision and 
325.10  meet the continuing education and mentoring requirements in this 
325.11  section.  
325.12     (f) A case manager associate (CMA) must work under the 
325.13  direction of a case manager or case management supervisor and 
325.14  must be at least 21 years of age.  A case manager associate must 
325.15  also have a high school diploma or its equivalent and meet one 
325.16  of the following criteria: 
325.17     (1) have an associate of arts degree in one of the 
325.18  behavioral sciences or human services; 
325.19     (2) be a registered nurse without a bachelor's degree; 
325.20     (3) within the previous ten years, have three years of life 
325.21  experience with serious and persistent mental illness as defined 
325.22  in section 245.462, subdivision 20; or as a child had severe 
325.23  emotional disturbance as defined in section 245.4871, 
325.24  subdivision 6; or have three years life experience as a primary 
325.25  caregiver to an adult with serious and persistent mental illness 
325.26  within the previous ten years; 
325.27     (4) have 6,000 hours work experience as a nondegreed state 
325.28  hospital technician; or 
325.29     (5) be a mental health practitioner as defined in section 
325.30  245.462, subdivision 17, clause (2). 
325.31     Individuals meeting one of the criteria in clauses (1) to 
325.32  (4) may qualify as a case manager after four years of supervised 
325.33  work experience as a case manager associate.  Individuals 
325.34  meeting the criteria in clause (5) may qualify as a case manager 
325.35  after three years of supervised experience as a case manager 
325.36  associate. 
326.1      Case management associates must have 40 hours preservice 
326.2   training under paragraph (d) and receive at least 40 hours of 
326.3   continuing education in mental illness and mental health 
326.4   services annually.  Case manager associates shall receive at 
326.5   least five hours of mentoring per week from a case management 
326.6   mentor.  A "case management mentor" means a qualified, 
326.7   practicing case manager or case management supervisor who 
326.8   teaches or advises and provides intensive training and clinical 
326.9   supervision to one or more case manager associates.  Mentoring 
326.10  may occur while providing direct services to consumers in the 
326.11  office or in the field and may be provided to individuals or 
326.12  groups of case manager associates.  At least two mentoring hours 
326.13  per week must be individual and face-to-face. 
326.14     (g) A case management supervisor must meet the criteria for 
326.15  mental health professionals, as specified in section 245.462, 
326.16  subdivision 18. 
326.17     (h) Until June 30, 1999, An immigrant who does not have the 
326.18  qualifications specified in this subdivision may provide case 
326.19  management services to adult immigrants with serious and 
326.20  persistent mental illness who are members of the same ethnic 
326.21  group as the case manager if the person:  (1) is currently 
326.22  enrolled in and is actively pursuing credits toward the 
326.23  completion of a bachelor's degree in one of the behavioral 
326.24  sciences or a related field including, but not limited to, 
326.25  social work, psychology, or nursing from an accredited college 
326.26  or university; (2) completes 40 hours of training as specified 
326.27  in this subdivision; and (3) receives clinical supervision at 
326.28  least once a week until the requirements of this subdivision are 
326.29  met. 
326.30     (b) The commissioner may approve waivers submitted by 
326.31  counties to allow case managers without a bachelor's degree but 
326.32  with 6,000 hours of supervised experience in the delivery of 
326.33  services to adults with mental illness if the person: 
326.34     (1) meets the qualifications for a mental health 
326.35  practitioner in subdivision 26; 
326.36     (2) has completed 40 hours of training approved by the 
327.1   commissioner in case management skills and in the 
327.2   characteristics and needs of adults with serious and persistent 
327.3   mental illness; and 
327.4      (3) demonstrates that the 6,000 hours of supervised 
327.5   experience are in identifying functional needs of persons with 
327.6   mental illness, coordinating assessment information and making 
327.7   referrals to appropriate service providers, coordinating a 
327.8   variety of services to support and treat persons with mental 
327.9   illness, and monitoring to ensure appropriate provision of 
327.10  services.  The county board is responsible to verify that all 
327.11  qualifications, including content of supervised experience, have 
327.12  been met. 
327.13     Sec. 3.  Minnesota Statutes 1998, section 245.462, 
327.14  subdivision 17, is amended to read: 
327.15     Subd. 17.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
327.16  practitioner" means a person providing services to persons with 
327.17  mental illness who is qualified in at least one of the following 
327.18  ways:  
327.19     (1) holds a bachelor's degree in one of the behavioral 
327.20  sciences or related fields from an accredited college or 
327.21  university and: 
327.22     (i) has at least 2,000 hours of supervised experience in 
327.23  the delivery of services to persons with mental illness; or 
327.24     (ii) is fluent in the non-English language of the ethnic 
327.25  group to which at least 50 percent of the practitioner's clients 
327.26  belong, completes 40 hours of training in the delivery of 
327.27  services to persons with mental illness, and receives clinical 
327.28  supervision from a mental health professional at least once a 
327.29  week until the requirement of 2,000 hours of supervised 
327.30  experience is met; 
327.31     (2) has at least 6,000 hours of supervised experience in 
327.32  the delivery of services to persons with mental illness; 
327.33     (3) is a graduate student in one of the behavioral sciences 
327.34  or related fields and is formally assigned by an accredited 
327.35  college or university to an agency or facility for clinical 
327.36  training; or 
328.1      (4) holds a master's or other graduate degree in one of the 
328.2   behavioral sciences or related fields from an accredited college 
328.3   or university and has less than 4,000 hours post-master's 
328.4   experience in the treatment of mental illness. 
328.5      Sec. 4.  Minnesota Statutes 1998, section 245.4711, 
328.6   subdivision 1, is amended to read: 
328.7      Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
328.8   (a) By January 1, 1989, the county board shall provide case 
328.9   management services for all adults with serious and persistent 
328.10  mental illness who are residents of the county and who request 
328.11  or consent to the services and to each adult for whom the court 
328.12  appoints a case manager.  Staffing ratios must be sufficient to 
328.13  serve the needs of the clients.  The case manager must meet the 
328.14  requirements in section 245.462, subdivision 4.  
328.15     (b) Case management services provided to adults with 
328.16  serious and persistent mental illness eligible for medical 
328.17  assistance must be billed to the medical assistance program 
328.18  under sections 256B.02, subdivision 8, and 256B.0625. 
328.19     (c) Case management services are eligible for reimbursement 
328.20  under the medical assistance program.  Costs associated with 
328.21  mentoring, supervision, and continuing education may be included 
328.22  in the reimbursement rate methodology used for case management 
328.23  services under the medical assistance program. 
328.24     Sec. 5.  Minnesota Statutes 1998, section 245.4712, 
328.25  subdivision 2, is amended to read: 
328.26     Subd. 2.  [DAY TREATMENT SERVICES PROVIDED.] (a) Day 
328.27  treatment services must be developed as a part of the community 
328.28  support services available to adults with serious and persistent 
328.29  mental illness residing in the county.  Adults may be required 
328.30  to pay a fee according to section 245.481.  Day treatment 
328.31  services must be designed to:  
328.32     (1) provide a structured environment for treatment; 
328.33     (2) provide support for residing in the community; 
328.34     (3) prevent placement in settings that are more intensive, 
328.35  costly, or restrictive than necessary and appropriate to meet 
328.36  client need; 
329.1      (4) coordinate with or be offered in conjunction with a 
329.2   local education agency's special education program; and 
329.3      (5) operate on a continuous basis throughout the year.  
329.4      (b) For purposes of complying with medical assistance 
329.5   requirements, an adult day treatment program may choose among 
329.6   the methods of clinical supervision specified in: 
329.7      (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 
329.8      (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 
329.9      (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 
329.10     A day treatment program may demonstrate compliance with 
329.11  these clinical supervision requirements by obtaining 
329.12  certification from the commissioner under Minnesota Rules, parts 
329.13  9520.0750 to 9520.0870, or by documenting in its own records 
329.14  that it complies with one of the above methods. 
329.15     (c) County boards may request a waiver from including day 
329.16  treatment services if they can document that:  
329.17     (1) an alternative plan of care exists through the county's 
329.18  community support services for clients who would otherwise need 
329.19  day treatment services; 
329.20     (2) day treatment, if included, would be duplicative of 
329.21  other components of the community support services; and 
329.22     (3) county demographics and geography make the provision of 
329.23  day treatment services cost ineffective and infeasible.  
329.24     Sec. 6.  Minnesota Statutes 1998, section 245.4871, 
329.25  subdivision 4, is amended to read: 
329.26     Subd. 4.  [CASE MANAGER MANAGEMENT SERVICE PROVIDER.] (a) 
329.27  "Case manager management service provider" means an individual a 
329.28  case manager or case manager associate employed by the county or 
329.29  other entity authorized by the county board to provide case 
329.30  management services specified in subdivision 3 for the child 
329.31  with severe emotional disturbance and the child's family.  A 
329.32  case manager must have experience and training in working with 
329.33  children. 
329.34     (b) A case manager must: 
329.35     (1) have at least a bachelor's degree in one of the 
329.36  behavioral sciences or a related field including, but not 
330.1   limited to, social work, psychology, or nursing from an 
330.2   accredited college or university; 
330.3      (2) have at least 2,000 hours of supervised experience in 
330.4   the delivery of mental health services to children; 
330.5      (3) have experience and training in identifying and 
330.6   assessing a wide range of children's needs; and 
330.7      (4) be knowledgeable about local community resources and 
330.8   how to use those resources for the benefit of children and their 
330.9   families. 
330.10     (c) The case manager may be a member of any professional 
330.11  discipline that is part of the local system of care for children 
330.12  established by the county board. 
330.13     (d) The case manager must meet in person with a mental 
330.14  health professional at least once each month to obtain clinical 
330.15  supervision shall receive regular ongoing supervision totaling 
330.16  38 hours per year, of which at least one hour per month must be 
330.17  clinical supervision regarding individual service delivery with 
330.18  a case management supervisor.  The remainder may be provided by 
330.19  a case manager with two years of experience.  Group supervision 
330.20  may not constitute more than one-half of the required 
330.21  supervision hours. 
330.22     (e) Case managers with a bachelor's degree but without 
330.23  2,000 hours of supervised experience in the delivery of mental 
330.24  health services to children with emotional disturbance must: 
330.25     (1) begin 40 hours of training approved by the commissioner 
330.26  of human services in case management skills and in the 
330.27  characteristics and needs of children with severe emotional 
330.28  disturbance before beginning to provide case management 
330.29  services; and 
330.30     (2) receive clinical supervision regarding individual 
330.31  service delivery from a mental health professional at least once 
330.32  one hour each week until the requirement of 2,000 hours of 
330.33  experience is met. 
330.34     (f) Clinical supervision must be documented in the child's 
330.35  record.  When the case manager is not a mental health 
330.36  professional, the county board must provide or contract for 
331.1   needed clinical supervision. 
331.2      (g) The county board must ensure that the case manager has 
331.3   the freedom to access and coordinate the services within the 
331.4   local system of care that are needed by the child. 
331.5      (h) Case managers who have a bachelor's degree but are not 
331.6   licensed, registered, or certified by a health-related licensing 
331.7   board must receive 30 hours of continuing education and training 
331.8   in severe emotional disturbance and mental health services 
331.9   annually. 
331.10     (i) Case managers without a bachelor's degree must meet one 
331.11  of the requirements in clauses (1) to (3): 
331.12     (1) have three or four years of experience as a case 
331.13  manager associate; 
331.14     (2) be a registered nurse without a bachelor's degree who 
331.15  has a combination of specialized training in psychiatry and work 
331.16  experience consisting of community interaction and involvement 
331.17  or community discharge planning in a mental health setting 
331.18  totaling three years; or 
331.19     (3) be a person who qualified as a case manager under the 
331.20  1998 department of human service federal waiver provision and 
331.21  meets the continuing education and mentoring requirements in 
331.22  this section. 
331.23     (j) A case manager associate (CMA) must work under the 
331.24  direction of a case manager or case management supervisor and 
331.25  must be at least 21 years of age.  A case manager associate must 
331.26  also have a high school diploma or its equivalent and meet one 
331.27  of the following criteria: 
331.28     (1) have an associate of arts degree in one of the 
331.29  behavioral sciences or human services; 
331.30     (2) be a registered nurse without a bachelor's degree; 
331.31     (3) have three years of life experience as a primary 
331.32  caregiver to a child with serious emotional disturbance as 
331.33  defined in section 245.4871, subdivision 6, within the previous 
331.34  ten years; 
331.35     (4) have 6,000 hours work experience as a nondegreed state 
331.36  hospital technician; or 
332.1      (5) be a mental health practitioner as defined in section 
332.2   245.462, subdivision 17, clause (2). 
332.3      Individuals meeting one of the criteria in clauses (1) to 
332.4   (4) may qualify as a case manager after four years of supervised 
332.5   work experience as a case manager associate.  Individuals 
332.6   meeting the criteria in clause (5) may qualify as a case manager 
332.7   after three years of supervised experience as a case manager 
332.8   associate. 
332.9      Case manager associates must have 40 hours of preservice 
332.10  training under paragraph (e), clause (1), and receive at least 
332.11  40 hours of continuing education in severe emotional disturbance 
332.12  and mental health service annually.  Case manager associates 
332.13  shall receive at least five hours of mentoring per week from a 
332.14  case management mentor.  A "case management mentor" means a 
332.15  qualified, practicing case manager or case management supervisor 
332.16  who teaches or advises and provides intensive training and 
332.17  clinical supervision to one or more case manager associates.  
332.18  Mentoring may occur while providing direct services to consumers 
332.19  in the office or in the field and may be provided to individuals 
332.20  or groups of case manager associates.  At least two mentoring 
332.21  hours per week must be individual and face-to-face. 
332.22     (k) A case management supervisor must meet the criteria for 
332.23  a mental health professional as specified in section 245.4871, 
332.24  subdivision 27. 
332.25     (l) Until June 30, 1999, An immigrant who does not have the 
332.26  qualifications specified in this subdivision may provide case 
332.27  management services to child immigrants with severe emotional 
332.28  disturbance of the same ethnic group as the immigrant if the 
332.29  person:  
332.30     (1) is currently enrolled in and is actively pursuing 
332.31  credits toward the completion of a bachelor's degree in one of 
332.32  the behavioral sciences or related fields at an accredited 
332.33  college or university; 
332.34     (2) completes 40 hours of training as specified in this 
332.35  subdivision; and 
332.36     (3) receives clinical supervision at least once a week 
333.1   until the requirements of obtaining a bachelor's degree and 
333.2   2,000 hours of supervised experience are met. 
333.3      (i) The commissioner may approve waivers submitted by 
333.4   counties to allow case managers without a bachelor's degree but 
333.5   with 6,000 hours of supervised experience in the delivery of 
333.6   services to children with severe emotional disturbance if the 
333.7   person: 
333.8      (1) meets the qualifications for a mental health 
333.9   practitioner in subdivision 26; 
333.10     (2) has completed 40 hours of training approved by the 
333.11  commissioner in case management skills and in the 
333.12  characteristics and needs of children with severe emotional 
333.13  disturbance; and 
333.14     (3) demonstrates that the 6,000 hours of supervised 
333.15  experience are in identifying functional needs of children with 
333.16  severe emotional disturbance, coordinating assessment 
333.17  information and making referrals to appropriate service 
333.18  providers, coordinating a variety of services to support and 
333.19  treat children with severe emotional disturbance, and monitoring 
333.20  to ensure appropriate provision of services.  The county board 
333.21  is responsible to verify that all qualifications, including 
333.22  content of supervised experience, have been met. 
333.23     Sec. 7.  Minnesota Statutes 1998, section 245.4871, 
333.24  subdivision 26, is amended to read: 
333.25     Subd. 26.  [MENTAL HEALTH PRACTITIONER.] "Mental health 
333.26  practitioner" means a person providing services to children with 
333.27  emotional disturbances.  A mental health practitioner must have 
333.28  training and experience in working with children.  A mental 
333.29  health practitioner must be qualified in at least one of the 
333.30  following ways:  
333.31     (1) holds a bachelor's degree in one of the behavioral 
333.32  sciences or related fields from an accredited college or 
333.33  university and:  
333.34     (i) has at least 2,000 hours of supervised experience in 
333.35  the delivery of mental health services to children with 
333.36  emotional disturbances; or 
334.1      (ii) is fluent in the non-English language of the ethnic 
334.2   group to which at least 50 percent of the practitioner's clients 
334.3   belong, completes 40 hours of training in the delivery of 
334.4   services to children with emotional disturbances, and receives 
334.5   clinical supervision from a mental health professional at least 
334.6   once a week until the requirement of 2,000 hours of supervised 
334.7   experience is met; 
334.8      (2) has at least 6,000 hours of supervised experience in 
334.9   the delivery of mental health services to children with 
334.10  emotional disturbances; 
334.11     (3) is a graduate student in one of the behavioral sciences 
334.12  or related fields and is formally assigned by an accredited 
334.13  college or university to an agency or facility for clinical 
334.14  training; or 
334.15     (4) holds a master's or other graduate degree in one of the 
334.16  behavioral sciences or related fields from an accredited college 
334.17  or university and has less than 4,000 hours post-master's 
334.18  experience in the treatment of emotional disturbance. 
334.19     Sec. 8.  Minnesota Statutes 1998, section 245.4881, 
334.20  subdivision 1, is amended to read: 
334.21     Subdivision 1.  [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 
334.22  (a) By April 1, 1992, the county board shall provide case 
334.23  management services for each child with severe emotional 
334.24  disturbance who is a resident of the county and the child's 
334.25  family who request or consent to the services.  Staffing ratios 
334.26  must be sufficient to serve the needs of the clients.  The case 
334.27  manager must meet the requirements in section 245.4871, 
334.28  subdivision 4.  
334.29     (b) Except as permitted by law and the commissioner under 
334.30  demonstration projects, case management services provided to 
334.31  children with severe emotional disturbance eligible for medical 
334.32  assistance must be billed to the medical assistance program 
334.33  under sections 256B.02, subdivision 8, and 256B.0625. 
334.34     (c) Case management services are eligible for reimbursement 
334.35  under the medical assistance program.  Costs of mentoring, 
334.36  supervision, and continuing education may be included in the 
335.1   reimbursement rate methodology used for case management services 
335.2   under the the medical assistance program. 
335.3      Sec. 9.  [246.0136] [PLANNING FOR TRANSITION OF REGIONAL 
335.4   TREATMENT CENTERS AND OTHER STATE-OPERATED SERVICES TO 
335.5   ENTERPRISE ACTIVITIES.] 
335.6      Subdivision 1.  [PLANNING FOR ENTERPRISE ACTIVITIES.] The 
335.7   commissioner of human services is directed to study and make 
335.8   recommendations to the legislature on establishing enterprise 
335.9   activities within state-operated services.  Before implementing 
335.10  an enterprise activity, the commissioner must obtain statutory 
335.11  authorization for its implementation, except that the 
335.12  commissioner has authority to implement enterprise activities 
335.13  for adolescent services and to establish a public group practice 
335.14  without statutory authorization.  Enterprise activities are 
335.15  defined as the range of services, which are delivered by state 
335.16  employees, needed by people with disabilities and are fully 
335.17  funded by public or private third-party health insurance or 
335.18  other revenue sources available to clients that provide 
335.19  reimbursement for the services provided. Enterprise activities 
335.20  within state-operated services shall specialize in caring for 
335.21  vulnerable people for whom no other providers are available or 
335.22  for whom state-operated services may be the provider selected by 
335.23  the payer.  In subsequent biennia after an enterprise activity 
335.24  is established within a state-operated service, the base state 
335.25  appropriation for that state-operated service shall be reduced 
335.26  proportionate to the size of the enterprise activity. 
335.27     Subd. 2.  [REQUIRED COMPONENTS OF ANY PROPOSAL; 
335.28  CONSIDERATIONS.] In any proposal for an enterprise activity 
335.29  brought to the legislature by the commissioner, the commissioner 
335.30  must demonstrate that there is public or private third-party 
335.31  health insurance or other revenue available to the people 
335.32  served, that the anticipated revenues to be collected will fully 
335.33  fund the services, that there will be sufficient funds for cash 
335.34  flow purposes, and that access to services by vulnerable 
335.35  populations served by state-operated services will not be 
335.36  limited by implementation of an enterprise activity.  In 
336.1   studying the feasibility of establishing an enterprise activity, 
336.2   the commissioner must consider: 
336.3      (1) creating public or private partnerships to facilitate 
336.4   client access to needed services; 
336.5      (2) administrative simplification and efficiencies 
336.6   throughout the state-operated services system; 
336.7      (3) converting or disposing of buildings not utilized and 
336.8   surplus lands; and 
336.9      (4) exploring the efficiencies and benefits of establishing 
336.10  state-operated services as an independent state agency. 
336.11     Sec. 10.  Minnesota Statutes 1998, section 246.18, 
336.12  subdivision 6, is amended to read: 
336.13     Subd. 6.  [COLLECTIONS DEDICATED.] Except for 
336.14  state-operated programs and services funded through a direct 
336.15  appropriation from the legislature, money received within the 
336.16  regional treatment center system for the following 
336.17  state-operated services is dedicated to the commissioner for the 
336.18  provision of those services: 
336.19     (1) community-based residential and day training and 
336.20  habilitation services for mentally retarded persons; 
336.21     (2) community health clinic services; 
336.22     (3) accredited hospital outpatient department services; 
336.23     (4) certified rehabilitation agency and rehabilitation 
336.24  hospital services; or 
336.25     (5) community-based transitional support services for 
336.26  adults with serious and persistent mental illness.  Except for 
336.27  state-operated programs funded through a direct appropriation 
336.28  from the legislature, any state-operated program or service 
336.29  established and operated as an enterprise activity, shall retain 
336.30  the revenues earned in an interest-bearing account. 
336.31     When the commissioner determines the intent to transition 
336.32  from a direct appropriation to enterprise activity for which the 
336.33  commissioner has authority, all collections for the targeted 
336.34  state-operated service shall be retained and deposited into an 
336.35  interest-bearing account.  At the end of the fiscal year, prior 
336.36  to establishing the enterprise activity, collections up to the 
337.1   amount of the appropriation for the targeted service shall be 
337.2   deposited to the general fund.  All funds in excess of the 
337.3   amount of the appropriation will be retained and used by the 
337.4   enterprise activity for cash flow purposes. 
337.5      These funds must be deposited in the state treasury in a 
337.6   revolving account and funds in the revolving account are 
337.7   appropriated to the commissioner to operate the services 
337.8   authorized, and any unexpended balances do not cancel but are 
337.9   available until spent. 
337.10     Sec. 11.  Minnesota Statutes 1998, section 252.46, 
337.11  subdivision 6, is amended to read: 
337.12     Subd. 6.  [VARIANCES.] (a) A variance from the minimum or 
337.13  maximum payment rates in subdivisions 2 and 3 may be granted by 
337.14  the commissioner when the vendor requests and the county board 
337.15  submits to the commissioner a written variance request on forms 
337.16  supplied by the commissioner with the recommended payment rates. 
337.17     (b) A variance to the rate maximum may be utilized for 
337.18  costs associated with compliance with state administrative 
337.19  rules, compliance with court orders, capital costs required for 
337.20  continued licensure, increased insurance costs, start-up and 
337.21  conversion costs for supported employment, direct service staff 
337.22  salaries and benefits, transportation, and other program related 
337.23  costs when any one of the criteria criterion in clauses (1) to 
337.24  (4) is also met: 
337.25     (1) change is necessary to comply with licensing citations; 
337.26     (2) a licensed vendor currently serving fewer than 70 
337.27  persons with payment rates of 80 percent or less of the 
337.28  statewide average rates and with clients meeting the behavioral 
337.29  or medical criteria under clause (3) approved by the 
337.30  commissioner as a significant program change under section 
337.31  252.28; 
337.32     (3) (1) A determination of need under section 252.28 is 
337.33  approved for a significant program change is approved by the 
337.34  commissioner under section 252.28 that is necessary for a vendor 
337.35  to provide authorized services to a new client or clients with 
337.36  very severe self-injurious or assaultive behavior, or medical 
338.1   conditions requiring delivery of physician-prescribed medical 
338.2   interventions requiring one-to-one staffing for at least 15 
338.3   minutes each time they are performed, or to a new client or 
338.4   clients directly discharged to the vendor's program from a 
338.5   regional treatment center; or 
338.6      (4) there is a need to maintain required staffing levels in 
338.7   order to provide authorized services approved by the 
338.8   commissioner under section 252.28, that is necessitated by a 
338.9   significant and permanent decrease in licensed capacity or 
338.10  clientele. 
338.11     The county shall review the adequacy of services provided 
338.12  by vendors whose payment rates are 80 percent or more of the 
338.13  statewide average rates and 50 percent or more of the vendor's 
338.14  clients meet the behavioral or medical criteria in clause (3). 
338.15     A variance under this paragraph may be approved only if the 
338.16  costs to the medical assistance program do not exceed the 
338.17  medical assistance costs for all clients served by the 
338.18  alternatives and all clients remaining in the existing services. 
338.19  one or more clients who meet one or more of the following 
338.20  criteria: 
338.21     (a) the client is a new client and: 
338.22     (i) exhibits severe behavior as indicated on the screening 
338.23  document; 
338.24     (ii) periodically requires one-to-one staff time for at 
338.25  least 15 minutes at a time to deliver physician prescribed 
338.26  medical interventions; or 
338.27     (iii) has been discharged directly to the vendor's program 
338.28  from a regional treatment center or the Minnesota extended 
338.29  treatment option. 
338.30     (b) the client is an existing client who has developed one 
338.31  of the following changed circumstances which increases costs 
338.32  that are not covered by the vendor's current rate, and for whom 
338.33  a significant program change is necessary to ensure the 
338.34  continued provision of authorized services to that client: 
338.35     (i) severe behavior as indicated on the screening document; 
338.36     (ii) a medical condition periodically requiring one-to-one 
339.1   staff time for at least 15 minutes at a time to deliver 
339.2   physician prescribed medical interventions; or 
339.3      (iii) a permanent decrease in skill functioning, as 
339.4   verified by medical reports or assessments; 
339.5      (2) A licensing determination requires a program change 
339.6   that the vendor cannot comply with due to funding restraints; 
339.7      (3) A determination of need under section 252.28 is 
339.8   approved for a significant and permanent decrease in licensed 
339.9   capacity and the vendor demonstrates the need to retain certain 
339.10  staffing levels to serve the remaining clients; or 
339.11     (4) In cases where conditions in clauses (1) to (3) do not 
339.12  apply, but a determination of need under section 252.28 is 
339.13  approved for an unusual circumstance which exists that 
339.14  significantly impacts the type or amount of services delivered, 
339.15  as evidenced by documentation presented by the vendor and with 
339.16  the concurrence of the commissioner.  
339.17     (b) (c) A variance to the rate minimum may be granted when: 
339.18     (1) the county board contracts for increased services from 
339.19  a vendor and for some or all individuals receiving services from 
339.20  the vendor lower per unit fixed costs result; or 
339.21     (2) when the actual costs of delivering authorized service 
339.22  over a 12-month contract period have decreased. 
339.23     (c) (d) The written variance request under this subdivision 
339.24  must include documentation that all the following criteria have 
339.25  been met: 
339.26     (1) The commissioner and the county board have both 
339.27  conducted a review and have identified a need for a change in 
339.28  the payment rates and recommended an effective date for the 
339.29  change in the rate. 
339.30     (2) The vendor documents efforts to reallocate current 
339.31  staff and any additional staffing needs cannot be met by using 
339.32  temporary special needs rate exceptions under Minnesota Rules, 
339.33  parts 9510.1020 to 9510.1140. 
339.34     (3) The vendor documents that financial resources have been 
339.35  reallocated before applying for a variance.  No variance may be 
339.36  granted for equipment, supplies, or other capital expenditures 
340.1   when depreciation expense for repair and replacement of such 
340.2   items is part of the current rate. 
340.3      (4) For variances related to loss of clientele, the vendor 
340.4   documents the other program and administrative expenses, if any, 
340.5   that have been reduced. 
340.6      (5) The county board submits verification of the conditions 
340.7   for which the variance is requested, a description of the nature 
340.8   and cost of the proposed changes, and how the county will 
340.9   monitor the use of money by the vendor to make necessary changes 
340.10  in services.  
340.11     (6) The county board's recommended payment rates do not 
340.12  exceed 95 percent of the greater of 125 percent of the current 
340.13  statewide median or 125 percent of the regional average payment 
340.14  rates, whichever is higher, for each of the regional commission 
340.15  districts under sections 462.381 to 462.396 in which the vendor 
340.16  is located except for the following:  when a variance is 
340.17  recommended to allow authorized service delivery to new clients 
340.18  with severe self-injurious or assaultive behaviors or with 
340.19  medical conditions requiring delivery of physician prescribed 
340.20  medical interventions, or to persons being directly discharged 
340.21  from a regional treatment center or Minnesota extended treatment 
340.22  options to the vendor's program, those persons must be assigned 
340.23  a payment rate of 200 percent of the current statewide average 
340.24  rates.  All other clients receiving services from the vendor 
340.25  must be assigned a payment rate equal to the vendor's current 
340.26  rate unless the vendor's current rate exceeds 95 percent of 125 
340.27  percent of the statewide median or 125 percent of the regional 
340.28  average payment rates, whichever is higher.  When the vendor's 
340.29  rates exceed 95 percent of 125 percent of the statewide median 
340.30  or 125 percent of the regional average rates, the maximum rates 
340.31  assigned to all other clients must be equal to the greater of 95 
340.32  percent of 125 percent of the statewide median or 125 percent of 
340.33  the regional average rates.  The maximum payment rate that may 
340.34  be recommended for the vendor under these conditions is 
340.35  determined by multiplying the number of clients at each limit by 
340.36  the rate corresponding to that limit and then dividing the sum 
341.1   by the total number of clients. 
341.2      (d) (e) The commissioner shall have 60 calendar days from 
341.3   the date of the receipt of the complete request to accept or 
341.4   reject it, or the request shall be deemed to have been granted.  
341.5   If the commissioner rejects the request, the commissioner shall 
341.6   state in writing the specific objections to the request and the 
341.7   reasons for its rejection. 
341.8      Sec. 12.  Minnesota Statutes 1998, section 253B.045, is 
341.9   amended by adding a subdivision to read: 
341.10     Subd. 5.  [HEALTH PLAN COMPANY; DEFINITION.] For purposes 
341.11  of this section, "health plan company" has the meaning given it 
341.12  in section 62Q.01, subdivision 4, and also includes a 
341.13  demonstration provider as defined in section 256B.69, 
341.14  subdivision 2, paragraph (b), a county or group of counties 
341.15  participating in county-based purchasing according to section 
341.16  256B.692, and a children's mental health collaborative under 
341.17  contract to provide medical assistance for individuals enrolled 
341.18  in the prepaid medical assistance and MinnesotaCare programs 
341.19  according to sections 245.493 to 245.496. 
341.20     Sec. 13.  Minnesota Statutes 1998, section 253B.045, is 
341.21  amended by adding a subdivision to read: 
341.22     Subd. 6.  [COVERAGE.] A health plan company must provide 
341.23  coverage, according to the terms of the policy, contract, or 
341.24  certificate of coverage, for all medically necessary covered 
341.25  services as determined by section 62Q.53 provided to an enrollee 
341.26  that are ordered by the court under this chapter. 
341.27     Sec. 14.  Minnesota Statutes 1998, section 253B.07, 
341.28  subdivision 1, is amended to read: 
341.29     Subdivision 1.  [PREPETITION SCREENING.] (a) Prior to 
341.30  filing a petition for commitment of or early intervention for a 
341.31  proposed patient, an interested person shall apply to the 
341.32  designated agency in the county of the proposed patient's 
341.33  residence or presence for conduct of a preliminary 
341.34  investigation, except when the proposed patient has been 
341.35  acquitted of a crime under section 611.026 and the county 
341.36  attorney is required to file a petition for commitment.  The 
342.1   designated agency shall appoint a screening team to conduct an 
342.2   investigation which shall include:  
342.3      (i) a personal interview with the proposed patient and 
342.4   other individuals who appear to have knowledge of the condition 
342.5   of the proposed patient.  If the proposed patient is not 
342.6   interviewed, reasons must be documented; 
342.7      (ii) identification and investigation of specific alleged 
342.8   conduct which is the basis for application; 
342.9      (iii) identification, exploration, and listing of the 
342.10  reasons for rejecting or recommending alternatives to 
342.11  involuntary placement; and 
342.12     (iv) in the case of a commitment based on mental illness, 
342.13  the following information, if it is known or available:  
342.14  information that may be relevant to the administration of 
342.15  neuroleptic medications, if necessary, including the existence 
342.16  of a declaration under section 253B.03, subdivision 6d, or a 
342.17  health care directive under chapter 145C or a guardian, 
342.18  conservator, proxy, or agent with authority to make health care 
342.19  decisions for the proposed patient; information regarding the 
342.20  capacity of the proposed patient to make decisions regarding 
342.21  administration of neuroleptic medication; and whether the 
342.22  proposed patient is likely to consent or refuse consent to 
342.23  administration of the medication; and 
342.24     (v) seeking input from the proposed patient's health plan 
342.25  company to provide the court with information about services the 
342.26  enrollee needs and the least restrictive alternatives. 
342.27     (b) In conducting the investigation required by this 
342.28  subdivision, the screening team shall have access to all 
342.29  relevant medical records of proposed patients currently in 
342.30  treatment facilities.  Data collected pursuant to this clause 
342.31  shall be considered private data on individuals.  The 
342.32  prepetition screening report is not admissible in any court 
342.33  proceedings unrelated to the commitment proceedings. 
342.34     (c) When the prepetition screening team recommends 
342.35  commitment, a written report shall be sent to the county 
342.36  attorney for the county in which the petition is to be filed. 
343.1      (d) The prepetition screening team shall refuse to support 
343.2   a petition if the investigation does not disclose evidence 
343.3   sufficient to support commitment.  Notice of the prepetition 
343.4   screening team's decision shall be provided to the prospective 
343.5   petitioner.  
343.6      (e) If the interested person wishes to proceed with a 
343.7   petition contrary to the recommendation of the prepetition 
343.8   screening team, application may be made directly to the county 
343.9   attorney, who may determine whether or not to proceed with the 
343.10  petition.  Notice of the county attorney's determination shall 
343.11  be provided to the interested party.  
343.12     (f) If the proposed patient has been acquitted of a crime 
343.13  under section 611.026, the county attorney shall apply to the 
343.14  designated county agency in the county in which the acquittal 
343.15  took place for a preliminary investigation unless substantially 
343.16  the same information relevant to the proposed patient's current 
343.17  mental condition, as could be obtained by a preliminary 
343.18  investigation, is part of the court record in the criminal 
343.19  proceeding or is contained in the report of a mental examination 
343.20  conducted in connection with the criminal proceeding.  If a 
343.21  court petitions for commitment pursuant to the rules of criminal 
343.22  or juvenile procedure or a county attorney petitions pursuant to 
343.23  acquittal of a criminal charge under section 611.026, the 
343.24  prepetition investigation, if required by this section, shall be 
343.25  completed within seven days after the filing of the petition.  
343.26     Sec. 15.  Minnesota Statutes 1998, section 253B.185, is 
343.27  amended by adding a subdivision to read: 
343.28     Subd. 5.  [AFTERCARE AND CASE MANAGEMENT.] The state, in 
343.29  collaboration with the designated agency, is responsible for 
343.30  arranging and funding the aftercare and case management services 
343.31  for persons under commitment as sexual psychopathic 
343.32  personalities and sexually dangerous persons discharged after 
343.33  July 1, 1999. 
343.34     Sec. 16.  Minnesota Statutes 1998, section 254B.01, is 
343.35  amended by adding a subdivision to read: 
343.36     Subd. 7.  [ROOM AND BOARD RATE.] "Room and board rate" 
344.1   means a rate set for shelter, fuel, food, utilities, household 
344.2   supplies, and other costs necessary to provide room and board 
344.3   for a person in need of chemical dependency services. 
344.4      Sec. 17.  Minnesota Statutes 1998, section 254B.03, 
344.5   subdivision 2, is amended to read: 
344.6      Subd. 2.  [CHEMICAL DEPENDENCY SERVICES FUND PAYMENT.] (a) 
344.7   Payment from the chemical dependency fund is limited to payments 
344.8   for services other than detoxification that, if located outside 
344.9   of federally recognized tribal lands, would be required to be 
344.10  licensed by the commissioner as a chemical dependency treatment 
344.11  or rehabilitation program under sections 245A.01 to 245A.16, and 
344.12  services other than detoxification provided in another state 
344.13  that would be required to be licensed as a chemical dependency 
344.14  program if the program were in the state.  Out of state vendors 
344.15  must also provide the commissioner with assurances that the 
344.16  program complies substantially with state licensing requirements 
344.17  and possesses all licenses and certifications required by the 
344.18  host state to provide chemical dependency treatment.  Hospitals 
344.19  may apply for and receive licenses to be eligible vendors, 
344.20  notwithstanding the provisions of section 245A.03.  Except for 
344.21  chemical dependency transitional rehabilitation programs, 
344.22  vendors receiving payments from the chemical dependency fund 
344.23  must not require copayment from a recipient of benefits for 
344.24  services provided under this subdivision.  Payment from the 
344.25  chemical dependency fund shall be made for necessary room and 
344.26  board costs provided by vendors certified according to section 
344.27  254B.05, or in a community hospital licensed by the commissioner 
344.28  of health according to sections 144.50 to 144.56 to a client who 
344.29  is: 
344.30     (1) determined to meet the criteria for placement in a 
344.31  residential chemical dependency treatment program according to 
344.32  rules adopted under section 254A.03, subdivision 3; and 
344.33     (2) concurrently receiving a chemical dependency treatment 
344.34  service in a program licensed by the commissioner and reimbursed 
344.35  by the chemical dependency fund. 
344.36     (b) A county may, from its own resources, provide chemical 
345.1   dependency services for which state payments are not made.  A 
345.2   county may elect to use the same invoice procedures and obtain 
345.3   the same state payment services as are used for chemical 
345.4   dependency services for which state payments are made under this 
345.5   section if county payments are made to the state in advance of 
345.6   state payments to vendors.  When a county uses the state system 
345.7   for payment, the commissioner shall make monthly billings to the 
345.8   county using the most recent available information to determine 
345.9   the anticipated services for which payments will be made in the 
345.10  coming month.  Adjustment of any overestimate or underestimate 
345.11  based on actual expenditures shall be made by the state agency 
345.12  by adjusting the estimate for any succeeding month. 
345.13     (c) The commissioner shall coordinate chemical dependency 
345.14  services and determine whether there is a need for any proposed 
345.15  expansion of chemical dependency treatment services.  The 
345.16  commissioner shall deny vendor certification to any provider 
345.17  that has not received prior approval from the commissioner for 
345.18  the creation of new programs or the expansion of existing 
345.19  program capacity.  The commissioner shall consider the 
345.20  provider's capacity to obtain clients from outside the state 
345.21  based on plans, agreements, and previous utilization history, 
345.22  when determining the need for new treatment services. 
345.23     Sec. 18.  Minnesota Statutes 1998, section 254B.05, 
345.24  subdivision 1, is amended to read: 
345.25     Subdivision 1.  [LICENSURE REQUIRED.] Programs licensed by 
345.26  the commissioner are eligible vendors.  Hospitals may apply for 
345.27  and receive licenses to be eligible vendors, notwithstanding the 
345.28  provisions of section 245A.03.  American Indian programs located 
345.29  on federally recognized tribal lands that provide chemical 
345.30  dependency primary treatment, extended care, transitional 
345.31  residence, or outpatient treatment services, and are licensed by 
345.32  tribal government are eligible vendors.  Detoxification programs 
345.33  are not eligible vendors.  Programs that are not licensed as a 
345.34  chemical dependency residential or nonresidential treatment 
345.35  program by the commissioner or by tribal government are not 
345.36  eligible vendors.  To be eligible for payment under the 
346.1   Consolidated Chemical Dependency Treatment Fund, a vendor of a 
346.2   chemical dependency service must participate in the Drug and 
346.3   Alcohol Abuse Normative Evaluation System and the treatment 
346.4   accountability plan. 
346.5      Effective January 1, 2000, vendors of room and board are 
346.6   eligible for chemical dependency fund payment if the vendor:  
346.7      (1) is certified by the county or tribal governing body as 
346.8   having rules prohibiting residents bringing chemicals into the 
346.9   facility or using chemicals while residing in the facility and 
346.10  provide consequences for infractions of those rules; 
346.11     (2) has a current contract with a county or tribal 
346.12  governing body; 
346.13     (3) is determined to meet applicable health and safety 
346.14  requirements; 
346.15     (4) is not a jail or prison; and 
346.16     (5) is not concurrently receiving funds under chapter 256I 
346.17  for the recipient. 
346.18     Sec. 19.  Minnesota Statutes 1998, section 256.01, 
346.19  subdivision 6, is amended to read: 
346.20     Subd. 6.  [ADVISORY TASK FORCES.] The commissioner may 
346.21  appoint advisory task forces to provide consultation on any of 
346.22  the programs under the commissioner's administration and 
346.23  supervision.  A task force shall expire and the compensation, 
346.24  terms of office and removal of members shall be as provided in 
346.25  section 15.059.  Notwithstanding section 15.059, the 
346.26  commissioner may pay a per diem of $35 to consumers and family 
346.27  members whose participation is needed in legislatively 
346.28  authorized state-level task forces, and whose participation on 
346.29  the task force is not as a paid representative of any agency, 
346.30  organization, or association. 
346.31     Sec. 20.  Minnesota Statutes 1998, section 256B.0625, 
346.32  subdivision 20, is amended to read: 
346.33     Subd. 20.  [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 
346.34  extent authorized by rule of the state agency, medical 
346.35  assistance covers case management services to persons with 
346.36  serious and persistent mental illness and children with severe 
347.1   emotional disturbance.  Services provided under this section 
347.2   must meet the relevant standards in sections 245.461 to 
347.3   245.4888, the Comprehensive Adult and Children's Mental Health 
347.4   Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 
347.5   9505.0322, excluding subpart 10. 
347.6      (b) Entities meeting program standards set out in rules 
347.7   governing family community support services as defined in 
347.8   section 245.4871, subdivision 17, are eligible for medical 
347.9   assistance reimbursement for case management services for 
347.10  children with severe emotional disturbance when these services 
347.11  meet the program standards in Minnesota Rules, parts 9520.0900 
347.12  to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 
347.13     (c) Medical assistance and MinnesotaCare payment for mental 
347.14  health case management shall be made on a monthly basis.  In 
347.15  order to receive payment for an eligible child, the provider 
347.16  must document at least a face-to-face contact with the child, 
347.17  the child's parents, or the child's legal representative.  To 
347.18  receive payment for an eligible adult, the provider must 
347.19  document: 
347.20     (1) at least a face-to-face contact with the adult or the 
347.21  adult's legal representative; or 
347.22     (2) at least a telephone contact with the adult or the 
347.23  adult's legal representative and document a face-to-face contact 
347.24  with the adult or the adult's legal representative within the 
347.25  preceding two months. 
347.26     (d) Payment for mental health case management provided by 
347.27  county or state staff shall be based on the monthly rate 
347.28  methodology under section 256B.094, subdivision 6, paragraph 
347.29  (b), with separate rates calculated for child welfare and mental 
347.30  health, and within mental health, separate rates for children 
347.31  and adults. 
347.32     (e) Payment for mental health case management provided by 
347.33  county-contracted vendors shall be based on a monthly rate 
347.34  negotiated by the host county.  The negotiated rate must not 
347.35  exceed the rate charged by the vendor for the same service to 
347.36  other payers.  If the service is provided by a team of 
348.1   contracted vendors, the county may negotiate a team rate with a 
348.2   vendor who is a member of the team.  The team shall determine 
348.3   how to distribute the rate among its members.  No reimbursement 
348.4   received by contracted vendors shall be returned to the county, 
348.5   except to reimburse the county for advance funding provided by 
348.6   the county to the vendor. 
348.7      (f) If the service is provided by a team which includes 
348.8   contracted vendors and county or state staff, the costs for 
348.9   county or state staff participation in the team shall be 
348.10  included in the rate for county-provided services.  In this 
348.11  case, the contracted vendor and the county may each receive 
348.12  separate payment for services provided by each entity in the 
348.13  same month.  In order to prevent duplication of services, the 
348.14  county must document, in the recipient's file, the need for team 
348.15  case management and a description of the roles of the team 
348.16  members. 
348.17     (g) The commissioner shall calculate the nonfederal share 
348.18  of actual medical assistance and general assistance medical care 
348.19  payments for each county, based on the higher of calendar year 
348.20  1995 or 1996, by service date, project that amount forward to 
348.21  1999, and transfer one-half of the result from medical 
348.22  assistance and general assistance medical care to each county's 
348.23  mental health grants under sections 245.4886 and 256E.12 for 
348.24  calendar year 1999.  The annualized minimum amount added to each 
348.25  county's mental health grant shall be $3,000 per year for 
348.26  children and $5,000 per year for adults.  The commissioner may 
348.27  reduce the statewide growth factor in order to fund these 
348.28  minimums.  The annualized total amount transferred shall become 
348.29  part of the base for future mental health grants for each county.
348.30     (h) Any net increase in revenue to the county as a result 
348.31  of the change in this section must be used to provide expanded 
348.32  mental health services as defined in sections 245.461 to 
348.33  245.4888, the Comprehensive Adult and Children's Mental Health 
348.34  Acts, excluding inpatient and residential treatment.  For 
348.35  adults, increased revenue may also be used for services and 
348.36  consumer supports which are part of adult mental health projects 
349.1   approved under Laws 1997, chapter 203, article 7, section 25.  
349.2   For children, increased revenue may also be used for respite 
349.3   care and nonresidential individualized rehabilitation services 
349.4   as defined in section 245.492, subdivisions 17 and 23.  
349.5   "Increased revenue" has the meaning given in Minnesota Rules, 
349.6   part 9520.0903, subpart 3.  
349.7      (i) Notwithstanding section 256B.19, subdivision 1, the 
349.8   nonfederal share of costs for mental health case management 
349.9   shall be provided by the recipient's county of responsibility, 
349.10  as defined in sections 256G.01 to 256G.12, from sources other 
349.11  than federal funds or funds used to match other federal funds.  
349.12     (j) The commissioner may suspend, reduce, or terminate the 
349.13  reimbursement to a provider that does not meet the reporting or 
349.14  other requirements of this section.  The county of 
349.15  responsibility, as defined in sections 256G.01 to 256G.12, is 
349.16  responsible for any federal disallowances.  The county may share 
349.17  this responsibility with its contracted vendors.  
349.18     (k) The commissioner shall set aside a portion of the 
349.19  federal funds earned under this section to repay the special 
349.20  revenue maximization account under section 256.01, subdivision 
349.21  2, clause (15).  The repayment is limited to: 
349.22     (1) the costs of developing and implementing this section; 
349.23  and 
349.24     (2) programming the information systems. 
349.25     (l) Notwithstanding section 256.025, subdivision 2, 
349.26  payments to counties for case management expenditures under this 
349.27  section shall only be made from federal earnings from services 
349.28  provided under this section.  Payments to contracted vendors 
349.29  shall include both the federal earnings and the county share. 
349.30     (m) Notwithstanding section 256B.041, county payments for 
349.31  the cost of mental health case management services provided by 
349.32  county or state staff shall not be made to the state treasurer.  
349.33  For the purposes of mental health case management services 
349.34  provided by county or state staff under this section, the 
349.35  centralized disbursement of payments to counties under section 
349.36  256B.041 consists only of federal earnings from services 
350.1   provided under this section. 
350.2      (n) Case management services under this subdivision do not 
350.3   include therapy, treatment, legal, or outreach services. 
350.4      (o) If the recipient is a resident of a nursing facility, 
350.5   intermediate care facility, or hospital, and the recipient's 
350.6   institutional care is paid by medical assistance, payment for 
350.7   case management services under this subdivision is limited to 
350.8   the last 30 days of the recipient's residency in that facility 
350.9   and may not exceed more than two months in a calendar year. 
350.10     (p) Payment for case management services under this 
350.11  subdivision shall not duplicate payments made under other 
350.12  program authorities for the same purpose. 
350.13     (q) By July 1, 2000, the commissioner shall evaluate the 
350.14  effectiveness of the changes required by this section, including 
350.15  changes in number of persons receiving mental health case 
350.16  management, changes in hours of service per person, and changes 
350.17  in caseload size. 
350.18     (r) For each calendar year beginning with the calendar year 
350.19  2001, the annualized amount of state funds for each county 
350.20  determined under paragraph (g) shall be adjusted by the county's 
350.21  percentage change in the average number of clients per month who 
350.22  received case management under this section during the fiscal 
350.23  year that ended six months prior to the calendar year in 
350.24  question, in comparison to the prior fiscal year. 
350.25     (s) For counties receiving the minimum allocation of $3,000 
350.26  or $5,000 described in paragraph (g), the adjustment in 
350.27  paragraph (r) shall be determined so that the county receives 
350.28  the higher of the following amounts: 
350.29     (1) a continuation of the minimum allocation in paragraph 
350.30  (g); or 
350.31     (2) an amount based on that county's average number of 
350.32  clients per month who received case management under this 
350.33  section during the fiscal year that ended six months prior to 
350.34  the calendar year in question, in comparison to the prior fiscal 
350.35  year, times the average statewide grant per person per month for 
350.36  counties not receiving the minimum allocation. 
351.1      (t) The adjustments in paragraphs (r) and (s) shall be 
351.2   calculated separately for children and adults. 
351.3      Sec. 21.  Laws 1995, chapter 207, article 8, section 41, as 
351.4   amended by Laws 1997, chapter 203, article 7, section 25, is 
351.5   amended to read: 
351.6      Sec. 41.  [245.4661] [PILOT PROJECTS TO TEST PROVIDE 
351.7   ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH SERVICES.] 
351.8      Subdivision 1.  [AUTHORIZATION FOR PILOT PROJECTS.] The 
351.9   commissioner of human services may approve pilot projects to 
351.10  test provide alternatives to or the enhanced enhance 
351.11  coordination of the delivery of mental health services required 
351.12  under the Minnesota Comprehensive Adult Mental Health Act, 
351.13  Minnesota Statutes, sections 245.461 to 245.486. 
351.14     Subd. 2.  [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 
351.15  pilot projects shall be established to design, plan, and improve 
351.16  the mental health service delivery system for adults with 
351.17  serious and persistent mental illness that would: 
351.18     (1) provide an expanded array of services from which 
351.19  clients can choose services appropriate to their needs; 
351.20     (2) be based on purchasing strategies that improve access 
351.21  and coordinate services without cost shifting; 
351.22     (3) incorporate existing state facilities and resources 
351.23  into the community mental health infrastructure through creative 
351.24  partnerships with local vendors; and 
351.25     (4) utilize existing categorical funding streams and 
351.26  reimbursement sources in combined and creative ways, except 
351.27  appropriations to regional treatment centers and all funds that 
351.28  are attributable to the operation of state-operated services are 
351.29  excluded unless appropriated specifically by the legislature for 
351.30  a purpose consistent with this section. 
351.31     (b) All projects funded by January 1, 1997, must complete 
351.32  the planning phase and be operational by June 30, 1997; all 
351.33  projects funded by January 1, 1998, must be operational by June 
351.34  30, 1998.  
351.35     Subd. 3.  [PROGRAM EVALUATION.] Evaluation of each project 
351.36  will be based on outcome evaluation criteria negotiated with 
352.1   each project prior to implementation. 
352.2      Subd. 4.  [NOTICE OF PROJECT DISCONTINUATION.] Each project 
352.3   may be discontinued for any reason by the project's managing 
352.4   entity or the commissioner of human services, after 90 days' 
352.5   written notice to the other party. 
352.6      Subd. 5.  [PLANNING FOR PILOT PROJECTS.] Each local plan 
352.7   for a pilot project must be developed under the direction of the 
352.8   county board, or multiple county boards acting jointly, as the 
352.9   local mental health authority.  The planning process for each 
352.10  pilot shall include, but not be limited to, mental health 
352.11  consumers, families, advocates, local mental health advisory 
352.12  councils, local and state providers, representatives of state 
352.13  and local public employee bargaining units, and the department 
352.14  of human services.  As part of the planning process, the county 
352.15  board or boards shall designate a managing entity responsible 
352.16  for receipt of funds and management of the pilot project. 
352.17     Subd. 6.  [DUTIES OF COMMISSIONER.] (a) For purposes of the 
352.18  pilot projects, the commissioner shall facilitate integration of 
352.19  funds or other resources as needed and requested by each 
352.20  project.  These resources may include: 
352.21     (1) residential services funds administered under Minnesota 
352.22  Rules, parts 9535.2000 to 9535.3000, in an amount to be 
352.23  determined by mutual agreement between the project's managing 
352.24  entity and the commissioner of human services after an 
352.25  examination of the county's historical utilization of facilities 
352.26  located both within and outside of the county and licensed under 
352.27  Minnesota Rules, parts 9520.0500 to 9520.0690; 
352.28     (2) community support services funds administered under 
352.29  Minnesota Rules, parts 9535.1700 to 9535.1760; 
352.30     (3) other mental health special project funds; 
352.31     (4) medical assistance, general assistance medical care, 
352.32  MinnesotaCare and group residential housing if requested by the 
352.33  project's managing entity, and if the commissioner determines 
352.34  this would be consistent with the state's overall health care 
352.35  reform efforts; and 
352.36     (5) regional treatment center nonfiscal resources to the 
353.1   extent agreed to by the project's managing entity and the 
353.2   regional treatment center. 
353.3      (b) The commissioner shall consider the following criteria 
353.4   in awarding start-up and implementation grants for the pilot 
353.5   projects: 
353.6      (1) the ability of the proposed projects to accomplish the 
353.7   objectives described in subdivision 2; 
353.8      (2) the size of the target population to be served; and 
353.9      (3) geographical distribution. 
353.10     (c) The commissioner shall review overall status of the 
353.11  projects initiatives at least every two years and recommend any 
353.12  legislative changes needed by January 15 of each odd-numbered 
353.13  year. 
353.14     (d) The commissioner may waive administrative rule 
353.15  requirements which are incompatible with the implementation of 
353.16  the pilot project. 
353.17     (e) The commissioner may exempt the participating counties 
353.18  from fiscal sanctions for noncompliance with requirements in 
353.19  laws and rules which are incompatible with the implementation of 
353.20  the pilot project. 
353.21     (f) The commissioner may award grants to an entity 
353.22  designated by a county board or group of county boards to pay 
353.23  for start-up and implementation costs of the pilot project. 
353.24     Subd. 7.  [DUTIES OF COUNTY BOARD.] The county board, or 
353.25  other entity which is approved to administer a pilot project, 
353.26  shall: 
353.27     (1) administer the project in a manner which is consistent 
353.28  with the objectives described in subdivision 2 and the planning 
353.29  process described in subdivision 5; 
353.30     (2) assure that no one is denied services for which they 
353.31  would otherwise be eligible; and 
353.32     (3) provide the commissioner of human services with timely 
353.33  and pertinent information through the following methods: 
353.34     (i) submission of community social services act plans and 
353.35  plan amendments; 
353.36     (ii) submission of social services expenditure and grant 
354.1   reconciliation reports, based on a coding format to be 
354.2   determined by mutual agreement between the project's managing 
354.3   entity and the commissioner; and 
354.4      (iii) submission of data and participation in an evaluation 
354.5   of the pilot projects, to be designed cooperatively by the 
354.6   commissioner and the projects. 
354.7      Sec. 22.  Laws 1997, chapter 203, article 9, section 19, is 
354.8   amended to read: 
354.9      Sec. 19.  [TRANSITION FOR THE COMPULSIVE GAMBLING TREATMENT 
354.10  PROGRAM.] 
354.11     The commissioner of human services shall conduct a 
354.12  transition of treatment programs for compulsive gambling from 
354.13  the treatment center model to a model in which reimbursement for 
354.14  treatment of an individual compulsive gambler from an approved 
354.15  provider is on a fee-for-service basis on the following schedule:
354.16     (1) one-third of compulsive gamblers treated through the 
354.17  program must receive services paid for from the individual 
354.18  treatment reimbursement model beginning October 1, 1997; 
354.19     (2) two-thirds of compulsive gamblers treated through the 
354.20  program must receive services paid for from the individual 
354.21  treatment reimbursement model beginning July 1, 1998; and 
354.22     (3) 100 percent of compulsive gamblers treated through the 
354.23  program must receive treatment paid for from the individual 
354.24  treatment reimbursement model beginning July 1, 1999 2000. 
354.25     Sec. 23.  Laws 1998, chapter 407, article 7, section 2, 
354.26  subdivision 3, is amended to read: 
354.27     Subd. 3.  [LAND DESCRIPTION.] That part of the Northeast 
354.28  Quarter (NE l/4) of Section 30 29, Township 45 North, Range 30 
354.29  West, Crow Wing county, Minnesota, described as follows: 
354.30     Commencing at the southeast corner of said Northeast 
354.31     quarter; thence North 00 degrees 46 minutes 05 seconds 
354.32     West, bearing based on the Crow Wing county Coordinate 
354.33     Database NAD 83/94, 1520.06 feet along the east line of 
354.34     said Northeast quarter to the point of beginning; thence 
354.35     continue North 00 degrees 46 minutes 05 seconds West 634.14 
354.36     feet along said east line of the Northeast quarter; thence 
355.1      South 89 degrees 13 minutes 20 seconds West 550.00 feet; 
355.2      thence South 18 degrees 57 minutes 23 seconds East 115.59 
355.3      feet; thence South 42 degrees 44 minutes 39 seconds East 
355.4      692.37 feet; thence South 62 degrees 46 minutes 19 seconds 
355.5      East 20.24 feet; thence North 89 degrees 13 minutes 55 
355.6      seconds East 33.00 feet to the point of beginning.  
355.7      Containing 4.69 acres, more or less.  Subject to the 
355.8      right-of-way of the Township road along the east side 
355.9      thereof, subject to other easements, reservations, and 
355.10     restrictions of record, if any. 
355.11     Sec. 24.  [ESTABLISHMENT AND PURPOSE OF THE SUPPORTIVE 
355.12  HOUSING AND MANAGED CARE PILOT PROJECT.] 
355.13     Subdivision 1.  [ESTABLISHMENT AND PURPOSE.] If funding is 
355.14  available, the commissioner of human services may establish a 
355.15  supportive housing and managed care pilot project to determine 
355.16  whether integrating the delivery of housing, supportive 
355.17  services, and health care into a single, flexible program will 
355.18  reduce public expenditures on homeless individuals, increase 
355.19  their employment rates, and provide a new alternative to 
355.20  providing services to a hard-to-serve population. 
355.21     The commissioner of human services may create a block grant 
355.22  program for counties for the purpose of providing rent subsidies 
355.23  and supportive services to eligible individuals.  Minimum 
355.24  project and application requirements may be developed by the 
355.25  commissioner in cooperation with counties and their nonprofit 
355.26  partners with the goal to provide the maximum flexibility in 
355.27  program design.  If any funds are available, the funds must be 
355.28  coordinated with health care services for eligible individuals. 
355.29     Subd. 2.  [COUNTY ELIGIBILITY.] If the commissioner 
355.30  establishes the pilot project under subdivision 1, a county may 
355.31  request funding for the purposes of the pilot project if the 
355.32  county: 
355.33     (1) agrees to develop, in cooperation with nonprofit 
355.34  partners, a supportive housing and managed care pilot project 
355.35  that integrates the delivery of housing, support services, and 
355.36  health care for eligible individuals or agrees to contract with 
356.1   an existing integrated program; and 
356.2      (2) develops a method for evaluating the quality of the 
356.3   integrated services provided and the amount of any resulting 
356.4   cost savings to the county and state. 
356.5      Subd. 3.  [PARTICIPANT ELIGIBILITY.] In order to be 
356.6   eligible for the pilot project, a county must determine that an 
356.7   individual: 
356.8      (1) meets the eligibility requirements of the group 
356.9   residential housing program under Minnesota Statutes, section 
356.10  256I.04, subdivision 1; 
356.11     (2) is a homeless person or a person at risk of 
356.12  homelessness.  For purposes of this pilot project, "homeless 
356.13  person" means a person who is living, or at imminent risk of 
356.14  living, on the street, in a shelter, or is evicted from a 
356.15  dwelling or discharged from a regional human services center, 
356.16  community hospital, or residential treatment program, and has no 
356.17  appropriate housing available and lacks the resources necessary 
356.18  to access permanent housing as determined by the county 
356.19  requesting funding under the pilot project; and 
356.20     (3) is a person with mental illness, a history of substance 
356.21  abuse, or a person with HIV. 
356.22     Subd. 4.  [FUNDING.] If the commissioner establishes the 
356.23  pilot project under subdivision 1, a county may request funding 
356.24  from the commissioner for a specified number of eligible 
356.25  participants for the pilot project.  The commissioner shall 
356.26  review the request for compliance with subdivisions 1 to 3 and 
356.27  may approve or disapprove the request.  The commissioner shall 
356.28  transfer funding to be allocated to participating counties as a 
356.29  block grant and paid on a monthly basis. 
356.30     Subd. 5.  [REPORT.] If the commissioner establishes the 
356.31  pilot project under subdivision 1, participating counties and 
356.32  the commissioner of human services shall collaborate to prepare 
356.33  and issue an annual report beginning December 1, 2001, to the 
356.34  appropriate committee chairs in the senate and house on the use 
356.35  of state resources, including other funds leveraged for this 
356.36  initiative, the status of individuals being served in the pilot 
357.1   project, and the cost-effectiveness of the pilot project.  The 
357.2   commissioner shall provide data that may be needed to evaluate 
357.3   the pilot project to counties that request the data. 
357.4      Subd. 6.  [SUNSET.] The pilot project shall sunset June 30, 
357.5   2005. 
357.6      Sec. 25.  [CONVEYANCE OF STATE LANDS TO COUNTY OF ISANTI.] 
357.7      (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
357.8   94.16, the commissioner of human services, through the 
357.9   commissioner of administration, may transfer to the county of 
357.10  Isanti the lands described in paragraph (c), for no 
357.11  consideration.  The commissioner of human services and the 
357.12  county may attach to the transfer conditions that they agree are 
357.13  appropriate, including conditions that relate to water and sewer 
357.14  service.  The deed to convey the property must contain a clause 
357.15  that the property shall revert to the state if the property 
357.16  ceases to be used for a public purpose. 
357.17     (b) The conveyance must be in a form approved by the 
357.18  attorney general. 
357.19     (c) The land that may be transferred consists of 21.9 
357.20  acres, more or less, and is described as follows: 
357.21     That part of the Southwest Quarter of the Southeast Quarter 
357.22     and that part of Government Lot 4, both in Section 32, 
357.23     Township 36, Range 23, Isanti County, Minnesota, described 
357.24     jointly as follows:  Commencing at the southwest corner of 
357.25     the Southwest Quarter of the Southeast Quarter of Section 
357.26     32; thence North 89 degrees 45 minutes 12 seconds East, 
357.27     assumed bearing, along the south line of said SW 1/4 of SE 
357.28     1/4, a distance of 609.48 feet; thence North 1 degree 30 
357.29     minutes 30 seconds West, a distance of 149.17 feet to the 
357.30     point of beginning of the parcel to be herein described; 
357.31     thence continuing North 1 degrees 30 minutes 30 seconds 
357.32     West, a distance of 1113.59 feet; thence South 89 degrees 
357.33     59 minutes 36 seconds West, a distance of 496.41 feet; 
357.34     thence southwesterly along a tangential curve concave to 
357.35     the southeast, radius 318.10 feet, central angle 90 degrees 
357.36     16 minutes 37 seconds, for an arc length of 501.21 feet; 
358.1      thence South 0 degrees 17 minutes 01 seconds East, tangent 
358.2      to said curve, for a distance of 86.59 feet; thence 
358.3      southerly along a tangential curve concave to the west, 
358.4      radius 398.10 feet, central angle 29 degrees 47 minutes 02 
358.5      seconds, for an arc length of 206.94 feet; thence south 29 
358.6      degrees 30 minutes 01 seconds West, tangent to said curve, 
358.7      for a distance of 34.23 feet; thence southerly along a 
358.8      tangential curve concave to the east, radius 318.10 feet, 
358.9      central angle 29 degrees 49 minutes 32 seconds, for an arc 
358.10     length of 165.59 feet; thence South 0 degrees 19 minutes 31 
358.11     seconds East, tangent to said curve for a distance of 
358.12     320.65 feet to the point of intersection with a line that 
358.13     bears West (North 90 degrees 00 minutes West) from the 
358.14     point of beginning; thence East (North 90 degrees 00 
358.15     minutes East), a distance of 951.22 feet to the point of 
358.16     beginning. 
358.17     Subject to the existing city of Cambridge water main 
358.18     easement. 
358.19     (d) The county of Isanti may use the land for economic 
358.20  development.  Economic development is a public purpose within 
358.21  the meaning of the term as used in Laws 1990, chapter 610, 
358.22  article 1, section 12, subdivision 5, and sales or conveyances 
358.23  to private parties shall be considered economic development.  
358.24  Property conveyed by the state under this section shall not 
358.25  revert to the state if it is conveyed or otherwise encumbered by 
358.26  the county as part of the county economic development activity. 
358.27     Sec. 26.  [CONVEYANCE OF STATE LAND TO CITY OF CAMBRIDGE.] 
358.28     (a) Notwithstanding Minnesota Statutes, sections 94.09 to 
358.29  94.16, the commissioner of human services, through the 
358.30  commissioner of administration, may transfer to the city of 
358.31  Cambridge the lands described in paragraph (c), for no 
358.32  consideration.  The commissioner of human services and the city 
358.33  may attach to the transfer conditions that they agree are 
358.34  appropriate, including conditions that relate to water and sewer 
358.35  service.  The deed to convey the property must contain a clause 
358.36  that the property shall revert to the state if the property 
359.1   ceases to be used for a public purpose. 
359.2      (b) The conveyance must be in a form approved by the 
359.3   attorney general. 
359.4      (c) Subject to the right-of-way for state trunk highway No. 
359.5   293 and south Dellwood street and subject to other easements, 
359.6   reservations, road or street right-of-ways, and restrictions of 
359.7   record, if any, the land to be conveyed may include all or part 
359.8   of any of the parcels described as follows: 
359.9      (1) that part of the Northeast Quarter of the Northeast 
359.10     Quarter of Section 5, Township 35, Range 23, Isanti County, 
359.11     Minnesota, lying north of a line drawn parallel with and 50 
359.12     feet north of the center line of State Highway No. 293, as 
359.13     laid out and constructed and lying westerly of the 
359.14     following described line: 
359.15     Commencing at a point where the West line of the 
359.16     right-of-way of the Great Northern Railway Company 
359.17     (presently the Burlington Northern and Santa Fe Railway) 
359.18     intersects the North line of said Section 5, said point now 
359.19     being the intersection of the North line of said Section 5 
359.20     with the center line of State Trunk Highway No. 65 as now 
359.21     laid out and constructed (presently known as South Main 
359.22     Street); thence on a bearing of West and along the North 
359.23     line of said Section 5 a distance of 539.5 feet to the 
359.24     point of beginning of the line to be herein described; 
359.25     thence on a bearing of South, a distance of 451.75 feet to 
359.26     the point of intersection with a line drawn parallel with 
359.27     and distant 50 feet north of the center line of State 
359.28     Highway No. 293, as laid out and constructed and there 
359.29     terminating.  Containing 1/4 acre, more or less. 
359.30     (2) that part of the Northwest Quarter of the Southeast 
359.31     Quarter and that part of Governments Lots 3 and 4, all in 
359.32     Section 32, Township 36, Range 23, Isanti County, 
359.33     Minnesota, described jointly as follows: 
359.34     Commencing at the East quarter corner of Section 32, 
359.35     Township 36, Range 23, Isanti County, Minnesota; thence 
359.36     South 89 degrees 44 minutes 35 seconds West, assumed 
360.1      bearing, along the east-west quarter line of said Section 
360.2      32, a distance of 2251.43 feet; thence South 1 degree 48 
360.3      minutes 40 seconds East, a distance of 344.47 feet to the 
360.4      south line of Lot 30 of Auditor's Subdivision No. 9; thence 
360.5      South 89 degrees 35 minutes 5 seconds West, along said 
360.6      south line and the westerly projection thereof, a distance 
360.7      of 740.00 feet to the point of beginning of the parcel to 
360.8      be herein described; thence North 89 degrees 35 minutes, 05 
360.9      seconds East, retracing the last described course, a 
360.10     distance of 534.66 feet to the northwest corner of the 
360.11     recorded plat of RIVERWOOD VILLAGE; thence South 2 degrees 
360.12     40 minutes 50 seconds East, a distance of 338.38 feet, 
360.13     along the westerly line of said RIVERWOOD VILLAGE to the 
360.14     southwest corner of said RIVERWOOD VILLAGE; thence North 89 
360.15     degrees 44 minutes 50 seconds East, along the south line of 
360.16     said RIVERWOOD VILLAGE, a distance of 1074.56 feet; thence 
360.17     South 3 degrees 35 minutes 15 seconds East, a distance of 
360.18     258.66 feet; thence southwesterly along a tangential curve 
360.19     concave to the northwest, radius 318.10 feet, central angle 
360.20     93 degrees 34 minutes 51 seconds for an arc length of 
360.21     519.56 feet; thence South 89 degrees 59 minutes 37 seconds 
360.22     West tangent to said curve for a distance of 825.86 feet; 
360.23     thence southwesterly along a tangential curve concave to 
360.24     the southeast, radius 398.10 feet, central angle 70 degrees 
360.25     55 minutes 13 seconds, for an arc length of 492.76 feet; 
360.26     thence South 89 degrees 51 minutes 30 seconds West, not 
360.27     tangent to the last described curve for a distance of 
360.28     523.31 feet; thence South 1 degree 57 minutes 33 seconds 
360.29     West, a distance of 29.59 feet; thence South 89 degrees 57 
360.30     minutes 55 seconds West, a distance of 1020 feet, more or 
360.31     less, to the easterly shoreline of the Rum River; thence 
360.32     northerly along said easterly shoreline to the point of 
360.33     intersection with a line that bears North 45 degrees 24 
360.34     minutes 55 seconds West from the point of beginning; thence 
360.35     South 45 degrees 24 minutes 55 seconds East, along said 
360.36     line, a distance of 180 feet, more or less, to the point of 
361.1      beginning.  Containing 48 acres, more or less. 
361.2      (3) that part of the Northwest Quarter of the Northeast 
361.3      Quarter and that part of the Northeast Quarter of the 
361.4      Northwest Quarter, both in Section 5, Township 35, Range 
361.5      23, Isanti County, Minnesota, described jointly as follows: 
361.6      Beginning at the northwest corner of the NW 1/4 of NE 1/4 
361.7      of Section 5; thence North 89 degrees 45 minutes 12 seconds 
361.8      East, assumed bearing, along the north line of said NW 1/4 
361.9      of NE 1/4, a distance of 1321.82 feet to the northeast 
361.10     corner of said NW 1/4 of NE 1/4 thence South 4 degrees 04 
361.11     minutes 02 seconds West, along the east line of said NW 1/4 
361.12     of NE 1/4, a distance of 452.83 feet; thence South 89 
361.13     degrees 45 minutes 02 seconds West, a distance of 1393.6 
361.14     feet; thence northwesterly, along a nontangential curve 
361.15     concave to the northeast, radius 318.17 feet, central angle 
361.16     75 degrees 28 minutes 03 seconds, for an arc length of 
361.17     419.08 feet (the chord of said curve bears North 38 degrees 
361.18     03 minutes 32 seconds West and has a length of 389.44 
361.19     feet); thence North 0 degrees 19 minutes 31 seconds West, 
361.20     tangent to said curve, for a distance of 142.65 feet to the 
361.21     north line of the NE 1/4 of NW 1/4 of said Section 5; 
361.22     thence North 89 degrees 32 minutes 15 seconds East, along 
361.23     said north line, a distance of 344.81 feet to the point of 
361.24     beginning.  Containing 16 acres, more or less.  
361.25     (4) that part of the Southwest Quarter of the Southeast 
361.26     Quarter, that part of the Northwest Quarter of the 
361.27     Southeast Quarter and that part of Government Lot 4, all in 
361.28     Section 32, Township 36, Range 23, Isanti County, 
361.29     Minnesota, described jointly as follows: 
361.30     Beginning at the southwest corner of the SW 1/4 of SE 1/4 
361.31     of Section 32; thence North 89 degrees 45 minutes 12 
361.32     seconds East, assumed bearing, along the south line of said 
361.33     SW 1/4 of SE 1/4, a distance of 1321.82 feet to the 
361.34     southeast corner of said SW 1/4 of SE 1/4 thence North 2 
361.35     degrees 40 minutes 49 seconds West, along the east line of 
361.36     said SW 1/4 of SE 1/4 and along the east line of the NW 1/4 
362.1      of SE 1/4, a distance of 1465.32 feet; thence southwesterly 
362.2      along a nontangential curve concave to the northwest, 
362.3      radius 398.10 feet, central angle 60 degrees 52 minutes 54 
362.4      seconds, for an arc length of 423.02 feet (said curve has a 
362.5      chord that bears South 59 degrees 33 minutes 09 seconds 
362.6      West and a chord length of 403.40 feet); thence South 89 
362.7      degrees 59 minutes 37 seconds West, tangent to said curve, 
362.8      for a distance of 825.68 feet; thence southwesterly along a 
362.9      tangential curve concave to the southeast, radius 318.10 
362.10     feet, central angle 90 degrees 16 minutes 37 seconds, for 
362.11     an arc length of 501.21 feet; thence South 0 degrees 17 
362.12     minutes 01 seconds East, tangent to said curve, for a 
362.13     distance of 86.59 feet; thence southerly along a tangential 
362.14     curve concave to the West, radius 398.10 feet, central 
362.15     angle 29 degrees 47 minutes 02 seconds, for an arc length 
362.16     of 206.94 feet; thence South 29 degrees 30 minutes 01 
362.17     seconds West tangent to said curve, for a distance of 34.23 
362.18     feet; thence southerly along a tangential curve concave to 
362.19     the east, radius 318.20 feet, central angle 29 degrees 49 
362.20     minutes 32 seconds for an arc length of 165.59 feet; thence 
362.21     South 0 degrees 19 minutes 31 seconds East, tangent to said 
362.22     curve, for a distance of 475.17 feet to the south line of 
362.23     Government Lot 4, Section 32; thence North 89 degrees 32 
362.24     minutes 15 seconds East, along said south line, a distance 
362.25     of 344.81 feet to the point of beginning.  Containing 44.9 
362.26     acres, more or less. 
362.27     EXCEPTING THEREFROM that parcel described on Quit Claim 
362.28     Deed from the State of Minnesota to Wilfred R. and June E. 
362.29     Norman, filed in Book 92 of Deeds, page 647, in the office 
362.30     of the County Recorder, Isanti County, Minnesota.  
362.31     ALSO EXCEPTING THEREFROM that parcel described on Quit 
362.32     Claim Deed from the State of Minnesota to Frank C. Brody 
362.33     and Lorraine D.S. Brody, filed in Book 102 of Deeds, page 
362.34     232, in the office of the County Recorder, Isanti County, 
362.35     Minnesota. 
362.36     (d) The city of Cambridge may use the land for economic 
363.1   development.  Economic development is a public purpose within 
363.2   the meaning of the term as used in Laws 1990, chapter 610, 
363.3   article 1, section 12, subdivision 5, and sales or conveyances 
363.4   to private parties shall be considered economic development.  
363.5   Property conveyed by the state under this section shall not 
363.6   revert to the state if it is conveyed or otherwise encumbered by 
363.7   the city as a part of the city economic development activity. 
363.8      Sec. 27.  [CONVEYANCE OF CITY LAND TO STATE OF MINNESOTA.] 
363.9      (a) The commissioner of administration may accept all, or 
363.10  any part of, the land described in paragraph (d) from the city 
363.11  of Cambridge, after the city council passes a resolution which 
363.12  declares the property is surplus to its needs. 
363.13     (b) The conveyance shall be in a form approved by the 
363.14  attorney general. 
363.15     (c) The conveyance may be subject to a scenic easement, as 
363.16  defined in Minnesota Statutes, section 103F.311, subdivision 6.  
363.17  The easement shall be under the custodial control of the 
363.18  commissioner of natural resources and only required on the 
363.19  portion of conveyed land that is designated for inclusion in the 
363.20  wild and scenic river system under Minnesota Statutes, section 
363.21  103F.325.  The scenic easement shall allow for continued use of 
363.22  any existing structures located within the easement and for 
363.23  development of walking paths or trails within the easement. 
363.24     (d) Subject to the right-of-way for state trunk highway No. 
363.25  293, and subject to other easements, reservations, street 
363.26  right-of-ways, and restrictions of record, if any, the land to 
363.27  be conveyed may include all, or part of, the parcel described as 
363.28  follows: 
363.29     That part of Government Lot 4 and that part of the 
363.30     Northeast Quarter of the Northwest Quarter, all in Section 
363.31     5, Township 35, Range 23, Isanti County, Minnesota, 
363.32     described jointly as follows:  Commencing at the Northeast 
363.33     corner of the Northwest Quarter of Section 5, thence South 
363.34     89 degrees 47 minutes 10 seconds West, assumed bearing 
363.35     along the north line of the Northwest Quarter of Section 5, 
363.36     a distance of 656.00 feet to the point of beginning of the 
364.1      parcel to be herein described, thence South 00 degrees 03 
364.2      minutes 35 seconds East, a distance of 350.00 feet, thence 
364.3      South 89 degrees 47 minutes 10 seconds West, parallel with 
364.4      the north line of said Northwest Quarter of Section 5 to 
364.5      the easterly shoreline of the Rum River, thence 
364.6      northeasterly along said easterly shoreline to the north 
364.7      line of the Northwest Quarter of Section 5, thence North 89 
364.8      degrees 47 minutes 10 seconds East, along said north line 
364.9      to the point of beginning. 
364.10     Sec. 28.  [REPORT TO LEGISLATURE ON ESTABLISHING ENTERPRISE 
364.11  ACTIVITIES WITHIN STATE-OPERATED SERVICES.] 
364.12     The commissioner of human services shall report and make 
364.13  recommendations to the legislature, by December 15, 1999, on 
364.14  establishing enterprise activities within state-operated 
364.15  services, under Minnesota Statutes, section 246.0136, and their 
364.16  status. 
364.17     Sec. 29.  [REPEALER.] 
364.18     Minnesota Statutes 1998, section 254A.145, is repealed. 
364.19                             ARTICLE 6 
364.20                        ASSISTANCE PROGRAMS 
364.21     Section 1.  Minnesota Statutes 1998, section 256D.051, 
364.22  subdivision 2a, is amended to read: 
364.23     Subd. 2a.  [DUTIES OF COMMISSIONER.] In addition to any 
364.24  other duties imposed by law, the commissioner shall: 
364.25     (1) based on this section and section 256D.052 and Code of 
364.26  Federal Regulations, title 7, section 273.7, supervise the 
364.27  administration of food stamp employment and training services to 
364.28  county agencies; 
364.29     (2) disburse money appropriated for food stamp employment 
364.30  and training services to county agencies based upon the county's 
364.31  costs as specified in section 256D.06 256D.051, subdivision 6c; 
364.32     (3) accept and supervise the disbursement of any funds that 
364.33  may be provided by the federal government or from other sources 
364.34  for use in this state for food stamp employment and training 
364.35  services; 
364.36     (4) cooperate with other agencies including any agency of 
365.1   the United States or of another state in all matters concerning 
365.2   the powers and duties of the commissioner under this section and 
365.3   section 256D.052; and 
365.4      (5) in cooperation with the commissioner of economic 
365.5   security, ensure that each component of an employment and 
365.6   training program carried out under this section is delivered 
365.7   through a statewide workforce development system, unless the 
365.8   component is not available locally through such a system. 
365.9      Sec. 2.  Minnesota Statutes 1998, section 256D.051, is 
365.10  amended by adding a subdivision to read: 
365.11     Subd. 6c.  [PROGRAM FUNDING.] Within the limits of 
365.12  available resources, the commissioner shall reimburse the actual 
365.13  costs of county agencies and their employment and training 
365.14  service providers for the provision of food stamp employment and 
365.15  training services, including participant support services, 
365.16  direct program services, and program administrative activities.  
365.17  The cost of services for each county's food stamp employment and 
365.18  training program shall not exceed an average of $400 per 
365.19  participant.  No more than 15 percent of program funds may be 
365.20  used for administrative activities.  The county agency may 
365.21  expend county funds in excess of the limits of this subdivision 
365.22  without state reimbursement. 
365.23     Program funds shall be allocated based on the county's 
365.24  average number of food stamp cases as compared to the statewide 
365.25  total number of such cases.  The average number of cases shall 
365.26  be based on counts of cases as of March 31, June 30, September 
365.27  30, and December 31 of the previous calendar year.  The 
365.28  commissioner may reallocate unexpended money appropriated under 
365.29  this section to those county agencies that demonstrate a need 
365.30  for additional funds. 
365.31     Sec. 3.  Minnesota Statutes 1998, section 256D.053, 
365.32  subdivision 1, is amended to read: 
365.33     Subdivision 1.  [PROGRAM ESTABLISHED.] For the period of 
365.34  July 1, 1998, to June 30, 1999, The Minnesota food assistance 
365.35  program is established to provide food assistance to legal 
365.36  noncitizens residing in this state who are ineligible to 
366.1   participate in the federal Food Stamp Program solely due to the 
366.2   provisions of section 402 or 403 of Public Law Number 104-193, 
366.3   as authorized by Title VII of the 1997 Emergency Supplemental 
366.4   Appropriations Act, Public Law Number 105-18, and as amended by 
366.5   Public Law Number 105-185. 
366.6      Beginning July 1, 2000, the Minnesota food assistance 
366.7   program is limited to those noncitizens described in this 
366.8   subdivision who are 50 years of age or older. 
366.9      Sec. 4.  Minnesota Statutes 1998, section 256D.06, 
366.10  subdivision 5, is amended to read: 
366.11     Subd. 5.  Any applicant, otherwise eligible for general 
366.12  assistance and possibly eligible for maintenance benefits from 
366.13  any other source shall (a) make application for those benefits 
366.14  within 30 days of the general assistance application; and (b) 
366.15  execute an interim assistance authorization agreement on a form 
366.16  as directed by the commissioner.  The commissioner shall review 
366.17  a denial of an application for other maintenance benefits and 
366.18  may require a recipient of general assistance to file an appeal 
366.19  of the denial if appropriate.  If found eligible for benefits 
366.20  from other sources, and a payment received from another source 
366.21  relates to the period during which general assistance was also 
366.22  being received, the recipient shall be required to reimburse the 
366.23  county agency for the interim assistance paid.  Reimbursement 
366.24  shall not exceed the amount of general assistance paid during 
366.25  the time period to which the other maintenance benefits apply 
366.26  and shall not exceed the state standard applicable to that time 
366.27  period.  The commissioner shall adopt rules authorizing county 
366.28  agencies or other client representatives to retain from the 
366.29  amount recovered under an interim assistance agreement 25 
366.30  percent plus actual reasonable fees, costs, and disbursements of 
366.31  appeals and litigation, of providing special assistance to the 
366.32  recipient in processing the recipient's claim for maintenance 
366.33  benefits from another source.  The money retained under this 
366.34  section shall be from the state share of the recovery.  The 
366.35  commissioner or the county agency may contract with qualified 
366.36  persons to provide the special assistance.  The rules adopted by 
367.1   the commissioner shall include the methods by which county 
367.2   agencies shall identify, refer, and assist recipients who may be 
367.3   eligible for benefits under federal programs for the disabled.  
367.4   This subdivision does not require repayment of per diem payments 
367.5   made to shelters for battered women pursuant to section 256D.05, 
367.6   subdivision 3. 
367.7      Sec. 5.  Minnesota Statutes 1998, section 256J.02, 
367.8   subdivision 2, is amended to read: 
367.9      Subd. 2.  [USE OF MONEY.] State money appropriated for 
367.10  purposes of this section and TANF block grant money must be used 
367.11  for: 
367.12     (1) financial assistance to or on behalf of any minor child 
367.13  who is a resident of this state under section 256J.12; 
367.14     (2) employment and training services under this chapter or 
367.15  chapter 256K; 
367.16     (3) emergency financial assistance and services under 
367.17  section 256J.48; 
367.18     (4) diversionary assistance under section 256J.47; and 
367.19     (5) the health care and human services training and 
367.20  retention program under chapter 116L, for costs associated with 
367.21  families with children with incomes below 200 percent of the 
367.22  federal poverty guidelines; 
367.23     (6) the pathways program under section 116L.04, subdivision 
367.24  1a; 
367.25     (7) welfare-to-work extended employment services for MFIP 
367.26  participants with severe impairment to employment as defined in 
367.27  section 268A.15, subdivision 1a; 
367.28     (8) the family homeless prevention and assistance program 
367.29  under section 462A.204; 
367.30     (9) the rent assistance for family stabilization 
367.31  demonstration project under section 462A.205; and 
367.32     (10) program administration under this chapter. 
367.33     Sec. 6.  Minnesota Statutes 1998, section 256J.08, 
367.34  subdivision 11, is amended to read: 
367.35     Subd. 11.  [CAREGIVER.] "Caregiver" means a minor child's 
367.36  natural or adoptive parent or parents and stepparent who live in 
368.1   the home with the minor child.  For purposes of determining 
368.2   eligibility for this program, caregiver also means any of the 
368.3   following individuals, if adults, who live with and provide care 
368.4   and support to a minor child when the minor child's natural or 
368.5   adoptive parent or parents or stepparents do not reside in the 
368.6   same home:  legal custodian or guardian, grandfather, 
368.7   grandmother, brother, sister, half-brother, half-sister, 
368.8   stepbrother, stepsister, uncle, aunt, first cousin or first 
368.9   cousin once removed, nephew, niece, person of preceding 
368.10  generation as denoted by prefixes of "great," "great-great," or 
368.11  "great-great-great," or a spouse of any person named in the 
368.12  above groups even after the marriage ends by death or divorce. 
368.13     Sec. 7.  Minnesota Statutes 1998, section 256J.08, 
368.14  subdivision 24, is amended to read: 
368.15     Subd. 24.  [DISREGARD.] "Disregard" means earned income 
368.16  that is not counted when determining initial eligibility or 
368.17  ongoing eligibility and calculating the amount of the assistance 
368.18  payment for participants.  The commissioner shall determine the 
368.19  amount of the disregard according to section 256J.24, 
368.20  subdivision 10. 
368.21     Sec. 8.  Minnesota Statutes 1998, section 256J.08, is 
368.22  amended by adding a subdivision to read: 
368.23     Subd. 28a.  [ENCUMBRANCE.] "Encumbrance" means a legal 
368.24  claim against real or personal property that is payable upon the 
368.25  sale of that property. 
368.26     Sec. 9.  Minnesota Statutes 1998, section 256J.08, is 
368.27  amended by adding a subdivision to read: 
368.28     Subd. 55a.  [MFIP STANDARD OF NEED.] "MFIP standard of need"
368.29  means the appropriate standard used to determine MFIP benefit 
368.30  payments for the MFIP unit and applies to: 
368.31     (1) the transitional standard, sections 256J.08, 
368.32  subdivision 85, and 256J.24, subdivision 5; 
368.33     (2) the shared household standard, section 256J.24, 
368.34  subdivision 9; and 
368.35     (3) the interstate transition standard, section 256J.43. 
368.36     Sec. 10.  Minnesota Statutes 1998, section 256J.08, 
369.1   subdivision 65, is amended to read: 
369.2      Subd. 65.  [PARTICIPANT.] "Participant" means a person who 
369.3   is currently receiving cash assistance and or the food portion 
369.4   available through MFIP-S MFIP as funded by TANF and the food 
369.5   stamp program.  A person who fails to withdraw or access 
369.6   electronically any portion of the person's cash and food 
369.7   assistance payment by the end of the payment month, who makes a 
369.8   written request for closure before the first of a payment month 
369.9   and repays cash and food assistance electronically issued for 
369.10  that payment month within that payment month, or who returns any 
369.11  uncashed assistance check and food coupons and withdraws from 
369.12  the program is not a participant.  A person who withdraws a cash 
369.13  or food assistance payment by electronic transfer or receives 
369.14  and cashes a cash an MFIP assistance check or food coupons and 
369.15  is subsequently determined to be ineligible for assistance for 
369.16  that period of time is a participant, regardless whether that 
369.17  assistance is repaid.  The term "participant" includes the 
369.18  caregiver relative and the minor child whose needs are included 
369.19  in the assistance payment.  A person in an assistance unit who 
369.20  does not receive a cash and food assistance payment because the 
369.21  person has been suspended from MFIP-S or because the person's 
369.22  need falls below the $10 minimum payment level MFIP is a 
369.23  participant. 
369.24     Sec. 11.  Minnesota Statutes 1998, section 256J.08, 
369.25  subdivision 82, is amended to read: 
369.26     Subd. 82.  [SANCTION.] "Sanction" means the reduction of a 
369.27  family's assistance payment by a specified percentage of 
369.28  the applicable transitional MFIP standard of need because:  a 
369.29  nonexempt participant fails to comply with the requirements of 
369.30  sections 256J.52 to 256J.55; a parental caregiver fails without 
369.31  good cause to cooperate with the child support enforcement 
369.32  requirements; or a participant fails to comply with the 
369.33  insurance, tort liability, or other requirements of this chapter.
369.34     Sec. 12.  Minnesota Statutes 1998, section 256J.08, 
369.35  subdivision 83, is amended to read: 
369.36     Subd. 83.  [SIGNIFICANT CHANGE.] "Significant change" means 
370.1   a decline in gross income of 36 percent the amount of the 
370.2   disregard as defined in subdivision 24 or more from the income 
370.3   used to determine the grant for the current month. 
370.4      Sec. 13.  Minnesota Statutes 1998, section 256J.08, 
370.5   subdivision 86a, is amended to read: 
370.6      Subd. 86a.  [UNRELATED MEMBER.] "Unrelated member" means an 
370.7   individual in the household who does not meet the definition of 
370.8   an eligible caregiver, but does not include an individual who 
370.9   provides child care to a child in the assistance unit. 
370.10     Sec. 14.  Minnesota Statutes 1998, section 256J.11, 
370.11  subdivision 2, is amended to read: 
370.12     Subd. 2.  [NONCITIZENS; FOOD PORTION.] (a) For the period 
370.13  September 1, 1997, to October 31, 1997, noncitizens who do not 
370.14  meet one of the exemptions in section 412 of the Personal 
370.15  Responsibility and Work Opportunity Reconciliation Act of 1996, 
370.16  but were residing in this state as of July 1, 1997, are eligible 
370.17  for the 6/10 of the average value of food stamps for the same 
370.18  family size and composition until MFIP-S is operative in the 
370.19  noncitizen's county of financial responsibility and thereafter, 
370.20  the 6/10 of the food portion of MFIP-S.  However, federal food 
370.21  stamp dollars cannot be used to fund the food portion of MFIP-S 
370.22  benefits for an individual under this subdivision. 
370.23     (b) For the period November 1, 1997, to June 30, 1999, 
370.24  noncitizens who do not meet one of the exemptions in section 412 
370.25  of the Personal Responsibility and Work Opportunity 
370.26  Reconciliation Act of 1996, and are receiving cash assistance 
370.27  under the AFDC, family general assistance, MFIP or MFIP-S 
370.28  programs are eligible for the average value of food stamps for 
370.29  the same family size and composition until MFIP-S is operative 
370.30  in the noncitizen's county of financial responsibility and 
370.31  thereafter, the food portion of MFIP-S.  However, federal food 
370.32  stamp dollars cannot be used to fund the food portion of MFIP-S 
370.33  benefits for an individual under this subdivision State dollars 
370.34  shall fund the food portion of a noncitizen's MFIP benefits when 
370.35  federal food stamp dollars cannot be used to fund those 
370.36  benefits.  The assistance provided under this subdivision, which 
371.1   is designated as a supplement to replace lost benefits under the 
371.2   federal food stamp program, must be disregarded as income in all 
371.3   programs that do not count food stamps as income where the 
371.4   commissioner has the authority to make the income disregard 
371.5   determination for the program. 
371.6      (c) The commissioner shall submit a state plan to the 
371.7   secretary of agriculture to allow the commissioner to purchase 
371.8   federal Food Stamp Program benefits in an amount equal to the 
371.9   MFIP-S food portion for each legal noncitizen receiving MFIP-S 
371.10  assistance who is ineligible to participate in the federal Food 
371.11  Stamp Program solely due to the provisions of section 402 or 403 
371.12  of Public Law Number 104-193, as authorized by Title VII of the 
371.13  1997 Emergency Supplemental Appropriations Act, Public Law 
371.14  Number 105-18.  The commissioner shall enter into a contract as 
371.15  necessary with the secretary to use the existing federal Food 
371.16  Stamp Program benefits delivery system for the purposes of 
371.17  administering the food portion of MFIP-S under this subdivision. 
371.18     Sec. 15.  Minnesota Statutes 1998, section 256J.11, 
371.19  subdivision 3, is amended to read: 
371.20     Subd. 3.  [BENEFITS FUNDED WITH STATE MONEY.] Legal adult 
371.21  noncitizens who have resided in the country for four years or 
371.22  more as a lawful permanent resident, whose benefits are funded 
371.23  entirely with state money, and who are under 70 years of age, 
371.24  must, as a condition of eligibility: 
371.25     (1) be enrolled in a literacy class, English as a second 
371.26  language class, or a citizen class; 
371.27     (2) be applying for admission to a literacy class, English 
371.28  as a second language class, and is on a waiting list; 
371.29     (3) be in the process of applying for a waiver from the 
371.30  Immigration and Naturalization Service of the English language 
371.31  or civics requirements of the citizenship test; 
371.32     (4) have submitted an application for citizenship to the 
371.33  Immigration and Naturalization Service and is waiting for a 
371.34  testing date or a subsequent swearing in ceremony; or 
371.35     (5) have been denied citizenship due to a failure to pass 
371.36  the test after two attempts or because of an inability to 
372.1   understand the rights and responsibilities of becoming a United 
372.2   States citizen, as documented by the Immigration and 
372.3   Naturalization Service or the county. 
372.4      If the county social service agency determines that a legal 
372.5   noncitizen subject to the requirements of this subdivision will 
372.6   require more than one year of English language training, then 
372.7   the requirements of clause (1) or (2) shall be imposed after the 
372.8   legal noncitizen has resided in the country for three years.  
372.9   Individuals who reside in a facility licensed under chapter 
372.10  144A, 144D, 245A, or 256I are exempt from the requirements of 
372.11  this subdivision. 
372.12     Sec. 16.  Minnesota Statutes 1998, section 256J.12, 
372.13  subdivision 1a, is amended to read: 
372.14     Subd. 1a.  [30-DAY RESIDENCY REQUIREMENT.] An assistance 
372.15  unit is considered to have established residency in this state 
372.16  only when a child or caregiver has resided in this state for at 
372.17  least 30 consecutive days with the intention of making the 
372.18  person's home here and not for any temporary purpose.  The birth 
372.19  of a child in Minnesota to a member of the assistance unit does 
372.20  not automatically establish the residency in this state under 
372.21  this subdivision of the other members of the assistance unit.  
372.22  Time spent in a shelter for battered women shall count toward 
372.23  satisfying the 30-day residency requirement. 
372.24     Sec. 17.  Minnesota Statutes 1998, section 256J.12, 
372.25  subdivision 2, is amended to read: 
372.26     Subd. 2.  [EXCEPTIONS.] (a) A county shall waive the 30-day 
372.27  residency requirement where unusual hardship would result from 
372.28  denial of assistance. 
372.29     (b) For purposes of this section, unusual hardship means an 
372.30  assistance unit: 
372.31     (1) is without alternative shelter; or 
372.32     (2) is without available resources for food. 
372.33     (c) For purposes of this subdivision, the following 
372.34  definitions apply (1) "metropolitan statistical area" is as 
372.35  defined by the U.S. Census Bureau; (2) "alternative shelter" 
372.36  includes any shelter that is located within the metropolitan 
373.1   statistical area containing the county and for which the family 
373.2   is eligible, provided the assistance unit does not have to 
373.3   travel more than 20 miles to reach the shelter and has access to 
373.4   transportation to the shelter.  Clause (2) does not apply to 
373.5   counties in the Minneapolis-St. Paul metropolitan statistical 
373.6   area. 
373.7      (d) Applicants are considered to meet the residency 
373.8   requirement under subdivision 1a if they once resided in 
373.9   Minnesota and: 
373.10     (1) joined the United States armed services, returned to 
373.11  Minnesota within 30 days of leaving the armed services, and 
373.12  intend to remain in Minnesota; or 
373.13     (2) left to attend school in another state, paid 
373.14  nonresident tuition or Minnesota tuition rates under a 
373.15  reciprocity agreement, and returned to Minnesota within 30 days 
373.16  of graduation with the intent to remain in Minnesota. 
373.17     (e) The 30-day residence requirement is met when: 
373.18     (1) a minor child or a minor caregiver moves from another 
373.19  state to the residence of a relative caregiver; and 
373.20     (2) the minor caregiver applies for and receives family 
373.21  cash assistance; 
373.22     (3) the relative caregiver chooses not to be part of the 
373.23  MFIP-S assistance unit; and 
373.24     (4) the relative caregiver has resided in Minnesota for at 
373.25  least 30 days prior to the date the assistance unit applies for 
373.26  cash assistance.  
373.27     (f) Ineligible mandatory unit members who have resided in 
373.28  Minnesota for 12 months immediately before the unit's date of 
373.29  application establish the other assistance unit members' 
373.30  eligibility for the MFIP-S transitional standard. 
373.31     (2) the relative caregiver has resided in Minnesota for at 
373.32  least 30 consecutive days and:  
373.33     (i) the minor caregiver applies for and receives MFIP; or 
373.34     (ii) the relative caregiver applies for assistance for the 
373.35  minor child but does not choose to be a member of the MFIP 
373.36  assistance unit. 
374.1      Sec. 18.  Minnesota Statutes 1998, section 256J.14, is 
374.2   amended to read: 
374.3      256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 
374.4      (a) The definitions in this paragraph only apply to this 
374.5   subdivision. 
374.6      (1) "Household of a parent, legal guardian, or other adult 
374.7   relative" means the place of residence of: 
374.8      (i) a natural or adoptive parent; 
374.9      (ii) a legal guardian according to appointment or 
374.10  acceptance under section 260.242, 525.615, or 525.6165, and 
374.11  related laws; 
374.12     (iii) a caregiver as defined in section 256J.08, 
374.13  subdivision 11; or 
374.14     (iv) an appropriate adult relative designated by a county 
374.15  agency. 
374.16     (2) "Adult-supervised supportive living arrangement" means 
374.17  a private family setting which assumes responsibility for the 
374.18  care and control of the minor parent and minor child, or other 
374.19  living arrangement, not including a public institution, licensed 
374.20  by the commissioner of human services which ensures that the 
374.21  minor parent receives adult supervision and supportive services, 
374.22  such as counseling, guidance, independent living skills 
374.23  training, or supervision. 
374.24     (b) A minor parent and the minor child who is in the care 
374.25  of the minor parent must reside in the household of a parent, 
374.26  legal guardian, other adult relative, or in an adult-supervised 
374.27  supportive living arrangement in order to receive MFIP-S MFIP 
374.28  unless: 
374.29     (1) the minor parent has no living parent, other adult 
374.30  relative, or legal guardian whose whereabouts is known; 
374.31     (2) no living parent, other adult relative, or legal 
374.32  guardian of the minor parent allows the minor parent to live in 
374.33  the parent's, other adult relative's, or legal guardian's home; 
374.34     (3) the minor parent lived apart from the minor parent's 
374.35  own parent or legal guardian for a period of at least one year 
374.36  before either the birth of the minor child or the minor parent's 
375.1   application for MFIP-S MFIP; 
375.2      (4) the physical or emotional health or safety of the minor 
375.3   parent or minor child would be jeopardized if the minor parent 
375.4   and the minor child resided in the same residence with the minor 
375.5   parent's parent, other adult relative, or legal guardian; or 
375.6      (5) an adult supervised supportive living arrangement is 
375.7   not available for the minor parent and child in the county in 
375.8   which the minor parent and child currently reside.  If an adult 
375.9   supervised supportive living arrangement becomes available 
375.10  within the county, the minor parent and child must reside in 
375.11  that arrangement. 
375.12     (c) The county agency shall inform minor applicants must be 
375.13  informed both orally and in writing about the eligibility 
375.14  requirements and, their rights and obligations under the MFIP-S 
375.15  MFIP program, and any other applicable orientation information.  
375.16  The county must advise the minor of the possible exemptions and 
375.17  specifically ask whether one or more of these exemptions is 
375.18  applicable.  If the minor alleges one or more of these 
375.19  exemptions, then the county must assist the minor in obtaining 
375.20  the necessary verifications to determine whether or not these 
375.21  exemptions apply. 
375.22     (d) If the county worker has reason to suspect that the 
375.23  physical or emotional health or safety of the minor parent or 
375.24  minor child would be jeopardized if they resided with the minor 
375.25  parent's parent, other adult relative, or legal guardian, then 
375.26  the county worker must make a referral to child protective 
375.27  services to determine if paragraph (b), clause (4), applies.  A 
375.28  new determination by the county worker is not necessary if one 
375.29  has been made within the last six months, unless there has been 
375.30  a significant change in circumstances which justifies a new 
375.31  referral and determination. 
375.32     (e) If a minor parent is not living with a parent, legal 
375.33  guardian, or other adult relative due to paragraph (b), clause 
375.34  (1), (2), or (4), the minor parent must reside, when possible, 
375.35  in a living arrangement that meets the standards of paragraph 
375.36  (a), clause (2). 
376.1      (f) When a minor parent and minor child live with a parent, 
376.2   other adult relative, legal guardian, or in an adult-supervised 
376.3   supportive Regardless of living arrangement, MFIP-S MFIP must be 
376.4   paid, when possible, in the form of a protective payment on 
376.5   behalf of the minor parent and minor child according to section 
376.6   256J.39, subdivisions 2 to 4. 
376.7      Sec. 19.  Minnesota Statutes 1998, section 256J.20, 
376.8   subdivision 3, is amended to read: 
376.9      Subd. 3.  [OTHER PROPERTY LIMITATIONS.] To be eligible for 
376.10  MFIP-S MFIP, the equity value of all nonexcluded real and 
376.11  personal property of the assistance unit must not exceed $2,000 
376.12  for applicants and $5,000 for ongoing participants.  The value 
376.13  of assets in clauses (1) to (20) must be excluded when 
376.14  determining the equity value of real and personal property: 
376.15     (1) a licensed vehicle up to a loan value of less than or 
376.16  equal to $7,500.  The county agency shall apply any excess loan 
376.17  value as if it were equity value to the asset limit described in 
376.18  this section.  If the assistance unit owns more than one 
376.19  licensed vehicle, the county agency shall determine the vehicle 
376.20  with the highest loan value and count only the loan value over 
376.21  $7,500, excluding:  (i) the value of one vehicle per physically 
376.22  disabled person when the vehicle is needed to transport the 
376.23  disabled unit member; this exclusion does not apply to mentally 
376.24  disabled people; (ii) the value of special equipment for a 
376.25  handicapped member of the assistance unit; and (iii) any vehicle 
376.26  used for long-distance travel, other than daily commuting, for 
376.27  the employment of a unit member. 
376.28     The county agency shall count the loan value of all other 
376.29  vehicles and apply this amount as if it were equity value to the 
376.30  asset limit described in this section.  The value of special 
376.31  equipment for a handicapped member of the assistance unit is 
376.32  excluded.  To establish the loan value of vehicles, a county 
376.33  agency must use the N.A.D.A. Official Used Car Guide, Midwest 
376.34  Edition, for newer model cars.  When a vehicle is not listed in 
376.35  the guidebook, or when the applicant or participant disputes the 
376.36  loan value listed in the guidebook as unreasonable given the 
377.1   condition of the particular vehicle, the county agency may 
377.2   require the applicant or participant document the loan value by 
377.3   securing a written statement from a motor vehicle dealer 
377.4   licensed under section 168.27, stating the amount that the 
377.5   dealer would pay to purchase the vehicle.  The county agency 
377.6   shall reimburse the applicant or participant for the cost of a 
377.7   written statement that documents a lower loan value; 
377.8      (2) the value of life insurance policies for members of the 
377.9   assistance unit; 
377.10     (3) one burial plot per member of an assistance unit; 
377.11     (4) the value of personal property needed to produce earned 
377.12  income, including tools, implements, farm animals, inventory, 
377.13  business loans, business checking and savings accounts used at 
377.14  least annually and used exclusively for the operation of a 
377.15  self-employment business, and any motor vehicles if at least 50 
377.16  percent of the vehicle's use is to produce income and if the 
377.17  vehicles are essential for the self-employment business; 
377.18     (5) the value of personal property not otherwise specified 
377.19  which is commonly used by household members in day-to-day living 
377.20  such as clothing, necessary household furniture, equipment, and 
377.21  other basic maintenance items essential for daily living; 
377.22     (6) the value of real and personal property owned by a 
377.23  recipient of Supplemental Security Income or Minnesota 
377.24  supplemental aid; 
377.25     (7) the value of corrective payments, but only for the 
377.26  month in which the payment is received and for the following 
377.27  month; 
377.28     (8) a mobile home or other vehicle used by an applicant or 
377.29  participant as the applicant's or participant's home; 
377.30     (9) money in a separate escrow account that is needed to 
377.31  pay real estate taxes or insurance and that is used for this 
377.32  purpose; 
377.33     (10) money held in escrow to cover employee FICA, employee 
377.34  tax withholding, sales tax withholding, employee worker 
377.35  compensation, business insurance, property rental, property 
377.36  taxes, and other costs that are paid at least annually, but less 
378.1   often than monthly; 
378.2      (11) monthly assistance, emergency assistance, and 
378.3   diversionary payments for the current month's needs; 
378.4      (12) the value of school loans, grants, or scholarships for 
378.5   the period they are intended to cover; 
378.6      (13) payments listed in section 256J.21, subdivision 2, 
378.7   clause (9), which are held in escrow for a period not to exceed 
378.8   three months to replace or repair personal or real property; 
378.9      (14) income received in a budget month through the end of 
378.10  the payment month; 
378.11     (15) savings from earned income of a minor child or a minor 
378.12  parent that are set aside in a separate account designated 
378.13  specifically for future education or employment costs; 
378.14     (16) the federal earned income credit, Minnesota working 
378.15  family credit, state and federal income tax refunds, state 
378.16  homeowners and renters credits under chapter 290A, property tax 
378.17  rebates under Laws 1997, chapter 231, article 1, section 16, and 
378.18  other federal or state tax rebates in the month received and the 
378.19  following month; 
378.20     (17) payments excluded under federal law as long as those 
378.21  payments are held in a separate account from any nonexcluded 
378.22  funds; 
378.23     (18) money received by a participant of the corps to career 
378.24  program under section 84.0887, subdivision 2, paragraph (b), as 
378.25  a postservice benefit under the federal Americorps Act; 
378.26     (19) the assets of children ineligible to receive MFIP-S 
378.27  MFIP benefits because foster care or adoption assistance 
378.28  payments are made on their behalf; and 
378.29     (20) the assets of persons whose income is excluded under 
378.30  section 256J.21, subdivision 2, clause (43). 
378.31     Sec. 20.  Minnesota Statutes 1998, section 256J.21, 
378.32  subdivision 2, is amended to read: 
378.33     Subd. 2.  [INCOME EXCLUSIONS.] (a) The following must be 
378.34  excluded in determining a family's available income: 
378.35     (1) payments for basic care, difficulty of care, and 
378.36  clothing allowances received for providing family foster care to 
379.1   children or adults under Minnesota Rules, parts 9545.0010 to 
379.2   9545.0260 and 9555.5050 to 9555.6265, and payments received and 
379.3   used for care and maintenance of a third-party beneficiary who 
379.4   is not a household member; 
379.5      (2) reimbursements for employment training received through 
379.6   the Job Training Partnership Act, United States Code, title 29, 
379.7   chapter 19, sections 1501 to 1792b; 
379.8      (3) reimbursement for out-of-pocket expenses incurred while 
379.9   performing volunteer services, jury duty, or employment, or 
379.10  informal carpooling arrangements directly related to employment; 
379.11     (4) all educational assistance, except the county agency 
379.12  must count graduate student teaching assistantships, 
379.13  fellowships, and other similar paid work as earned income and, 
379.14  after allowing deductions for any unmet and necessary 
379.15  educational expenses, shall count scholarships or grants awarded 
379.16  to graduate students that do not require teaching or research as 
379.17  unearned income; 
379.18     (5) loans, regardless of purpose, from public or private 
379.19  lending institutions, governmental lending institutions, or 
379.20  governmental agencies; 
379.21     (6) loans from private individuals, regardless of purpose, 
379.22  provided an applicant or participant documents that the lender 
379.23  expects repayment; 
379.24     (7)(i) state income tax refunds; and 
379.25     (ii) federal income tax refunds; 
379.26     (8)(i) federal earned income credits; 
379.27     (ii) Minnesota working family credits; 
379.28     (iii) state homeowners and renters credits under chapter 
379.29  290A; and 
379.30     (iv) property tax rebates under Laws 1997, chapter 231, 
379.31  article 1, section 16; and 
379.32     (v) other federal or state tax rebates; 
379.33     (9) funds received for reimbursement, replacement, or 
379.34  rebate of personal or real property when these payments are made 
379.35  by public agencies, awarded by a court, solicited through public 
379.36  appeal, or made as a grant by a federal agency, state or local 
380.1   government, or disaster assistance organizations, subsequent to 
380.2   a presidential declaration of disaster; 
380.3      (10) the portion of an insurance settlement that is used to 
380.4   pay medical, funeral, and burial expenses, or to repair or 
380.5   replace insured property; 
380.6      (11) reimbursements for medical expenses that cannot be 
380.7   paid by medical assistance; 
380.8      (12) payments by a vocational rehabilitation program 
380.9   administered by the state under chapter 268A, except those 
380.10  payments that are for current living expenses; 
380.11     (13) in-kind income, including any payments directly made 
380.12  by a third party to a provider of goods and services; 
380.13     (14) assistance payments to correct underpayments, but only 
380.14  for the month in which the payment is received; 
380.15     (15) emergency assistance payments; 
380.16     (16) funeral and cemetery payments as provided by section 
380.17  256.935; 
380.18     (17) nonrecurring cash gifts of $30 or less, not exceeding 
380.19  $30 per participant in a calendar month; 
380.20     (18) any form of energy assistance payment made through 
380.21  Public Law Number 97-35, Low-Income Home Energy Assistance Act 
380.22  of 1981, payments made directly to energy providers by other 
380.23  public and private agencies, and any form of credit or rebate 
380.24  payment issued by energy providers; 
380.25     (19) Supplemental Security Income, including retroactive 
380.26  payments; 
380.27     (20) Minnesota supplemental aid, including retroactive 
380.28  payments; 
380.29     (21) proceeds from the sale of real or personal property; 
380.30     (22) adoption assistance payments under section 259.67; 
380.31     (23) state-funded family subsidy program payments made 
380.32  under section 252.32 to help families care for children with 
380.33  mental retardation or related conditions; 
380.34     (24) interest payments and dividends from property that is 
380.35  not excluded from and that does not exceed the asset limit; 
380.36     (25) rent rebates; 
381.1      (26) income earned by a minor caregiver or, minor child 
381.2   through age 6, or a minor child who is at least a half-time 
381.3   student in an approved elementary or secondary education 
381.4   program; 
381.5      (27) income earned by a caregiver under age 20 who is at 
381.6   least a half-time student in an approved elementary or secondary 
381.7   education program; 
381.8      (28) MFIP-S MFIP child care payments under section 119B.05; 
381.9      (29) all other payments made through MFIP-S MFIP to support 
381.10  a caregiver's pursuit of greater self-support; 
381.11     (30) income a participant receives related to shared living 
381.12  expenses; 
381.13     (31) reverse mortgages; 
381.14     (32) benefits provided by the Child Nutrition Act of 1966, 
381.15  United States Code, title 42, chapter 13A, sections 1771 to 
381.16  1790; 
381.17     (33) benefits provided by the women, infants, and children 
381.18  (WIC) nutrition program, United States Code, title 42, chapter 
381.19  13A, section 1786; 
381.20     (34) benefits from the National School Lunch Act, United 
381.21  States Code, title 42, chapter 13, sections 1751 to 1769e; 
381.22     (35) relocation assistance for displaced persons under the 
381.23  Uniform Relocation Assistance and Real Property Acquisition 
381.24  Policies Act of 1970, United States Code, title 42, chapter 61, 
381.25  subchapter II, section 4636, or the National Housing Act, United 
381.26  States Code, title 12, chapter 13, sections 1701 to 1750jj; 
381.27     (36) benefits from the Trade Act of 1974, United States 
381.28  Code, title 19, chapter 12, part 2, sections 2271 to 2322; 
381.29     (37) war reparations payments to Japanese Americans and 
381.30  Aleuts under United States Code, title 50, sections 1989 to 
381.31  1989d; 
381.32     (38) payments to veterans or their dependents as a result 
381.33  of legal settlements regarding Agent Orange or other chemical 
381.34  exposure under Public Law Number 101-239, section 10405, 
381.35  paragraph (a)(2)(E); 
381.36     (39) income that is otherwise specifically excluded from 
382.1   the MFIP-S program MFIP consideration in federal law, state law, 
382.2   or federal regulation; 
382.3      (40) security and utility deposit refunds; 
382.4      (41) American Indian tribal land settlements excluded under 
382.5   Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 
382.6   Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 
382.7   reservations and payments to members of the White Earth Band, 
382.8   under United States Code, title 25, chapter 9, section 331, and 
382.9   chapter 16, section 1407; 
382.10     (42) all income of the minor parent's parent parents and 
382.11  stepparent stepparents when determining the grant for the minor 
382.12  parent in households that include a minor parent living with a 
382.13  parent parents or stepparent stepparents on MFIP-S MFIP with 
382.14  other children; and 
382.15     (43) income of the minor parent's parent parents and 
382.16  stepparent stepparents equal to 200 percent of the federal 
382.17  poverty guideline for a family size not including the minor 
382.18  parent and the minor parent's child in households that include a 
382.19  minor parent living with a parent parents or stepparent 
382.20  stepparents not on MFIP-S MFIP when determining the grant for 
382.21  the minor parent.  The remainder of income is deemed as 
382.22  specified in section 256J.37, subdivision 1b; 
382.23     (44) payments made to children eligible for relative 
382.24  custody assistance under section 257.85; 
382.25     (45) vendor payments for goods and services made on behalf 
382.26  of a client unless the client has the option of receiving the 
382.27  payment in cash; and 
382.28     (46) the principal portion of a contract for deed payment. 
382.29     Sec. 21.  Minnesota Statutes 1998, section 256J.21, 
382.30  subdivision 3, is amended to read: 
382.31     Subd. 3.  [INITIAL INCOME TEST.] The county agency shall 
382.32  determine initial eligibility by considering all earned and 
382.33  unearned income that is not excluded under subdivision 2.  To be 
382.34  eligible for MFIP-S MFIP, the assistance unit's countable income 
382.35  minus the disregards in paragraphs (a) and (b) must be below the 
382.36  transitional standard of assistance according to section 256J.24 
383.1   for that size assistance unit. 
383.2      (a) The initial eligibility determination must disregard 
383.3   the following items: 
383.4      (1) the employment disregard is 18 percent of the gross 
383.5   earned income whether or not the member is working full time or 
383.6   part time; 
383.7      (2) dependent care costs must be deducted from gross earned 
383.8   income for the actual amount paid for dependent care up to a 
383.9   maximum of $200 per month for each child less than two years of 
383.10  age, and $175 per month for each child two years of age and 
383.11  older under this chapter and chapter 119B; 
383.12     (3) all payments made according to a court order for 
383.13  spousal support or the support of children not living in the 
383.14  assistance unit's household shall be disregarded from the income 
383.15  of the person with the legal obligation to pay support, provided 
383.16  that, if there has been a change in the financial circumstances 
383.17  of the person with the legal obligation to pay support since the 
383.18  support order was entered, the person with the legal obligation 
383.19  to pay support has petitioned for a modification of the support 
383.20  order; and 
383.21     (4) an allocation for the unmet need of an ineligible 
383.22  spouse or an ineligible child under the age of 21 for whom the 
383.23  caregiver is financially responsible and who lives with the 
383.24  caregiver according to section 256J.36. 
383.25     (b) Notwithstanding paragraph (a), when determining initial 
383.26  eligibility for applicant units when at least one member has 
383.27  received AFDC, family general assistance, MFIP, MFIP-R, work 
383.28  first, or MFIP-S MFIP in this state within four months of the 
383.29  most recent application for MFIP-S MFIP, apply the employment 
383.30  disregard as defined in section 256J.08, subdivision 24, for all 
383.31  unit members is 36 percent of the gross earned income. 
383.32     After initial eligibility is established, the assistance 
383.33  payment calculation is based on the monthly income test. 
383.34     Sec. 22.  Minnesota Statutes 1998, section 256J.21, 
383.35  subdivision 4, is amended to read: 
383.36     Subd. 4.  [MONTHLY INCOME TEST AND DETERMINATION OF 
384.1   ASSISTANCE PAYMENT.] The county agency shall determine ongoing 
384.2   eligibility and the assistance payment amount according to the 
384.3   monthly income test.  To be eligible for MFIP-S MFIP, the result 
384.4   of the computations in paragraphs (a) to (e) must be at least $1.
384.5      (a) Apply a 36 percent an income disregard as defined in 
384.6   section 256J.08, subdivision 24, to gross earnings and subtract 
384.7   this amount from the family wage level.  If the difference is 
384.8   equal to or greater than the transitional MFIP standard of need, 
384.9   the assistance payment is equal to the transitional MFIP 
384.10  standard of need.  If the difference is less than 
384.11  the transitional MFIP standard of need, the assistance payment 
384.12  is equal to the difference.  The employment disregard in this 
384.13  paragraph must be deducted every month there is earned income. 
384.14     (b) All payments made according to a court order for 
384.15  spousal support or the support of children not living in the 
384.16  assistance unit's household must be disregarded from the income 
384.17  of the person with the legal obligation to pay support, provided 
384.18  that, if there has been a change in the financial circumstances 
384.19  of the person with the legal obligation to pay support since the 
384.20  support order was entered, the person with the legal obligation 
384.21  to pay support has petitioned for a modification of the court 
384.22  order. 
384.23     (c) An allocation for the unmet need of an ineligible 
384.24  spouse or an ineligible child under the age of 21 for whom the 
384.25  caregiver is financially responsible and who lives with the 
384.26  caregiver must be made according to section 256J.36. 
384.27     (d) Subtract unearned income dollar for dollar from 
384.28  the transitional MFIP standard of need to determine the 
384.29  assistance payment amount. 
384.30     (e) When income is both earned and unearned, the amount of 
384.31  the assistance payment must be determined by first treating 
384.32  gross earned income as specified in paragraph (a).  After 
384.33  determining the amount of the assistance payment under paragraph 
384.34  (a), unearned income must be subtracted from that amount dollar 
384.35  for dollar to determine the assistance payment amount. 
384.36     (f) When the monthly income is greater than the 
385.1   transitional or family wage level MFIP standard of need after 
385.2   applicable deductions and the income will only exceed the 
385.3   standard for one month, the county agency must suspend the 
385.4   assistance payment for the payment month. 
385.5      Sec. 23.  Minnesota Statutes 1998, section 256J.24, 
385.6   subdivision 2, is amended to read: 
385.7      Subd. 2.  [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 
385.8   for minor caregivers and their children who must be in a 
385.9   separate assistance unit from the other persons in the 
385.10  household, when the following individuals live together, they 
385.11  must be included in the assistance unit: 
385.12     (1) a minor child, including a pregnant minor; 
385.13     (2) the minor child's minor siblings, minor half-siblings, 
385.14  and minor step-siblings; 
385.15     (3) the minor child's natural parents, adoptive parents, 
385.16  and stepparents; and 
385.17     (4) the spouse of a pregnant woman.  
385.18     Sec. 24.  Minnesota Statutes 1998, section 256J.24, 
385.19  subdivision 3, is amended to read: 
385.20     Subd. 3.  [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 
385.21  ASSISTANCE UNIT.] (a) The following individuals who are part of 
385.22  the assistance unit determined under subdivision 2 are 
385.23  ineligible to receive MFIP-S MFIP: 
385.24     (1) individuals receiving Supplemental Security Income or 
385.25  Minnesota supplemental aid; 
385.26     (2) individuals living at home while performing 
385.27  court-imposed, unpaid community service work due to a criminal 
385.28  conviction; 
385.29     (3) individuals disqualified from the food stamp program or 
385.30  MFIP-S MFIP, until the disqualification ends; 
385.31     (4) (3) children on whose behalf federal, state or local 
385.32  foster care payments are made, except as provided in sections 
385.33  256J.13, subdivision 2, and 256J.74, subdivision 2; and 
385.34     (5) (4) children receiving ongoing monthly adoption 
385.35  assistance payments under section 259.67.  
385.36     (b) The exclusion of a person under this subdivision does 
386.1   not alter the mandatory assistance unit composition. 
386.2      Sec. 25.  Minnesota Statutes 1998, section 256J.24, 
386.3   subdivision 7, is amended to read: 
386.4      Subd. 7.  [FAMILY WAGE LEVEL STANDARD.] The family wage 
386.5   level standard is 110 percent of the transitional standard under 
386.6   subdivision 5 and is the standard used when there is earned 
386.7   income in the assistance unit.  As specified in section 256J.21, 
386.8   earned income is subtracted from the family wage level to 
386.9   determine the amount of the assistance payment.  Not including 
386.10  the family wage level standard, assistance payments may not 
386.11  exceed the shared household standard or the transitional MFIP 
386.12  standard of need for the assistance unit, whichever is less. 
386.13     Sec. 26.  Minnesota Statutes 1998, section 256J.24, 
386.14  subdivision 8, is amended to read: 
386.15     Subd. 8.  [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE UNITS.] 
386.16  Except for assistance units where a nonparental caregiver is not 
386.17  included in the grant, payments for shelter up to the amount of 
386.18  the cash portion of MFIP-S MFIP benefits for which the 
386.19  assistance unit is eligible shall be vendor paid for as many 
386.20  months as the assistance unit is eligible or six months, 
386.21  whichever comes first.  The residual amount of the grant after 
386.22  vendor payment, if any, must be paid to the MFIP-S MFIP 
386.23  caregiver. 
386.24     Sec. 27.  Minnesota Statutes 1998, section 256J.24, 
386.25  subdivision 9, is amended to read: 
386.26     Subd. 9.  [SHARED HOUSEHOLD STANDARD; MFIP-S MFIP.] (a) 
386.27  Except as prohibited in paragraph (b), the county agency must 
386.28  use the shared household standard when the household includes 
386.29  one or more unrelated members, as that term is defined in 
386.30  section 256J.08, subdivision 86a.  The county agency must use 
386.31  the shared household standard, unless a member of the assistance 
386.32  unit is a victim of domestic violence and has an approved safety 
386.33  plan, regardless of the number of unrelated members in the 
386.34  household. 
386.35     (b) The county agency must not use the shared household 
386.36  standard when all unrelated members are one of the following: 
387.1      (1) a recipient of public assistance benefits, including 
387.2   food stamps, Supplemental Security Income, adoption assistance, 
387.3   relative custody assistance, or foster care payments; 
387.4      (2) a roomer or boarder, or a person to whom the assistance 
387.5   unit is paying room or board; 
387.6      (3) a minor child under the age of 18; 
387.7      (4) a minor caregiver living with the minor caregiver's 
387.8   parents or in an approved supervised living arrangement; or 
387.9      (5) a caregiver who is not the parent of the minor child in 
387.10  the assistance unit; or 
387.11     (6) an individual who provides child care to a child in the 
387.12  MFIP assistance unit. 
387.13     (c) The shared household standard must be discontinued if 
387.14  it is not approved by the United States Department of 
387.15  Agriculture under the MFIP-S MFIP waiver. 
387.16     Sec. 28.  Minnesota Statutes 1998, section 256J.24, is 
387.17  amended by adding a subdivision to read: 
387.18     Subd. 10.  [MFIP EXIT LEVEL.] (a) In state fiscal years 
387.19  2000 and 2001, the commissioner shall adjust the MFIP earned 
387.20  income disregard to ensure that most participants do not lose 
387.21  eligibility for MFIP until their income reaches at least 120 
387.22  percent of the federal poverty guidelines in effect in October 
387.23  of each fiscal year.  The adjustment to the disregard shall be 
387.24  based on a household size of three, and the resulting earned 
387.25  income disregard percentage must be applied to all household 
387.26  sizes.  The adjustment under this subdivision must be 
387.27  implemented at the same time as the October food stamp 
387.28  cost-of-living adjustment is reflected in the food portion of 
387.29  MFIP transitional standard as required under subdivision 5a. 
387.30     (b) In state fiscal year 2002 and thereafter, the earned 
387.31  income disregard percentage must be the same as the percentage 
387.32  implemented in October 2000. 
387.33     Sec. 29.  Minnesota Statutes 1998, section 256J.26, 
387.34  subdivision 1, is amended to read: 
387.35     Subdivision 1.  [PERSON CONVICTED OF DRUG OFFENSES.] (a) 
387.36  Applicants or participants who have been convicted of a drug 
388.1   offense committed after July 1, 1997, may, if otherwise 
388.2   eligible, receive AFDC or MFIP-S MFIP benefits subject to the 
388.3   following conditions: 
388.4      (1) Benefits for the entire assistance unit must be paid in 
388.5   vendor form for shelter and utilities during any time the 
388.6   applicant is part of the assistance unit. 
388.7      (2) The convicted applicant or participant shall be subject 
388.8   to random drug testing as a condition of continued eligibility 
388.9   and following any positive test for an illegal controlled 
388.10  substance is subject to the following sanctions: 
388.11     (i) for failing a drug test the first time, the 
388.12  participant's grant shall be reduced by ten percent of the 
388.13  MFIP-S transitional MFIP standard of need, the shared household 
388.14  standard, or the interstate transitional standard, whichever is 
388.15  applicable prior to making vendor payments for shelter and 
388.16  utility costs; or 
388.17     (ii) for failing a drug test two or more times, the 
388.18  residual amount of the participant's grant after making vendor 
388.19  payments for shelter and utility costs, if any, must be reduced 
388.20  by an amount equal to 30 percent of the MFIP-S transitional 
388.21  standard, the shared household standard, or the interstate 
388.22  transitional standard, whichever is applicable MFIP standard of 
388.23  need. 
388.24     (3) A participant who fails an initial drug test and is 
388.25  under a sanction due to other MFIP program requirements is 
388.26  subject to the sanction in clause (2)(ii). 
388.27     (b) Applicants requesting only food stamps or participants 
388.28  receiving only food stamps, who have been convicted of a drug 
388.29  offense that occurred after July 1, 1997, may, if otherwise 
388.30  eligible, receive food stamps if the convicted applicant or 
388.31  participant is subject to random drug testing as a condition of 
388.32  continued eligibility.  Following a positive test for an illegal 
388.33  controlled substance, the applicant is subject to the following 
388.34  sanctions: 
388.35     (1) for failing a drug test the first time, food stamps 
388.36  shall be reduced by ten percent of the applicable food stamp 
389.1   allotment; and 
389.2      (2) for failing a drug test two or more times, food stamps 
389.3   shall be reduced by an amount equal to 30 percent of the 
389.4   applicable food stamp allotment.  
389.5      (c) For the purposes of this subdivision, "drug offense" 
389.6   means a conviction an offense that occurred after July 1, 1997, 
389.7   of sections 152.021 to 152.025, 152.0261, or 152.096.  Drug 
389.8   offense also means a conviction in another jurisdiction of the 
389.9   possession, use, or distribution of a controlled substance, or 
389.10  conspiracy to commit any of these offenses, if the offense 
389.11  occurred after July 1, 1997, and the conviction is a felony 
389.12  offense in that jurisdiction, or in the case of New Jersey, a 
389.13  high misdemeanor. 
389.14     Sec. 30.  Minnesota Statutes 1998, section 256J.30, 
389.15  subdivision 2, is amended to read: 
389.16     Subd. 2.  [REQUIREMENT TO APPLY FOR OTHER BENEFITS.] An 
389.17  applicant or participant must apply for, accept if eligible, and 
389.18  follow through with appealing any denials of eligibility for 
389.19  benefits from other programs for which the applicant or 
389.20  participant is potentially eligible and which would, if 
389.21  received, offset assistance payments.  An applicant's or 
389.22  participant's failure to complete application for these benefits 
389.23  without good cause results in denial or termination of 
389.24  assistance.  Good cause for failure to apply for these benefits 
389.25  is allowed when circumstances beyond the control of the 
389.26  applicant or participant prevent the applicant or participant 
389.27  from making an application. 
389.28     Sec. 31.  Minnesota Statutes 1998, section 256J.30, 
389.29  subdivision 7, is amended to read: 
389.30     Subd. 7.  [DUE DATE OF MFIP-S MFIP HOUSEHOLD REPORT FORM.] 
389.31  An MFIP-S MFIP household report form must be received by the 
389.32  county agency by the eighth calendar day of the month following 
389.33  the reporting period covered by the form.  When the eighth 
389.34  calendar day of the month falls on a weekend or holiday, 
389.35  the MFIP-S MFIP household report form must be received by the 
389.36  county agency the first working day that follows the eighth 
390.1   calendar day.  The county agency must send a notice of 
390.2   termination because of a late or incomplete MFIP-S household 
390.3   report form. 
390.4      Sec. 32.  Minnesota Statutes 1998, section 256J.30, 
390.5   subdivision 8, is amended to read: 
390.6      Subd. 8.  [LATE MFIP-S MFIP HOUSEHOLD REPORT FORMS.] 
390.7   Paragraphs (a) to (d) apply to the reporting requirements in 
390.8   subdivision 7. 
390.9      (a) When a caregiver submits the county agency receives an 
390.10  incomplete MFIP-S MFIP household report form before the last 
390.11  working day of the month on which a ten-day notice of 
390.12  termination can be issued, the county agency must immediately 
390.13  return the incomplete form on or before the ten-day notice 
390.14  deadline or any previously sent ten-day notice of termination is 
390.15  invalid and clearly state what the caregiver must do for the 
390.16  form to be complete. 
390.17     (b) When a complete MFIP-S household report form is not 
390.18  received by a county agency before the last ten days of the 
390.19  month in which the form is due, the county agency must send The 
390.20  automated eligibility system must send a notice of proposed 
390.21  termination of assistance to the assistance unit if a complete 
390.22  MFIP household report form is not received by a county agency.  
390.23  The automated notice must be mailed to the caregiver by 
390.24  approximately the 16th of the month.  When a caregiver submits 
390.25  an incomplete form on or after the date a notice of proposed 
390.26  termination has been sent, the termination is valid unless the 
390.27  caregiver submits a complete form before the end of the month. 
390.28     (c) An assistance unit required to submit an MFIP-S MFIP 
390.29  household report form is considered to have continued its 
390.30  application for assistance if a complete MFIP-S MFIP household 
390.31  report form is received within a calendar month after the month 
390.32  in which assistance was received the form was due and assistance 
390.33  shall be paid for the period beginning with the first day of the 
390.34  month in which the report was due that calendar month. 
390.35     (d) A county agency must allow good cause exemptions from 
390.36  the reporting requirements under subdivisions 5 and 6 when any 
391.1   of the following factors cause a caregiver to fail to provide 
391.2   the county agency with a completed MFIP-S MFIP household report 
391.3   form before the end of the month in which the form is due: 
391.4      (1) an employer delays completion of employment 
391.5   verification; 
391.6      (2) a county agency does not help a caregiver complete the 
391.7   MFIP-S MFIP household report form when the caregiver asks for 
391.8   help; 
391.9      (3) a caregiver does not receive an MFIP-S MFIP household 
391.10  report form due to mistake on the part of the department or the 
391.11  county agency or due to a reported change in address; 
391.12     (4) a caregiver is ill, or physically or mentally 
391.13  incapacitated; or 
391.14     (5) some other circumstance occurs that a caregiver could 
391.15  not avoid with reasonable care which prevents the caregiver from 
391.16  providing a completed MFIP-S MFIP household report form before 
391.17  the end of the month in which the form is due. 
391.18     Sec. 33.  Minnesota Statutes 1998, section 256J.30, 
391.19  subdivision 9, is amended to read: 
391.20     Subd. 9.  [CHANGES THAT MUST BE REPORTED.] A caregiver must 
391.21  report the changes or anticipated changes specified in clauses 
391.22  (1) to (16) (17) within ten days of the date they occur, within 
391.23  ten days of the date the caregiver learns that the change will 
391.24  occur, at the time of the periodic recertification of 
391.25  eligibility under section 256J.32, subdivision 6, or within 
391.26  eight calendar days of a reporting period as in subdivision 5 or 
391.27  6, whichever occurs first.  A caregiver must report other 
391.28  changes at the time of the periodic recertification of 
391.29  eligibility under section 256J.32, subdivision 6, or at the end 
391.30  of a reporting period under subdivision 5 or 6, as applicable.  
391.31  A caregiver must make these reports in writing to the county 
391.32  agency.  When a county agency could have reduced or terminated 
391.33  assistance for one or more payment months if a delay in 
391.34  reporting a change specified under clauses (1) to (16) had not 
391.35  occurred, the county agency must determine whether a timely 
391.36  notice under section 256J.31, subdivision 4, could have been 
392.1   issued on the day that the change occurred.  When a timely 
392.2   notice could have been issued, each month's overpayment 
392.3   subsequent to that notice must be considered a client error 
392.4   overpayment under section 256J.38.  Calculation of overpayments 
392.5   for late reporting under clause (17) is specified in section 
392.6   256J.09, subdivision 9.  Changes in circumstances which must be 
392.7   reported within ten days must also be reported on the MFIP-S 
392.8   MFIP household report form for the reporting period in which 
392.9   those changes occurred.  Within ten days, a caregiver must 
392.10  report: 
392.11     (1) a change in initial employment; 
392.12     (2) a change in initial receipt of unearned income; 
392.13     (3) a recurring change in unearned income; 
392.14     (4) a nonrecurring change of unearned income that exceeds 
392.15  $30; 
392.16     (5) the receipt of a lump sum; 
392.17     (6) an increase in assets that may cause the assistance 
392.18  unit to exceed asset limits; 
392.19     (7) a change in the physical or mental status of an 
392.20  incapacitated member of the assistance unit if the physical or 
392.21  mental status is the basis of exemption from an MFIP-S work and 
392.22  training MFIP employment services program; 
392.23     (8) a change in employment status; 
392.24     (9) a change in household composition, including births, 
392.25  returns to and departures from the home of assistance unit 
392.26  members and financially responsible persons, or a change in the 
392.27  custody of a minor child information affecting an exception 
392.28  under section 256J.24, subdivision 9; 
392.29     (10) a change in health insurance coverage; 
392.30     (11) the marriage or divorce of an assistance unit member; 
392.31     (12) the death of a parent, minor child, or financially 
392.32  responsible person; 
392.33     (13) a change in address or living quarters of the 
392.34  assistance unit; 
392.35     (14) the sale, purchase, or other transfer of property; 
392.36     (15) a change in school attendance of a custodial parent or 
393.1   an employed child; and 
393.2      (16) filing a lawsuit, a workers' compensation claim, or a 
393.3   monetary claim against a third party; and 
393.4      (17) a change in household composition, including births, 
393.5   returns to and departures from the home of assistance unit 
393.6   members and financially responsible persons, or a change in the 
393.7   custody of a minor child. 
393.8      Sec. 34.  Minnesota Statutes 1998, section 256J.31, 
393.9   subdivision 5, is amended to read: 
393.10     Subd. 5.  [MAILING OF NOTICE.] The notice of adverse action 
393.11  shall be issued according to paragraphs (a) to (c) (d). 
393.12     (a) A county agency shall mail a notice of adverse action 
393.13  must be mailed at least ten days before the effective date of 
393.14  the adverse action, except as provided in paragraphs (b) and (c) 
393.15  to (d). 
393.16     (b) A county agency must mail a notice of adverse action at 
393.17  least five days before the effective date of the adverse action 
393.18  when the county agency has factual information that requires an 
393.19  action to reduce, suspend, or terminate assistance based on 
393.20  probable fraud. 
393.21     (c) A county agency shall mail A notice of adverse action 
393.22  before or on the effective date of the adverse action must be 
393.23  mailed no later than four working days before the end of the 
393.24  month when the county agency: 
393.25     (1) receives the caregiver's signed monthly MFIP-S 
393.26  household report form that includes information that requires 
393.27  payment reduction, suspension, or termination; 
393.28     (2) is informed of the death of a participant the only 
393.29  caregiver or the payee in an assistance unit; 
393.30     (3) (2) receives a signed statement from the caregiver that 
393.31  assistance is no longer wanted; 
393.32     (4) receives a signed statement from the caregiver that 
393.33  provides information that requires the termination or reduction 
393.34  of assistance (3) has factual information to reduce, suspend, or 
393.35  terminate assistance based on the failure to timely report 
393.36  changes; 
394.1      (5) verifies that a member of the assistance unit is absent 
394.2   from the home and does not meet temporary absence provisions in 
394.3   section 256J.13; 
394.4      (6) (4) verifies that a member of the assistance unit has 
394.5   entered a regional treatment center or a licensed residential 
394.6   facility for medical or psychological treatment or 
394.7   rehabilitation; 
394.8      (7) (5) verifies that a member of an assistance unit has 
394.9   been removed from the home as a result of a judicial 
394.10  determination or placed in foster care, and the provisions of 
394.11  section 256J.13, subdivision 2, paragraph (c), clause (2), do 
394.12  not apply; 
394.13     (8) verifies that a member of an assistance unit has been 
394.14  approved to receive assistance by another state; or 
394.15     (9) (6) cannot locate a caregiver. 
394.16     (c) A notice of adverse action must be mailed for a payment 
394.17  month when the caregiver makes a written request for closure 
394.18  before the first of that payment month. 
394.19     (d) A notice of adverse action must be mailed before the 
394.20  effective date of the adverse action when the county agency 
394.21  receives the caregiver's signed and completed MFIP household 
394.22  report form or recertification form that includes information 
394.23  that requires payment reduction, suspension, or termination. 
394.24     Sec. 35.  Minnesota Statutes 1998, section 256J.31, 
394.25  subdivision 12, is amended to read: 
394.26     Subd. 12.  [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 
394.27  participant who is not in vendor payment status may discontinue 
394.28  receipt of the cash assistance portion of MFIP-S the MFIP 
394.29  assistance grant and retain eligibility for child care 
394.30  assistance under section 119B.05 and for medical assistance 
394.31  under sections 256B.055, subdivision 3a, and 256B.0635.  For the 
394.32  months a participant chooses to discontinue the receipt of the 
394.33  cash portion of the MFIP grant, the assistance unit accrues 
394.34  months of eligibility to be applied toward eligibility for child 
394.35  care under section 119B.05 and for medical assistance under 
394.36  sections 256B.055, subdivision 3a, and 256B.0635. 
395.1      Sec. 36.  Minnesota Statutes 1998, section 256J.32, 
395.2   subdivision 4, is amended to read: 
395.3      Subd. 4.  [FACTORS TO BE VERIFIED.] The county agency shall 
395.4   verify the following at application: 
395.5      (1) identity of adults; 
395.6      (2) presence of the minor child in the home, if 
395.7   questionable; 
395.8      (3) relationship of a minor child to caregivers in the 
395.9   assistance unit; 
395.10     (4) age, if necessary to determine MFIP-S MFIP eligibility; 
395.11     (5) immigration status; 
395.12     (6) social security number according to the requirements of 
395.13  section 256J.30, subdivision 12; 
395.14     (7) income; 
395.15     (8) self-employment expenses used as a deduction; 
395.16     (9) source and purpose of deposits and withdrawals from 
395.17  business accounts; 
395.18     (10) spousal support and child support payments made to 
395.19  persons outside the household; 
395.20     (11) real property; 
395.21     (12) vehicles; 
395.22     (13) checking and savings accounts; 
395.23     (14) savings certificates, savings bonds, stocks, and 
395.24  individual retirement accounts; 
395.25     (15) pregnancy, if related to eligibility; 
395.26     (16) inconsistent information, if related to eligibility; 
395.27     (17) medical insurance; 
395.28     (18) anticipated graduation date of an 18-year-old; 
395.29     (19) burial accounts; 
395.30     (20) (19) school attendance, if related to eligibility; 
395.31     (21) (20) residence; 
395.32     (22) (21) a claim of domestic violence if used as a basis 
395.33  for a deferral or exemption from the 60-month time limit in 
395.34  section 256J.42 or employment and training services requirements 
395.35  in section 256J.56; and 
395.36     (23) (22) disability if used as an exemption from 
396.1   employment and training services requirements under section 
396.2   256J.56; and 
396.3      (23) information needed to establish an exception under 
396.4   section 256J.24, subdivision 9. 
396.5      Sec. 37.  Minnesota Statutes 1998, section 256J.32, 
396.6   subdivision 6, is amended to read: 
396.7      Subd. 6.  [RECERTIFICATION.] The county agency shall 
396.8   recertify eligibility in an annual face-to-face interview with 
396.9   the participant and verify the following: 
396.10     (1) presence of the minor child in the home, if 
396.11  questionable; 
396.12     (2) income, unless excluded, including self-employment 
396.13  expenses used as a deduction or deposits or withdrawals from 
396.14  business accounts; 
396.15     (3) assets when the value is within $200 of the asset 
396.16  limit; and 
396.17     (4) information to establish an exception under section 
396.18  256J.24, subdivision 9, if questionable; and 
396.19     (5) inconsistent information, if related to eligibility.  
396.20     Sec. 38.  Minnesota Statutes 1998, section 256J.33, is 
396.21  amended to read: 
396.22     256J.33 [PROSPECTIVE AND RETROSPECTIVE DETERMINATION OF 
396.23  MFIP-S MFIP ELIGIBILITY.] 
396.24     Subdivision 1.  [DETERMINATION OF ELIGIBILITY.] A county 
396.25  agency must determine MFIP-S MFIP eligibility prospectively for 
396.26  a payment month based on retrospectively assessing income and 
396.27  the county agency's best estimate of the circumstances that will 
396.28  exist in the payment month. 
396.29     Except as described in section 256J.34, subdivision 1, when 
396.30  prospective eligibility exists, a county agency must calculate 
396.31  the amount of the assistance payment using retrospective 
396.32  budgeting.  To determine MFIP-S MFIP eligibility and the 
396.33  assistance payment amount, a county agency must apply countable 
396.34  income, described in section 256J.37, subdivisions 3 to 10, 
396.35  received by members of an assistance unit or by other persons 
396.36  whose income is counted for the assistance unit, described under 
397.1   sections 256J.21 and 256J.37, subdivisions 1 to 2. 
397.2      This income must be applied to the transitional MFIP 
397.3   standard, shared household standard, of need or family 
397.4   wage standard level subject to this section and sections 256J.34 
397.5   to 256J.36.  Income received in a calendar month and not 
397.6   otherwise excluded under section 256J.21, subdivision 2, must be 
397.7   applied to the needs of an assistance unit. 
397.8      Subd. 2.  [PROSPECTIVE ELIGIBILITY.] A county agency must 
397.9   determine whether the eligibility requirements that pertain to 
397.10  an assistance unit, including those in sections 256J.11 to 
397.11  256J.15 and 256J.20, will be met prospectively for the payment 
397.12  month.  Except for the provisions in section 256J.34, 
397.13  subdivision 1, the income test will be applied retrospectively. 
397.14     Subd. 3.  [RETROSPECTIVE ELIGIBILITY.] After the first two 
397.15  months of MFIP-S MFIP eligibility, a county agency must continue 
397.16  to determine whether an assistance unit is prospectively 
397.17  eligible for the payment month by looking at all factors other 
397.18  than income and then determine whether the assistance unit is 
397.19  retrospectively income eligible by applying the monthly income 
397.20  test to the income from the budget month.  When the monthly 
397.21  income test is not satisfied, the assistance payment must be 
397.22  suspended when ineligibility exists for one month or ended when 
397.23  ineligibility exists for more than one month. 
397.24     Subd. 4.  [MONTHLY INCOME TEST.] A county agency must apply 
397.25  the monthly income test retrospectively for each month of MFIP-S 
397.26  MFIP eligibility.  An assistance unit is not eligible when the 
397.27  countable income equals or exceeds the transitional MFIP 
397.28  standard, the shared household standard, of need or the family 
397.29  wage level for the assistance unit.  The income applied against 
397.30  the monthly income test must include: 
397.31     (1) gross earned income from employment, prior to mandatory 
397.32  payroll deductions, voluntary payroll deductions, wage 
397.33  authorizations, and after the disregards in section 256J.21, 
397.34  subdivision 4, and the allocations in section 256J.36, unless 
397.35  the employment income is specifically excluded under section 
397.36  256J.21, subdivision 2; 
398.1      (2) gross earned income from self-employment less 
398.2   deductions for self-employment expenses in section 256J.37, 
398.3   subdivision 5, but prior to any reductions for personal or 
398.4   business state and federal income taxes, personal FICA, personal 
398.5   health and life insurance, and after the disregards in section 
398.6   256J.21, subdivision 4, and the allocations in section 256J.36; 
398.7      (3) unearned income after deductions for allowable expenses 
398.8   in section 256J.37, subdivision 9, and allocations in section 
398.9   256J.36, unless the income has been specifically excluded in 
398.10  section 256J.21, subdivision 2; 
398.11     (4) gross earned income from employment as determined under 
398.12  clause (1) which is received by a member of an assistance unit 
398.13  who is a minor child or minor caregiver and less than a 
398.14  half-time student; 
398.15     (5) child support and spousal support received or 
398.16  anticipated to be received by an assistance unit; 
398.17     (6) the income of a parent when that parent is not included 
398.18  in the assistance unit; 
398.19     (7) the income of an eligible relative and spouse who seek 
398.20  to be included in the assistance unit; and 
398.21     (8) the unearned income of a minor child included in the 
398.22  assistance unit. 
398.23     Subd. 5.  [WHEN TO TERMINATE ASSISTANCE.] When an 
398.24  assistance unit is ineligible for MFIP-S MFIP assistance for two 
398.25  consecutive months, the county agency must terminate MFIP-S MFIP 
398.26  assistance. 
398.27     Sec. 39.  Minnesota Statutes 1998, section 256J.34, 
398.28  subdivision 1, is amended to read: 
398.29     Subdivision 1.  [PROSPECTIVE BUDGETING.] A county agency 
398.30  must use prospective budgeting to calculate the assistance 
398.31  payment amount for the first two months for an applicant who has 
398.32  not received assistance in this state for at least one payment 
398.33  month preceding the first month of payment under a current 
398.34  application.  Notwithstanding subdivision 3, paragraph (a), 
398.35  clause (2), a county agency must use prospective budgeting for 
398.36  the first two months for a person who applies to be added to an 
399.1   assistance unit.  Prospective budgeting is not subject to 
399.2   overpayments or underpayments unless fraud is determined under 
399.3   section 256.98. 
399.4      (a) The county agency must apply the income received or 
399.5   anticipated in the first month of MFIP-S MFIP eligibility 
399.6   against the need of the first month.  The county agency must 
399.7   apply the income received or anticipated in the second month 
399.8   against the need of the second month. 
399.9      (b) When the assistance payment for any part of the first 
399.10  two months is based on anticipated income, the county agency 
399.11  must base the initial assistance payment amount on the 
399.12  information available at the time the initial assistance payment 
399.13  is made. 
399.14     (c) The county agency must determine the assistance payment 
399.15  amount for the first two months of MFIP-S MFIP eligibility by 
399.16  budgeting both recurring and nonrecurring income for those two 
399.17  months. 
399.18     (d) The county agency must budget the child support income 
399.19  received or anticipated to be received by an assistance unit to 
399.20  determine the assistance payment amount from the month of 
399.21  application through the date in which MFIP-S MFIP eligibility is 
399.22  determined and assistance is authorized.  Child support income 
399.23  which has been budgeted to determine the assistance payment in 
399.24  the initial two months is considered nonrecurring income.  An 
399.25  assistance unit must forward any payment of child support to the 
399.26  child support enforcement unit of the county agency following 
399.27  the date in which assistance is authorized. 
399.28     Sec. 40.  Minnesota Statutes 1998, section 256J.34, 
399.29  subdivision 3, is amended to read: 
399.30     Subd. 3.  [ADDITIONAL USES OF RETROSPECTIVE BUDGETING.] 
399.31  Notwithstanding subdivision 1, the county agency must use 
399.32  retrospective budgeting to calculate the monthly assistance 
399.33  payment amount for the first two months under paragraphs (a) and 
399.34  (b). 
399.35     (a) The county agency must use retrospective budgeting to 
399.36  determine the amount of the assistance payment in the first two 
400.1   months of MFIP-S MFIP eligibility: 
400.2      (1) when an assistance unit applies for assistance for the 
400.3   same month for which assistance has been interrupted, the 
400.4   interruption in eligibility is less than one payment month, the 
400.5   assistance payment for the preceding month was issued in this 
400.6   state, and the assistance payment for the immediately preceding 
400.7   month was determined retrospectively; or 
400.8      (2) when a person applies in order to be added to an 
400.9   assistance unit, that assistance unit has received assistance in 
400.10  this state for at least the two preceding months, and that 
400.11  person has been living with and has been financially responsible 
400.12  for one or more members of that assistance unit for at least the 
400.13  two preceding months. 
400.14     (b) Except as provided in clauses (1) to (4), the county 
400.15  agency must use retrospective budgeting and apply income 
400.16  received in the budget month by an assistance unit and by a 
400.17  financially responsible household member who is not included in 
400.18  the assistance unit against the appropriate transitional or 
400.19  family wage level MFIP standard of need or family wage level to 
400.20  determine the assistance payment to be issued for the payment 
400.21  month. 
400.22     (1) When a source of income ends prior to the third payment 
400.23  month, that income is not considered in calculating the 
400.24  assistance payment for that month.  When a source of income ends 
400.25  prior to the fourth payment month, that income is not considered 
400.26  when determining the assistance payment for that month. 
400.27     (2) When a member of an assistance unit or a financially 
400.28  responsible household member leaves the household of the 
400.29  assistance unit, the income of that departed household member is 
400.30  not budgeted retrospectively for any full payment month in which 
400.31  that household member does not live with that household and is 
400.32  not included in the assistance unit. 
400.33     (3) When an individual is removed from an assistance unit 
400.34  because the individual is no longer a minor child, the income of 
400.35  that individual is not budgeted retrospectively for payment 
400.36  months in which that individual is not a member of the 
401.1   assistance unit, except that income of an ineligible child in 
401.2   the household must continue to be budgeted retrospectively 
401.3   against the child's needs when the parent or parents of that 
401.4   child request allocation of their income against any unmet needs 
401.5   of that ineligible child. 
401.6      (4) When a person ceases to have financial responsibility 
401.7   for one or more members of an assistance unit, the income of 
401.8   that person is not budgeted retrospectively for the payment 
401.9   months which follow the month in which financial responsibility 
401.10  ends. 
401.11     Sec. 41.  Minnesota Statutes 1998, section 256J.34, 
401.12  subdivision 4, is amended to read: 
401.13     Subd. 4.  [SIGNIFICANT CHANGE IN GROSS INCOME.] The county 
401.14  agency must recalculate the assistance payment when an 
401.15  assistance unit experiences a significant change, as defined in 
401.16  section 256J.08, resulting in a reduction in the gross income 
401.17  received in the payment month from the gross income received in 
401.18  the budget month.  The county agency must issue a supplemental 
401.19  assistance payment based on the county agency's best estimate of 
401.20  the assistance unit's income and circumstances for the payment 
401.21  month.  Budget adjustments Supplemental assistance payments that 
401.22  result from significant changes are limited to two in a 12-month 
401.23  period regardless of the reason for the change.  Budget 
401.24  adjustments Notwithstanding any other statute or rule of law, 
401.25  supplementary assistance payments shall not be made when the 
401.26  significant change in income is the result of receipt of a lump 
401.27  sum, receipt of an extra paycheck, business fluctuation in 
401.28  self-employment income, or an assistance unit member's 
401.29  participation in a strike or other labor action.  Supplementary 
401.30  assistance payments due to a significant change in the amount of 
401.31  direct support received must not be made after the date the 
401.32  assistance unit is required to forward support to the child 
401.33  support enforcement unit under subdivision 1, paragraph (d). 
401.34     Sec. 42.  Minnesota Statutes 1998, section 256J.35, is 
401.35  amended to read: 
401.36     256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 
402.1      Except as provided in paragraphs (a) to (d) (c), the amount 
402.2   of an assistance payment is equal to the difference between the 
402.3   transitional MFIP standard, shared household standard, of need 
402.4   or the Minnesota family wage level in section 256J.24, whichever 
402.5   is less, and countable income. 
402.6      (a) When MFIP-S MFIP eligibility exists for the month of 
402.7   application, the amount of the assistance payment for the month 
402.8   of application must be prorated from the date of application or 
402.9   the date all other eligibility factors are met for that 
402.10  applicant, whichever is later.  This provision applies when an 
402.11  applicant loses at least one day of MFIP-S MFIP eligibility. 
402.12     (b) MFIP-S MFIP overpayments to an assistance unit must be 
402.13  recouped according to section 256J.38, subdivision 4. 
402.14     (c) An initial assistance payment must not be made to an 
402.15  applicant who is not eligible on the date payment is made. 
402.16     (d) An individual whose needs have been otherwise provided 
402.17  for in another state, in whole or in part by county, state, or 
402.18  federal dollars during a month, is ineligible to receive MFIP-S 
402.19  for the month. 
402.20     Sec. 43.  Minnesota Statutes 1998, section 256J.36, is 
402.21  amended to read: 
402.22     256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 
402.23  MEMBERS.] 
402.24     Except as prohibited in paragraphs (a) and (b), an 
402.25  allocation of income is allowed from the caregiver's income to 
402.26  meet the unmet need of an ineligible spouse or an ineligible 
402.27  child under the age of 21 for whom the caregiver is financially 
402.28  responsible who also lives with the caregiver.  That allocation 
402.29  is allowed in an amount up to the difference between the MFIP-S 
402.30  transitional MFIP standard of need for the assistance unit when 
402.31  that ineligible person is included in the assistance unit and 
402.32  the MFIP-S family allowance MFIP standard of need for the 
402.33  assistance unit when the ineligible person is not included in 
402.34  the assistance unit.  These allocations must be deducted from 
402.35  the caregiver's counted earnings and from unearned income 
402.36  subject to paragraphs (a) and (b). 
403.1      (a) Income of a minor child in the assistance unit must not 
403.2   be allocated to meet the need of an ineligible person, including 
403.3   the child's parent, even when that parent is the payee of the 
403.4   child's income. 
403.5      (b) Income of a caregiver must not be allocated to meet the 
403.6   needs of a disqualified person. 
403.7      Sec. 44.  Minnesota Statutes 1998, section 256J.37, 
403.8   subdivision 1, is amended to read: 
403.9      Subdivision 1.  [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 
403.10  MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 
403.11  the income of ineligible household members must be deemed after 
403.12  allowing the following disregards: 
403.13     (1) the first 18 percent of the ineligible family member's 
403.14  gross earned income; 
403.15     (2) amounts the ineligible person actually paid to 
403.16  individuals not living in the same household but whom the 
403.17  ineligible person claims or could claim as dependents for 
403.18  determining federal personal income tax liability; 
403.19     (3) all payments made by the ineligible person according to 
403.20  a court order for spousal support or the support of children not 
403.21  living in the assistance unit's household, provided that, if 
403.22  there has been a change in the financial circumstances of the 
403.23  ineligible person since the support order was entered, the 
403.24  ineligible person has petitioned for a modification of the 
403.25  support order; and 
403.26     (4) an amount for the needs of the ineligible person and 
403.27  other persons who live in the household but are not included in 
403.28  the assistance unit and are or could be claimed by an ineligible 
403.29  person as dependents for determining federal personal income tax 
403.30  liability.  This amount is equal to the difference between the 
403.31  MFIP-S transitional MFIP standard of need when the ineligible 
403.32  person is included in the assistance unit and the MFIP-S 
403.33  transitional MFIP standard of need when the ineligible person is 
403.34  not included in the assistance unit. 
403.35     Sec. 45.  Minnesota Statutes 1998, section 256J.37, 
403.36  subdivision 1a, is amended to read: 
404.1      Subd. 1a.  [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 
404.2   income of disqualified members must be deemed after allowing the 
404.3   following disregards: 
404.4      (1) the first 18 percent of the disqualified member's gross 
404.5   earned income; 
404.6      (2) amounts the disqualified member actually paid to 
404.7   individuals not living in the same household but whom the 
404.8   disqualified member claims or could claim as dependents for 
404.9   determining federal personal income tax liability; 
404.10     (3) all payments made by the disqualified member according 
404.11  to a court order for spousal support or the support of children 
404.12  not living in the assistance unit's household, provided that, if 
404.13  there has been a change in the financial circumstances of the 
404.14  disqualified member's legal obligation to pay support since the 
404.15  support order was entered, the disqualified member has 
404.16  petitioned for a modification of the support order; and 
404.17     (4) an amount for the needs of other persons who live in 
404.18  the household but are not included in the assistance unit and 
404.19  are or could be claimed by the disqualified member as dependents 
404.20  for determining federal personal income tax liability.  This 
404.21  amount is equal to the difference between the MFIP-S 
404.22  transitional MFIP standard of need when the ineligible person is 
404.23  included in the assistance unit and the MFIP-S transitional MFIP 
404.24  standard of need when the ineligible person is not included in 
404.25  the assistance unit.  An amount shall not be allowed for the 
404.26  needs of a disqualified member. 
404.27     Sec. 46.  Minnesota Statutes 1998, section 256J.37, 
404.28  subdivision 2, is amended to read: 
404.29     Subd. 2.  [DEEMED INCOME AND ASSETS OF SPONSOR OF 
404.30  NONCITIZENS.] If a noncitizen applies for or receives MFIP-S, 
404.31  the county must deem the income and assets of the noncitizen's 
404.32  sponsor and the sponsor's spouse who have signed an affidavit of 
404.33  support for the noncitizen as specified in Public Law Number 
404.34  104-193, title IV, sections 421 and 422, the Personal 
404.35  Responsibility and Work Opportunity Reconciliation Act of 1996.  
404.36  The income of a sponsor and the sponsor's spouse is considered 
405.1   unearned income of the noncitizen.  The assets of a sponsor and 
405.2   the sponsor's spouse are considered available assets of the 
405.3   noncitizen.  (a) If a noncitizen applies for or receives MFIP, 
405.4   the county must deem the income and assets of the noncitizen's 
405.5   s