1st Engrossment - 81st Legislature (1999 - 2000) Posted on 12/15/2009 12:00am
1.1 A bill for an act 1.2 relating to human services; appropriating money for 1.3 the departments of human services and health, the 1.4 veterans nursing homes board, the health-related 1.5 boards, the emergency medical services board, the 1.6 council on disability, the ombudsman for mental health 1.7 and mental retardation, and the ombudsman for 1.8 families; amending Minnesota Statutes 1998, sections 1.9 13.99, subdivision 38a, and by adding a subdivision; 1.10 16A.76, subdivision 2; 16C.10, subdivision 5; 60A.15, 1.11 subdivision 1; 62A.045; 62J.69; 116L.02; 125A.08; 1.12 125A.21, subdivision 1; 125A.74, subdivisions 1 and 2; 1.13 144.065; 144.148; 144.1761, subdivision 1; 144.99, 1.14 subdivision 1, and by adding a subdivision; 144A.073, 1.15 subdivision 5; 144A.10, by adding subdivisions; 1.16 144D.01, subdivision 4; 144E.001, by adding 1.17 subdivisions; 144E.10, subdivision 1; 144E.11, by 1.18 adding a subdivision; 144E.16, subdivision 4; 144E.18; 1.19 144E.27, by adding subdivisions; 144E.50, by adding a 1.20 subdivision; 145.924; 145A.02, subdivision 10; 1.21 148.5194, subdivisions 2, 3, 4, and by adding a 1.22 subdivision; 148B.32, subdivision 1; 150A.10, 1.23 subdivision 1; 245.462, subdivisions 4 and 17; 1.24 245.4711, subdivision 1; 245.4712, subdivision 2; 1.25 245.4871, subdivisions 4 and 26; 245.4881, subdivision 1.26 1; 245A.04, subdivision 3a; 245A.08, subdivision 5; 1.27 245A.30; 245B.05, subdivision 7; 245B.07, subdivisions 1.28 5, 8, and 10; 246.18, subdivision 6; 252.28, 1.29 subdivision 1; 252.291, by adding a subdivision; 1.30 252.32, subdivision 3a; 252.46, subdivision 6; 1.31 253B.045, by adding subdivisions; 253B.07, subdivision 1.32 1; 253B.185, by adding a subdivision; 254B.01, by 1.33 adding a subdivision; 254B.03, subdivision 2; 254B.04, 1.34 subdivision 1; 254B.05, subdivision 1; 256.01, 1.35 subdivision 2; 256.015, subdivisions 1 and 3; 256.87, 1.36 subdivision 1a; 256.955, subdivisions 3, 4, 7, 8, and 1.37 9; 256.9685, subdivision 1a; 256.969, subdivision 1; 1.38 256B.04, subdivision 16, and by adding a subdivision; 1.39 256B.042, subdivisions 1, 2, and 3; 256B.055, 1.40 subdivision 3a; 256B.056, subdivision 4; 256B.057, 1.41 subdivision 3, and by adding a subdivision; 256B.0575; 1.42 256B.061; 256B.0625, subdivisions 6a, 8, 8a, 13, 19c, 1.43 20, 26, 28, 30, 32, 35, and by adding subdivisions; 1.44 256B.0627, subdivisions 1, 2, 4, 5, 8, and by adding 1.45 subdivisions; 256B.0635, subdivision 3; 256B.064, 1.46 subdivisions 1a, 1b, 1c, 2, and by adding a 2.1 subdivision; 256B.0911, subdivision 6; 256B.0913, 2.2 subdivisions 5, 10, 12, and 16; 256B.0917, subdivision 2.3 8; 256B.094, subdivisions 3, 5, and 6; 256B.37, 2.4 subdivision 2; 256B.431, subdivisions 2i, 17, 26, and 2.5 by adding a subdivision; 256B.434, subdivisions 3, 4, 2.6 13, and by adding a subdivision; 256B.435; 256B.48, 2.7 subdivisions 1, 1a, 1b, and 6; 256B.50, subdivision 2.8 1e; 256B.501, subdivision 8a, and by adding a 2.9 subdivision; 256B.5011, subdivisions 1 and 2; 256B.69, 2.10 subdivisions 3a, 5b, 6a, 6b, and by adding 2.11 subdivisions; 256B.692, subdivision 2; 256B.75; 2.12 256B.76; 256B.77, subdivisions 7a, 8, and by adding 2.13 subdivisions; 256D.03, subdivisions 3, 4, and 8; 2.14 256D.051, subdivision 2a, and by adding a subdivision; 2.15 256D.053, subdivision 1; 256D.06, subdivision 5; 2.16 256F.03, subdivision 5; 256F.05, subdivision 8; 2.17 256F.10, subdivisions 1, 4, 6, 7, 8, 9, and 10; 2.18 256I.04, subdivision 3; 256I.05, subdivisions 1 and 2.19 1a; 256J.08, subdivisions 11, 24, 65, 82, 83, 86a, and 2.20 by adding subdivisions; 256J.11, subdivisions 2 and 3; 2.21 256J.12, subdivisions 1a and 2; 256J.14; 256J.20, 2.22 subdivision 3; 256J.21, subdivisions 2, 3, and 4; 2.23 256J.24, subdivisions 2, 3, 7, 8, 9, and by adding a 2.24 subdivision; 256J.26, subdivision 1; 256J.30, 2.25 subdivisions 2, 7, 8, and 9; 256J.31, subdivisions 5 2.26 and 12; 256J.32, subdivisions 4 and 6; 256J.33; 2.27 256J.34, subdivisions 1, 3, and 4; 256J.35; 256J.36; 2.28 256J.37, subdivisions 1, 1a, 2, 9, and 10; 256J.38, 2.29 subdivision 4; 256J.42, subdivisions 1, 5, and by 2.30 adding a subdivision; 256J.43; 256J.45, subdivision 1; 2.31 256J.46, subdivisions 1, 2, and 2a; 256J.47, 2.32 subdivision 4; 256J.48, subdivisions 2 and 3; 256J.50, 2.33 subdivision 1; 256J.515; 256J.52, subdivisions 1, 4, 2.34 8, and by adding a subdivision; 256J.55, subdivision 2.35 4; 256J.56; 256J.57, subdivision 1; 256J.62, 2.36 subdivisions 1, 6, 7, 8, 9, and by adding a 2.37 subdivision; 256J.67, subdivision 4; 256J.74, 2.38 subdivision 2; 256J.76, subdivisions 1, 2, and 4; 2.39 256L.03, subdivisions 5 and 6; 256L.04, subdivisions 2.40 2, 7, 8, 11, and 13; 256L.05, subdivision 4, and by 2.41 adding a subdivision; 256L.06, subdivision 3; 256L.07; 2.42 256L.15, subdivisions 1, 1b, 2, and 3; 257.071, 2.43 subdivisions 1, 1a, 1c, 1d, 1e, 3, and 4; 257.66, 2.44 subdivision 3; 257.75, subdivision 2; 257.85, 2.45 subdivisions 2, 3, 4, 5, 6, 7, 9, and 11; 259.67, 2.46 subdivisions 6 and 7; 259.73; 259.85, subdivisions 2, 2.47 3, and 5; 259.89, by adding a subdivision; 260.011, 2.48 subdivision 2; 260.012; 260.015, subdivisions 2a, 13, 2.49 and 29; 260.131, subdivision 1a; 260.133, subdivisions 2.50 1 and 2; 260.135, by adding a subdivision; 260.172, 2.51 subdivision 1, and by adding a subdivision; 260.191, 2.52 subdivisions 1, 1a, 1b, and 3b; 260.192; 260.221, 2.53 subdivisions 1, 1a, 1b, 1c, 3, and 5; 326.40, 2.54 subdivisions 2, 4, and 5; 518.10; 518.551, by adding a 2.55 subdivision; 518.5853, by adding a subdivision; 2.56 626.556, subdivisions 2, 3, 4, 7, 10, 10b, 10d, 10e, 2.57 10f, 10i, 10j, 11, 11b, 11c, and by adding a 2.58 subdivision; and 626.558, subdivision 1; Laws 1995, 2.59 chapter 178, article 2, section 46, subdivision 10; 2.60 chapter 207, article 8, section 41, as amended; Laws 2.61 1998, chapter 407, article 7, section 2, subdivision 2.62 3; proposing coding for new law in Minnesota Statutes, 2.63 chapters 10; 62J; 116L; 137; 144; 144A; 144E; 214; 2.64 245; 246; 252; 254A; 256; 256B; 256J; and 626; 2.65 proposing coding for new law as Minnesota Statutes, 2.66 chapter 256M; repealing Minnesota Statutes 1998, 2.67 sections 62J.77; 62J.78; 62J.79; 144.0723; 144E.16, 2.68 subdivisions 1, 2, 3, and 6; 144E.17; 144E.25; 2.69 144E.30, subdivisions 1, 2, and 6; 145.46; 256B.434, 2.70 subdivision 17; 256B.501, subdivision 3g; 256B.5011, 2.71 subdivision 3; 256B.74, subdivisions 2 and 5; 3.1 256D.051, subdivisions 6 and 19; 256D.053, subdivision 3.2 4; 256J.03; 256J.30, subdivision 6; 256J.62, 3.3 subdivisions 2, 3, and 5; 257.071, subdivisions 8 and 3.4 10; and 462A.208; Laws 1997, chapter 85, article 1, 3.5 section 63; chapter 203, article 4, section 55; Laws 3.6 1998, chapter 407, article 2, section 104; Minnesota 3.7 Rules, parts 4690.0100, subparts 4, 13, 15, 19, 20, 3.8 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 4690.0400; 3.9 4690.0500; 4690.0600; 4690.0700; 4690.0800, subparts 1 3.10 and 2; 4690.0900; 4690.1000; 4690.1100; 4690.1200; 3.11 4690.1300; 4690.1600; 4690.1700; 4690.2100; 4690.2200, 3.12 subparts 1, 3, 4, and 5; 4690.2300; 4690.2400, 3.13 subparts 1, 2, and 3; 4690.2500; 4690.2900; 4690.3000; 3.14 4690.3700; 4690.3900; 4690.4000; 4690.4100; 4690.4200; 3.15 4690.4300; 4690.4400; 4690.4500; 4690.4600; 4690.4700; 3.16 4690.4800; 4690.4900; 4690.5000; 4690.5100; 4690.5200; 3.17 4690.5300; 4690.5400; 4690.5500; 4690.5700; 4690.5800; 3.18 4690.5900; 4690.6000; 4690.6100; 4690.6200; 4690.6300; 3.19 4690.6400; 4690.6500; 4690.6600; 4690.6700; 4690.6800; 3.20 4690.7000; 4690.7100; 4690.7200; 4690.7300; 4690.7400; 3.21 4690.7500; 4690.7600; 4690.7700; 4690.7800; 4690.8300, 3.22 subparts 1, 2, 3, 4, and 5; and 4735.5000. 3.23 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.24 ARTICLE 1 3.25 APPROPRIATIONS 3.26 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.27 The sums shown in the columns marked "APPROPRIATIONS" are 3.28 appropriated from the general fund, or any other fund named, to 3.29 the agencies and for the purposes specified in the following 3.30 sections of this article, to be available for the fiscal years 3.31 indicated for each purpose. The figures "2000" and "2001" where 3.32 used in this article, mean that the appropriation or 3.33 appropriations listed under them are available for the fiscal 3.34 year ending June 30, 2000, or June 30, 2001, respectively. 3.35 Where a dollar amount appears in parentheses, it means a 3.36 reduction of an appropriation. 3.37 SUMMARY BY FUND 3.38 APPROPRIATIONS BIENNIAL 3.39 2000 2001 TOTAL 3.40 General $2,648,495,000 $2,777,133,000 $5,425,628,000 3.41 State Government 3.42 Special Revenue 36,438,000 36,194,000 72,632,000 3.43 Health Care 3.44 Access 149,417,000 188,885,000 338,302,000 3.45 Metropolitan 3.46 Landfill Contingency 3.47 Action Fund 196,000 199,000 395,000 3.48 Trunk Highway 1,726,000 1,773,000 3,499,000 3.49 Lottery Prize 1,300,000 1,300,000 2,600,000 4.1 TOTAL $2,837,572,000 $3,005,484,000 $5,843,056,000 4.2 [SPENDING TAILS CAP.] (a) The 4.3 commissioner of finance shall make 4.4 transfers and base reductions described 4.5 in clauses (1) and (2) below to reduce 4.6 the recognized fund balance 4.7 expenditures including planning 4.8 estimates, if any, for fiscal years 4.9 2002 and 2003 to $6,247,197,000, 4.10 provided that the reductions shall not 4.11 exceed $42,000,000: 4.12 (1) Notwithstanding any contrary 4.13 provision in section 2, subdivision 10, 4.14 paragraph (a), of this article, 4.15 $12,000,000 in fiscal year 2002 and 4.16 $12,000,000 in fiscal year 2003 shall 4.17 be transferred to the state's federal 4.18 Title XX block grant to be allocated 4.19 according to the community social 4.20 services aids formula in Minnesota 4.21 Statutes, section 256E.06, and the base 4.22 funding level for the community social 4.23 services block grant shall be reduced 4.24 by $12,000,000 in fiscal year 2002 and 4.25 fiscal year 2003. 4.26 (2) If full implementation of clause 4.27 (1) does not produce sufficient 4.28 reductions, notwithstanding any 4.29 contrary provision in article 10, 4.30 section 7, of this act, in fiscal year 4.31 2002 the first $6,000,000 in earnings 4.32 credited to the tobacco prevention 4.33 endowment fund shall be appropriated to 4.34 the commissioner of finance and 4.35 transferred to the general fund, and in 4.36 fiscal year 2003 the first $12,000,000 4.37 in earnings credited to the tobacco 4.38 prevention endowment fund shall be 4.39 appropriated to the commissioner of 4.40 finance and transferred to the general 4.41 fund. 4.42 (b) The spending cap of $6,247,197,000 4.43 shall be adjusted upward by an amount 4.44 equivalent to additional spending and 4.45 applicable planning estimates, if any, 4.46 approved after December 31, 1999, for 4.47 activities funded in this article. 4.48 (c) This provision shall not take 4.49 effect if the recognized fund balance 4.50 expenditures including planning 4.51 estimates, if any, for the activities 4.52 referenced in paragraph (b) are 4.53 determined by the commissioner of 4.54 finance at any time between May 1, 4.55 1999, and March 31, 2001, to be below 4.56 $6,247,197,000. 4.57 APPROPRIATIONS 4.58 Available for the Year 4.59 Ending June 30 4.60 2000 2001 4.61 Sec. 2. COMMISSIONER OF 4.62 HUMAN SERVICES 4.63 Subdivision 1. Total 5.1 Appropriation $2,695,782,000 $2,863,372,000 5.2 Summary by Fund 5.3 General 2,555,853,000 2,683,303,000 5.4 State Government 5.5 Special Revenue 485,000 507,000 5.6 Health Care 5.7 Access 138,743,000 178,362,000 5.8 Lottery Prize 1,300,000 1,300,000 5.9 Subd. 2. Agency Management 5.10 General 28,661,000 28,961,000 5.11 State Government 5.12 Special Revenue 371,000 392,000 5.13 Health Care 5.14 Access 3,268,000 3,321,000 5.15 The amounts that may be spent from the 5.16 appropriation for each purpose are as 5.17 follows: 5.18 (a) Financial Operations 5.19 General 7,433,000 7,569,000 5.20 Health Care 5.21 Access 691,000 702,000 5.22 [RECEIPTS FOR SYSTEMS PROJECTS.] 5.23 Appropriations and federal receipts for 5.24 information system projects for MAXIS, 5.25 electronic benefit system, social 5.26 services information system, child 5.27 support enforcement, and Minnesota 5.28 Medicaid information system (MMIS II) 5.29 must be deposited in the state system 5.30 account authorized in Minnesota 5.31 Statutes, section 256.014. Money 5.32 appropriated for computer projects 5.33 approved by the information policy 5.34 office, funded by the legislature, and 5.35 approved by the commissioner of finance 5.36 may be transferred from one project to 5.37 another and from development to 5.38 operations as the commissioner of human 5.39 services considers necessary. Any 5.40 unexpended balance in the appropriation 5.41 for these projects does not cancel but 5.42 is available for ongoing development 5.43 and operations. 5.44 (b) Legal & Regulation Operations 5.45 General 6,579,000 6,671,000 5.46 State Government 5.47 Special Revenue 371,000 392,000 5.48 Health Care 5.49 Access 141,000 145,000 5.50 [REIMBURSEMENT OF COUNTY COSTS.] Of the 5.51 general fund appropriation, $10,000 is 5.52 for the commissioner for the biennium 6.1 beginning July 1, 1999, to reimburse 6.2 counties for the legal and related 6.3 costs of contesting through the 6.4 administrative and judicial systems 6.5 decisions that affect state spending 6.6 but not county spending on programs 6.7 administered or financed by the 6.8 commissioner. The commissioner may 6.9 reimburse expenses that occurred on or 6.10 after January 1, 1998. 6.11 (c) Management Operations 6.12 General 14,649,000 14,721,000 6.13 Health Care 6.14 Access 2,436,000 2,474,000 6.15 [COMMUNICATION COSTS.] The commissioner 6.16 shall continue to operate the 6.17 department of human services 6.18 communication systems account 6.19 established in Laws 1993, First Special 6.20 Session chapter 1, article 1, section 6.21 2, subdivision 2, to manage shared 6.22 communication costs necessary for the 6.23 operation of the programs the 6.24 commissioner supervises. A 6.25 communications account may also be 6.26 established for each regional treatment 6.27 center which operates communication 6.28 systems. Each account shall be used to 6.29 manage shared communication costs 6.30 necessary for the operation of programs 6.31 the commissioner supervises. The 6.32 commissioner may distribute the costs 6.33 of operating and maintaining 6.34 communication systems to participants 6.35 in a manner that reflects actual 6.36 usage. Costs may include acquisition, 6.37 licensing, insurance, maintenance, 6.38 repair, staff time, and other costs as 6.39 determined by the commissioner. 6.40 Nonprofit organizations and state, 6.41 county, and local government agencies 6.42 involved in the operation of programs 6.43 the commissioner supervises may 6.44 participate in the use of the 6.45 department's communication technology 6.46 and share in the cost of operation. 6.47 The commissioner may accept on behalf 6.48 of the state any gift, bequest, devise, 6.49 or personal property of any kind, or 6.50 money tendered to the state for any 6.51 lawful purpose pertaining to the 6.52 communication activities of the 6.53 department. Any money received for 6.54 this purpose must be deposited in the 6.55 department of human services 6.56 communication systems accounts. Money 6.57 collected by the commissioner for the 6.58 use of communication systems must be 6.59 deposited in the state communication 6.60 systems account and is appropriated to 6.61 the commissioner for purposes of this 6.62 section. 6.63 [ISSUANCE OPERATIONS CENTER.] Payments 6.64 to the commissioner from other 6.65 governmental units and private 6.66 enterprises for (1) services performed 7.1 by the issuance operations center, or 7.2 (2) reports generated by the payment 7.3 and eligibility systems must be 7.4 deposited in the state systems account 7.5 authorized in Minnesota Statutes, 7.6 section 256.014. These payments are 7.7 appropriated to the commissioner for 7.8 the operation of the issuance center or 7.9 system, in accordance with Minnesota 7.10 Statutes, section 256.014. 7.11 Subd. 3. Children's Grants 7.12 General 52,845,000 54,931,000 7.13 Subd. 4. Children's Services Management 7.14 General 3,350,000 3,140,000 7.15 Subd. 5. Basic Health Care Grants 7.16 Summary by Fund 7.17 General 869,070,000 919,566,000 7.18 Health Care 7.19 Access 117,877,000 155,573,000 7.20 The amounts that may be spent from this 7.21 appropriation for each purpose are as 7.22 follows: 7.23 (a) Minnesota Care Grants- 7.24 Health Care 7.25 Access 117,877,000 155,573,000 7.26 [MINNESOTACARE PROGRAM EXPANSION.] Of 7.27 this appropriation, $5,442,000 in 7.28 fiscal year 2001 is from the health 7.29 care access fund to the commissioner 7.30 for the eligibility expansion of the 7.31 MinnesotaCare program up to 275 percent 7.32 of the federal poverty guidelines for 7.33 single adults and households without 7.34 children. 7.35 [SUBSIDIZED EMPLOYER HEALTH COVERAGE.] 7.36 Of this appropriation, $4,059,000 in 7.37 the biennium is from the health care 7.38 access fund to the commissioner for the 7.39 subsidized employer health coverage 7.40 program described in Minnesota 7.41 Statutes, chapter 256M, if enacted. 7.42 [MINNESOTACARE OUTREACH FEDERAL 7.43 MATCHING FUNDS.] Any federal matching 7.44 funds received as a result of the 7.45 MinnesotaCare outreach activities 7.46 authorized by Laws 1997, chapter 225, 7.47 article 7, section 2, subdivision 1, 7.48 shall be deposited in the health care 7.49 access fund and dedicated to the 7.50 commissioner to be used for those 7.51 outreach purposes. 7.52 [FEDERAL RECEIPTS FOR ADMINISTRATION.] 7.53 Receipts received as a result of 7.54 federal participation pertaining to 7.55 administrative costs of the Minnesota 7.56 health care reform waiver shall be 7.57 deposited as nondedicated revenue in 8.1 the health care access fund. Receipts 8.2 received as a result of federal 8.3 participation pertaining to grants 8.4 shall be deposited in the federal fund 8.5 and shall offset health care access 8.6 funds for payments to providers. 8.7 [HEALTH CARE ACCESS FUND.] The 8.8 commissioner may expend money 8.9 appropriated from the health care 8.10 access fund for MinnesotaCare in either 8.11 fiscal year of the biennium. 8.12 (b) MA Basic Health Care Grants- 8.13 Families and Children 8.14 General 307,413,000 321,562,000 8.15 (c) MA Basic Health Care Grants- 8.16 Elderly & Disabled 8.17 General 405,535,000 452,901,000 8.18 [PUBLIC HEALTH NURSE ASSESSMENT.] The 8.19 reimbursement for public health nurse 8.20 visits relating to the provision of 8.21 personal care services under Minnesota 8.22 Statutes, sections 256B.0625, 8.23 subdivision 19a, and 256B.0627, is 8.24 $210.50 for a face-to-face assessment 8.25 visit, $105.25 for each service update, 8.26 and $105.25 for each request for a 8.27 temporary service increase. These 8.28 rates shall be adjusted based on rate 8.29 increases approved by the legislature 8.30 for cost-of-living or wage enhancements 8.31 for personal care assistant services. 8.32 [SURCHARGE COMPLIANCE.] In the event 8.33 that federal financial participation in 8.34 the Minnesota medical assistance 8.35 program is reduced as a result of a 8.36 determination that the surcharge and 8.37 intergovernmental transfers governed by 8.38 Minnesota Statutes, sections 256.9657 8.39 and 256B.19 are out of compliance with 8.40 United States Code, title 42, section 8.41 1396b(w), or its implementing 8.42 regulations or with any other federal 8.43 law designed to restrict provider tax 8.44 programs or intergovernmental 8.45 transfers, the commissioner shall 8.46 appeal the determination to the fullest 8.47 extent permitted by law and may ratably 8.48 reduce all medical assistance and 8.49 general assistance medical care 8.50 payments to providers other than the 8.51 state of Minnesota in order to 8.52 eliminate any shortfall resulting from 8.53 the reduced federal funding. Any 8.54 amount later recovered through the 8.55 appeals process shall be used to 8.56 reimburse providers for any ratable 8.57 reductions taken. 8.58 [BLOOD PRODUCTS LITIGATION.] To the 8.59 extent permitted by federal law, 8.60 Minnesota Statutes, section 256.015, 8.61 256B.042, and 256B.15, are waived as 8.62 necessary for the limited purpose of 8.63 resolving the state's claims in 9.1 connection with In re Factor VIII or IX 9.2 Concentrate Blood Products Litigation, 9.3 MDL-986, No. 93-C7452 (N.D.III.). 9.4 (d) General Assistance Medical Care 9.5 General 142,502,000 128,921,000 9.6 (e) Basic Health Care - Nonentitlement 9.7 General 13,620,000 16,182,000 9.8 [DENTAL ACCESS GRANT.] Of this 9.9 appropriation, $75,000 is from the 9.10 general fund to the commissioner in 9.11 fiscal year 2000 for a grant to a 9.12 nonprofit dental provider group 9.13 operating a dental clinic in Clay 9.14 county. The grant must be used to 9.15 increase access to dental services for 9.16 recipients of medical assistance, 9.17 general assistance medical care, and 9.18 the MinnesotaCare program in the 9.19 northwest area of the state. This 9.20 appropriation is available the day 9.21 following final enactment. 9.22 [SENIOR DRUG PROGRAM PREMIUM 9.23 REIMBURSEMENT.] Of this appropriation, 9.24 $118,000 in fiscal year 2000 is to the 9.25 commissioner to refund to current 9.26 enrollees the balance of their annual 9.27 premiums on a pro rata basis for the 9.28 months remaining in their first 9.29 12-month annual enrollment cycle. 9.30 Subd. 6. Basic Health Care Management 9.31 General 23,360,000 23,576,000 9.32 Health Care 9.33 Access 16,285,000 18,150,000 9.34 The amounts that may be spent from this 9.35 appropriation for each purpose are as 9.36 follows: 9.37 (a) Health Care Policy Administration 9.38 General 3,076,000 3,157,000 9.39 Health Care 9.40 Access 570,000 582,000 9.41 [CONSUMER SATISFACTION SURVEY.] Any 9.42 federal matching money received through 9.43 the medical assistance program for the 9.44 consumer satisfaction survey is 9.45 appropriated to the commissioner for 9.46 this purpose. The commissioner may 9.47 expend the federal money received for 9.48 the consumer satisfaction survey in 9.49 either year of the biennium. 9.50 (b) Health Care Operations 9.51 General 20,284,000 20,419,000 9.52 Health Care 9.53 Access 15,715,000 17,568,000 10.1 [MINNESOTACARE STAFF.] Of this 10.2 appropriation, $2,121,000 for fiscal 10.3 year 2000 and $1,465,000 for fiscal 10.4 year 2001 is from the health care 10.5 access fund to the commissioner for 10.6 staff and other administrative services 10.7 associated with improving MinnesotaCare 10.8 processing and caseload management. Of 10.9 this appropriation, $965,000 shall 10.10 become part of the base. 10.11 [PREPAID MEDICAL PROGRAMS.] The 10.12 nonfederal share of the prepaid medical 10.13 assistance program fund, which has been 10.14 appropriated to fund county managed 10.15 care advocacy and enrollment operating 10.16 costs, shall be disbursed as grants 10.17 using either a reimbursement or block 10.18 grant mechanism and may also be 10.19 transferred between grants and nongrant 10.20 administration costs with approval of 10.21 the commissioner of finance. 10.22 Subd. 7. State-Operated Services 10.23 General 206,785,000 211,902,000 10.24 The amounts that may be spent from this 10.25 appropriation for each purpose are as 10.26 follows: 10.27 (a) SOS-Campus Based Programs 10.28 General 185,552,000 190,043,000 10.29 [DAY TRAINING SERVICES.] In order to 10.30 ensure eligible individuals have access 10.31 to day training and habilitation 10.32 services, the regional treatment 10.33 centers, the Minnesota extended 10.34 treatment options program, and 10.35 state-operated community services 10.36 operating according to Minnesota 10.37 Statutes, section 252.50, are exempt 10.38 from the provisions of Minnesota 10.39 Statutes, section 252.41, subdivision 10.40 9, clause (2). Notwithstanding section 10.41 13, this provision shall not expire. 10.42 [MITIGATION RELATED TO DEVELOPMENTAL 10.43 DISABILITIES DOWNSIZING.] Money 10.44 appropriated to finance mitigation 10.45 expenses related to the downsizing of 10.46 regional treatment center developmental 10.47 disabilities programs may be 10.48 transferred between fiscal years within 10.49 the biennium. 10.50 [REGIONAL TREATMENT CENTER CHEMICAL 10.51 DEPENDENCY PROGRAMS.] When the 10.52 operations of the regional treatment 10.53 center chemical dependency fund created 10.54 in Minnesota Statutes, section 246.18, 10.55 subdivision 2, are impeded by projected 10.56 cash deficiencies resulting from delays 10.57 in the receipt of grants, dedicated 10.58 income, or other similar receivables, 10.59 and when the deficiencies would be 10.60 corrected within the budget period 10.61 involved, the commissioner of finance 10.62 may transfer general fund cash reserves 11.1 into this account as necessary to meet 11.2 cash demands. The cash flow transfers 11.3 must be returned to the general fund in 11.4 the fiscal year that the transfer was 11.5 made. Any interest earned on general 11.6 fund cash flow transfers accrues to the 11.7 general fund and not the regional 11.8 treatment center chemical dependency 11.9 fund. 11.10 [LEAVE LIABILITIES.] The accrued leave 11.11 liabilities of state employees 11.12 transferred to state-operated community 11.13 services programs may be paid from the 11.14 appropriation in this subdivision for 11.15 state-operated services. Funds set 11.16 aside for this purpose shall not exceed 11.17 the amount of the actual leave 11.18 liability calculated as of June 30, 11.19 2000, and shall be available until 11.20 expended. 11.21 [REGIONAL TREATMENT CENTER 11.22 RESTRUCTURING.] For purposes of 11.23 restructuring the regional treatment 11.24 centers and state nursing homes, any 11.25 regional treatment center or state 11.26 nursing home employee whose position is 11.27 to be eliminated shall be afforded the 11.28 options provided in applicable 11.29 collective bargaining agreements. All 11.30 salary and mitigation allocations from 11.31 fiscal year 2000 shall be carried 11.32 forward into fiscal year 2001. 11.33 Provided there is no conflict with any 11.34 collective bargaining agreement, any 11.35 regional treatment center or state 11.36 nursing home position reduction must 11.37 only be accomplished through 11.38 mitigation, attrition, transfer, and 11.39 other measures as provided in state or 11.40 applicable collective bargaining 11.41 agreements and in Minnesota Statutes, 11.42 section 252.50, subdivision 11, and not 11.43 through layoff. 11.44 [REGIONAL TREATMENT CENTER POPULATION.] 11.45 If the resident population at the 11.46 regional treatment centers is projected 11.47 to be higher than the estimates upon 11.48 which the medical assistance forecast 11.49 and budget recommendations for the 11.50 2000-2001 biennium is based, the amount 11.51 of the medical assistance appropriation 11.52 that is attributable to the cost of 11.53 services that would have been provided 11.54 as an alternative to regional treatment 11.55 center services, including resources 11.56 for community placements and waivered 11.57 services for persons with mental 11.58 retardation and related conditions, is 11.59 transferred to the residential 11.60 facilities appropriation. 11.61 [REPAIRS AND BETTERMENTS.] The 11.62 commissioner may transfer unencumbered 11.63 appropriation balances between fiscal 11.64 years for the state residential 11.65 facilities repairs and betterments 11.66 account and special equipment. 12.1 [PROJECT LABOR.] Wages for project 12.2 labor may be paid by the commissioner 12.3 out of repairs and betterments money if 12.4 the individual is to be engaged in a 12.5 construction project or a repair 12.6 project of short-term and nonrecurring 12.7 nature. Compensation for project labor 12.8 shall be based on the prevailing wage 12.9 rates, as defined in Minnesota 12.10 Statutes, section 177.42, subdivision 12.11 6. Project laborers are excluded from 12.12 the provisions of Minnesota Statutes, 12.13 sections 43A.22 to 43A.30, and shall 12.14 not be eligible for state-paid 12.15 insurance and benefits. 12.16 [DEVELOPMENTAL DISABILITIES CRISIS 12.17 UNIT.] The commissioner shall establish 12.18 a 16-bed developmental disabilities 12.19 crisis unit at the Brainerd regional 12.20 treatment center to provide short-term 12.21 crisis services to community-based 12.22 residents of state and private programs 12.23 for persons with mental retardation or 12.24 related conditions. 12.25 [LOCAL FIRE DEPARTMENT FUNDING.] (a) 12.26 The St. Peter Human Services Center 12.27 shall continue funding for fiscal year 12.28 2000 to the local fire department in an 12.29 amount equal to the funding provided to 12.30 the local fire department in the 1999 12.31 fiscal year. 12.32 (b) The Moose Lake Sexual Psychopathic 12.33 Personality Treatment Center shall 12.34 resume funding for fiscal year 2000 to 12.35 the local fire department in an amount 12.36 equal to one-half of the amount paid in 12.37 the last fiscal year the former Moose 12.38 Lake Human Services Center provided 12.39 funding to the local fire department. 12.40 (c) The commissioner of human services, 12.41 in consultation with the St. Peter and 12.42 Moose Lake fire departments, shall 12.43 report to the legislature by January 12.44 15, 2000, on the fiscal impact, and any 12.45 other relevant impact on the local 12.46 communities, of continuing or 12.47 discontinuing the funding to the local 12.48 fire departments. 12.49 (b) State-Operated Community 12.50 Services - Northeast Minnesota 12.51 Mental Health Services 12.52 General 3,983,000 4,055,000 12.53 (c) State-Operated Community 12.54 Services - Statewide DD Supports 12.55 General 15,493,000 16,047,000 12.56 (d) State-Operated Services - 12.57 Enterprise Activities 12.58 General 1,757,000 1,757,000 12.59 Subd. 8. Continuing Care and 12.60 Community Support Grants 13.1 General 1,171,727,000 1,253,915,000 13.2 Lottery Prize 1,158,000 1,158,000 13.3 The amounts that may be spent from this 13.4 appropriation for each purpose are as 13.5 follows: 13.6 (a) Community Social Services 13.7 Block Grants 13.8 42,597,000 43,498,000 13.9 [CSSA TRADITIONAL APPROPRIATION.] 13.10 Notwithstanding Minnesota Statutes, 13.11 section 256E.06, subdivisions 1 and 2, 13.12 the appropriations available under that 13.13 section in fiscal years 2000 and 2001 13.14 must be distributed to each county 13.15 proportionately to the aid received by 13.16 the county in calendar year 1998. The 13.17 commissioner, in consultation with 13.18 counties, shall study the formula 13.19 limitations in subdivision 2 of that 13.20 section, and report findings and any 13.21 recommendations for revision of the 13.22 CSSA formula and its formula limitation 13.23 provisions to the legislature by 13.24 January 15, 2000. 13.25 (b) Consumer Support Grants 13.26 1,123,000 1,123,000 13.27 (c) Aging Adult Service Grants 13.28 8,134,000 7,745,000 13.29 [LIVING-AT-HOME/BLOCK NURSE PROGRAM.] 13.30 Of the general fund appropriation, 13.31 $60,000 in fiscal year 2000 and $60,000 13.32 in fiscal year 2001 is for the 13.33 commissioner to provide funding to 13.34 three additional living-at-home/block 13.35 nurse programs. This appropriation 13.36 shall become part of the base for the 13.37 2002-2003 biennium. 13.38 [AREA AGENCIES ON AGING.] Of this 13.39 appropriation, $70,000 in fiscal year 13.40 2000 and $70,000 in fiscal year 2001 is 13.41 from the general fund to the 13.42 commissioner to be distributed to area 13.43 agencies on aging to provide technical 13.44 support and planning services to enable 13.45 older adults to remain living in the 13.46 community. The appropriation shall be 13.47 disbursed among area agencies in 13.48 proportion to the number of citizens 13.49 over 60 years of age living in each 13.50 region. This appropriation shall 13.51 become part of the base for the 13.52 2002-2003 biennium. 13.53 [MINNESOTA SENIOR SERVICE CORPS.] Of 13.54 this appropriation, $160,000 for the 13.55 biennium is from the general fund to 13.56 the commissioner for the following 13.57 purposes: 14.1 (a) $40,000 in fiscal year 2000 and 14.2 $40,000 in fiscal year 2001 is to 14.3 increase the hourly stipend by ten 14.4 cents per hour in the foster 14.5 grandparent program, the retired and 14.6 senior volunteer program, and the 14.7 senior companion program. 14.8 (b) $40,000 in fiscal year 2000 and 14.9 $40,000 in fiscal year 2001 is for a 14.10 grant to the tri-valley opportunity 14.11 council in Crookston to expand services 14.12 in the ten-county area of northwestern 14.13 Minnesota. 14.14 (c) This appropriation shall become 14.15 part of the base for the 2002-2003 14.16 biennium. 14.17 [SUPPLEMENTAL NUTRITION FUNDING.] Of 14.18 this appropriation, $150,000 in fiscal 14.19 year 2000 is to the commissioner for 14.20 grants to three counties that financed 14.21 congregate and home-delivered meals 14.22 locally prior to county participation 14.23 in the nutrition program of the Older 14.24 Americans Act. 14.25 [HEALTH INSURANCE COUNSELING.] Of this 14.26 appropriation, $100,000 in fiscal year 14.27 2000 and $100,000 in fiscal year 2001 14.28 is from the general fund to the 14.29 commissioner to transfer to the board 14.30 on aging for the purpose of awarding 14.31 health insurance counseling and 14.32 assistance grants to the area agencies 14.33 on aging providing state-funded health 14.34 insurance counseling services. Access 14.35 to health insurance counseling programs 14.36 shall be provided by the senior linkage 14.37 line service of the board on aging and 14.38 the area agencies on aging. The board 14.39 on aging shall explore opportunities 14.40 for obtaining alternative funding from 14.41 nonstate sources, including 14.42 contributions from individuals seeking 14.43 health insurance counseling services. 14.44 (d) Deaf and Hard-of-Hearing 14.45 Services Grants 14.46 1,949,000 1,970,000 14.47 [DEAF AND HARD-OF-HEARING ADULTS WITH 14.48 MENTAL ILLNESS.] Of this appropriation, 14.49 $200,000 in fiscal year 2000 and 14.50 $200,000 in fiscal year 2001 is from 14.51 the general fund to the commissioner 14.52 for the following purposes: 14.53 (a) $100,000 in fiscal year 2000 and 14.54 $100,000 in fiscal year 2001 is for a 14.55 grant to a nonprofit agency that 14.56 currently serves deaf and 14.57 hard-of-hearing adults with mental 14.58 illness through residential programs 14.59 and supported housing outreach to 14.60 operate a community-support program for 14.61 persons with mental illness that is 14.62 communicatively accessible for persons 14.63 who are deaf or hard-of-hearing. 15.1 (b) $100,000 in fiscal year 2000 and 15.2 $100,000 in fiscal year 2001 is for 15.3 grants to provide specialized 15.4 community-based mental health services 15.5 for the deaf and hard-of-hearing 15.6 residing outside the seven-county 15.7 metropolitan area. Services provided 15.8 under these grants may use remote 15.9 access technology for delivering mental 15.10 health services via teleconferencing 15.11 from a centralized site. 15.12 (c) These appropriations shall become 15.13 part of the base for the 2002-2003 15.14 biennium. 15.15 [MOBILITY SPECIALIST FOR DEAF-BLIND 15.16 PEOPLE.] Of this appropriation, $60,000 15.17 in fiscal year 2000 and $60,000 in 15.18 fiscal year 2001 is from the general 15.19 fund to the commissioner for a grant to 15.20 DeafBlind Services Minnesota to hire an 15.21 orientation and mobility specialist to 15.22 work with deaf-blind people. The 15.23 specialist shall provide services to 15.24 deaf-blind Minnesotans and training to 15.25 teachers and rehabilitation counselors 15.26 statewide. Any amount of this 15.27 appropriation that is not expended in 15.28 the first year shall not cancel but 15.29 shall be available for the second year. 15.30 This appropriation shall not become 15.31 part of the base for the 2002-2003 15.32 biennium. 15.33 [MINNESOTA COMMISSION SERVING DEAF AND 15.34 HARD-OF-HEARING.] Of this 15.35 appropriation, $50,000 in fiscal year 15.36 2000 and $50,000 in fiscal year 2001 is 15.37 from the general fund to the 15.38 commissioner for the Minnesota 15.39 commission serving deaf and 15.40 hard-of-hearing people. This 15.41 appropriation may be used for 15.42 communication access, printing, travel, 15.43 supplies, and equipment, but shall not 15.44 be used for staff compensation. This 15.45 appropriation shall become part of the 15.46 base for the 2002-2003 biennium. 15.47 (e) Mental Health Grants 15.48 General 45,154,000 46,537,000 15.49 Lottery Prize 1,158,000 1,158,000 15.50 [CRISIS HOUSING.] Of the general fund 15.51 appropriation, $126,000 in fiscal year 15.52 2000 and $174,000 in fiscal year 2001 15.53 is to the commissioner for the adult 15.54 mental illness crisis housing 15.55 assistance program. This appropriation 15.56 shall become part of the base for the 15.57 2002-2003 biennium. 15.58 [ADOLESCENT COMPULSIVE GAMBLING GRANT.] 15.59 $150,000 in fiscal year 2000 and 15.60 $150,000 in fiscal year 2001 is 15.61 appropriated from the lottery prize 15.62 fund created under Minnesota Statutes, 15.63 section 349A.10, subdivision 2, to the 16.1 commissioner for the purposes of a 16.2 grant to a compulsive gambling council 16.3 located in St. Louis county for a 16.4 statewide compulsive gambling 16.5 prevention and education project for 16.6 adolescents. 16.7 (f) Developmental Disabilities 16.8 Community Support Grants 16.9 8,323,000 9,458,000 16.10 [CRISIS INTERVENTION PROJECT.] Of this 16.11 appropriation, $40,000 in fiscal year 16.12 2000 is to the commissioner for the 16.13 action, support, and prevention project 16.14 of southeastern Minnesota. 16.15 (g) Medical Assistance Long-Term 16.16 Care Waivers and Home Care 16.17 347,130,000 409,142,000 16.18 [PROVIDER RATE INCREASES.] (a) The 16.19 commissioner shall increase 16.20 reimbursement rates by four percent the 16.21 first year of the biennium and by three 16.22 percent the second year for the 16.23 providers listed in paragraph (b). The 16.24 increases shall be effective for 16.25 services rendered on or after July 1 of 16.26 each year. 16.27 (b) The rate increases described in 16.28 this section shall be provided to home 16.29 and community-based waivered services 16.30 for persons with mental retardation or 16.31 related conditions under Minnesota 16.32 Statutes, section 256B.501; home and 16.33 community-based waivered services for 16.34 the elderly under Minnesota Statutes, 16.35 section 256B.0915; waivered services 16.36 under community alternatives for 16.37 disabled individuals under Minnesota 16.38 Statutes, section 256B.49; community 16.39 alternative care waivered services 16.40 under Minnesota Statutes, section 16.41 256B.49; traumatic brain injury 16.42 waivered services under Minnesota 16.43 Statutes, section 256B.49; nursing 16.44 services and home health services under 16.45 Minnesota Statutes, section 256B.0625, 16.46 subdivision 6a; personal care services 16.47 and nursing supervision of personal 16.48 care services under Minnesota Statutes, 16.49 section 256B.0625, subdivision 19a; 16.50 private-duty nursing services under 16.51 Minnesota Statutes, section 256B.0625, 16.52 subdivision 7; day training and 16.53 habilitation services for adults with 16.54 mental retardation or related 16.55 conditions under Minnesota Statutes, 16.56 sections 252.40 to 252.46; alternative 16.57 care services under Minnesota Statutes, 16.58 section 256B.0913; adult residential 16.59 program grants under Minnesota Rules, 16.60 parts 9535.2000 to 9535.3000; adult and 16.61 family community support grants under 16.62 Minnesota Rules, parts 9535.1700 to 16.63 9535.1760; semi-independent living 16.64 services under Minnesota Statutes, 17.1 section 252.275, including SILS funding 17.2 under county social services grants 17.3 formerly funded under Minnesota 17.4 Statutes, chapter 256I; day treatment 17.5 under Minnesota Rules, part 9505.0323; 17.6 the skills training component of (a) 17.7 family community support services under 17.8 Minnesota Statutes, section 256B.0625, 17.9 subdivisions 5 and 35, (b) therapeutic 17.10 support of foster care under Minnesota 17.11 Statutes, section 256B.0625, 17.12 subdivisions 5 and 36, and (c) 17.13 home-based treatment under Minnesota 17.14 Rules, part 9505.0324; community 17.15 support services for deaf and 17.16 hard-of-hearing adults with mental 17.17 illness who use or wish to use sign 17.18 language as their primary means of 17.19 communication; and the group 17.20 residential housing supplementary 17.21 service rate under Minnesota Statutes, 17.22 section 256I.05, subdivision 1a. 17.23 (c) Providers that receive a rate 17.24 increase under this section shall use 17.25 at least 90 percent of the additional 17.26 revenue to increase the wages paid to 17.27 employees other than the administrator 17.28 and central office staff and for 17.29 payroll taxes associated with these 17.30 wage increases. 17.31 (d) A copy of the provider's plan for 17.32 complying with paragraph (c) must be 17.33 made available to all employees. This 17.34 must be done by giving each employee a 17.35 copy or by posting it in an area of the 17.36 provider's operation to which all 17.37 employees have access. If an employee 17.38 does not receive the salary adjustment 17.39 described in the plan and is unable to 17.40 resolve the problem with the provider, 17.41 the employee may contact the employee's 17.42 union representative. If the employee 17.43 is not covered by a collective 17.44 bargaining agreement, the employee may 17.45 contact the commissioner at a phone 17.46 number provided by the commissioner and 17.47 included in the provider's plan. 17.48 (e) Section 13, sunset of uncodified 17.49 language, does not apply to this 17.50 provision. 17.51 [COUNTY WAIVERED SERVICES RESERVE.] 17.52 Notwithstanding the provisions of 17.53 Minnesota Statutes, section 256B.092, 17.54 subdivision 4, and Minnesota Rules, 17.55 part 9525.1830, subpart 2, the 17.56 commissioner may approve written 17.57 procedures and criteria for the 17.58 allocation of home and community-based 17.59 waivered services funding for persons 17.60 with mental retardation or related 17.61 conditions which enables a county to 17.62 maintain a reserve resource account. 17.63 The reserve resource account may not 17.64 exceed five percent of the county 17.65 agency's total annual allocation of 17.66 home and community-based waivered 17.67 services funds. The reserve may be 18.1 utilized to ensure the county's ability 18.2 to meet the changing needs of current 18.3 recipients, to ensure the health and 18.4 safety needs of current recipients, or 18.5 to provide short-term emergency 18.6 intervention care to eligible waiver 18.7 recipients. 18.8 (h) Medical Assistance Long-Term 18.9 Care Facilities 18.10 545,560,000 557,620,000 18.11 [MORATORIUM EXCEPTIONS.] Of this 18.12 appropriation, $250,000 in fiscal year 18.13 2000 and $250,000 in fiscal year 2001 18.14 is from the general fund to the 18.15 commissioner for the medical assistance 18.16 costs of moratorium exceptions approved 18.17 by the commissioner of health under 18.18 Minnesota Statutes, section 144A.073. 18.19 Unexpended money appropriated for 18.20 fiscal year 2000 shall not cancel but 18.21 shall be available for fiscal year 2001. 18.22 (i) Alternative Care Grants 18.23 General 60,873,000 59,981,000 18.24 [ALTERNATIVE CARE TRANSFER.] Any money 18.25 allocated to the alternative care 18.26 program that is not spent for the 18.27 purposes indicated does not cancel but 18.28 shall be transferred to the medical 18.29 assistance account. 18.30 [PREADMISSION SCREENING AMOUNT.] The 18.31 preadmission screening payment to all 18.32 counties shall continue at the payment 18.33 amount in effect for fiscal year 1999. 18.34 [ALTERNATIVE CARE APPROPRIATION.] The 18.35 commissioner may expend the money 18.36 appropriated for the alternative care 18.37 program for that purpose in either year 18.38 of the biennium. 18.39 (j) Group Residential Housing 18.40 General 67,131,000 71,491,000 18.41 [GROUP RESIDENTIAL FACILITY FOR WOMEN 18.42 IN RAMSEY COUNTY.] (a) Notwithstanding 18.43 Minnesota Statutes 1998, section 18.44 256I.05, subdivision 1d, the new group 18.45 residential facility for women in 18.46 Ramsey county, with approval by the 18.47 county agency, may negotiate a 18.48 supplementary service rate in addition 18.49 to the board and lodging rate for 18.50 facilities licensed and registered by 18.51 the Minnesota department of health 18.52 under Minnesota Statutes, section 18.53 15.17. The supplementary service rate 18.54 shall not exceed $564 per person per 18.55 month and the total rate may not exceed 18.56 $1,177 per person per month. 18.57 (b) Of the general fund appropriation, 18.58 $19,000 in fiscal year 2000 and $38,000 18.59 in fiscal year 2001 is to the 19.1 commissioner for the costs associated 19.2 with paragraph (a). This appropriation 19.3 shall become part of the base for the 19.4 2002-2003 biennium. 19.5 [ELDERLY HOUSING AND SERVICES NEEDS 19.6 STUDY.] The commissioner shall study 19.7 and report to the legislature by 19.8 January 15, 2000, with a comprehensive 19.9 plan for the provision of housing and 19.10 services to low-income elderly 19.11 persons. The plan must incorporate 19.12 existing state and county programs and 19.13 funding options and identify unmet 19.14 needs for arrangements that provide 19.15 seniors with a combination of housing 19.16 and services. The report must analyze 19.17 the impact the plan may have on 19.18 existing institutional health care 19.19 providers and on state and county 19.20 budgets. The study shall be conducted 19.21 in cooperation with the commissioner of 19.22 housing finance and with local public 19.23 housing authorities and housing and 19.24 redevelopment officials. 19.25 (k) Chemical Dependency 19.26 Entitlement Grants 19.27 General 37,250,000 38,847,000 19.28 (l) Chemical Dependency 19.29 Nonentitlement Grants 19.30 General 6,503,000 6,503,000 19.31 [CHEMICAL DEPENDENCY SERVICES.] Of this 19.32 appropriation, $499,000 in fiscal year 19.33 2000 is to the commissioner for 19.34 chemical dependency services to persons 19.35 who qualify under Minnesota Statutes, 19.36 section 254B.04, subdivision 1, 19.37 paragraph (b). 19.38 [REPEAT DWI OFFENDER PROGRAM.] Of this 19.39 appropriation, $100,000 in fiscal year 19.40 2000 and $100,000 in fiscal year 2001 19.41 is for the commissioner to pay for 19.42 chemical dependency treatment for 19.43 participants in the Camp Ripley repeat 19.44 DWI offender program at Brainerd 19.45 regional human services center. 19.46 Payment to the Brainerd regional human 19.47 services center may only be authorized 19.48 from this appropriation after all 19.49 potential public and private 19.50 third-party payers have been billed and 19.51 a determination made that the 19.52 participant is not eligible for 19.53 reimbursement of the treatment costs. 19.54 This appropriation shall not become 19.55 part of the base for the 2002-2003 19.56 biennium. 19.57 Subd. 9. Continuing Care and 19.58 Community Support Management 19.59 General 17,084,000 17,384,000 19.60 Lottery Prize 142,000 142,000 20.1 State Government 20.2 Special Revenue 114,000 115,000 20.3 [MINNESOTA SENIOR HEALTH OPTIONS 20.4 PROJECT.] Of this appropriation, up to 20.5 $200,000 may be transferred to the 20.6 Minnesota senior health options project 20.7 special revenue account during the 20.8 biennium ending June 30, 2001, to serve 20.9 as matching funds. 20.10 [PERSONS WITH BRAIN INJURIES.] (a) The 20.11 commissioner shall study and report to 20.12 the legislature by January 15, 2000, on 20.13 the status of persons with brain 20.14 injuries residing in public and private 20.15 institutions. The report shall include 20.16 information on lengths of stay, ages of 20.17 institutionalized persons, and on the 20.18 supports and services needed to allow 20.19 these persons to return to their 20.20 communities. 20.21 (b) The commissioner shall apply to the 20.22 Health Care Financing Administration 20.23 for a grant to carry out a 20.24 demonstration project to transition 20.25 disabled persons out of nursing homes. 20.26 The project must: 20.27 (1) identify persons with brain 20.28 injuries and other disabled persons 20.29 residing in nursing homes who could 20.30 live successfully in the community with 20.31 appropriate supports; 20.32 (2) develop community-based services 20.33 and supports for institutionalized 20.34 persons; 20.35 (3) eliminate incentives to keep these 20.36 persons in institutions; 20.37 (4) foster the independence of 20.38 institutionalized persons by involving 20.39 them in the selection and management of 20.40 community-based services, such as 20.41 personal care assistance; 20.42 (5) develop innovative funding 20.43 arrangements to enable funding to 20.44 follow the individual; and 20.45 (6) empower disabled persons, families, 20.46 and advocacy groups by including them 20.47 in the design and implementation of 20.48 service delivery models that maximize 20.49 consumer choice and direction. 20.50 (c) Paragraph (b) is effective the day 20.51 following final enactment. 20.52 Subd. 10. Economic Support Grants 20.53 General 144,124,000 127,674,000 20.54 [GIFTS.] Notwithstanding Minnesota 20.55 Statutes, chapter 7, the commissioner 20.56 may accept on behalf of the state 20.57 additional funding from sources other 20.58 than state funds for the purpose of 21.1 financing the cost of assistance 21.2 program grants or nongrant 21.3 administration. All additional funding 21.4 is appropriated to the commissioner for 21.5 use as designated by the grantee of 21.6 funding. 21.7 [CHILD SUPPORT PAYMENT CENTER 21.8 RECOUPMENT ACCOUNT.] The child support 21.9 payment center is authorized to 21.10 establish an account to cover checks 21.11 issued in error or in cases where 21.12 insufficient funds are available to pay 21.13 the checks. All recoupments against 21.14 payments from the account must be 21.15 deposited in the child support payment 21.16 center recoupment account and are 21.17 appropriated to the commissioner for 21.18 the purposes of the account. Any 21.19 unexpended balance in the account does 21.20 not cancel, but is available until 21.21 expended. 21.22 The amounts that may be spent from this 21.23 appropriation for each purpose are as 21.24 follows: 21.25 (a) Assistance to Families Grants 21.26 General 64,870,000 66,117,000 21.27 [FEDERAL TANF FUNDS.] (1) Federal 21.28 Temporary Assistance for Needy Families 21.29 block grant funds authorized under 21.30 title I, Public Law Number 104-193, the 21.31 Personal Responsibility and Work 21.32 Opportunity Reconciliation Act of 1996, 21.33 and awarded in federal fiscal years 21.34 1997 to 2002 are appropriated to the 21.35 commissioner in amounts up to 21.36 $307,140,000 is fiscal year 2000 and 21.37 $306,974,000 in fiscal year 2001. 21.38 (2) Of the amounts in clause (1), 21.39 $45,700,000 the first year and 21.40 $45,125,000 the second year is 21.41 transferred to the state's federal 21.42 child care and development fund block 21.43 grant, and is appropriated to the 21.44 commissioner of children, families, and 21.45 learning. Of these amounts, 21.46 $45,000,000 in each year is for the 21.47 purposes of Minnesota Statutes, section 21.48 119B.03, and $700,000 the first year 21.49 and $125,000 the second year is for 21.50 child care development activities 21.51 required under the federal child care 21.52 and development fund. In fiscal years 21.53 2002 and 2003 the transfer shall be 21.54 $15,000,000 per year for the purposes 21.55 of Minnesota Statutes, section 119B.03. 21.56 (3) Of the amounts in clause (1), 21.57 $15,000,000 is transferred each year of 21.58 the biennium to the state's federal 21.59 Title XX block grant. Notwithstanding 21.60 the provisions of Minnesota Statutes, 21.61 section 256E.07, in each year of the 21.62 biennium the commissioner shall 21.63 allocate $15,000,000 of the state's 21.64 Title XX block grant funds based on the 22.1 community social services aids formula 22.2 in Minnesota Statutes, section 22.3 256E.06. The commissioner shall ensure 22.4 that money allocated to counties under 22.5 this provision is used according to the 22.6 requirements of United States Code, 22.7 title 42, section 604(d)(3)(B). Any 22.8 reductions to the amount of the 22.9 community social services block grant 22.10 in fiscal year 2000 or 2001 as a result 22.11 of these actions are one-time 22.12 reductions and shall not reduce the 22.13 base for the CSSA block grant for the 22.14 2002-2003 biennial budget. 22.15 (4) Of the amounts in clause (1), 22.16 $10,000,000 is transferred each year 22.17 from the state's federal TANF block 22.18 grant to the state's federal Title XX 22.19 block grant. In each year $140,000 is 22.20 for grants according to Minnesota 22.21 Statutes, section 257.3571, subdivision 22.22 2a, to the Indian child welfare defense 22.23 corporation to promote statewide 22.24 compliance with the Indian Child 22.25 Welfare Act of 1978; $4,650,000 is for 22.26 grants to counties for concurrent 22.27 permanency planning; and $5,210,000 is 22.28 for the commissioner to distribute 22.29 according to the formula in Minnesota 22.30 Statutes, section 256E.07. The 22.31 commissioner shall ensure that money 22.32 allocated under this clause is used 22.33 according to the requirements of United 22.34 States Code, title 42, section 22.35 604(d)(3)(B). In fiscal years 2002 and 22.36 2003, $9,860,000 per year is for the 22.37 commissioner to distribute according to 22.38 the formula in Minnesota Statutes, 22.39 section 256E.07, and $140,000 per year 22.40 is for grants according to Minnesota 22.41 Statutes, section 257.3571, subdivision 22.42 2a, to the Indian child welfare defense 22.43 corporation to promote statewide 22.44 compliance with the Indian Child 22.45 Welfare Act of 1978. 22.46 (5) Of the amounts in clause (1), 22.47 $20,000,000 each year is for increased 22.48 employment and training efforts and 22.49 shall be expended as follows: 22.50 (a) $5,000,000 each year is for the 22.51 commissioner to provide employment 22.52 services to MFIP participants who face 22.53 serious and multiple barriers to 22.54 employment. 22.55 (b) $140,000 each year is for a grant 22.56 to the new chance program. The new 22.57 chance program shall provide 22.58 comprehensive services through a 22.59 private, nonprofit agency to young 22.60 parents in Hennepin county who have 22.61 dropped out of school and are receiving 22.62 public assistance. The program 22.63 administrator shall report annually to 22.64 the commissioner on skills development, 22.65 education, job training, and job 22.66 placement outcomes for program 22.67 participants. This appropriation is 23.1 available for either year of the 23.2 biennium. 23.3 (c) $400,000 each year is for grants to 23.4 counties to operate the parents fair 23.5 share program to assist unemployed, 23.6 noncustodial parents with job search 23.7 and parenting skills. 23.8 (d) $1,500,000 each year is to be 23.9 transferred to the job skills 23.10 partnership board for the health care 23.11 and human services worker training and 23.12 retention program. 23.13 (e) $12,960,000 each year is to 23.14 increase employment and training 23.15 services grants for MFIP. 23.16 (f) These appropriations shall become 23.17 part of the base for the 2002-2003 23.18 biennium. 23.19 (6) Of the amounts in clause (1), 23.20 $1,094,000 in fiscal year 2000 and 23.21 $1,676,000 in fiscal year 2001 is 23.22 transferred from the state's federal 23.23 TANF block grant to the state's federal 23.24 child care and development fund block 23.25 grant, and is appropriated to the 23.26 commissioner of children, families, and 23.27 learning for the purposes of Minnesota 23.28 Statutes, section 119B.05. 23.29 (7) Of the amounts in clause (1), 23.30 $1,500,000 for the biennium is for the 23.31 purposes of creating and expanding 23.32 adult-supervised supportive living 23.33 arrangements under Minnesota Statutes, 23.34 section 256J.14. The commissioner 23.35 shall request proposals from interested 23.36 parties that have knowledge and 23.37 experience in the area of adolescent 23.38 housing, and award grants for the 23.39 purpose of either expanding existing 23.40 living arrangements or creating new 23.41 living arrangements. Minor parents who 23.42 are MFIP participants shall be given 23.43 priority for housing, and excess living 23.44 arrangements may be used by minor 23.45 parents who are not MFIP participants. 23.46 [EMPLOYMENT SERVICES CARRYOVER.] 23.47 General fund and federal TANF block 23.48 grant appropriations for employment 23.49 services that remain unexpended 23.50 subsequent to the reallocation process 23.51 required in Minnesota Statutes, section 23.52 256J.62, do not cancel but are 23.53 available for these purposes in fiscal 23.54 year 2001. 23.55 [CASH BENEFITS IN ADVANCE.] The 23.56 commissioner, with the advance approval 23.57 of the commissioner of finance, is 23.58 authorized to issue cash assistance 23.59 benefits up to three days before the 23.60 first day of each month, including 23.61 three days before the start of each 23.62 state fiscal year. Of the money 23.63 appropriated for cash assistance grants 24.1 for each fiscal year, up to three 24.2 percent of the annual state 24.3 appropriation is available to the 24.4 commissioner in the previous fiscal 24.5 year. If that amount is insufficient 24.6 for the costs incurred, an additional 24.7 amount of the appropriation as needed 24.8 may be transferred with the advance 24.9 approval of the commissioner of 24.10 finance. This paragraph is effective 24.11 the day following final enactment. 24.12 (b) Work Grants 24.13 General 12,031,000 12,031,000 24.14 (c) Aid to Families With 24.15 Dependent Children and Other 24.16 Assistance 24.17 General 1,053,000 1,119,000 24.18 (d) Child Support Enforcement 24.19 General 5,371,000 5,455,000 24.20 [CHILD SUPPORT PAYMENT CENTER.] 24.21 Payments to the commissioner from other 24.22 governmental units, private 24.23 enterprises, and individuals for 24.24 services performed by the child support 24.25 payment center must be deposited in the 24.26 state systems account authorized under 24.27 Minnesota Statutes, section 256.014. 24.28 These payments are appropriated to the 24.29 commissioner for the operation of the 24.30 child support payment center or system, 24.31 according to Minnesota Statutes, 24.32 section 256.014. 24.33 [EXPEDITED PROCESS.] Appropriations 24.34 relating to the operation of the 24.35 administrative process under Minnesota 24.36 Statutes 1998, section 518.5511, may be 24.37 used for the expedited child support 24.38 hearing process. Appropriations for 24.39 the second year of the biennium are 24.40 available in the first year, but only 24.41 to the extent that the costs of the 24.42 expedited child support hearing process 24.43 exceed the base budget for the 24.44 administrative process because of an 24.45 increase in the number of orders in the 24.46 process. The commissioner shall 24.47 include cost reimbursement claims for 24.48 the child support expedited process in 24.49 the department's federal cost 24.50 reimbursement claim process according 24.51 to federal law. Federal dollars earned 24.52 under these claims are appropriated to 24.53 the commissioner and shall be disbursed 24.54 according to department procedures and 24.55 schedules. 24.56 [FATHER PROJECT.] (a) The commissioner 24.57 shall waive the enforcement of any 24.58 existing specific statutory program 24.59 requirements, administrative rules, and 24.60 standards, including the relevant 24.61 provisions of the following sections of 24.62 Minnesota Statutes: 25.1 (1) 256.741, subdivision 2, paragraph 25.2 (a); 25.3 (2) 256J.30, subdivision 11; 25.4 (3) 256J.33, subdivision 4, clause (5); 25.5 and 25.6 (4) 256J.34, subdivision 1, paragraph 25.7 (d). 25.8 The waivers permitted under this 25.9 paragraph are for the limited purposes 25.10 of allowing the entire amount of child 25.11 support payments to be passed through 25.12 for the children of individuals 25.13 participating in the FATHER project and 25.14 excluding child support payments paid 25.15 by FATHER participants as income for 25.16 MFIP participants who receive the child 25.17 support payments. The waiver authority 25.18 granted by this section sunsets on July 25.19 1, 2002. 25.20 (b) Of this appropriation, $12,000 in 25.21 fiscal year 2000 and $96,000 in fiscal 25.22 year 2001 is to offset the increased 25.23 costs to the state for reimbursing the 25.24 federal government for their share of 25.25 child support collections relating to 25.26 the implementation of the waivers under 25.27 paragraph (a). This appropriation is 25.28 available until expended and is 25.29 available only to the extent that it is 25.30 completely reimbursed by money provided 25.31 by the private philanthropical 25.32 community. 25.33 (e) General Assistance 25.34 General 33,927,000 14,973,000 25.35 [TRANSFERS FROM STATE TANF RESERVE.] 25.36 $4,666,000 in fiscal year 2000 is 25.37 transferred from the state TANF reserve 25.38 account to the general fund. 25.39 [GENERAL ASSISTANCE STANDARD.] The 25.40 commissioner shall set the monthly 25.41 standard of assistance for general 25.42 assistance units consisting of an adult 25.43 recipient who is childless and 25.44 unmarried or living apart from his or 25.45 her parents or a legal guardian at 25.46 $203. The commissioner may reduce this 25.47 amount in accordance with Laws 1997, 25.48 chapter 85, article 3, section 54. 25.49 (f) Minnesota Supplemental Aid 25.50 General 25,767,000 26,874,000 25.51 (g) Refugee Services 25.52 General 1,105,000 1,105,000 25.53 Subd. 11. Economic Support 25.54 Management 25.55 General 38,847,000 42,254,000 26.1 Health Care 26.2 Access 1,313,000 1,318,000 26.3 The amounts that may be spent from this 26.4 appropriation for each purpose are as 26.5 follows: 26.6 (a) Economic Support Policy 26.7 Administration 26.8 General 7,100,000 6,951,000 26.9 [FOOD STAMP ADMINISTRATIVE 26.10 REIMBURSEMENT.] The commissioner shall 26.11 reduce quarterly food stamp 26.12 administrative reimbursement to 26.13 counties in fiscal years 1999, 2000, 26.14 and 2001 by the amount that the United 26.15 States Department of Health and Human 26.16 Services determines to be the county 26.17 random moment study share of the food 26.18 stamp adjustment under Public Law 26.19 Number 105-185. The reductions shall 26.20 be allocated to each county in 26.21 proportion to each county's 26.22 contribution, if any, to the amount of 26.23 the adjustment. Any adjustment to 26.24 medical assistance administrative 26.25 reimbursement that is based on the 26.26 United States Department of Health and 26.27 Human Services' determinations under 26.28 Public Law Number 105-185 shall be 26.29 distributed to counties in the same 26.30 manner. This provision is effective 26.31 the day following final enactment. 26.32 [SPENDING AUTHORITY FOR FOOD STAMP 26.33 ENHANCED FUNDING.] In the event that 26.34 Minnesota qualifies for United States 26.35 Department of Agriculture Food and 26.36 Nutrition Services Food Stamp Program 26.37 enhanced funding beginning in federal 26.38 fiscal year 1998, the money is 26.39 appropriated to the commissioner for 26.40 the purposes of the program. The 26.41 commissioner may retain 25 percent of 26.42 the enhanced funding, with the 26.43 remaining 75 percent divided among the 26.44 counties according to a formula that 26.45 takes into account each county's impact 26.46 on the statewide food stamp error rate. 26.47 [ELIGIBILITY DETERMINATION FUNDING.] 26.48 Increased federal funds for the costs 26.49 of eligibility determination and other 26.50 permitted activities that are available 26.51 to the state through section 114 of the 26.52 Personal Responsibility and Work 26.53 Opportunity Reconciliation Act, Public 26.54 Law Number 104-193, are appropriated to 26.55 the commissioner. 26.56 (b) Economic Support Operations 26.57 General 31,747,000 35,303,000 26.58 Health Care 26.59 Access 1,303,000 1,318,000 26.60 [FRAUD PREVENTION AND CONTROL FUNDING.] 26.61 Unexpended funds appropriated for the 27.1 provision of program integrity 27.2 activities for fiscal year 2000 are 27.3 also available to the commissioner to 27.4 fund fraud prevention and control 27.5 initiatives, and do not cancel but are 27.6 available to the commissioner for these 27.7 purposes for fiscal year 2001. 27.8 Unexpended funds may be transferred 27.9 between the fraud prevention 27.10 investigation program and fraud control 27.11 programs to promote the provisions of 27.12 Minnesota Statutes, sections 256.983 27.13 and 256.9861. 27.14 Sec. 3. COMMISSIONER OF HEALTH 27.15 Subdivision 1. Total 27.16 Appropriation 100,129,000 99,611,000 27.17 Summary by Fund 27.18 General 63,673,000 63,814,000 27.19 Metropolitan 27.20 Landfill Contingency 27.21 Action Fund 196,000 199,000 27.22 State Government 27.23 Special Revenue 25,586,000 25,075,000 27.24 Health Care 27.25 Access 10,674,000 10,523,000 27.26 [LANDFILL CONTINGENCY.] The 27.27 appropriation from the metropolitan 27.28 landfill contingency action fund is for 27.29 monitoring well water supplies and 27.30 conducting health assessments in the 27.31 metropolitan area. 27.32 [MINIMUM GRANT LEVELS.] The total level 27.33 of grants awarded by the commissioner 27.34 to local public health boards or 27.35 authorities under the community health 27.36 services act and under the maternal and 27.37 child health program shall not be less 27.38 than the amount awarded by the 27.39 commissioner in calendar year 1998. On 27.40 January 15 of each year, the 27.41 commissioner of finance shall report to 27.42 the chairs of the house health and 27.43 human services finance committee and 27.44 the senate health and family security 27.45 budget division and give assurances 27.46 that the awards under these programs 27.47 meet this test. 27.48 Subd. 2. Health Systems 27.49 and Special Populations 67,453,000 66,577,000 27.50 Summary by Fund 27.51 General 46,673,000 46,499,000 27.52 State Government 27.53 Special Revenue 10,202,000 9,653,000 27.54 Health Care 27.55 Access 10,578,000 10,425,000 27.56 [STATE VITAL STATISTICS REDESIGN 28.1 PROJECT ACCOUNT.] The amount 28.2 appropriated from the state government 28.3 special revenue fund in Laws 1997, 28.4 chapter 203, article 1, section 3, 28.5 subdivision 2, for the vital records 28.6 redesign project is available for 28.7 development and implementation costs 28.8 until expended. 28.9 [WIC TRANSFERS.] The general fund 28.10 appropriation for the women, infants, 28.11 and children (WIC) food supplement 28.12 program is available for either year of 28.13 the biennium. Transfers of these funds 28.14 between fiscal years must either be to 28.15 maximize federal funds or to minimize 28.16 fluctuations in the number of program 28.17 participants. 28.18 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 28.19 NEEDS CARRYOVER.] General fund 28.20 appropriations for treatment services 28.21 in the services for Minnesota children 28.22 with special health needs program are 28.23 available for either year of the 28.24 biennium. 28.25 [FAMILY PLANNING GRANTS.] The 28.26 commissioner must allocate to each 28.27 organization receiving funds under 28.28 Minnesota Statutes, section 145.925, on 28.29 July 1, 1999, the same proportion of 28.30 grant funds for the 2000 to 2001 grant 28.31 funding cycle as the organization 28.32 received for the 1998 to 1999 grant 28.33 funding cycle, not to exceed the amount 28.34 received for the 1998 to 1999 grant 28.35 cycle, provided that the organization 28.36 submits revised goals, objectives, 28.37 methodologies, and budgets. 28.38 [FEE CHANGES.] When setting fees for 28.39 the speech language pathologist and 28.40 audiologist registration system 28.41 established under Minnesota Statutes, 28.42 sections 148.511 to 148.5196, the 28.43 commissioner is exempt from Minnesota 28.44 Statutes, section 16A.1285, subdivision 28.45 2. 28.46 [SUICIDE PREVENTION PROGRAM.] Of this 28.47 appropriation, $50,000 in fiscal year 28.48 2000 and $50,000 in fiscal year 2001 is 28.49 from the general fund to the 28.50 commissioner for the establishment of a 28.51 suicide prevention program. 28.52 [FAMILY PRACTICE RESIDENCY PROGRAM.] Of 28.53 the general fund appropriation, 28.54 $300,000 in fiscal year 2000 is to the 28.55 commissioner to make a grant to the 28.56 city of Duluth for a family practice 28.57 residency program for northeastern 28.58 Minnesota. 28.59 [UNCOMPENSATED CARE.] The commissioner 28.60 shall study and report to the 28.61 legislature by January 15, 2000, with: 28.62 (1) statistical information on the 28.63 amount of uncompensated health care 29.1 provided in Minnesota, the types of 29.2 care provided, the settings in which 29.3 the care is provided, and, if known, 29.4 the most common reasons why the care is 29.5 uncompensated; and 29.6 (2) recommendations for reducing the 29.7 level of uncompensated care, including, 29.8 but not limited to, methods to enroll 29.9 eligible persons in public health care 29.10 programs through simplification of the 29.11 application process and other efforts. 29.12 [RURAL AREA PHARMACY FINANCIAL 29.13 ASSISTANCE.] (a) Of this appropriation, 29.14 $500,000 in fiscal year 2000 and 29.15 $500,000 in fiscal year 2001 is from 29.16 the health care access fund to the 29.17 commissioner to award financial 29.18 assistance grants to pharmacies in 29.19 rural areas designated as sole 29.20 community pharmacies. 29.21 (b) A pharmacy advisory committee shall 29.22 be established jointly by the 29.23 commissioner, the University of 29.24 Minnesota college of pharmacy, and a 29.25 statewide pharmacist association 29.26 representing all pharmacy practice 29.27 settings. The advisory committee shall 29.28 establish criteria for determining sole 29.29 community pharmacies in rural areas. 29.30 (c) In selecting pharmacies to receive 29.31 grants, the commissioner shall take 29.32 into account the extent of local 29.33 support for the pharmacy. Evidence of 29.34 local support may include statements 29.35 issued by a local government entity, 29.36 such as a city or county, and loans, 29.37 grants, or donations to the pharmacy 29.38 from local government entities, private 29.39 organizations, or individuals. 29.40 (d) The commissioner shall determine 29.41 the amount of the award to be given to 29.42 each eligible pharmacy based on the 29.43 pharmacy's total operating losses as a 29.44 percentage of total operating revenue 29.45 for two of the previous three most 29.46 recent consecutive fiscal years. For 29.47 purposes of calculating a pharmacy's 29.48 operating loss margin, total operating 29.49 revenue does not include grant funding 29.50 provided under this section. The 29.51 available funds shall be disbursed 29.52 proportionately based on the operating 29.53 loss margins of all eligible pharmacies. 29.54 (e) This appropriation shall not become 29.55 part of the base for the 2002-2003 29.56 biennium. 29.57 [RURAL HOSPITAL CAPITAL IMPROVEMENT 29.58 GRANT PROGRAM.] Of this appropriation, 29.59 $2,867,000 for each fiscal year is from 29.60 the health care access fund to the 29.61 commissioner for the rural hospital 29.62 capital improvement grant program 29.63 described in Minnesota Statutes, 29.64 section 144.148. This appropriation 30.1 shall not become part of the base for 30.2 the 2002-2003 biennium. 30.3 [MINIMUM DATA SET ACCESS.] The 30.4 commissioner, in cooperation with the 30.5 commissioner of administration, shall 30.6 attempt to obtain access to information 30.7 from the Health Care Financing 30.8 Administration that is provided by 30.9 nursing facilities to the federal 30.10 minimum data set database. If access 30.11 is obtained, the commissioner shall 30.12 make minimum data set data available on 30.13 a quarterly basis to industry trade 30.14 associations for use in quality 30.15 improvement efforts and comparative 30.16 analysis. Minimum data set data shall 30.17 be provided to the associations in 30.18 summary aggregate form without patient 30.19 identifiers to protect resident 30.20 privacy. The commissioner may charge a 30.21 fee for the actual cost of accessing 30.22 and reproducing these documents. 30.23 [REPORT ON SIDE RAIL USE AND NONUSE IN 30.24 NURSING HOMES.] The commissioner shall 30.25 report to the chairs of the house 30.26 health and human services committee and 30.27 the senate health and family security 30.28 committee by December 15, 1999, with 30.29 information from all available data 30.30 gathered on the incidence of patient 30.31 deaths, serious injuries, and falls 30.32 involving the use or nonuse of side 30.33 rails and alternative interventions in 30.34 long-term care facilities during the 30.35 last five years for which data is 30.36 available. The report shall include, 30.37 but not be limited to, an analysis of: 30.38 (1) data on the number of deaths 30.39 arising from side rail entanglements 30.40 and information about bed, mattress, 30.41 and rail combinations used; the form of 30.42 monitoring device used; and resident 30.43 characteristics and conditions; and 30.44 (2) data on the incidence of resident 30.45 falls, serious injury, or death and the 30.46 prevalence of physical restraint use in 30.47 resident and patient care practice to 30.48 determine if there is a correlation 30.49 between resident falls, serious 30.50 injuries, or deaths and the use or 30.51 nonuse of physical restraints. 30.52 The commissioner shall work 30.53 cooperatively with the long-term care 30.54 industry to share and utilize the 30.55 information and analysis in the report 30.56 to identify and promote best care 30.57 practices. 30.58 [NURSING FACILITY DEFICIENCY FINES.] 30.59 The commissioner, in cooperation with 30.60 the commissioner of human services, 30.61 shall apply to the federal government 30.62 for a waiver to allow the use of fines 30.63 collected for nursing facility 30.64 deficiencies to train nursing facility 30.65 staff regarding health department 31.1 expectations and inspection standards. 31.2 [NURSING HOME MORATORIUM REPORT.] In 31.3 preparing the report required by 31.4 Minnesota Statutes, section 144A.071, 31.5 subdivision 5, the commissioner and the 31.6 commissioner of human services shall 31.7 analyze the adequacy of the supply of 31.8 nursing home beds by measuring the 31.9 ability of hospitals to promptly 31.10 discharge patients to a nursing home 31.11 within the hospital's primary service 31.12 area. If it is determined that a 31.13 shortage of beds exists, the report 31.14 shall present a plan to correct the 31.15 service deficits. The report shall 31.16 also analyze the impact of assisted 31.17 living services on the medical 31.18 assistance utilization of nursing homes. 31.19 Subd. 3. Health Protection 27,795,000 28,028,000 31.20 Summary by Fund 31.21 General 12,396,000 12,592,000 31.22 Metro Landfill 31.23 Contingency 196,000 199,000 31.24 State Government 31.25 Special Revenue 15,203,000 15,237,000 31.26 [OCCUPATIONAL RESPIRATORY DISEASE 31.27 INFORMATION SYSTEM.] Unexpended funds 31.28 appropriated in Laws 1998, chapter 407, 31.29 article 1, section 3, subdivision 3, to 31.30 design an occupational respiratory 31.31 disease information system do not 31.32 cancel but are available until 31.33 expended. This provision is effective 31.34 the day following final enactment. 31.35 [HIV/STD.] Of the general fund 31.36 appropriation, $150,000 in fiscal year 31.37 2000 and $150,000 in fiscal year 2001 31.38 is to the commissioner for activities 31.39 described under Minnesota Statutes, 31.40 sections 144.065 and 144.066, of which 31.41 no less than 65 percent shall be 31.42 distributed as grants under Minnesota 31.43 Statutes, section 144.066, to 31.44 demonstrate effective integration of 31.45 STD and HIV prevention education to 31.46 reach adolescents with the highest 31.47 health risks, including youth of 31.48 color. This appropriation shall become 31.49 part of the base for the 2002-2003 31.50 biennium. 31.51 [STD SCREENING.] Of this appropriation, 31.52 $125,000 in fiscal year 2000 and 31.53 $125,000 in fiscal year 2001 is from 31.54 the general fund to the commissioner 31.55 for grants to boards of health, state 31.56 agencies, state councils, and nonprofit 31.57 corporations to expand access to free 31.58 STD screening. When making grants, the 31.59 commissioner shall give priority to 31.60 grantees that provide services to 31.61 youth. This appropriation shall become 31.62 part of the base for the 2002-2003 32.1 biennium. 32.2 Subd. 4. Management and 32.3 Support Services 4,881,000 5,006,000 32.4 Summary by Fund 32.5 General 4,604,000 4,723,000 32.6 State Government 32.7 Special Revenue 181,000 185,000 32.8 Health Care 32.9 Access 96,000 98,000 32.10 [AT-RISK POPULATIONS.] Of the general 32.11 fund appropriation, $400,000 in fiscal 32.12 year 2000 and $400,000 in fiscal year 32.13 2001 is for grants to local health 32.14 agencies to conduct a health needs 32.15 assessment that is specific to 32.16 populations of color or other at-risk 32.17 populations. This appropriation shall 32.18 not become part of the base for the 32.19 2002-2003 biennium. 32.20 Sec. 4. VETERANS NURSING 32.21 HOMES BOARD 26,121,000 27,103,000 32.22 [ALLOWANCE FOR FOOD.] The allowance for 32.23 food may be adjusted annually to 32.24 reflect changes in the producer price 32.25 index, as prepared by the United States 32.26 Bureau of Labor Statistics, with the 32.27 approval of the commissioner of 32.28 finance. Adjustments for fiscal year 32.29 2000 and fiscal year 2001 must be based 32.30 on the June 1998 and June 1999 producer 32.31 price index respectively, but the 32.32 adjustment must be prorated if it would 32.33 require money in excess of the 32.34 appropriation. 32.35 [IMPROVEMENTS USING DONATED MONEY.] 32.36 Notwithstanding Minnesota Statutes, 32.37 section 16B.30, the board may make and 32.38 maintain the following improvements to 32.39 the veterans homes using money donated 32.40 for those purposes: 32.41 (1) a picnic pavilion at the 32.42 Minneapolis veterans home; 32.43 (2) walking trails at the Hastings 32.44 veterans home; 32.45 (3) walking trails and landscaping at 32.46 the Silver Bay veterans home; 32.47 (4) an entrance canopy at the Fergus 32.48 Falls veterans home; and 32.49 (5) a suspended wooden dining deck at 32.50 the Luverne veterans home. 32.51 [ASSET PRESERVATION; FACILITY REPAIR.] 32.52 Of the general fund appropriation, 32.53 $1,190,000 each year is for asset 32.54 preservation and facility repair. The 32.55 appropriations are available in either 32.56 year of the biennium and may be used 33.1 for abatement and repair at the Luverne 33.2 home. This appropriation shall become 33.3 part of the board's base level funding 33.4 for the 2002-2003 biennium. 33.5 [VETERANS HOMES SPECIAL REVENUE 33.6 ACCOUNT.] The general fund 33.7 appropriations made to the board shall 33.8 be transferred to a veterans homes 33.9 special revenue account in the special 33.10 revenue fund in the same manner as 33.11 other receipts are deposited according 33.12 to Minnesota Statutes, section 198.34, 33.13 and are appropriated to the board for 33.14 the operation of board facilities and 33.15 programs. 33.16 [SETTING COST OF CARE.] (a) The board 33.17 may set the cost of care at the Fergus 33.18 Falls facility for fiscal year 2000 33.19 based on the cost of average skilled 33.20 nursing care provided to residents of 33.21 the Minneapolis veterans home for 33.22 fiscal year 2000. 33.23 (b) The cost of care for the 33.24 domiciliary residents at the 33.25 Minneapolis veterans home and the 33.26 skilled nursing care residents at the 33.27 Luverne nursing home for fiscal year 33.28 2000 and fiscal year 2001 shall be 33.29 calculated based on 100 percent 33.30 occupancy at each facility. 33.31 [LICENSED BED CAPACITY FOR MINNEAPOLIS 33.32 VETERANS HOME.] The commissioner of 33.33 health shall not reduce the licensed 33.34 bed capacity for the Minneapolis 33.35 veterans home pending completion of the 33.36 project authorized by Laws 1990, 33.37 chapter 610, article 1, section 9, 33.38 subdivision 3. 33.39 [LUVERNE ENVIRONMENTAL QUALITY.] Of 33.40 this appropriation, $591,000 in fiscal 33.41 year 2000 is from the general fund to 33.42 the board to ensure an adequate 33.43 staffing complement during the repairs 33.44 at the Luverne home. Of that amount, 33.45 $229,000 is available the day following 33.46 final enactment. 33.47 Sec. 5. HEALTH-RELATED BOARDS 33.48 Subdivision 1. Total 33.49 Appropriation 10,367,000 10,612,000 33.50 [STATE GOVERNMENT SPECIAL REVENUE 33.51 FUND.] The appropriations in this 33.52 section are from the state government 33.53 special revenue fund. 33.54 [NO SPENDING IN EXCESS OF REVENUES.] 33.55 The commissioner of finance shall not 33.56 permit the allotment, encumbrance, or 33.57 expenditure of money appropriated in 33.58 this section in excess of the 33.59 anticipated biennial revenues or 33.60 accumulated surplus revenues from fees 33.61 collected by the boards. Neither this 33.62 provision nor Minnesota Statutes, 34.1 section 214.06, applies to transfers 34.2 from the general contingent account. 34.3 [CENTRALIZED LICENSING FUNCTION.] The 34.4 health-related licensing boards shall 34.5 develop a plan to centralize their 34.6 licensing functions within the 34.7 administrative services unit and report 34.8 to the legislature by January 15, 34.9 2000. If the plan is not submitted: 34.10 (1) the appropriations in this section 34.11 to the board of medical practice and 34.12 the board of nursing for licensing and 34.13 disciplinary systems for fiscal year 34.14 2001 shall not be expended; and 34.15 (2) three percent of the appropriations 34.16 in this section for fiscal year 2001 34.17 for the board of chiropractic 34.18 examiners, the board of dietetic and 34.19 nutrition practice, the board of 34.20 marriage and family therapy, the board 34.21 of nursing home administrators, the 34.22 board of optometry, the board of 34.23 pharmacy, the board of podiatry, the 34.24 board of psychology, the board of 34.25 social work, and the board of 34.26 veterinary medicine, shall not be 34.27 expended. 34.28 Subd. 2. Board of Chiropractic 34.29 Examiners 350,000 361,000 34.30 Subd. 3. Board of Dentistry 783,000 806,000 34.31 Subd. 4. Board of Dietetic 34.32 and Nutrition Practice 92,000 95,000 34.33 Subd. 5. Board of Marriage and 34.34 Family Therapy 107,000 111,000 34.35 Subd. 6. Board of Medical 34.36 Practice 3,687,000 3,814,000 34.37 Subd. 7. Board of Nursing 2,202,000 2,245,000 34.38 Subd. 8. Board of Nursing 34.39 Home Administrators 548,000 566,000 34.40 [HEALTH PROFESSIONAL SERVICES 34.41 ACTIVITY.] Of these appropriations, 34.42 $368,000 the first year and $380,000 34.43 the second year are for the Health 34.44 Professional Services Activity. 34.45 Subd. 9. Board of Optometry 87,000 90,000 34.46 Subd. 10. Board of Pharmacy 1,125,000 1,137,000 34.47 [ADMINISTRATIVE SERVICES UNIT.] Of this 34.48 appropriation, $259,000 the first year 34.49 and $270,000 the second year are for 34.50 the health boards administrative 34.51 services unit. The administrative 34.52 services unit may receive and expend 34.53 reimbursements for services performed 34.54 for other agencies. 34.55 Subd. 11. Board of Podiatry 41,000 42,000 35.1 Subd. 12. Board of Psychology 556,000 534,000 35.2 [PART-TIME POSITIONS FUNDING.] Of this 35.3 appropriation, $34,000 in fiscal year 35.4 2000 is from the special revenue fund 35.5 to the board to fund two part-time 35.6 positions previously funded through the 35.7 legislative advisory commission and for 35.8 a budget shortage due to position 35.9 reallocations. This appropriation is 35.10 available the day following final 35.11 enactment. 35.12 Subd. 13. Board of Social Work 641,000 658,000 35.13 Subd. 14. Board of Veterinary 35.14 Medicine 148,000 153,000 35.15 Sec. 6. EMERGENCY MEDICAL 35.16 SERVICES BOARD 2,420,000 2,467,000 35.17 Summary by Fund 35.18 General 694,000 694,000 35.19 Trunk Highway 1,726,000 1,773,000 35.20 [COMPREHENSIVE ADVANCED LIFE SUPPORT.] 35.21 Of the general fund appropriation, 35.22 $108,000 in fiscal year 2000 and 35.23 $108,000 in fiscal year 2001 is to the 35.24 board to establish a comprehensive 35.25 advanced life support educational 35.26 program to train rural medical 35.27 personnel, including physicians, 35.28 physician assistants, nurses, and 35.29 allied health care providers, in a team 35.30 approach to anticipate, recognize, and 35.31 treat life-threatening emergencies 35.32 before serious injury or cardiac arrest 35.33 occurs. This appropriation shall 35.34 become part of the base for the 35.35 2002-2003 biennium. 35.36 [EMERGENCY MEDICAL SERVICES GRANTS.] Of 35.37 the appropriation from the trunk 35.38 highway fund, $18,000 in fiscal year 35.39 2000 and $36,000 in fiscal year 2001 is 35.40 to the board for grants to regional 35.41 emergency medical services programs. 35.42 This appropriation shall become part of 35.43 the base for the 2002-2003 biennium. 35.44 Sec. 7. COUNCIL ON DISABILITY 650,000 670,000 35.45 Sec. 8. OMBUDSMAN FOR MENTAL 35.46 HEALTH AND MENTAL RETARDATION 1,338,000 1,378,000 35.47 Sec. 9. OMBUDSMAN 35.48 FOR FAMILIES 166,000 171,000 35.49 Sec. 10. TRANSFERS 35.50 Subdivision 1. Grant Programs 35.51 The commissioner of human services, 35.52 with the approval of the commissioner 35.53 of finance, and after notification of 35.54 the chair of the senate health and 35.55 family security budget division and the 35.56 chair of the house health and human 36.1 services finance committee, may 36.2 transfer unencumbered appropriation 36.3 balances for the biennium ending June 36.4 30, 2001, within fiscal years among the 36.5 MFIP, general assistance, general 36.6 assistance medical care, medical 36.7 assistance, Minnesota supplemental aid, 36.8 and group residential housing programs, 36.9 and the entitlement portion of the 36.10 chemical dependency consolidated 36.11 treatment fund, and between fiscal 36.12 years of the biennium. 36.13 Subd. 2. Approval Required 36.14 Positions, salary money, and nonsalary 36.15 administrative money may be transferred 36.16 within the departments of human 36.17 services and health and within the 36.18 programs operated by the veterans 36.19 nursing homes board as the 36.20 commissioners and the board consider 36.21 necessary, with the advance approval of 36.22 the commissioner of finance. The 36.23 commissioner or the board shall inform 36.24 the chairs of the house health and 36.25 human services finance committee and 36.26 the senate health and family security 36.27 budget division quarterly about 36.28 transfers made under this provision. 36.29 Sec. 11. PROVISIONS 36.30 (a) Money appropriated to the 36.31 commissioner of human services for the 36.32 purchase of provisions must be used 36.33 solely for that purpose. Money 36.34 provided and not used for the purchase 36.35 of provisions must be canceled into the 36.36 fund from which appropriated, except 36.37 that money provided and not used for 36.38 the purchase of provisions because of 36.39 population decreases may be transferred 36.40 and used for the purchase of drugs and 36.41 medical and hospital supplies and 36.42 equipment with the approval of the 36.43 commissioner of finance after 36.44 notification of the chairs of the house 36.45 health and human services finance 36.46 committee and the senate health and 36.47 family security budget division. 36.48 (b) For fiscal year 2000, the allowance 36.49 for food may be adjusted to the 36.50 equivalent of the 75th percentile of 36.51 the comparable raw food costs for 36.52 community nursing homes as reported to 36.53 the commissioner of human services. 36.54 For fiscal year 2001, an adjustment may 36.55 be made to reflect the annual change in 36.56 the United States Bureau of Labor 36.57 Statistics producer price index as of 36.58 June 2000 with the approval of the 36.59 commissioner of finance. The 36.60 adjustments for either year must be 36.61 prorated if they would require money in 36.62 excess of this appropriation. 36.63 Sec. 12. CARRYOVER LIMITATION 36.64 None of the appropriations in this act 37.1 which are allowed to be carried forward 37.2 from fiscal year 2000 to fiscal year 37.3 2001 shall become part of the base 37.4 level funding for the 2002-2003 37.5 biennial budget, unless specifically 37.6 directed by the legislature. 37.7 Sec. 13. SUNSET OF UNCODIFIED LANGUAGE 37.8 All uncodified language contained in 37.9 this article expires on June 30, 2001, 37.10 unless a different expiration date is 37.11 explicit. 37.12 Sec. 14. [REPEALER.] 37.13 Minnesota Statutes 1998, section 256J.03, is repealed 37.14 effective July 2, 1999. Section 13, sunset of uncodified 37.15 language, does not apply to this section. 37.16 ARTICLE 2 37.17 HEALTH DEPARTMENT 37.18 Section 1. [62J.535] [UNIFORM BILLING REQUIREMENTS.] 37.19 Subdivision 1. [DEVELOPMENT OF UNIFORM BILLING 37.20 TRANSACTIONS.] The commissioners of commerce and health shall 37.21 adopt uniform billing standards that comply with Public Law 37.22 Number 104-91 enacted by Congress on August 21, 1996. The 37.23 uniform billing standards shall apply to all paper and 37.24 electronic claim transactions and shall apply to all Minnesota 37.25 payers, including government programs. 37.26 Subd. 2. [COMPLIANCE.] Concurrent with the effective dates 37.27 established under Public Law Number 104-91 for uniform 37.28 electronic billing standards, all health care providers must 37.29 conform to the uniform billing standards developed by the 37.30 commissioners of commerce and health. 37.31 Sec. 2. Minnesota Statutes 1998, section 144.065, is 37.32 amended to read: 37.33 144.065 [VENEREAL DISEASE TREATMENT CENTERSPREVENTION AND 37.34 TREATMENT OF SEXUALLY TRANSMITTED INFECTIONS.] 37.35 The state commissioner of health shall assist local health 37.36 agencies and organizations throughout the state with the 37.37 development and maintenance of services for the detection and 37.38 treatment ofvenereal diseasessexually transmitted infections. 37.39 These services shall provide for research, screening and 37.40 diagnosis, treatment, case finding, investigation, and the 38.1 dissemination of appropriate educational information. The state 38.2 commissioner of health shallpromulgate rules relative to38.3 determine the composition of such services and shall establish a 38.4 method of providing funds tolocal health agenciesboards of 38.5 health as defined in section 145A.02, subdivision 2, state 38.6 agencies, state councils, andorganizationsnonprofit 38.7 corporations, which offer such services. The state commissioner 38.8 of health shall provide technical assistance to such agencies 38.9 and organizations in accordance with the needs of the local 38.10 area. Planning and implementation of services, and technical 38.11 assistance may be conducted in collaboration with boards of 38.12 health; state agencies, including the University of Minnesota 38.13 and the department of children, families, and learning; state 38.14 councils; nonprofit organizations; and representatives of 38.15 affected populations. 38.16 Sec. 3. [144.066] [SEXUALLY TRANSMITTED INFECTIONS 38.17 PREVENTION AND TREATMENT GRANTS.] 38.18 The commissioner may award grants to boards of health as 38.19 defined in section 145A.02, subdivision 2, state agencies, state 38.20 councils, or nonprofit corporations to provide services 38.21 described in section 144.065 to populations most vulnerable to 38.22 sexually transmitted infections as determined by current 38.23 epidemiological research. 38.24 Sec. 4. [144.1201] [DEFINITIONS.] 38.25 Subdivision 1. [APPLICABILITY.] For purposes of sections 38.26 144.1201 to 144.1204, the terms defined in this section have the 38.27 meanings given to them. 38.28 Subd. 2. [BY-PRODUCT NUCLEAR MATERIAL.] "By-product 38.29 nuclear material" means a radioactive material, other than 38.30 special nuclear material, yielded in or made radioactive by 38.31 exposure to radiation created incident to the process of 38.32 producing or utilizing special nuclear material. 38.33 Subd. 3. [RADIATION.] "Radiation" means ionizing radiation 38.34 and includes alpha rays; beta rays; gamma rays; x-rays; high 38.35 energy neutrons, protons, or electrons; and other atomic 38.36 particles. 39.1 Subd. 4. [RADIOACTIVE MATERIAL.] "Radioactive material" 39.2 means a matter that emits radiation. Radioactive material 39.3 includes special nuclear material, source nuclear material, and 39.4 by-product nuclear material. 39.5 Subd. 5. [SOURCE NUCLEAR MATERIAL.] "Source nuclear 39.6 material" means uranium or thorium, or a combination thereof, in 39.7 any physical or chemical form; or ores that contain by weight 39.8 1/20 of one percent (0.05 percent) or more of uranium, thorium, 39.9 or a combination thereof. Source nuclear material does not 39.10 include special nuclear material. 39.11 Subd. 6. [SPECIAL NUCLEAR MATERIAL.] "Special nuclear 39.12 material" means: 39.13 (1) plutonium, uranium enriched in the isotope 233 or in 39.14 the isotope 235, and any other material that the Nuclear 39.15 Regulatory Commission determines to be special nuclear material 39.16 according to United States Code, title 42, section 2071, except 39.17 that source nuclear material is not included; and 39.18 (2) a material artificially enriched by any of the 39.19 materials listed in clause (1), except that source nuclear 39.20 material is not included. 39.21 Sec. 5. [144.1202] [UNITED STATES NUCLEAR REGULATORY 39.22 COMMISSION AGREEMENT.] 39.23 Subdivision 1. [AGREEMENT AUTHORIZED.] In order to have a 39.24 comprehensive program to protect the public from radiation 39.25 hazards, the governor, on behalf of the state, is authorized to 39.26 enter into agreements with the United States Nuclear Regulatory 39.27 Commission under the Atomic Energy Act of 1954, section 274b, as 39.28 amended. The agreement shall provide for the discontinuance of 39.29 portions of the Nuclear Regulatory Commission's licensing and 39.30 related regulatory authority over by-product, source, and 39.31 special nuclear materials, and the assumption of regulatory 39.32 authority over these materials by the state. 39.33 Subd. 2. [HEALTH DEPARTMENT DESIGNATED LEAD.] The 39.34 department of health is designated as the lead agency to pursue 39.35 an agreement on behalf of the governor and for any assumption of 39.36 specified licensing and regulatory authority from the Nuclear 40.1 Regulatory Commission under an agreement with the commission. 40.2 The commissioner of health shall establish an advisory group to 40.3 assist in preparing the state to meet the requirements for 40.4 reaching an agreement. The commissioner may adopt rules to 40.5 allow the state to assume regulatory authority under an 40.6 agreement under this section, including the licensing and 40.7 regulation of radioactive materials. Any regulatory authority 40.8 assumed by the state includes the ability to set and collect 40.9 fees. 40.10 Subd. 3. [TRANSITION.] A person who, on the effective date 40.11 of an agreement under this section, possesses a Nuclear 40.12 Regulatory Commission license that is subject to the agreement 40.13 is deemed to possess a similar license issued by the department 40.14 of health. A department of health license obtained under this 40.15 subdivision expires on the expiration date specified in the 40.16 federal license. 40.17 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 40.18 agreement entered into before August 2, 2002, must remain in 40.19 effect until terminated under the Atomic Energy Act of 1954, 40.20 United States Code, title 42, section 2021, paragraph (j). The 40.21 governor may not enter into an initial agreement with the 40.22 Nuclear Regulatory Commission after August 1, 2002. If an 40.23 agreement is not entered into by August 1, 2002, any rules 40.24 adopted under this section are repealed effective August 1, 2002. 40.25 (b) An agreement authorized under subdivision 1 must be 40.26 approved by law before it may be implemented. 40.27 Sec. 6. [144.1203] [TRAINING; RULEMAKING.] 40.28 The commissioner shall adopt rules to ensure that 40.29 individuals handling or utilizing radioactive materials under 40.30 the terms of a license issued by the commissioner under section 40.31 144.1202 have proper training and qualifications to do so. The 40.32 rules adopted must be at least as stringent as federal 40.33 regulations on proper training and qualifications adopted by the 40.34 Nuclear Regulatory Commission. Rules adopted under this section 40.35 may incorporate federal regulations by reference. 40.36 Sec. 7. [144.1204] [SURETY REQUIREMENTS.] 41.1 Subdivision 1. [FINANCIAL ASSURANCE REQUIRED.] The 41.2 commissioner may require an applicant for a license under 41.3 section 144.1202, or a person who was formerly licensed by the 41.4 Nuclear Regulatory Commission and is now subject to sections 41.5 144.1201 to 144.1204, to post financial assurances to ensure the 41.6 completion of all requirements established by the commissioner 41.7 for the decontamination, closure, decommissioning, and 41.8 reclamation of sites, structures, and equipment used in 41.9 conjunction with activities related to licensure. The financial 41.10 assurances posted must be sufficient to restore the site to 41.11 unrestricted future use and must be sufficient to provide for 41.12 surveillance and care when radioactive materials remain at the 41.13 site after the licensed activities cease. The commissioner may 41.14 establish financial assurance criteria by rule. In establishing 41.15 such criteria, the commissioner may consider: 41.16 (1) the chemical and physical form of the licensed 41.17 radioactive material; 41.18 (2) the quantity of radioactive material authorized; 41.19 (3) the particular radioisotopes authorized and their 41.20 subsequent radiotoxicity; 41.21 (4) the method in which the radioactive material is held, 41.22 used, stored, processed, transferred, or disposed of; and 41.23 (5) the potential costs of decontamination, treatment, or 41.24 disposal of a licensee's equipment and facilities. 41.25 Subd. 2. [ACCEPTABLE FINANCIAL ASSURANCES.] The 41.26 commissioner may, by rule, establish types of financial 41.27 assurances that meet the requirements of this section. Such 41.28 financial assurances may include bank letters of credit, 41.29 deposits of cash, or deposits of government securities. 41.30 Subd. 3. [TRUST AGREEMENTS.] Financial assurances must be 41.31 established together with trust agreements. Both the financial 41.32 assurances and the trust agreements must be in a form and 41.33 substance that meet requirements established by the commissioner. 41.34 Subd. 4. [EXEMPTIONS.] The commissioner is authorized to 41.35 exempt from the requirements of this section, by rule, any 41.36 category of licensee upon a determination by the commissioner 42.1 that an exemption does not result in a significant risk to the 42.2 public health or safety or to the environment and does not pose 42.3 a financial risk to the state. 42.4 Subd. 5. [OTHER REMEDIES UNAFFECTED.] Nothing in this 42.5 section relieves a licensee of a civil liability incurred, nor 42.6 may this section be construed to relieve the licensee of 42.7 obligations to prevent or mitigate the consequences of improper 42.8 handling or abandonment of radioactive materials. 42.9 Sec. 8. Minnesota Statutes 1998, section 144.148, is 42.10 amended to read: 42.11 144.148 [RURAL HOSPITAL CAPITAL IMPROVEMENT GRANTAND LOAN42.12 PROGRAM.] 42.13 Subdivision 1. [DEFINITION.] (a) For purposes of this 42.14 section, the following definitions apply. 42.15 (b) "Eligible rural hospital" meansaany nonfederal, 42.16 general acute care hospital that: 42.17 (1) is either located in a rural area, as defined in the 42.18 federal Medicare regulations, Code of Federal Regulations, title 42.19 42, section 405.1041, or located in a community with a 42.20 population of less than 5,000, according to United States Census 42.21 Bureau Statistics, outside the seven-county metropolitan area; 42.22 (2) has 50 or fewerlicensed hospitalbedswith a net42.23hospital operating margin not greater than two percent in the42.24two fiscal years prior to application; and 42.25 (3) is25 miles or more from another hospitalnot for 42.26 profit. 42.27 (c) "Eligible project" means a modernization project to 42.28 update, remodel, or replace aging hospital facilities and 42.29 equipment necessary to maintain the operations of a hospital. 42.30 Subd. 2. [PROGRAM.] The commissioner of health shall award 42.31 rural hospital capital improvement grantsor loansto eligible 42.32 rural hospitals. A grantor loanshall not exceed 42.33$1,500,000$300,000 per hospital.Grants or loans shall be42.34interest free. An eligible rural hospital may apply the funds42.35retroactively to capital improvements made during the two fiscal42.36years preceding the fiscal year in which the grant or loan was43.1received, provided the hospital met the eligibility criteria43.2during that time periodPrior to the receipt of any grant, the 43.3 hospital must certify to the commissioner that at least 43.4 one-quarter of the grant amount, which may include in-kind 43.5 services, is available for the same purposes from nonstate 43.6 resources. 43.7 Subd. 3. [APPLICATIONS.] Eligible hospitals seeking a 43.8 grantor loanshall apply to the commissioner. Applications 43.9 must include a description of the problem that the proposed 43.10 project will address, a description of the project including 43.11 construction and remodeling drawings or specifications, sources 43.12 of funds for the project, uses of funds for the project, the 43.13 results expected, and a plan to maintain or operate any facility 43.14 or equipment included in the project. The applicant must 43.15 describe achievable objectives, a timetable, and roles and 43.16 capabilities of responsible individuals and organization. 43.17 Applicants must submit to the commissioner evidence that 43.18 competitive bidding was used to select contractors for the 43.19 project. 43.20 Subd. 4. [CONSIDERATION OF APPLICATIONS.] The commissioner 43.21 shall review each application to determine whether or not the 43.22 hospital's application is complete and whether the hospital and 43.23 the project are eligible for a grantor loan. In evaluating 43.24 applications, the commissioner shall score each application on a 43.25 100 point scale, assigning: a maximum of 40 points for an 43.26 applicant's clarity and thoroughness in describing the problem 43.27 and the project; a maximum of 40 points for the extent to which 43.28 the applicant has demonstrated that it has made adequate 43.29 provisions to assure proper and efficient operation of the 43.30 facility once the project is completed; and a maximum of 20 43.31 points for the extent to which the proposed project is 43.32 consistent with the hospital's capital improvement plan or 43.33 strategic plan. The commissioner may also take into account 43.34 other relevant factors. During application review, the 43.35 commissioner may request additional information about a proposed 43.36 project, including information on project cost. Failure to 44.1 provide the information requested disqualifiesa loanan 44.2 applicant. 44.3 Subd. 5. [PROGRAM OVERSIGHT.]The commissioner of health44.4shall review audited financial information of the hospital to44.5assess eligibility.The commissioner shall determine the amount 44.6 of a grantor loanto be given to an eligible rural hospital 44.7 based on the relative score of each eligible hospital's 44.8 application and the funds available to the commissioner. The 44.9 grantor loanshall be used to update, remodel, or replace aging 44.10 facilities and equipment necessary to maintain the operations of 44.11 the hospital. The commissioner may collect, from the hospitals 44.12 receiving grants, any information necessary to evaluate the 44.13 program. 44.14Subd. 6. [LOAN PAYMENT.] Loans shall be repaid as provided44.15in this subdivision over a period of 15 years. In those years44.16when an eligible rural hospital experiences a positive net44.17operating margin in excess of two percent, the eligible rural44.18hospital shall pay to the state one-half of the excess above two44.19percent, up to the yearly payment amount based upon a loan44.20period of 15 years. If the amount paid back in any year is less44.21than the yearly payment amount, or if no payment is required44.22because the eligible rural hospital does not experience a44.23positive net operating margin in excess of two percent, the44.24amount unpaid for that year shall be forgiven by the state44.25without any financial penalty. As a condition of receiving an44.26award through this program, eligible hospitals must agree to any44.27and all collection activities the commissioner finds necessary44.28to collect loan payments in those years a payment is due.44.29Subd. 7. [ACCOUNTING TREATMENT.] The commissioner of44.30finance shall record as grants in the state accounting system44.31funds obligated by this section. Loan payments received under44.32this section shall be deposited in the health care access fund.44.33 Subd. 8. [EXPIRATION.] This section expires June 30, 44.3419992001. 44.35 Sec. 9. Minnesota Statutes 1998, section 144.99, 44.36 subdivision 1, is amended to read: 45.1 Subdivision 1. [REMEDIES AVAILABLE.] The provisions of 45.2 chapters 103I and 157 and sections 115.71 to 115.77; 144.12, 45.3 subdivision 1, paragraphs (1), (2), (5), (6), (10), (12), (13), 45.4 (14), and (15); 144.1201 to 144.1204; 144.121; 144.1222; 144.35; 45.5 144.381 to 144.385; 144.411 to 144.417; 144.495; 144.71 to 45.6 144.74; 144.9501 to 144.9509; 144.992; 326.37 to 326.45; 326.57 45.7 to 326.785; 327.10 to 327.131; and 327.14 to 327.28 and all 45.8 rules, orders, stipulation agreements, settlements, compliance 45.9 agreements, licenses, registrations, certificates, and permits 45.10 adopted or issued by the department or under any other law now 45.11 in force or later enacted for the preservation of public health 45.12 may, in addition to provisions in other statutes, be enforced 45.13 under this section. 45.14 Sec. 10. Minnesota Statutes 1998, section 144.99, is 45.15 amended by adding a subdivision to read: 45.16 Subd. 12. [SECURING RADIOACTIVE MATERIALS.] (a) In the 45.17 event of an emergency that poses a danger to the public health, 45.18 the commissioner shall have the authority to impound radioactive 45.19 materials and the associated shielding in the possession of a 45.20 person who fails to abide by the provisions of the statutes, 45.21 rules, and any other item listed in subdivision 1. If 45.22 impounding the source of these materials is impractical, the 45.23 commissioner shall have the authority to lock or otherwise 45.24 secure a facility that contains the source of such materials, 45.25 but only the portions of the facility as is necessary to protect 45.26 the public health. An action taken under this paragraph is 45.27 effective for up to 72 hours. The commissioner must seek an 45.28 injunction or take other administrative action to secure 45.29 radioactive materials beyond the initial 72-hour period. 45.30 (b) The commissioner may release impounded radioactive 45.31 materials and the associated shielding to the owner of the 45.32 radioactive materials and associated shielding, upon terms and 45.33 conditions that are in accordance with the provisions of 45.34 statutes, rules, and other items listed in subdivision 1. In 45.35 the alternative, the commissioner may bring an action in a court 45.36 of competent jurisdiction for an order directing the disposal of 46.1 impounded radioactive materials and associated shielding or 46.2 directing other disposition as necessary to protect the public 46.3 health and safety and the environment. The costs of 46.4 decontamination, transportation, burial, disposal, or other 46.5 disposition shall be borne by the owner or licensee of the 46.6 radioactive materials and shielding or by any other person who 46.7 has used the radioactive materials and shielding for business 46.8 purposes. 46.9 Sec. 11. Minnesota Statutes 1998, section 145.924, is 46.10 amended to read: 46.11 145.924 [AIDS AND SEXUALLY TRANSMITTED DISEASE PREVENTION 46.12 GRANTS.] 46.13 (a) The commissioner may award grants to boards of health 46.14 as defined in section 145A.02, subdivision 2, state agencies, 46.15 state councils, or nonprofit corporations to provide evaluation 46.16 and counseling services to populations at risk for acquiring 46.17 human immunodeficiency virus infection, including, but not 46.18 limited to, minorities, adolescents, intravenous drug users, and 46.19 homosexual men. 46.20 (b) The commissioner may award grants to agencies 46.21 experienced in providing services to communities of color, for 46.22 the design of innovative outreach and education programs for 46.23 targeted groups within the community who may be at risk of 46.24 acquiring the human immunodeficiency virus infection, including 46.25 intravenous drug users and their partners, adolescents, gay and 46.26 bisexual individuals and women. Grants shall be awarded on a 46.27 request for proposal basis and shall include funds for 46.28 administrative costs. Priority for grants shall be given to 46.29 agencies or organizations that have experience in providing 46.30 service to the particular community which the grantee proposes 46.31 to serve; that have policymakers representative of the targeted 46.32 population; that have experience in dealing with issues relating 46.33 to HIV/AIDS; and that have the capacity to deal effectively with 46.34 persons of differing sexual orientations.For purposes of this46.35paragraph, the "communities of color" are: the American-Indian46.36community; the Hispanic community; the African-American47.1community; and the Asian-Pacific community.47.2 (c) The commissioner shall award grants to agencies 47.3 experienced in providing services to adolescents, including 47.4 community-based organizations, to fund services to prevent human 47.5 immunodeficiency virus infection and sexually transmitted 47.6 disease infection among adolescents, with an emphasis on serving 47.7 adolescents from communities of color and gay and bisexual 47.8 adolescents. Grants shall be awarded on a request for proposal 47.9 basis and shall include funds for administrative costs. To be 47.10 eligible for grants, an agency must demonstrate the potential 47.11 capacity to work with the adolescent community or communities to 47.12 be served by the agency by: 47.13 (1) having ongoing involvement with the adolescent 47.14 community or communities to be served and their representatives 47.15 by either (i) involving members of the adolescent community or 47.16 communities to be served and their representatives in the 47.17 agency's operation or program development through the agency's 47.18 policymaking body; or (ii) creating an advisory group comprised 47.19 of members of the adolescent community or communities to be 47.20 served and their representatives to advise the agency's 47.21 policymaking body on agency operations and program development 47.22 issues; 47.23 (2) having at least 60 percent of the agency's client base 47.24 consist of members of the adolescent community or communities to 47.25 be served; 47.26 (3) clearly defining service gaps and how cultural barriers 47.27 cause unmet needs experienced by the adolescent community or 47.28 communities to be served; and 47.29 (4) based on an analysis of service gaps and cultural 47.30 barriers, developing interventions to provide effective 47.31 prevention services to the adolescent community or communities 47.32 to be served. 47.33 (d) For purposes of this section, "communities of color" 47.34 are the African-American community; the American Indian 47.35 community; the Chicano/Latino community; and the Asian and 47.36 Pacific Islander community. 48.1 Sec. 12. Minnesota Statutes 1998, section 148.5194, 48.2 subdivision 2, is amended to read: 48.3 Subd. 2. [BIENNIAL REGISTRATION FEE.] The fee for initial 48.4 registration and biennial registration, temporary registration, 48.5 or renewal is$160$200. 48.6 Sec. 13. Minnesota Statutes 1998, section 148.5194, 48.7 subdivision 3, is amended to read: 48.8 Subd. 3. [BIENNIAL REGISTRATION FEE FOR DUAL REGISTRATION 48.9 AS A SPEECH-LANGUAGE PATHOLOGIST AND AUDIOLOGIST.] The fee for 48.10 initial registration and biennial registration, temporary 48.11 registration, or renewal is$160$200. 48.12 Sec. 14. Minnesota Statutes 1998, section 148.5194, is 48.13 amended by adding a subdivision to read: 48.14 Subd. 3a. [SURCHARGE FEE.] For a period of four years 48.15 following the effective date of this subdivision, an applicant 48.16 for registration or registration renewal must pay a surcharge 48.17 fee of $25 in addition to any other fees due upon registration 48.18 or registration renewal. 48.19 Sec. 15. Minnesota Statutes 1998, section 148.5194, 48.20 subdivision 4, is amended to read: 48.21 Subd. 4. [PENALTY FEE FOR LATE RENEWALS.] The penalty fee 48.22 for late submission of a renewal application is$15$45. 48.23 Sec. 16. Minnesota Statutes 1998, section 326.40, 48.24 subdivision 2, is amended to read: 48.25 Subd. 2. [MASTER PLUMBER'S LICENSE;BONDAND; INSURANCE 48.26REQUIREMENTS.]The applicant for a master plumber license may48.27give bond to the state in the total penal sum of $2,00048.28conditioned upon the faithful and lawful performance of all work48.29entered upon within the state.Any person contracting to do 48.30 plumbing work must give bond to the state in the amount of 48.31 $25,000. The bond shall be for the benefit of persons injured 48.32 or suffering financial loss by reason of failureof performance48.33 to comply with the requirements of the plumbing code.The term48.34of the bond shall be concurrent with the term of the license.48.35TheA bond given to the state shall be filed with the secretary 48.36 of state and shall be in lieu of all otherlicensebonds to any 49.1 political subdivision required for plumbing work. The bond 49.2 shall be written by a corporate surety licensed to do business 49.3 in the state. 49.4 In addition, each applicant for a master plumber license or 49.5 renewal thereof, may provide evidence of public liability 49.6 insurance, including products liability insurance with limits of 49.7 at least $50,000 per person and $100,000 per occurrence and 49.8 property damage insurance with limits of at least $10,000. The 49.9 insurance shall be written by an insurer licensed to do business 49.10 in the state of Minnesota and each licensed master plumber shall 49.11 maintain on file with the state commissioner of health a 49.12 certificate evidencing the insurance providing that the 49.13 insurance shall not be canceled without the insurer first giving 49.14 15 days written notice to the commissioner. The term of the 49.15 insurance shall be concurrent with the term of the license. The 49.16 certificate shall be in lieu of all other certificates required 49.17 by any political subdivision for licensing purposes. 49.18 Sec. 17. Minnesota Statutes 1998, section 326.40, 49.19 subdivision 4, is amended to read: 49.20 Subd. 4. [ALTERNATIVE COMPLIANCE.] Compliance with the 49.21 local bond requirements of a locale within which work is to be 49.22 performed shall be deemed to satisfy the bond and insurance 49.23 requirements of subdivision 2, provided the local ordinance 49.24 requires at least a $25,000 bond. 49.25 Sec. 18. Minnesota Statutes 1998, section 326.40, 49.26 subdivision 5, is amended to read: 49.27 Subd. 5. [FEE.] The state commissioner of health may 49.28 charge eachapplicant for a master plumber license or for a49.29renewal of a master plumber license and an additional feeperson 49.30 giving bond an annual bond filing fee commensurate with the cost 49.31 of administering the bond and insurance requirements of 49.32 subdivision 2. 49.33 Sec. 19. [REPEALER.] 49.34 (a) Minnesota Statutes 1998, sections 62J.77; 62J.78; 49.35 62J.79; and 145.46, are repealed. 49.36 (b) Laws 1998, chapter 407, article 2, section 104, is 50.1 repealed. 50.2 ARTICLE 3 50.3 LONG-TERM CARE 50.4 Section 1. Minnesota Statutes 1998, section 144A.073, 50.5 subdivision 5, is amended to read: 50.6 Subd. 5. [REPLACEMENT RESTRICTIONS.] (a) Proposals 50.7 submitted or approved under this section involving replacement 50.8 must provide for replacement of the facility on the existing 50.9 site except as allowed in this subdivision. 50.10 (b) Facilities located in a metropolitan statistical area 50.11 other than the Minneapolis-St. Paul seven-county metropolitan 50.12 area may relocate to a site within the same census tract or a 50.13 contiguous census tract. 50.14 (c) Facilities located in the Minneapolis-St. Paul 50.15 seven-county metropolitan area may relocate to a site within the 50.16 same or contiguous health planning area as adopted in March 1982 50.17 by the metropolitan council. 50.18 (d) Facilities located outside a metropolitan statistical 50.19 area may relocate to a site within the same city or township, or 50.20 within a contiguous township. 50.21 (e) A facility relocated to a different site under 50.22 paragraph (b), (c), or (d) must not be relocated to a site more 50.23 than six miles from the existing site. 50.24 (f) The relocation of part of an existing first facility to 50.25 a second location, under paragraphs (d) and (e), may include the 50.26 relocation to the second location of up to four beds from part 50.27 of an existing third facility located in a township contiguous 50.28 to the location of the first facility. The six-mile limit in 50.29 paragraph (e) does not apply to this relocation from the third 50.30 facility. 50.31 (g) For proposals approved on January 13, 1994, under this 50.32 section involving the replacement of 102 licensed and certified 50.33 beds, the relocation of the existing first facility to the 50.34second and third locationsnew location under paragraphs (d) and 50.35 (e) may include the relocation of up to50 percent of the75 50.36 beds of the existingfirstfacilityto each of the locations. 51.1 The six-mile limit in paragraph (e) does not apply to this 51.2 relocationto the third location. Notwithstanding subdivision51.33, construction of this project may be commenced any time prior51.4to January 1, 1996. 51.5 Sec. 2. Minnesota Statutes 1998, section 144A.10, is 51.6 amended by adding a subdivision to read: 51.7 Subd. 1a. [TRAINING AND EDUCATION FOR NURSING FACILITY 51.8 PROVIDERS.] The commissioner of health must establish and 51.9 implement a prescribed process and program for providing 51.10 training and education to providers licensed by the department 51.11 of health, either by itself or in conjunction with the industry 51.12 trade associations, before using any new regulatory guideline, 51.13 regulation, interpretation, program letter or memorandum, or any 51.14 other materials used in surveyor training to survey licensed 51.15 providers. The process should include, but is not limited to, 51.16 the following key components: 51.17 (1) facilitate the implementation of immediate revisions to 51.18 any course curriculum for nursing assistants which reflect any 51.19 new standard of care practice that has been adopted or 51.20 referenced by the health department concerning the issue in 51.21 question; 51.22 (2) conduct training of long-term care providers and health 51.23 department survey inspectors either jointly or during the same 51.24 time frame on the department's new expectations; and 51.25 (3) within available resources the commissioner shall 51.26 cooperate in the development of clinical standards, work with 51.27 vendors of supplies and services regarding hazards, and identify 51.28 research of interest to the long-term care community. 51.29 (Effective date: Section 2 (144A.10, subd. 1a) is 51.30 effective the day following final enactment.) 51.31 Sec. 3. Minnesota Statutes 1998, section 144A.10, is 51.32 amended by adding a subdivision to read: 51.33 Subd. 11. [DATA ON FOLLOW-UP SURVEYS.] (a) If requested, 51.34 and not prohibited by federal law, the commissioner shall make 51.35 available to the nursing home associations and the public 51.36 photocopies of statements of deficiencies and related letters 52.1 from the department pertaining to federal certification 52.2 surveys. The commissioner may charge for the actual cost of 52.3 reproduction of these documents. 52.4 (b) The commissioner shall also make available on a 52.5 quarterly basis aggregate data for all statements of 52.6 deficiencies issued after federal certification follow-up 52.7 surveys related to surveys that were conducted in the quarter 52.8 prior to the immediately preceding quarter. The data shall 52.9 include the number of facilities with deficiencies, the total 52.10 number of deficiencies, the number of facilities that did not 52.11 have any deficiencies, the number of facilities for which a 52.12 resurvey or follow-up survey was not performed, and the average 52.13 number of days between the follow-up or resurvey and the exit 52.14 date of the preceding survey. 52.15 (Effective date: Section 3 (144A.10, subd. 11) is 52.16 effective the day following final enactment.) 52.17 Sec. 4. Minnesota Statutes 1998, section 144A.10, is 52.18 amended by adding a subdivision to read: 52.19 Subd. 12. [NURSE AIDE TRAINING WAIVERS.] Because any 52.20 disruption or delay in the training and registration of nurse 52.21 aides may reduce access to care in certified facilities, the 52.22 commissioner shall grant all possible waivers for the 52.23 continuation of an approved nurse aide training and competency 52.24 evaluation program or nurse aide training program or competency 52.25 evaluation program conducted by or on the site of any certified 52.26 nursing facility or skilled nursing facility that would 52.27 otherwise lose approval for the program or programs. The 52.28 commissioner shall take into consideration the distance to other 52.29 training programs, the frequency of other training programs, and 52.30 the impact that the loss of the onsite training will have on the 52.31 nursing facility's ability to recruit and train nurse aides. 52.32 (Effective date: Section 4 (144A.10, subd. 12) is 52.33 effective the day following final enactment.) 52.34 Sec. 5. Minnesota Statutes 1998, section 144A.10, is 52.35 amended by adding a subdivision to read: 52.36 Subd. 13. [IMMEDIATE JEOPARDY.] When conducting survey 53.1 certification and enforcement activities related to regular, 53.2 expanded, or extended surveys under Code of Federal Regulations, 53.3 title 42, part 488, the commissioner may not issue a finding of 53.4 immediate jeopardy unless the specific event or omission that 53.5 constitutes the violation of the requirements of participation 53.6 poses an imminent risk of life-threatening or serious injury to 53.7 a resident. The commissioner may not issue any findings of 53.8 immediate jeopardy after the conclusion of a regular, expanded, 53.9 or extended survey unless the survey team identified the 53.10 deficient practice or practices that constitute immediate 53.11 jeopardy and the residents at risk prior to the close of the 53.12 exit conference. 53.13 (Effective date: Section 5 (144A.10, subd. 13) is 53.14 effective the day following final enactment.) 53.15 Sec. 6. Minnesota Statutes 1998, section 144A.10, is 53.16 amended by adding a subdivision to read: 53.17 Subd. 14. [INFORMAL DISPUTE RESOLUTION.] The commissioner 53.18 shall respond in writing to a request from a nursing facility 53.19 certified under the federal Medicare and Medicaid programs for 53.20 an informal dispute resolution within 30 days of the exit date 53.21 of the facility's survey. The commissioner's response shall 53.22 identify the commissioner's decision regarding the continuation 53.23 of each deficiency citation challenged by the nursing facility, 53.24 as well as a statement of any changes in findings, level of 53.25 severity or scope, and proposed remedies or sanctions for each 53.26 deficiency citation. 53.27 (Effective date: Section 6 (144A.10, subd. 14) is 53.28 effective the day following final enactment.) 53.29 Sec. 7. [144A.102] [USE OF CIVIL MONEY PENALTIES; WAIVER 53.30 FROM STATE AND FEDERAL RULES AND REGULATIONS.] 53.31 By January 2000, the commissioner of health shall work with 53.32 providers to examine state and federal rules and regulations 53.33 governing the provision of care in licensed nursing facilities 53.34 and apply for federal waivers and identify necessary changes in 53.35 state law to: 53.36 (1) allow the use of civil money penalties imposed upon 54.1 nursing facilities to abate any deficiencies identified in a 54.2 nursing facility's plan of correction; and 54.3 (2) stop the accrual of any fine imposed by the health 54.4 department when a follow-up inspection survey is not conducted 54.5 by the department within the regulatory deadline. 54.6 (Effective date: Section 7 (144A.102) is effective the day 54.7 following final enactment.) 54.8 Sec. 8. Minnesota Statutes 1998, section 144D.01, 54.9 subdivision 4, is amended to read: 54.10 Subd. 4. [HOUSING WITH SERVICES ESTABLISHMENT OR 54.11 ESTABLISHMENT.] "Housing with services establishment" or 54.12 "establishment" means an establishment providing sleeping 54.13 accommodations to one or more adult residents, at least 80 54.14 percent of which are 55 years of age or older, and offering or 54.15 providing, for a fee, one or more regularly scheduled 54.16 health-related services or two or more regularly scheduled 54.17 supportive services, whether offered or provided directly by the 54.18 establishment or by another entity arranged for by the 54.19 establishment. 54.20 Housing with services establishment does not include: 54.21 (1) a nursing home licensed under chapter 144A; 54.22 (2) a hospital, certified boarding care home, or supervised 54.23 living facility licensed under sections 144.50 to 144.56; 54.24 (3) a board and lodging establishment licensed under 54.25 chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 54.26 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 54.27 9530.4450, or under chapter 245B; 54.28 (4) a board and lodging establishment which serves as a 54.29 shelter for battered women or other similar purpose; 54.30 (5) a family adult foster care home licensed by the 54.31 department of human services; 54.32 (6) private homes in which the residents are related by 54.33 kinship, law, or affinity with the providers of services; 54.34 (7) residential settings for persons with mental 54.35 retardation or related conditions in which the services are 54.36 licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 55.1 applicable successor rules or laws; 55.2 (8) a home-sharing arrangement such as when an elderly or 55.3 disabled person or single-parent family makes lodging in a 55.4 private residence available to another person in exchange for 55.5 services or rent, or both; 55.6 (9) a duly organized condominium, cooperative, common 55.7 interest community, or owners' association of the foregoing 55.8 where at least 80 percent of the units that comprise the 55.9 condominium, cooperative, or common interest community are 55.10 occupied by individuals who are the owners, members, or 55.11 shareholders of the units; or 55.12 (10) services for persons with developmental disabilities 55.13 that are provided under a license according to Minnesota Rules, 55.14 parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 55.15 under chapter 245B. 55.16 Sec. 9. Minnesota Statutes 1998, section 252.28, 55.17 subdivision 1, is amended to read: 55.18 Subdivision 1. [DETERMINATIONS; REDETERMINATIONS.] In 55.19 conjunction with the appropriate county boards, the commissioner 55.20 of human services shall determine, and shall redetermine at 55.21 least every four years, the need, location, size, and program of 55.22 public and privateresidential services andday training and 55.23 habilitation services for persons with mental retardation or 55.24 related conditions. This subdivision does not apply to 55.25 semi-independent living services and residential-based 55.26 habilitation services provided to four or fewer persons at a 55.27 single site funded as home and community-based services. A 55.28 determination of need shall not be required for a change in 55.29 ownership. 55.30 Sec. 10. [252.282] [ICF/MR LOCAL SYSTEM NEEDS PLANNING.] 55.31 Subdivision 1. [HOST COUNTY RESPONSIBILITY.] (a) For 55.32 purposes of this section, "local system needs planning" means 55.33 the determination of need for ICF/MR services by program type, 55.34 location, demographics, and size of licensed services for 55.35 persons with developmental disabilities or related conditions. 55.36 (b) This section does not apply to semi-independent living 56.1 services and residential-based habilitation services funded as 56.2 home and community-based services. 56.3 (c) In collaboration with the commissioner and ICF/MR 56.4 providers, counties shall complete a local system needs planning 56.5 process for each ICF/MR facility. Counties shall evaluate the 56.6 preferences and needs of persons with developmental disabilities 56.7 to determine resource demands through a systematic assessment 56.8 and planning process by May 15, 2000, and by July 1 every two 56.9 years thereafter beginning in 2001. 56.10 (d) A local system needs planning process shall be 56.11 undertaken more frequently when the needs or preferences of 56.12 consumers change significantly to require reformation of the 56.13 resources available to persons with developmental disabilities. 56.14 (e) A local system needs plan shall be amended anytime 56.15 recommendations for modifications to existing ICF/MR services 56.16 are made to the host county, including recommendations for: 56.17 (1) closure; 56.18 (2) relocation of services; 56.19 (3) downsizing; 56.20 (4) rate adjustments exceeding 90 days duration to address 56.21 access; or 56.22 (5) modification of existing services for which a change in 56.23 the framework of service delivery is advocated. 56.24 Subd. 2. [CONSUMER NEEDS AND PREFERENCES.] In conducting 56.25 the local system needs planning process, the host county must 56.26 use information from the individual service plans of persons for 56.27 whom the county is financially responsible and of persons from 56.28 other counties for whom the county has agreed to be the host 56.29 county. The determination of services and supports offered 56.30 within the county shall be based on the preferences and needs of 56.31 consumers. The host county shall also consider the community 56.32 social services plan, waiting lists, and other sources that 56.33 identify unmet needs for services. A review of ICF/MR facility 56.34 licensing and certification surveys, substantiated maltreatment 56.35 reports, and established service standards shall be employed to 56.36 assess the performance of providers and shall be considered in 57.1 the county's recommendations. Consumer satisfaction surveys may 57.2 also be considered in this process. 57.3 Subd. 3. [RECOMMENDATIONS.] (a) Upon completion of the 57.4 local system needs planning assessment, the host county shall 57.5 make recommendations by May 15, 2000, and by July 1 every two 57.6 years thereafter beginning in 2001. If no change is 57.7 recommended, a copy of the assessment along with corresponding 57.8 documentation shall be provided to the commissioner by July 1 57.9 prior to the contract year. 57.10 (b) Except as provided in section 252.292, subdivision 4, 57.11 recommendations regarding closures, relocations, or downsizings 57.12 that include a rate increase and recommendations regarding rate 57.13 adjustments exceeding 90 days shall be submitted to the 57.14 statewide advisory committee for review and determination, along 57.15 with the assessment, plan, and corresponding budget. 57.16 (c) Recommendations for closures, relocations, and 57.17 downsizings that do not include a rate increase and for 57.18 modification of existing services for which a change in the 57.19 framework of service delivery is necessary shall be provided to 57.20 the commissioner by July 1 prior to the contract year or at 57.21 least 90 days prior to the anticipated change, along with the 57.22 assessment and corresponding documentation. 57.23 Subd. 4. [THE STATEWIDE ADVISORY COMMITTEE.] (a) The 57.24 commissioner shall appoint a five-member statewide advisory 57.25 committee. The advisory committee shall include representatives 57.26 of providers and counties and the commissioner or the 57.27 commissioner's designee. 57.28 (b) The criteria for ranking proposals, already developed 57.29 in 1997 by a task force authorized by the legislature, shall be 57.30 adopted and incorporated into the decision-making process. 57.31 Specific guidelines, including time frame for submission of 57.32 requests, shall be established and announced through the State 57.33 Register, and all requests shall be considered in comparison to 57.34 each other and the ranking criteria. The advisory committee 57.35 shall review and recommend requests for facility rate 57.36 adjustments to address closures, downsizing, relocation, or 58.1 access needs within the county and shall forward recommendations 58.2 and documentation to the commissioner. The committee shall 58.3 ensure that: 58.4 (1) applications are in compliance with applicable state 58.5 and federal law and with the state plan; and 58.6 (2) cost projections for the proposed service are within 58.7 fiscal limitations. 58.8 (c) The advisory committee shall review proposals and 58.9 submit recommendations to the commissioner within 60 days 58.10 following the published deadline for submission under 58.11 subdivision 5. 58.12 Subd. 5. [RESPONSIBILITIES OF THE COMMISSIONER.] (a) In 58.13 collaboration with counties, providers, and the statewide 58.14 advisory committee, the commissioner shall ensure that services 58.15 recognize the preferences and needs of persons with 58.16 developmental disabilities and related conditions through a 58.17 recurring systemic review and assessment of ICF/MR facilities 58.18 within the state. 58.19 (b) The commissioner shall publish a notice in the State 58.20 Register twice each calendar year to announce the opportunity 58.21 for counties or providers to submit requests for rate 58.22 adjustments associated with plans for downsizing, relocation, 58.23 and closure of ICF/MR facilities. 58.24 (c) The commissioner shall designate funding parameters to 58.25 counties and to the statewide advisory committee for the overall 58.26 implementation of system needs within the fiscal resources 58.27 allocated by the legislature. 58.28 (d) The commissioner shall contract with ICF/MR providers. 58.29 The second contracts shall cover the period from October 1, 58.30 2001, to December 31, 2002. Subsequent contracts shall be for 58.31 two-year periods beginning January 1, 2003. 58.32 Sec. 11. Minnesota Statutes 1998, section 252.291, is 58.33 amended by adding a subdivision to read: 58.34 Subd. 2a. [EXCEPTION FOR LAKE OWASSO PROJECT.] (a) The 58.35 commissioner shall authorize and grant a license under chapter 58.36 245A to a new intermediate care facility for persons with mental 59.1 retardation effective January 1, 2000, under the following 59.2 circumstances: 59.3 (1) the new facility replaces an existing 64-bed 59.4 intermediate care facility for the mentally retarded located in 59.5 Ramsey county; 59.6 (2) the new facility is located upon a parcel of land 59.7 contiguous to the parcel upon which the existing 64-bed facility 59.8 is located; 59.9 (3) the new facility is comprised of no more than eight 59.10 twin home style buildings and an administration building; 59.11 (4) the total licensed bed capacity of the facility does 59.12 not exceed 64 beds; and 59.13 (5) the existing 64-bed facility is demolished. 59.14 (b) The medical assistance payment rate for the new 59.15 facility shall be the higher of the rate specified in paragraph 59.16 (c) or as otherwise provided by law. 59.17 (c) The new facility shall be considered a newly 59.18 established facility for rate setting purposes, and shall be 59.19 eligible for the investment per bed limit specified in section 59.20 256B.501, subdivision 11, paragraph (c), and the interest 59.21 expense limitation specified in section 256B.501, subdivision 59.22 11, paragraph (d). Notwithstanding section 256B.5011, the newly 59.23 established facility's initial payment rate shall be set 59.24 according to Minnesota Rules, part 9553.0075, and shall not be 59.25 subject to the provisions of section 256B.501, subdivision 5b. 59.26 Sec. 12. Minnesota Statutes 1998, section 256B.0911, 59.27 subdivision 6, is amended to read: 59.28 Subd. 6. [PAYMENT FOR PREADMISSION SCREENING.] (a) The 59.29 total screening payment for each county must be paid monthly by 59.30 certified nursing facilities in the county. The monthly amount 59.31 to be paid by each nursing facility for each fiscal year must be 59.32 determined by dividing the county's annual allocation for 59.33 screenings by 12 to determine the monthly payment and allocating 59.34 the monthly payment to each nursing facility based on the number 59.35 of licensed beds in the nursing facility. 59.36 (b) The commissioner shall include the total annual payment 60.1 for screening for each nursing facility according to section 60.2 256B.431, subdivision 2b, paragraph (g), or 256B.435. 60.3 (c) Payments for screening activities are available to the 60.4 county or counties to cover staff salaries and expenses to 60.5 provide the screening function. The lead agency shall employ, 60.6 or contract with other agencies to employ, within the limits of 60.7 available funding, sufficient personnel to conduct the 60.8 preadmission screening activity while meeting the state's 60.9 long-term care outcomes and objectives as defined in section 60.10 256B.0917, subdivision 1. The local agency shall be accountable 60.11 for meeting local objectives as approved by the commissioner in 60.12 the CSSA biennial plan. 60.13(c)(d) Notwithstanding section 256B.0641, overpayments 60.14 attributable to payment of the screening costs under the medical 60.15 assistance program may not be recovered from a facility. 60.16(d)(e) The commissioner of human services shall amend the 60.17 Minnesota medical assistance plan to include reimbursement for 60.18 the local screening teams. 60.19 Sec. 13. Minnesota Statutes 1998, section 256B.0913, 60.20 subdivision 5, is amended to read: 60.21 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 60.22 Alternative care funding may be used for payment of costs of: 60.23 (1) adult foster care; 60.24 (2) adult day care; 60.25 (3) home health aide; 60.26 (4) homemaker services; 60.27 (5) personal care; 60.28 (6) case management; 60.29 (7) respite care; 60.30 (8) assisted living; 60.31 (9) residential care services; 60.32 (10) care-related supplies and equipment; 60.33 (11) meals delivered to the home; 60.34 (12) transportation; 60.35 (13) skilled nursing; 60.36 (14) chore services; 61.1 (15) companion services; 61.2 (16) nutrition services; 61.3 (17) training for direct informal caregivers;and61.4 (18) telemedicine devices to monitor recipients in their 61.5 own homes as an alternative to hospital care, nursing home care, 61.6 or home visits.; and 61.7 (19) other services including direct cash payments to 61.8 clients, approved by the county agency, subject to the 61.9 provisions of paragraph (m). Total annual payments for other 61.10 services for all clients within a county may not exceed either 61.11 ten percent of that county's annual alternative care program 61.12 base allocation or $5,000, whichever is greater. In no case 61.13 shall this amount exceed the county's total annual alternative 61.14 care program base allocation. 61.15 (b) The county agency must ensure that the funds are used 61.16 only to supplement and not supplant services available through 61.17 other public assistance or services programs. 61.18 (c) Unless specified in statute, the service standards for 61.19 alternative care services shall be the same as the service 61.20 standards defined in the elderly waiver. Except for the county 61.21 agencies' approval of direct cash payments to clients, persons 61.22 or agencies must be employed by or under a contract with the 61.23 county agency or the public health nursing agency of the local 61.24 board of health in order to receive funding under the 61.25 alternative care program. 61.26 (d) The adult foster care rate shall be considered a 61.27 difficulty of care payment and shall not include room and 61.28 board. The adult foster care daily rate shall be negotiated 61.29 between the county agency and the foster care provider. The 61.30 rate established under this section shall not exceed 75 percent 61.31 of the state average monthly nursing home payment for the case 61.32 mix classification to which the individual receiving foster care 61.33 is assigned, and it must allow for other alternative care 61.34 services to be authorized by the case manager. 61.35 (e) Personal care services may be provided by a personal 61.36 care provider organization. A county agency may contract with a 62.1 relative of the client to provide personal care services, but 62.2 must ensure nursing supervision. Covered personal care services 62.3 defined in section 256B.0627, subdivision 4, must meet 62.4 applicable standards in Minnesota Rules, part 9505.0335. 62.5 (f) A county may use alternative care funds to purchase 62.6 medical supplies and equipment without prior approval from the 62.7 commissioner when: (1) there is no other funding source; (2) 62.8 the supplies and equipment are specified in the individual's 62.9 care plan as medically necessary to enable the individual to 62.10 remain in the community according to the criteria in Minnesota 62.11 Rules, part 9505.0210, item A; and (3) the supplies and 62.12 equipment represent an effective and appropriate use of 62.13 alternative care funds. A county may use alternative care funds 62.14 to purchase supplies and equipment from a non-Medicaid certified 62.15 vendor if the cost for the items is less than that of a Medicaid 62.16 vendor. A county is not required to contract with a provider of 62.17 supplies and equipment if the monthly cost of the supplies and 62.18 equipment is less than $250. 62.19 (g) For purposes of this section, residential care services 62.20 are services which are provided to individuals living in 62.21 residential care homes. Residential care homes are currently 62.22 licensed as board and lodging establishments and are registered 62.23 with the department of health as providing special services. 62.24 Residential care services are defined as "supportive services" 62.25 and "health-related services." "Supportive services" means the 62.26 provision of up to 24-hour supervision and oversight. 62.27 Supportive services includes: (1) transportation, when provided 62.28 by the residential care center only; (2) socialization, when 62.29 socialization is part of the plan of care, has specific goals 62.30 and outcomes established, and is not diversional or recreational 62.31 in nature; (3) assisting clients in setting up meetings and 62.32 appointments; (4) assisting clients in setting up medical and 62.33 social services; (5) providing assistance with personal laundry, 62.34 such as carrying the client's laundry to the laundry room. 62.35 Assistance with personal laundry does not include any laundry, 62.36 such as bed linen, that is included in the room and board rate. 63.1 Health-related services are limited to minimal assistance with 63.2 dressing, grooming, and bathing and providing reminders to 63.3 residents to take medications that are self-administered or 63.4 providing storage for medications, if requested. Individuals 63.5 receiving residential care services cannot receive both personal 63.6 care services and residential care services. 63.7 (h) For the purposes of this section, "assisted living" 63.8 refers to supportive services provided by a single vendor to 63.9 clients who reside in the same apartment building of three or 63.10 more units which are not subject to registration under chapter 63.11 144D. Assisted living services are defined as up to 24-hour 63.12 supervision, and oversight, supportive services as defined in 63.13 clause (1), individualized home care aide tasks as defined in 63.14 clause (2), and individualized home management tasks as defined 63.15 in clause (3) provided to residents of a residential center 63.16 living in their units or apartments with a full kitchen and 63.17 bathroom. A full kitchen includes a stove, oven, refrigerator, 63.18 food preparation counter space, and a kitchen utensil storage 63.19 compartment. Assisted living services must be provided by the 63.20 management of the residential center or by providers under 63.21 contract with the management or with the county. 63.22 (1) Supportive services include: 63.23 (i) socialization, when socialization is part of the plan 63.24 of care, has specific goals and outcomes established, and is not 63.25 diversional or recreational in nature; 63.26 (ii) assisting clients in setting up meetings and 63.27 appointments; and 63.28 (iii) providing transportation, when provided by the 63.29 residential center only. 63.30 Individuals receiving assisted living services will not 63.31 receive both assisted living services and homemaking or personal 63.32 care services. Individualized means services are chosen and 63.33 designed specifically for each resident's needs, rather than 63.34 provided or offered to all residents regardless of their 63.35 illnesses, disabilities, or physical conditions. 63.36 (2) Home care aide tasks means: 64.1 (i) preparing modified diets, such as diabetic or low 64.2 sodium diets; 64.3 (ii) reminding residents to take regularly scheduled 64.4 medications or to perform exercises; 64.5 (iii) household chores in the presence of technically 64.6 sophisticated medical equipment or episodes of acute illness or 64.7 infectious disease; 64.8 (iv) household chores when the resident's care requires the 64.9 prevention of exposure to infectious disease or containment of 64.10 infectious disease; and 64.11 (v) assisting with dressing, oral hygiene, hair care, 64.12 grooming, and bathing, if the resident is ambulatory, and if the 64.13 resident has no serious acute illness or infectious disease. 64.14 Oral hygiene means care of teeth, gums, and oral prosthetic 64.15 devices. 64.16 (3) Home management tasks means: 64.17 (i) housekeeping; 64.18 (ii) laundry; 64.19 (iii) preparation of regular snacks and meals; and 64.20 (iv) shopping. 64.21 Assisted living services as defined in this section shall 64.22 not be authorized in boarding and lodging establishments 64.23 licensed according to sections 157.011 and 157.15 to 157.22. 64.24 (i) For establishments registered under chapter 144D, 64.25 assisted living services under this section means the services 64.26 described and licensed under section 144A.4605. 64.27 (j) For the purposes of this section, reimbursement for 64.28 assisted living services and residential care services shall be 64.29 a monthly rate negotiated and authorized by the county agency 64.30 based on an individualized service plan for each resident. The 64.31 rate shall not exceed the nonfederal share of the greater of 64.32 either the statewide or any of the geographic groups' weighted 64.33 average monthly medical assistance nursing facility payment rate 64.34 of the case mix resident class to which the 180-day eligible 64.35 client would be assigned under Minnesota Rules, parts 9549.0050 64.36 to 9549.0059, unless the services are provided by a home care 65.1 provider licensed by the department of health and are provided 65.2 in a building that is registered as a housing with services 65.3 establishment under chapter 144D and that provides 24-hour 65.4 supervision. 65.5 (k) For purposes of this section, companion services are 65.6 defined as nonmedical care, supervision and oversight, provided 65.7 to a functionally impaired adult. Companions may assist the 65.8 individual with such tasks as meal preparation, laundry and 65.9 shopping, but do not perform these activities as discrete 65.10 services. The provision of companion services does not entail 65.11 hands-on medical care. Providers may also perform light 65.12 housekeeping tasks which are incidental to the care and 65.13 supervision of the recipient. This service must be approved by 65.14 the case manager as part of the care plan. Companion services 65.15 must be provided by individuals ornonprofitorganizations who 65.16 are under contract with the local agency to provide the 65.17 service. Any person related to the waiver recipient by blood, 65.18 marriage or adoption cannot be reimbursed under this service. 65.19 Persons providing companion services will be monitored by the 65.20 case manager. 65.21 (l) For purposes of this section, training for direct 65.22 informal caregivers is defined as a classroom or home course of 65.23 instruction which may include: transfer and lifting skills, 65.24 nutrition, personal and physical cares, home safety in a home 65.25 environment, stress reduction and management, behavioral 65.26 management, long-term care decision making, care coordination 65.27 and family dynamics. The training is provided to an informal 65.28 unpaid caregiver of a 180-day eligible client which enables the 65.29 caregiver to deliver care in a home setting with high levels of 65.30 quality. The training must be approved by the case manager as 65.31 part of the individual care plan. Individuals, agencies, and 65.32 educational facilities which provide caregiver training and 65.33 education will be monitored by the case manager. 65.34 (m) A county agency may make payment from their alternative 65.35 care program allocation for other services provided to an 65.36 alternative care program recipient if those services prevent, 66.1 shorten, or delay institutionalization. These services may 66.2 include direct cash payments to the recipient for the purpose of 66.3 purchasing the recipient's services. The following provisions 66.4 apply to payments under this paragraph: 66.5 (1) a cash payment to a client under this provision cannot 66.6 exceed 80 percent of the monthly payment limit for that client 66.7 as specified in subdivision 4, paragraph (a), clause (7); 66.8 (2) a county may not approve any cash payment for a client 66.9 who has been assessed as having a dependency in orientation, 66.10 unless the client has an authorized representative under section 66.11 256.476, subdivision 2, paragraph (g), or for a client who is 66.12 concurrently receiving adult foster care, residential care, or 66.13 assisted living services; 66.14 (3) any service approved under this section must be a 66.15 service which meets the purpose and goals of the program as 66.16 listed in subdivision 1; 66.17 (4) cash payments must also meet the criteria in section 66.18 256.476, subdivision 4, paragraph (b), and recipients of cash 66.19 grants must meet the requirements in section 256.476, 66.20 subdivision 10; and 66.21 (5) the county shall report client outcomes, services, and 66.22 costs under this paragraph in a manner prescribed by the 66.23 commissioner. 66.24 Upon implementation of direct cash payments to clients under 66.25 this section, any person determined eligible for the alternative 66.26 care program who chooses a cash payment approved by the county 66.27 agency shall receive the cash payment under this section and not 66.28 under section 256.476 unless the person was receiving a consumer 66.29 support grant under section 256.476 before implementation of 66.30 direct cash payments under this section. 66.31 Sec. 14. Minnesota Statutes 1998, section 256B.0913, 66.32 subdivision 10, is amended to read: 66.33 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 66.34 appropriation for fiscal years 1992 and beyond shall cover only 66.35 180-day eligible clients. 66.36 (b) Prior to July 1 of each year, the commissioner shall 67.1 allocate to county agencies the state funds available for 67.2 alternative care for persons eligible under subdivision 2. The 67.3 allocation for fiscal year 1992 shall be calculated using a base 67.4 that is adjusted to exclude the medical assistance share of 67.5 alternative care expenditures. The adjusted base is calculated 67.6 by multiplying each county's allocation for fiscal year 1991 by 67.7 the percentage of county alternative care expenditures for 67.8 180-day eligible clients. The percentage is determined based on 67.9 expenditures for services rendered in fiscal year 1989 or 67.10 calendar year 1989, whichever is greater. 67.11 (c) If the county expenditures for 180-day eligible clients 67.12 are 95 percent or more of its adjusted base allocation, the 67.13 allocation for the next fiscal year is 100 percent of the 67.14 adjusted base, plus inflation to the extent that inflation is 67.15 included in the state budget. 67.16 (d) If the county expenditures for 180-day eligible clients 67.17 are less than 95 percent of its adjusted base allocation, the 67.18 allocation for the next fiscal year is the adjusted base 67.19 allocation less the amount of unspent funds below the 95 percent 67.20 level. 67.21 (e) For fiscal year 1992 only, a county may receive an 67.22 increased allocation if annualized service costs for the month 67.23 of May 1991 for 180-day eligible clients are greater than the 67.24 allocation otherwise determined. A county may apply for this 67.25 increase by reporting projected expenditures for May to the 67.26 commissioner by June 1, 1991. The amount of the allocation may 67.27 exceed the amount calculated in paragraph (b). The projected 67.28 expenditures for May must be based on actual 180-day eligible 67.29 client caseload and the individual cost of clients' care plans. 67.30 If a county does not report its expenditures for May, the amount 67.31 in paragraph (c) or (d) shall be used. 67.32 (f) Calculations for paragraphs (c) and (d) are to be made 67.33 as follows: for each county, the determination of expenditures 67.34 shall be based on payments for services rendered from April 1 67.35 through March 31 in the base year, to the extent that claims 67.36 have been submitted by June 1 of that year. Calculations for 68.1 paragraphs (c) and (d) must also include the funds transferred 68.2 to the consumer support grant program for clients who have 68.3 transferred to that program from April 1 through March 31 in the 68.4 base year. 68.5 (g) For the biennium ending June 30, 2001, the allocation 68.6 of state funds to county agencies shall be calculated as 68.7 described in paragraphs (c) and (d). If the annual legislative 68.8 appropriation for the alternative care program is inadequate to 68.9 fund the combined county allocations for fiscal year 2000 or 68.10 2001, the commissioner shall distribute to each county the 68.11 entire annual appropriation as that county's percentage of the 68.12 computed base as calculated in paragraph (f). 68.13 Sec. 15. Minnesota Statutes 1998, section 256B.0913, 68.14 subdivision 12, is amended to read: 68.15 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 68.16 all 180-day eligible clients to help pay for the cost of 68.17 participating in the program. The amount of the premium for the 68.18 alternative care client shall be determined as follows: 68.19 (1) when the alternative care client's income less 68.20 recurring and predictable medical expenses is greater than the 68.21 medical assistance income standard but less than 150 percent of 68.22 the federal poverty guideline, and total assets are less than 68.23$6,000$10,000, the fee is zero; 68.24 (2) when the alternative care client's income less 68.25 recurring and predictable medical expenses is greater than 150 68.26 percent of the federal poverty guideline, and total assets are 68.27 less than$6,000$10,000, the fee is 25 percent of the cost of 68.28 alternative care services or the difference between 150 percent 68.29 of the federal poverty guideline and the client's income less 68.30 recurring and predictable medical expenses, whichever is less; 68.31 and 68.32 (3) when the alternative care client's total assets are 68.33 greater than$6,000$10,000, the fee is 25 percent of the cost 68.34 of alternative care services. 68.35 For married persons, total assets are defined as the total 68.36 marital assets less the estimated community spouse asset 69.1 allowance, under section 256B.059, if applicable. For married 69.2 persons, total income is defined as the client's income less the 69.3 monthly spousal allotment, under section 256B.058. 69.4 All alternative care services except case management shall 69.5 be included in the estimated costs for the purpose of 69.6 determining 25 percent of the costs. 69.7 The monthly premium shall be calculated based on the cost 69.8 of the first full month of alternative care services and shall 69.9 continue unaltered until the next reassessment is completed or 69.10 at the end of 12 months, whichever comes first. Premiums are 69.11 due and payable each month alternative care services are 69.12 received unless the actual cost of the services is less than the 69.13 premium. 69.14 (b) The fee shall be waived by the commissioner when: 69.15 (1) a person who is residing in a nursing facility is 69.16 receiving case management only; 69.17 (2) a person is applying for medical assistance; 69.18 (3) a married couple is requesting an asset assessment 69.19 under the spousal impoverishment provisions; 69.20 (4) a person is a medical assistance recipient, but has 69.21 been approved for alternative care-funded assisted living 69.22 services; 69.23 (5) a person is found eligible for alternative care, but is 69.24 not yet receiving alternative care services; or 69.25 (6) a person's fee under paragraph (a) is less than $25. 69.26 (c) The county agency must collect the premium from the 69.27 client and forward the amounts collected to the commissioner in 69.28 the manner and at the times prescribed by the commissioner. 69.29 Money collected must be deposited in the general fund and is 69.30 appropriated to the commissioner for the alternative care 69.31 program. The client must supply the county with the client's 69.32 social security number at the time of application. If a client 69.33 fails or refuses to pay the premium due, the county shall supply 69.34 the commissioner with the client's social security number and 69.35 other information the commissioner requires to collect the 69.36 premium from the client. The commissioner shall collect unpaid 70.1 premiums using the Revenue Recapture Act in chapter 270A and 70.2 other methods available to the commissioner. The commissioner 70.3 may require counties to inform clients of the collection 70.4 procedures that may be used by the state if a premium is not 70.5 paid. 70.6 (d) The commissioner shall begin to adopt emergency or 70.7 permanent rules governing client premiums within 30 days after 70.8 July 1, 1991, including criteria for determining when services 70.9 to a client must be terminated due to failure to pay a premium. 70.10 Sec. 16. Minnesota Statutes 1998, section 256B.0913, 70.11 subdivision 16, is amended to read: 70.12 Subd. 16. [CONVERSION OF ENROLLMENT.] Upon approval of the 70.13 elderly waiver amendments described in section 256B.0915, 70.14 subdivision 1d, persons currently receiving services shall have 70.15 their eligibility for the elderly waiver program determined 70.16 under section 256B.0915. Persons currently receiving 70.17 alternative care services whose income is under the special 70.18 income standard according to Code of Federal Regulations, title 70.19 42, section 435.236, who are eligible for the elderly waiver 70.20 program shall be transferred to that program and shall receive 70.21 priority access to elderly waiver slots for six months after 70.22 implementation of this subdivision, except that persons whose 70.23 income is above the maintenance needs amount described in 70.24 section 256B.0915, subdivision 1d, paragraph (a), shall have the 70.25 option of remaining in the alternative care program. Persons 70.26 currently enrolled in the alternative care program who are not 70.27 eligible for the elderly waiver program shall continue to be 70.28 eligible for the alternative care programas long as continuous70.29eligibility is maintained. Continued eligibility for the70.30alternative care program shall be reviewed every six months.70.31Persons who apply for the alternative care program after70.32approval of the elderly waiver amendments in section 256B.0915,70.33subdivision 1d, are not eligible for alternative care if they70.34would qualify for the elderly waiver, with or without a70.35spenddown. Persons who apply for the alternative care program 70.36 after approval of the elderly waiver amendments in section 71.1 256B.0915, subdivision 1d, whose income is under the special 71.2 income standard according to Code of Federal Regulations, title 71.3 42, section 435.236, are not eligible for alternative care if 71.4 they would qualify for the elderly waiver, except that persons 71.5 whose income is above the maintenance needs amount described in 71.6 section 256B.0915, subdivision 1d, paragraph (a), shall have the 71.7 option of remaining in the alternative care program. 71.8 Sec. 17. Minnesota Statutes 1998, section 256B.431, 71.9 subdivision 2i, is amended to read: 71.10 Subd. 2i. [OPERATING COSTS AFTER JULY 1, 1988.] (a) 71.11 [OTHER OPERATING COST LIMITS.]For the rate year beginning July71.121, 1988, the commissioner shall increase the other operating71.13cost limits established in Minnesota Rules, part 9549.0055,71.14subpart 2, item E, to 110 percent of the median of the array of71.15allowable historical other operating cost per diems and index71.16these limits as in Minnesota Rules, part 9549.0056, subparts 371.17and 4. The limits must be established in accordance with71.18subdivision 2b, paragraph (d).For rate years beginning on or 71.19 after July 1, 1989, the adjusted other operating cost limits 71.20 must be indexed as in Minnesota Rules, part 9549.0056, subparts 71.21 3 and 4. For the rate period beginning October 1, 1992, and for 71.22 rate years beginning after June 30, 1993, the amount of the 71.23 surcharge under section 256.9657, subdivision 1, shall be 71.24 included in the plant operations and maintenance operating cost 71.25 category. The surcharge shall be an allowable cost for the 71.26 purpose of establishing the payment rate. 71.27 (b) [CARE-RELATED OPERATING COST LIMITS.]For the rate year71.28beginning July 1, 1988, the commissioner shall increase the71.29care-related operating cost limits established in Minnesota71.30Rules, part 9549.0055, subpart 2, items A and B, to 125 percent71.31of the median of the array of the allowable historical case mix71.32operating cost standardized per diems and the allowable71.33historical other care-related operating cost per diems and index71.34those limits as in Minnesota Rules, part 9549.0056, subparts 171.35and 2. The limits must be established in accordance with71.36subdivision 2b, paragraph (d).For rate years beginning on or 72.1 after July 1, 1989, the adjusted care-related limits must be 72.2 indexed as in Minnesota Rules, part 9549.0056, subparts 1 and 2. 72.3 (c) [SALARY ADJUSTMENT PER DIEM.] Effective July 1, 1998, 72.4 to June 30, 2000, the commissioner shall make available the 72.5 salary adjustment per diem calculated in clause (1) or (2) to 72.6 the total operating cost payment rate of each nursing facility 72.7 reimbursed under this section or section 256B.434. The salary 72.8 adjustment per diem for each nursing facility must be determined 72.9 as follows: 72.10 (1) For each nursing facility that reports salaries for 72.11 registered nurses, licensed practical nurses, and aides, 72.12 orderlies and attendants separately, the commissioner shall 72.13 determine the salary adjustment per diem by multiplying the 72.14 total salaries, payroll taxes, and fringe benefits allowed in 72.15 each operating cost category, except management fees and 72.16 administrator and central office salaries and the related 72.17 payroll taxes and fringe benefits, by 3.0 percent and then 72.18 dividing the resulting amount by the nursing facility's actual 72.19 resident days. 72.20 (2) For each nursing facility that does not report salaries 72.21 for registered nurses, licensed practical nurses, aides, 72.22 orderlies, and attendants separately, the salary adjustment per 72.23 diem is the weighted average salary adjustment per diem increase 72.24 determined under clause (1). 72.25 (3) A nursing facility may apply for the salary adjustment 72.26 per diem calculated under clauses (1) and (2). The application 72.27 must be made to the commissioner and contain a plan by which the 72.28 nursing facility will distribute the salary adjustment to 72.29 employees of the nursing facility. In order to apply for a 72.30 salary adjustment, a nursing facility reimbursed under section 72.31 256B.434, must report the information required by clause (1) or 72.32 (2) in the application, in the manner specified by the 72.33 commissioner. For nursing facilities in which the employees are 72.34 represented by an exclusive bargaining representative, an 72.35 agreement negotiated and agreed to by the employer and the 72.36 exclusive bargaining representative, after July 1, 1998, may 73.1 constitute the plan for the salary distribution. The 73.2 commissioner shall review the plan to ensure that the salary 73.3 adjustment per diem is used solely to increase the compensation 73.4 of nursing home facility employees. To be eligible, a facility 73.5 must submit its plan for the salary distribution by December 31, 73.6 1998. If a facility's plan for salary distribution is effective 73.7 for its employees after July 1, 1998, the salary adjustment cost 73.8 per diem shall be effective the same date as its plan. 73.9 (4) Additional costs incurred by nursing facilities as a 73.10 result of this salary adjustment are not allowable costs for 73.11 purposes of the September 30, 1998, cost report. 73.12(d) [NEW BASE YEAR.] The commissioner shall establish new73.13base years for both the reporting year ending September 30,73.141989, and the reporting year ending September 30, 1990. In73.15establishing new base years, the commissioner must take into73.16account:73.17(1) statutory changes made in geographic groups;73.18(2) redefinitions of cost categories; and73.19(3) reclassification, pass-through, or exemption of certain73.20costs such as Public Employee Retirement Act contributions.73.21(e)(d) [NEW BASE YEAR.] The commissioner shall establish a 73.22 new base year for the reporting years ending September 30, 1991, 73.23 and September 30, 1992. In establishing a new base year, the 73.24 commissioner must take into account: 73.25 (1) statutory changes made in geographic groups; 73.26 (2) redefinitions of cost categories; and 73.27 (3) reclassification, pass-through, or exemption of certain 73.28 costs. 73.29 Sec. 18. Minnesota Statutes 1998, section 256B.431, 73.30 subdivision 17, is amended to read: 73.31 Subd. 17. [SPECIAL PROVISIONS FOR MORATORIUM EXCEPTIONS.] 73.32 (a) Notwithstanding Minnesota Rules, part 9549.0060, subpart 3, 73.33 for rate periods beginning on October 1, 1992, and for rate 73.34 years beginning after June 30, 1993, a nursing facility that (1) 73.35 has completed a construction project approved under section 73.36 144A.071, subdivision 4a, clause (m); (2) has completed a 74.1 construction project approved under section 144A.071, 74.2 subdivision 4a, and effective after June 30, 1995; or (3) has 74.3 completed a renovation, replacement, or upgrading project 74.4 approved under the moratorium exception process in section 74.5 144A.073 shall be reimbursed for costs directly identified to 74.6 that project as provided in subdivision 16 and this subdivision. 74.7 (b) Notwithstanding Minnesota Rules, part 9549.0060, 74.8 subparts 5, item A, subitems (1) and (3), and 7, item D, 74.9 allowable interest expense on debt shall include: 74.10 (1) interest expense on debt related to the cost of 74.11 purchasing or replacing depreciable equipment, excluding 74.12 vehicles, not to exceed six percent of the total historical cost 74.13 of the project; and 74.14 (2) interest expense on debt related to financing or 74.15 refinancing costs, including costs related to points, loan 74.16 origination fees, financing charges, legal fees, and title 74.17 searches; and issuance costs including bond discounts, bond 74.18 counsel, underwriter's counsel, corporate counsel, printing, and 74.19 financial forecasts. Allowable debt related to items in this 74.20 clause shall not exceed seven percent of the total historical 74.21 cost of the project. To the extent these costs are financed, 74.22 the straight-line amortization of the costs in this clause is 74.23 not an allowable cost; and 74.24 (3) interest on debt incurred for the establishment of a 74.25 debt reserve fund, net of the interest earned on the debt 74.26 reserve fund. 74.27 (c) Debt incurred for costs under paragraph (b) is not 74.28 subject to Minnesota Rules, part 9549.0060, subpart 5, item A, 74.29 subitem (5) or (6). 74.30 (d) The incremental increase in a nursing facility's rental 74.31 rate, determined under Minnesota Rules, parts 9549.0010 to 74.32 9549.0080, and this section, resulting from the acquisition of 74.33 allowable capital assets, and allowable debt and interest 74.34 expense under this subdivision shall be added to its 74.35 property-related payment rate and shall be effective on the 74.36 first day of the month following the month in which the 75.1 moratorium project was completed. 75.2 (e) Notwithstanding subdivision 3f, paragraph (a), for rate 75.3 periods beginning on October 1, 1992, and for rate years 75.4 beginning after June 30, 1993, the replacement-costs-new per bed 75.5 limit to be used in Minnesota Rules, part 9549.0060, subpart 4, 75.6 item B, for a nursing facility that has completed a renovation, 75.7 replacement, or upgrading project that has been approved under 75.8 the moratorium exception process in section 144A.073, or that 75.9 has completed an addition to or replacement of buildings, 75.10 attached fixtures, or land improvements for which the total 75.11 historical cost exceeds the lesser of $150,000 or ten percent of 75.12 the most recent appraised value, must be $47,500 per licensed 75.13 bed in multiple-bed rooms and $71,250 per licensed bed in a 75.14 single-bed room. These amounts must be adjusted annually as 75.15 specified in subdivision 3f, paragraph (a), beginning January 1, 75.16 1993. 75.17 (f) A nursing facility that completes a project identified 75.18 in this subdivision and, as of April 17, 1992, has not been 75.19 mailed a rate notice with a special appraisal for a completed 75.20 project, or completes a project after April 17, 1992, but before 75.21 September 1, 1992, may elect either to request a special 75.22 reappraisal with the corresponding adjustment to the 75.23 property-related payment rate under the laws in effect on June 75.24 30, 1992, or to submit their capital asset and debt information 75.25 after that date and obtain the property-related payment rate 75.26 adjustment under this section, but not both. 75.27 (g) For purposes of this paragraph, a total replacement 75.28 means the complete replacement of the nursing facility's 75.29 physical plant through the construction of a new physical plant 75.30 or the transfer of the nursing facility's license from one 75.31 physical plant location to another. For total replacement 75.32 projects completed on or after July 1, 1992, the commissioner 75.33 shall compute the incremental change in the nursing facility's 75.34 rental per diem, for rate years beginning on or after July 1, 75.35 1995, by replacing its appraised value, including the historical 75.36 capital asset costs, and the capital debt and interest costs 76.1 with the new nursing facility's allowable capital asset costs 76.2 and the related allowable capital debt and interest costs. If 76.3 the new nursing facility has decreased its licensed capacity, 76.4 the aggregate investment per bed limit in subdivision 3a, 76.5 paragraph (d), shall apply. If the new nursing facility has 76.6 retained a portion of the original physical plant for nursing 76.7 facility usage, then a portion of the appraised value prior to 76.8 the replacement must be retained and included in the calculation 76.9 of the incremental change in the nursing facility's rental per 76.10 diem. For purposes of this part, the original nursing facility 76.11 means the nursing facility prior to the total replacement 76.12 project. The portion of the appraised value to be retained 76.13 shall be calculated according to clauses (1) to (3): 76.14 (1) The numerator of the allocation ratio shall be the 76.15 square footage of the area in the original physical plant which 76.16 is being retained for nursing facility usage. 76.17 (2) The denominator of the allocation ratio shall be the 76.18 total square footage of the original nursing facility physical 76.19 plant. 76.20 (3) Each component of the nursing facility's allowable 76.21 appraised value prior to the total replacement project shall be 76.22 multiplied by the allocation ratio developed by dividing clause 76.23 (1) by clause (2). 76.24 In the case of either type of total replacement as 76.25 authorized under section 144A.071 or 144A.073, the provisions of 76.26 this subdivision shall also apply. For purposes of the 76.27 moratorium exception authorized under section 144A.071, 76.28 subdivision 4a, paragraph (s), if the total replacement involves 76.29 the renovation and use of an existing health care facility 76.30 physical plant, the new allowable capital asset costs and 76.31 related debt and interest costs shall include first the 76.32 allowable capital asset costs and related debt and interest 76.33 costs of the renovation, to which shall be added the allowable 76.34 capital asset costs of the existing physical plant prior to the 76.35 renovation, and if reported by the facility, the related 76.36 allowable capital debt and interest costs. 77.1 (h) Notwithstanding Minnesota Rules, part 9549.0060, 77.2 subpart 11, item C, subitem (2), for a total replacement, as 77.3 defined in paragraph (g), authorized under section 144A.071 or 77.4 144A.073 after July 1, 1999, the replacement costs new per bed 77.5 limit shall be $74,280 per licensed bed in multiple-bed rooms, 77.6 $92,850 per licensed bed in semiprivate rooms with a fixed 77.7 partition separating the resident beds, and $111,420 per 77.8 licensed bed in single rooms. Minnesota Rules, part 9549.0060, 77.9 subpart 11, item C, subitem (2), does not apply. These amounts 77.10 must be adjusted annually as specified in subdivision 3f, 77.11 paragraph (a), beginning January 1, 2000. 77.12 (i) For a total replacement, as defined in paragraph (g), 77.13 authorized under section 144A.073 for a 96-bed nursing home in 77.14 Carlton county, the replacement costs new per bed limit shall be 77.15 $74,280 per licensed bed in multiple-bed rooms, $92,850 per 77.16 licensed bed in semiprivate rooms with a fixed partition 77.17 separating the resident's beds, and $111,420 per licensed bed in 77.18 a single room. Minnesota Rules, part 9549.0060, subpart 11, 77.19 item C, subitem (2), does not apply. The resulting maximum 77.20 allowable replacement costs new multiplied by 1.25 shall 77.21 constitute the project's dollar threshold for purposes of 77.22 application of the limit set forth in section 144A.073, 77.23 subdivision 2. The commissioner of health may waive the 77.24 requirements of section 144A.073, subdivision 3b, paragraph (b), 77.25 clause (2), on the condition that the other requirements of that 77.26 paragraph are met. 77.27 Sec. 19. Minnesota Statutes 1998, section 256B.431, 77.28 subdivision 26, is amended to read: 77.29 Subd. 26. [CHANGES TO NURSING FACILITY REIMBURSEMENT 77.30 BEGINNING JULY 1, 1997.] The nursing facility reimbursement 77.31 changes in paragraphs (a) to (f) shall apply in the sequence 77.32 specified in Minnesota Rules, parts 9549.0010 to 9549.0080, and 77.33 this section, beginning July 1, 1997. 77.34 (a) For rate years beginning on or after July 1, 1997, the 77.35 commissioner shall limit a nursing facility's allowable 77.36 operating per diem for each case mix category for each rate year. 78.1 The commissioner shall group nursing facilities into two groups, 78.2 freestanding and nonfreestanding, within each geographic group, 78.3 using their operating cost per diem for the case mix A 78.4 classification. A nonfreestanding nursing facility is a nursing 78.5 facility whose other operating cost per diem is subject to the 78.6 hospital attached, short length of stay, or the rule 80 limits. 78.7 All other nursing facilities shall be considered freestanding 78.8 nursing facilities. The commissioner shall then array all 78.9 nursing facilities in each grouping by their allowable case mix 78.10 A operating cost per diem. In calculating a nursing facility's 78.11 operating cost per diem for this purpose, the commissioner shall 78.12 exclude the raw food cost per diem related to providing special 78.13 diets that are based on religious beliefs, as determined in 78.14 subdivision 2b, paragraph (h). For those nursing facilities in 78.15 each grouping whose case mix A operating cost per diem: 78.16 (1) is at or below the median of the array, the 78.17 commissioner shall limit the nursing facility's allowable 78.18 operating cost per diem for each case mix category to the lesser 78.19 of the prior reporting year's allowable operating cost per diem 78.20 as specified in Laws 1996, chapter 451, article 3, section 11, 78.21 paragraph (h), plus the inflation factor as established in 78.22 paragraph (d), clause (2), increased by two percentage points, 78.23 or the current reporting year's corresponding allowable 78.24 operating cost per diem; or 78.25 (2) is above the median of the array, the commissioner 78.26 shall limit the nursing facility's allowable operating cost per 78.27 diem for each case mix category to the lesser of the prior 78.28 reporting year's allowable operating cost per diem as specified 78.29 in Laws 1996, chapter 451, article 3, section 11, paragraph (h), 78.30 plus the inflation factor as established in paragraph (d), 78.31 clause (2), increased by one percentage point, or the current 78.32 reporting year's corresponding allowable operating cost per diem. 78.33 For purposes of paragraph (a), if a nursing facility 78.34 reports on its cost report a reduction in cost due to a refund 78.35 or credit for a rate year beginning on or after July 1, 1998, 78.36 the commissioner shall increase that facility's spend-up limit 79.1 for the rate year following the current rate year by the amount 79.2 of the cost reduction divided by its resident days for the 79.3 reporting year preceding the rate year in which the adjustment 79.4 is to be made. 79.5 (b) For rate years beginning on or after July 1, 1997, the 79.6 commissioner shall limit the allowable operating cost per diem 79.7 for high cost nursing facilities. After application of the 79.8 limits in paragraph (a) to each nursing facility's operating 79.9 cost per diem, the commissioner shall group nursing facilities 79.10 into two groups, freestanding or nonfreestanding, within each 79.11 geographic group. A nonfreestanding nursing facility is a 79.12 nursing facility whose other operating cost per diem are subject 79.13 to hospital attached, short length of stay, or rule 80 limits. 79.14 All other nursing facilities shall be considered freestanding 79.15 nursing facilities. The commissioner shall then array all 79.16 nursing facilities within each grouping by their allowable case 79.17 mix A operating cost per diem. In calculating a nursing 79.18 facility's operating cost per diem for this purpose, the 79.19 commissioner shall exclude the raw food cost per diem related to 79.20 providing special diets that are based on religious beliefs, as 79.21 determined in subdivision 2b, paragraph (h). For those nursing 79.22 facilities in each grouping whose case mix A operating cost per 79.23 diem exceeds 1.0 standard deviation above the median, the 79.24 commissioner shall reduce their allowable operating cost per 79.25 diem by three percent. For those nursing facilities in each 79.26 grouping whose case mix A operating cost per diem exceeds 0.5 79.27 standard deviation above the median but is less than or equal to 79.28 1.0 standard deviation above the median, the commissioner shall 79.29 reduce their allowable operating cost per diem by two percent. 79.30 However, in no case shall a nursing facility's operating cost 79.31 per diem be reduced below its grouping's limit established at 79.32 0.5 standard deviations above the median. 79.33 (c) For rate years beginning on or after July 1, 1997, the 79.34 commissioner shall determine a nursing facility's efficiency 79.35 incentive by first computing the allowable difference, which is 79.36 the lesser of $4.50 or the amount by which the facility's other 80.1 operating cost limit exceeds its nonadjusted other operating 80.2 cost per diem for that rate year. The commissioner shall 80.3 compute the efficiency incentive by: 80.4 (1) subtracting the allowable difference from $4.50 and 80.5 dividing the result by $4.50; 80.6 (2) multiplying 0.20 by the ratio resulting from clause 80.7 (1), and then; 80.8 (3) adding 0.50 to the result from clause (2); and 80.9 (4) multiplying the result from clause (3) times the 80.10 allowable difference. 80.11 The nursing facility's efficiency incentive payment shall 80.12 be the lesser of $2.25 or the product obtained in clause (4). 80.13 (d) For rate years beginning on or after July 1, 1997, the 80.14 forecasted price index for a nursing facility's allowable 80.15 operating cost per diem shall be determined under clauses (1) 80.16 and (2) using the change in the Consumer Price Index-All Items 80.17 (United States city average) (CPI-U) as forecasted by Data 80.18 Resources, Inc. The commissioner shall use the indices as 80.19 forecasted in the fourth quarter of the calendar year preceding 80.20 the rate year, subject to subdivision 2l, paragraph (c). 80.21 (1) The CPI-U forecasted index for allowable operating cost 80.22 per diem shall be based on the 21-month period from the midpoint 80.23 of the nursing facility's reporting year to the midpoint of the 80.24 rate year following the reporting year. 80.25 (2) For rate years beginning on or after July 1, 1997, the 80.26 forecasted index for operating cost limits referred to in 80.27 subdivision 21, paragraph (b), shall be based on the CPI-U for 80.28 the 12-month period between the midpoints of the two reporting 80.29 years preceding the rate year. 80.30 (e) After applying these provisions for the respective rate 80.31 years, the commissioner shall index these allowable operating 80.32 cost per diem by the inflation factor provided for in paragraph 80.33 (d), clause (1), and add the nursing facility's efficiency 80.34 incentive as computed in paragraph (c). 80.35 (f) For rate years beginning on or after July 1, 1997, the 80.36 total operating cost payment rates for a nursing facility shall 81.1 be the greater of the total operating cost payment rates 81.2 determined under this section or the total operating cost 81.3 payment rates in effect on June 30, 1997, subject to rate 81.4 adjustments due to field audit or rate appeal resolution. This 81.5 provision shall not apply to subsequent field audit adjustments 81.6 of the nursing facility's operating cost rates for rate years 81.7 beginning on or after July 1, 1997. 81.8 (g) For the rate years beginning on July 1, 1997, July 1, 81.9 1998, and July 1, 1999, a nursing facility licensed for 40 beds 81.10 effective May 1, 1992, with a subsequent increase of 20 81.11 Medicare/Medicaid certified beds, effective January 26, 1993, in 81.12 accordance with an increase in licensure is exempt from 81.13 paragraphs (a) and (b). 81.14 (h) For a nursing facility whose construction project was 81.15 authorized according to section 144A.073, subdivision 5, 81.16 paragraph (g), the operating cost payment rates for thethird81.17 new location shall be determined based on Minnesota Rules, part 81.18 9549.0057. The relocation allowed under section 144A.073, 81.19 subdivision 5, paragraph (g), and the rate determination allowed 81.20 under this paragraph must meet the cost neutrality requirements 81.21 of section 144A.073, subdivision 3c. Paragraphs (a) and (b) 81.22 shall not apply until the second rate year after the settle-up 81.23 cost report is filed. Notwithstanding subdivision 2b, paragraph 81.24 (g), real estate taxes and special assessments payable by 81.25 thethirdnew location, a 501(c)(3) nonprofit corporation, shall 81.26 be included in the payment rates determined under this 81.27 subdivision for all subsequent rate years. 81.28 (i) For the rate year beginning July 1, 1997, the 81.29 commissioner shall compute the payment rate for a nursing 81.30 facility licensed for 94 beds on September 30, 1996, that 81.31 applied in October 1993 for approval of a total replacement 81.32 under the moratorium exception process in section 144A.073, and 81.33 completed the approved replacement in June 1995, with other 81.34 operating cost spend-up limit under paragraph (a), increased by 81.35 $3.98, and after computing the facility's payment rate according 81.36 to this section, the commissioner shall make a one-year positive 82.1 rate adjustment of $3.19 for operating costs related to the 82.2 newly constructed total replacement, without application of 82.3 paragraphs (a) and (b). The facility's per diem, before the 82.4 $3.19 adjustment, shall be used as the prior reporting year's 82.5 allowable operating cost per diem for payment rate calculation 82.6 for the rate year beginning July 1, 1998. A facility described 82.7 in this paragraph is exempt from paragraph (b) for the rate 82.8 years beginning July 1, 1997, and July 1, 1998. 82.9 (j) For the purpose of applying the limit stated in 82.10 paragraph (a), a nursing facility in Kandiyohi county licensed 82.11 for 86 beds that was granted hospital-attached status on 82.12 December 1, 1994, shall have the prior year's allowable 82.13 care-related per diem increased by $3.207 and the prior year's 82.14 other operating cost per diem increased by $4.777 before adding 82.15 the inflation in paragraph (d), clause (2), for the rate year 82.16 beginning on July 1, 1997. 82.17 (k) For the purpose of applying the limit stated in 82.18 paragraph (a), a 117 bed nursing facility located in Pine county 82.19 shall have the prior year's allowable other operating cost per 82.20 diem increased by $1.50 before adding the inflation in paragraph 82.21 (d), clause (2), for the rate year beginning on July 1, 1997. 82.22 (l) For the purpose of applying the limit under paragraph 82.23 (a), a nursing facility in Hibbing licensed for 192 beds shall 82.24 have the prior year's allowable other operating cost per diem 82.25 increased by $2.67 before adding the inflation in paragraph (d), 82.26 clause (2), for the rate year beginning July 1, 1997. 82.27 Sec. 20. Minnesota Statutes 1998, section 256B.431, is 82.28 amended by adding a subdivision to read: 82.29 Subd. 28. [NURSING FACILITY RATE INCREASES BEGINNING JULY 82.30 1, 1999, AND JULY 1, 2000.] (a) For the rate year beginning July 82.31 1, 1999, the commissioner shall make available an operating 82.32 payment rate increase equal to four percent. The commissioner 82.33 shall make available salary adjustments equal to 4.75 percent in 82.34 each category except management fees and administrator and 82.35 central office, which shall be used solely to increase wages or 82.36 pay payroll taxes associated with these wage increases, and 83.1 shall use the remainder of the amount appropriated by the 83.2 legislature to increase per diem payment rates in all operating 83.3 rate categories not subject to the 4.75 percent increase. 83.4 (b) For the rate year beginning July 1, 2000, the 83.5 commissioner shall make available an operating payment rate 83.6 increase equal to three percent. The commissioner shall make 83.7 available salary adjustments equal to 3.5 percent in each 83.8 category except management fees and administrator and central 83.9 office, which shall be used solely to increase wages or pay 83.10 payroll taxes associated with these wage increases, and shall 83.11 use the remainder of the amount appropriated to increase per 83.12 diem payment rates in all operating rate categories not subject 83.13 to the 3.5 percent increase. 83.14 (c) Effective July 1, 1999, to June 30, 2001, the 83.15 commissioner shall make available the salary adjustment per diem 83.16 calculated in clause (1) or (2) to the total operating cost 83.17 payment rate of each nursing facility reimbursed under this 83.18 section or section 256B.434. The salary adjustment per diem for 83.19 each nursing facility must be determined as follows: 83.20 (1) for each nursing facility that reports salaries for 83.21 registered nurses, licensed practical nurses, and aides, 83.22 orderlies, and attendants separately, the commissioner shall 83.23 determine the salary adjustment per diem by multiplying the 83.24 total salaries, payroll taxes, and fringe benefits allowed in 83.25 each operating cost category, except management fees and 83.26 administrator and central office salaries and the related 83.27 payroll taxes and fringe benefits, by 4.75 percent and 3.5 83.28 percent respectively, and then dividing the resulting amount by 83.29 the nursing facility's actual resident days; 83.30 (2) for each nursing facility that does not report salaries 83.31 for registered nurses, licensed practical nurses, aides, 83.32 orderlies, and attendants separately, the salary adjustment per 83.33 diem is the weighted average salary adjustment per diem increase 83.34 determined under clause (1); 83.35 (3) a nursing facility may apply for the salary adjustment 83.36 per diem calculated under clauses (1) and (2). The application 84.1 must be made to the commissioner and contain a plan by which the 84.2 nursing facility will distribute the salary adjustment to 84.3 employees of the nursing facility. In order to apply for a 84.4 salary adjustment, a nursing facility reimbursed under section 84.5 256B.434 must report the information required by clause (1) or 84.6 (2) in the application, in the manner specified by the 84.7 commissioner. For nursing facilities in which the employees are 84.8 represented by an exclusive bargaining representative, an 84.9 agreement negotiated and agreed to by the employer and the 84.10 exclusive bargaining representative may constitute the plan for 84.11 the salary distribution. The commissioner shall review the plan 84.12 to ensure that the salary adjustment per diem is used solely to 84.13 increase the wages of nursing home facility employees and pay 84.14 payroll taxes associated with these increased wages. To be 84.15 eligible, a facility must submit its plan for the salary 84.16 distribution by December 31 each year. A facility may amend its 84.17 plan for the second rate year by submitting a revised plan by 84.18 December 31, 2000. If a facility's plan for salary distribution 84.19 is effective for its employees after July 1 of the year that the 84.20 funds are available, the salary adjustment cost per diem shall 84.21 be effective the same date as its plan; and 84.22 (4) additional costs incurred by nursing facilities as a 84.23 result of this salary adjustment are not allowable costs for 84.24 purposes of the September 30, 1999, or September 30, 2000, cost 84.25 report. 84.26 (d) A copy of the approved distribution plan must be made 84.27 available to all employees. This must be done by giving each 84.28 employee a copy or by posting it in an area of the nursing 84.29 facility to which all employees have access. If an employee 84.30 does not receive the salary adjustment described in their 84.31 facility's approved plan and is unable to resolve the problem 84.32 with the facility's management, the employee may contact the 84.33 employee's union representative. If the employee is not covered 84.34 by a collective bargaining agreement, the employee may contact 84.35 the commissioner at a phone number provided by the commissioner 84.36 and included in the approved plan. 85.1 (e) For the rate year beginning July 1, 1999, the following 85.2 nursing facilities shall be allowed a rate increase equal to 67 85.3 percent of the rate increase that would be allowed if 85.4 subdivision 26, paragraph (a), was not applied: 85.5 (1) a nursing facility in Carver county licensed for 33 85.6 nursing home beds and four boarding care beds; 85.7 (2) a nursing facility in Faribault county licensed for 159 85.8 nursing home beds on September 30, 1998; and 85.9 (3) a nursing facility in Houston county licensed for 68 85.10 nursing home beds on September 30, 1998. 85.11 (f) For the rate year beginning July 1, 1999, the following 85.12 nursing facilities shall be allowed a rate increase equal to 67 85.13 percent of the rate increase that would be allowed if 85.14 subdivision 26, paragraphs (a) and (b), were not applied: 85.15 (1) a nursing facility in Chisago county licensed for 135 85.16 nursing home beds on September 30, 1998; and 85.17 (2) a nursing facility in Murray county licensed for 62 85.18 nursing home beds on September 30, 1998. 85.19 (g) For the rate year beginning July 1, 1999, a nursing 85.20 facility in Hennepin county licensed for 134 beds on September 85.21 30, 1998, shall: 85.22 (1) have the prior year's allowable care-related per diem 85.23 increased by $3.93 and the prior year's other operating cost per 85.24 diem increased by $1.69 before adding the inflation in 85.25 subdivision 26, paragraph (d), clause (2); and 85.26 (2) be allowed a rate increase equal to 67 percent of the 85.27 rate increase that would be allowed if subdivision 26, 85.28 paragraphs (a) and (b), were not applied. 85.29 Sec. 21. Minnesota Statutes 1998, section 256B.434, 85.30 subdivision 3, is amended to read: 85.31 Subd. 3. [DURATION AND TERMINATION OF CONTRACTS.] (a) 85.32 Subject to available resources, the commissioner may begin to 85.33 execute contracts with nursing facilities November 1, 1995. 85.34 (b) All contracts entered into under this section are for a 85.35 term of one year. Either party may terminate a contract at any 85.36 time without cause by providing3090 calendar days advance 86.1 written notice to the other party. The decision to terminate a 86.2 contract is not appealable.If neither party provides written86.3notice of termination the contract shall be renegotiated for86.4additional one-year terms, for up to a total of four consecutive86.5one-year termsNotwithstanding section 16C.05, subdivision 2, 86.6 paragraph (a), clause (5), the contract shall be renegotiated 86.7 for additional one-year terms unless either party provides 86.8 written notice of termination. The provisions of the contract 86.9 shall be renegotiated annually by the parties prior to the 86.10 expiration date of the contract. The parties may voluntarily 86.11 renegotiate the terms of the contract at any time by mutual 86.12 agreement. 86.13 (c) If a nursing facility fails to comply with the terms of 86.14 a contract, the commissioner shall provide reasonable notice 86.15 regarding the breach of contract and a reasonable opportunity 86.16 for the facility to come into compliance. If the facility fails 86.17 to come into compliance or to remain in compliance, the 86.18 commissioner may terminate the contract. If a contract is 86.19 terminated, the contract payment remains in effect for the 86.20 remainder of the rate year in which the contract was terminated, 86.21 but in all other respects the provisions of this section do not 86.22 apply to that facility effective the date the contract is 86.23 terminated. The contract shall contain a provision governing 86.24 the transition back to the cost-based reimbursement system 86.25 established under section 256B.431, subdivision 25, and 86.26 Minnesota Rules, parts 9549.0010 to 9549.0080. A contract 86.27 entered into under this section may be amended by mutual 86.28 agreement of the parties. 86.29 Sec. 22. Minnesota Statutes 1998, section 256B.434, 86.30 subdivision 4, is amended to read: 86.31 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 86.32 nursing facilities which have their payment rates determined 86.33 under this section rather than section 256B.431, subdivision 25, 86.34 the commissioner shall establish a rate under this subdivision. 86.35 The nursing facility must enter into a written contract with the 86.36 commissioner. 87.1 (b) A nursing facility's case mix payment rate for the 87.2 first rate year of a facility's contract under this section is 87.3 the payment rate the facility would have received under section 87.4 256B.431, subdivision 25. 87.5 (c) A nursing facility's case mix payment rates for the 87.6 second and subsequent years of a facility's contract under this 87.7 section are the previous rate year's contract payment rates plus 87.8 an inflation adjustment. The index for the inflation adjustment 87.9 must be based on the change in the Consumer Price Index-All 87.10 Items (United States City average) (CPI-U) forecasted by Data 87.11 Resources, Inc., as forecasted in the fourth quarter of the 87.12 calendar year preceding the rate year. The inflation adjustment 87.13 must be based on the 12-month period from the midpoint of the 87.14 previous rate year to the midpoint of the rate year for which 87.15 the rate is being determined. This paragraph shall not apply 87.16 for the rate years beginning July 1, 1999, and July 1, 2000. 87.17 (d) The commissioner shall develop additional 87.18 incentive-based payments of up to five percent above the 87.19 standard contract rate for achieving outcomes specified in each 87.20 contract. The specified facility-specific outcomes must be 87.21 measurable and approved by the commissioner. The commissioner 87.22 may establish, for each contract, various levels of achievement 87.23 within an outcome. After the outcomes have been specified the 87.24 commissioner shall assign various levels of payment associated 87.25 with achieving the outcome. Any incentive-based payment cancels 87.26 if there is a termination of the contract. In establishing the 87.27 specified outcomes and related criteria the commissioner shall 87.28 consider the following state policy objectives: 87.29 (1) improved cost effectiveness and quality of life as 87.30 measured by improved clinical outcomes; 87.31 (2) successful diversion or discharge to community 87.32 alternatives; 87.33 (3) decreased acute care costs; 87.34 (4) improved consumer satisfaction; 87.35 (5) the achievement of quality; or 87.36 (6) any additional outcomes proposed by a nursing facility 88.1 that the commissioner finds desirable. 88.2 Sec. 23. Minnesota Statutes 1998, section 256B.434, is 88.3 amended by adding a subdivision to read: 88.4 Subd. 4a. [FACILITY RATE INCREASES.] For the rate year 88.5 beginning July 1, 1999, the nursing facilities described in 88.6 clauses (1) to (4) shall receive the rate increases indicated. 88.7 The increases provided under this subdivision shall be included 88.8 in the facility's total payment rates for the purpose of 88.9 determining future rates under this section or any other section: 88.10 (1) a nursing facility in Becker county licensed for 102 88.11 nursing home beds on September 30, 1998, shall receive an 88.12 increase of $1.30 in its case mix class A payment rate; an 88.13 increase of $1.33 in its case mix class B payment rate; an 88.14 increase of $1.36 in its case mix class C payment rate; an 88.15 increase of $1.39 in its case mix class D payment rate; an 88.16 increase of $1.42 in its case mix class E payment rate; an 88.17 increase of $1.42 in its case mix class F payment rate; an 88.18 increase of $1.45 in its case mix class G payment rate; an 88.19 increase of $1.49 in its case mix class H payment rate; an 88.20 increase of $1.51 in its case mix class I payment rate; an 88.21 increase of $1.54 in its case mix class J payment rate; and an 88.22 increase of $1.59 in its case mix class K payment rate; 88.23 (2) a nursing facility in Chisago county licensed for 101 88.24 nursing home beds on September 30, 1998, shall receive an 88.25 increase of $3.67 in each case mix payment rate; 88.26 (3) a nursing facility in Canby, licensed for 75 beds shall 88.27 have its property-related per diem rate increased by $1.21. 88.28 This increase shall be recognized in the facility's contract 88.29 payment rate under this section; and 88.30 (4) a nursing facility in Golden Valley with all its beds 88.31 licensed to provide residential rehabilitative services to young 88.32 adults under Minnesota Rules, parts 9570.2000 to 9570.3400, 88.33 shall have the payment rate computed according to this section 88.34 increased by $14.83. 88.35 Sec. 24. Minnesota Statutes 1998, section 256B.434, 88.36 subdivision 13, is amended to read: 89.1 Subd. 13. [PAYMENT SYSTEM REFORM ADVISORY COMMITTEE.](a)89.2 The commissioner, in consultation with an advisory committee, 89.3 shall study options for reforming the regulatory and 89.4 reimbursement system for nursing facilities to reduce the level 89.5 of regulation, reporting, and procedural requirements, and to 89.6 provide greater flexibility and incentives to stimulate 89.7 competition and innovation. The advisory committee shall 89.8 include, at a minimum, representatives from the long-term care 89.9 provider community, the department of health, and consumers of 89.10 long-term care services.The advisory committee sunsets on June89.1130, 1997.Among other things, the commissioner shall consider 89.12 the feasibility and desirability of changing from a 89.13 certification requirement to an accreditation requirement for 89.14 participation in the medical assistance program, options to 89.15 encourage early discharge of short-term residents through the 89.16 provision of intensive therapy, and further modifications needed 89.17 in rate equalization. The commissioner shall also include 89.18 detailed recommendations for a permanent managed care payment 89.19 system to replace the contractual alternative payment 89.20 demonstration project authorized under this section. The 89.21 commissioner shall submit a report with findings and 89.22 recommendations to the legislature by January 15, 1997. 89.23(b) If a permanent managed care payment system has not been89.24enacted into law by July 1, 1997, the commissioner shall develop89.25and implement a transition plan to enable nursing facilities89.26under contract with the commissioner under this section to89.27revert to the cost-based payment system at the expiration of the89.28alternative payment demonstration project. The commissioner89.29shall include in the alternative payment demonstration project89.30contracts entered into under this section a provision to permit89.31an amendment to the contract to be made after July 1, 1997,89.32governing the transition back to the cost-based payment system.89.33The transition plan and contract amendments are not subject to89.34rulemaking requirements.89.35 Sec. 25. Minnesota Statutes 1998, section 256B.435, is 89.36 amended to read: 90.1 256B.435 [NURSING FACILITY REIMBURSEMENT SYSTEM EFFECTIVE 90.2 JULY 1,20002001.] 90.3 Subdivision 1. [IN GENERAL.] Effective July 1,20002001, 90.4 the commissioner shall implement a performance-based contracting 90.5 system to replace the current method of setting operating cost 90.6 payment rates under sections 256B.431 and 256B.434 and Minnesota 90.7 Rules, parts 9549.0010 to 9549.0080. Operating cost payment 90.8 rates for newly established facilities under Minnesota Rules, 90.9 part 9549.0057, shall be established using section 256B.431 and 90.10 Minnesota Rules, parts 9549.0010 to 9549.0070. A nursing 90.11 facility in operation on May 1, 1998, with payment rates not 90.12 established under section 256B.431 or 256B.434 on that date, is 90.13 ineligible for this performance-based contracting system. In 90.14 determining prospective payment rates of nursing facility 90.15 services, the commissioner shall distinguish between operating 90.16 costs and property-related costs. The commissioner of finance 90.17 shall include an annual inflationary adjustment in operating 90.18 costs for nursing facilities using the inflation factor 90.19 specified in subdivision 3 and funding for incentive-based 90.20 payments as a budget change request in each biennial detailed 90.21 expenditure budget submitted to the legislature under section 90.22 16A.11. Property related payment rates, including real estate 90.23 taxes and special assessments, shall be determined under section 90.24 256B.431 or 256B.434 or under a new property-related 90.25 reimbursement system, if one is implemented by the commissioner 90.26 under subdivision 3. The commissioner shall present additional 90.27 recommendations for performance-based contracting for nursing 90.28 facilities to the legislature by February 15, 2000, in the 90.29 following specific areas: 90.30 (1) development of an interim default payment mechanism for 90.31 nursing facilities that do not respond to the state's request 90.32 for proposal but wish to continue participation in the medical 90.33 assistance program, and nursing facilities the state does not 90.34 select in the request for proposal process, and nursing 90.35 facilities whose contract has been canceled; 90.36 (2) development of criteria for facilities to earn 91.1 performance-based incentive payments based on relevant outcomes 91.2 negotiated by nursing facilities and the commissioner and that 91.3 recognize both continuous quality efforts and quality 91.4 improvement; 91.5 (3) development of criteria and a process under which 91.6 nursing facilities can request rate adjustments for low base 91.7 rates, geographic disparities, or other reasons; 91.8 (4) development of a dispute resolution mechanism for 91.9 nursing facilities that are denied a contract, denied incentive 91.10 payments, or denied a rate adjustment; 91.11 (5) development of a property payment system to address the 91.12 capital needs of nursing facilities that will be funded with 91.13 additional appropriations; 91.14 (6) establishment of a transitional plan to move from dual 91.15 assessment instruments to the federally mandated resident 91.16 assessment system, whereby the financial impact for each 91.17 facility would be budget neutral; 91.18 (7) identification of net cost implications for facilities 91.19 and to the department of preparing for and implementing 91.20 performance-based contracting or any proposed alternative 91.21 system; 91.22 (8) identification of facility financial and statistical 91.23 reporting requirements; and 91.24 (9) identification of exemptions from current regulations 91.25 and statutes applicable under performance-based contracting. 91.26 Subd. 1a. [REQUESTS FOR PROPOSALS.] (a) For nursing 91.27 facilities with rates established under section 256B.434 on 91.28 January 1, 2001, the commissioner shall renegotiate contracts 91.29 without requiring a response to a request for proposal, 91.30 notwithstanding the solicitation process described in chapter 91.31 16C. 91.32 (b) Prior to July 1, 2001, the commissioner shall publish 91.33 in the State Register a request for proposals to provide nursing 91.34 facility services according to this section. The commissioner 91.35 will consider proposals from all nursing facilities that have 91.36 payment rates established under section 256B.431. The 92.1 commissioner must respond to all proposals in a timely manner. 92.2 (c) In issuing a request for proposals, the commissioner 92.3 may develop reasonable requirements which, in the judgment of 92.4 the commissioner, are necessary to protect residents or ensure 92.5 that the performance-based contracting system furthers the 92.6 interests of the state of Minnesota. The request for proposals 92.7 may include, but need not be limited to: 92.8 (1) a requirement that a nursing facility make reasonable 92.9 efforts to maximize Medicare payments on behalf of eligible 92.10 residents; 92.11 (2) requirements designed to prevent inappropriate or 92.12 illegal discrimination against residents enrolled in the medical 92.13 assistance program as compared to private paying residents; 92.14 (3) requirements designed to ensure that admissions to a 92.15 nursing facility are appropriate and that reasonable efforts are 92.16 made to place residents in home and community-based settings 92.17 when appropriate; 92.18 (4) a requirement to agree to participate in the 92.19 development of data collection systems and outcome-based 92.20 standards. Among other requirements specified by the 92.21 commissioner, each facility entering into a contract may be 92.22 required to pay an annual fee not to exceed $1,000. The 92.23 commissioner must use revenue generated from the fees to 92.24 contract with a qualified consultant or contractor to develop 92.25 data collection systems and outcome-based contracting standards; 92.26 (5) a requirement that Medicare-certified contractors agree 92.27 to maintain Medicare cost reports and to submit them to the 92.28 commissioner upon request, or at times specified by the 92.29 commissioner; and that contractors that are not 92.30 Medicare-certified agree to maintain a uniform cost report in a 92.31 format established by the commissioner and to submit the report 92.32 to the commissioner upon request, or at times specified by the 92.33 commissioner; 92.34 (6) a requirement that demonstrates willingness and ability 92.35 to develop and maintain data collection and retrieval systems to 92.36 measure outcomes; and 93.1 (7) a requirement to provide all information and assurances 93.2 required by the terms and conditions of the federal waiver or 93.3 federal approval. 93.4 (d) In addition to the information and assurances contained 93.5 in the submitted proposals, the commissioner may consider the 93.6 following criteria in developing the terms of the contract: 93.7 (1) the facility's history of compliance with federal and 93.8 state laws and rules. A facility deemed to be in substantial 93.9 compliance with federal and state laws and rules is eligible to 93.10 respond to a request for proposals. A facility's compliance 93.11 history shall not be the sole determining factor in situations 93.12 where the facility has been sold and the new owners have 93.13 submitted a proposal; 93.14 (2) whether the facility has a record of excessive 93.15 licensure fines or sanctions or fraudulent cost reports; 93.16 (3) the facility's financial history and solvency; and 93.17 (4) other factors identified by the commissioner deemed 93.18 relevant to developing the terms of the contract, including a 93.19 determination that a contract with a particular facility is not 93.20 in the best interests of the residents of the facility or the 93.21 state of Minnesota. 93.22 (e) Notwithstanding the requirements of the solicitation 93.23 process described in chapter 16C, the commissioner may contract 93.24 with nursing facilities established according to section 93.25 144A.073 without issuing a request for proposals. 93.26 (f) Notwithstanding subdivision 1, after July 1, 2001, the 93.27 commissioner may contract with additional nursing facilities, 93.28 according to requests for proposals. 93.29 Subd. 2. [CONTRACT PROVISIONS.] (a) The performance-based 93.30 contract with each nursing facility must include provisions that: 93.31 (1) apply the resident case mix assessment provisions of 93.32 Minnesota Rules, parts 9549.0051, 9549.0058, and 9549.0059, or 93.33 another assessment system, with the goal of moving to a single 93.34 assessment system; 93.35 (2) monitor resident outcomes through various methods, such 93.36 as quality indicators based on the minimum data set and other 94.1 utilization and performance measures; 94.2 (3) require the establishment and use of a continuous 94.3 quality improvement process that integrates information from 94.4 quality indicators and regular resident and family satisfaction 94.5 interviews; 94.6 (4) require annual reporting of facility statistical 94.7 information, including resident days by case mix category, 94.8 productive nursing hours, wages and benefits, and raw food costs 94.9 for use by the commissioner in the development of facility 94.10 profiles that include trends in payment and service utilization; 94.11 (5) require from each nursing facility an annual certified 94.12 audited financial statement consisting of a balance sheet, 94.13 income and expense statements, and an opinion from either a 94.14 licensed or certified public accountant, if a certified audit 94.15 was prepared, or unaudited financial statements if no certified 94.16 audit was prepared;and94.17 (6) specify the method for resolving disputes; and 94.18 (7) establish additional requirementsand penaltiesfor 94.19 nursing facilities not meeting the standards set forth in the 94.20 performance-based contract. 94.21 (b) The commissioner may develop additional incentive-based 94.22 payments for achieving specified outcomes specified in each 94.23 contract. The specified facility-specific outcomes must be 94.24 measurable and approved by the commissioner. 94.25 (c) The commissioner may also contract with nursing 94.26 facilities in other ways through requests for proposals, 94.27 including contracts on a risk or nonrisk basis, with nursing 94.28 facilities or consortia of nursing facilities, to provide 94.29 comprehensive long-term care coverage on a premium or capitated 94.30 basis. 94.31 (d) The commissioner may negotiate different contract terms 94.32 for different nursing facilities. 94.33 Subd. 2a. [DURATION AND TERMINATION OF CONTRACTS.] (a) All 94.34 contracts entered into under this section are for a term of one 94.35 year. Either party may terminate this contract at any time 94.36 without cause by providing 90 calendar days' advance written 95.1 notice to the other party. Notwithstanding section 16C.05, 95.2 subdivisions 2, paragraph (a), and 5, if neither party provides 95.3 written notice of termination, the contract shall be 95.4 renegotiated for additional one-year terms or the terms of the 95.5 existing contract will be extended for one year. The provisions 95.6 of the contract shall be renegotiated annually by the parties 95.7 prior to the expiration date of the contract. The parties may 95.8 voluntarily renegotiate the terms of the contract at any time by 95.9 mutual agreement. 95.10 (b) If a nursing facility fails to comply with the terms of 95.11 a contract, the commissioner shall provide reasonable notice 95.12 regarding the breach of contract and a reasonable opportunity 95.13 for the facility to come into compliance. If the facility fails 95.14 to come into compliance or to remain in compliance, the 95.15 commissioner may terminate the contract. If a contract is 95.16 terminated, provisions of section 256B.48, subdivision 1a, shall 95.17 apply. 95.18 Subd. 3. [PAYMENT RATE PROVISIONS.] (a) For rate years 95.19 beginning on or after July 1,20002001, within the limits of 95.20 appropriations specifically for this purpose, the commissioner 95.21 shall determine operating cost payment rates for each licensed 95.22 and certified nursing facility by indexing its operating cost 95.23 payment rates in effect on June 30,20002001, for inflation. 95.24The inflation factor to be used must be based on the change in95.25the Consumer Price Index-All Items, United States city average95.26(CPI-U) as forecasted by Data Resources, Inc. in the fourth95.27quarter preceding the rate year.For rate years beginning on or 95.28 after July 1, 2001, the inflation factor must be based on the 95.29 change in the Employment Cost Index for Private Industry Workers 95.30 - Total Compensation as forecasted by Data Resources, Inc., in 95.31 the fourth quarter preceding the rate year. TheCPI-U95.32 forecasted index for operating cost payment rates shall be based 95.33 on the 12-month period from the midpoint of the nursing 95.34 facility's prior rate year to the midpoint of the rate year for 95.35 which the operating payment rate is being determined. The 95.36 operating cost payment rate to be inflated shall be the total 96.1 payment rate in effect on June 30, 2001, minus the portion 96.2 determined to be the property-related payment rate, minus the 96.3 per diem amount of the preadmission screening cost included in 96.4 the nursing facility's last payment rate established under 96.5 section 256B.431. 96.6 (b)Beginning July 1, 2000, each nursing facility subject96.7to a performance-based contract under this section shall choose96.8one of two methods of payment for property-related costs:96.9(1) the method established in section 256B.434; or96.10(2) the method established in section 256B.431.96.11Once the nursing facility has made the election in this96.12paragraph, that election shall remain in effect for at least96.13four years or until an alternative property payment system is96.14developed.A per diem amount for preadmission screening will be 96.15 added onto the contract payment rates according to the method of 96.16 distribution of county allocation described in section 96.17 256B.0911, subdivision 6, paragraph (a). 96.18 (c) For rate years beginning on or after July 1,20002001, 96.19 the commissioner may implement a new method of payment for 96.20 property-related costs that addresses the capital needs of 96.21 facilities.Notwithstanding paragraph (b),The new property 96.22 payment system or systems, if implemented, shall replace the 96.23 currentmethodmethods of setting property payment rates under 96.24 sections 256B.431 and 256B.434. 96.25 Subd. 4. [CONTRACT PAYMENT RATES; APPEALS.] If an appeal 96.26 is pending concerning the cost-based payment rates that are the 96.27 basis for the calculation of the payment rate under this 96.28 section, the commissioner and the nursing facility may agree on 96.29 an interim contract rate to be used until the appeal is 96.30 resolved. When the appeal is resolved, the contract rate must 96.31 be adjusted retroactively according to the appeal decision. 96.32 Subd. 5. [CONSUMER PROTECTION.] In addition to complying 96.33 with all applicable laws regarding consumer protection, as a 96.34 condition of entering into a contract under this section, a 96.35 nursing facility must agree to: 96.36 (1) establish resident grievance procedures; 97.1 (2) establish expedited grievance procedures to resolve 97.2 complaints made by short-stay residents; and 97.3 (3) make available to residents and families a copy of the 97.4 performance-based contract and outcomes to be achieved. 97.5 Subd. 6. [CONTRACTS ARE VOLUNTARY.] Participation of 97.6 nursing facilities in the medical assistance program is 97.7 voluntary. The terms and procedures governing the 97.8 performance-based contract are determined under this section and 97.9 through negotiations between the commissioner and nursing 97.10 facilities. 97.11 Subd. 7. [FEDERAL REQUIREMENTS.] The commissioner shall 97.12 implement the performance-based contracting system subject to 97.13 any required federal waivers or approval and in a manner that is 97.14 consistent with federal requirements. If a provision of this 97.15 section is inconsistent with a federal requirement, the federal 97.16 requirement supersedes the inconsistent provision. The 97.17 commissioner shall seek federal approval and request waivers as 97.18 necessary to implement this section. 97.19 Subd. 8. [QUALITY MEASURES.] On or after July 1, 1999, the 97.20 commissioner shall implement quality measures, as they are 97.21 developed, for nursing facilities reimbursed under this section, 97.22 section 256B.431, or 256B.434, and shall publicly disclose the 97.23 findings of these measures. Quality measures the commissioner 97.24 may consider include the measures of nursing facility 97.25 performance in clauses (1) to (6): 97.26 (1) quality indicator measures of clinical outcomes; 97.27 (2) findings of the department of health in licensing and 97.28 certification surveys, complaint investigations, and case mix 97.29 reviews; 97.30 (3) measures of the nursing facility's impact on the 97.31 quality of life of residents; 97.32 (4) standardized measures of consumer satisfaction; 97.33 (5) measures of progress on quality improvement; and 97.34 (6) additional measures proposed by nursing facilities that 97.35 the commissioner finds desirable. 97.36 Sec. 26. Minnesota Statutes 1998, section 256B.48, 98.1 subdivision 1, is amended to read: 98.2 Subdivision 1. [PROHIBITED PRACTICES.] A nursing facility 98.3 is not eligible to receive medical assistance payments unless it 98.4 refrains from all of the following: 98.5 (a) Charging private paying residents rates for similar 98.6 services which exceed those which are approved by the state 98.7 agency for medical assistance recipients as determined by the 98.8 prospective desk audit rate, except under the following 98.9 circumstances: the nursing facility may (1) charge private 98.10 paying residents a higher rate for a private room, and (2) 98.11 charge for special services which are not included in the daily 98.12 rate if medical assistance residents are charged separately at 98.13 the same rate for the same services in addition to the daily 98.14 rate paid by the commissioner. Services covered by the payment 98.15 rate must be the same regardless of payment source. Special 98.16 services, if offered, must be available to all residents in all 98.17 areas of the nursing facility and charged separately at the same 98.18 rate. Residents are free to select or decline special 98.19 services. Special services must not include services which must 98.20 be provided by the nursing facility in order to comply with 98.21 licensure or certification standards and that if not provided 98.22 would result in a deficiency or violation by the nursing 98.23 facility. Services beyond those required to comply with 98.24 licensure or certification standards must not be charged 98.25 separately as a special service if they were included in the 98.26 payment rate for the previous reporting year. A nursing 98.27 facility that charges a private paying resident a rate in 98.28 violation of this clause is subject to an action by the state of 98.29 Minnesota or any of its subdivisions or agencies for civil 98.30 damages. A private paying resident or the resident's legal 98.31 representative has a cause of action for civil damages against a 98.32 nursing facility that charges the resident rates in violation of 98.33 this clause. The damages awarded shall include three times the 98.34 payments that result from the violation, together with costs and 98.35 disbursements, including reasonable attorneys' fees or their 98.36 equivalent. A private paying resident or the resident's legal 99.1 representative, the state, subdivision or agency, or a nursing 99.2 facility may request a hearing to determine the allowed rate or 99.3 rates at issue in the cause of action. Within 15 calendar days 99.4 after receiving a request for such a hearing, the commissioner 99.5 shall request assignment of an administrative law judge under 99.6 sections 14.48 to 14.56 to conduct the hearing as soon as 99.7 possible or according to agreement by the parties. The 99.8 administrative law judge shall issue a report within 15 calendar 99.9 days following the close of the hearing. The prohibition set 99.10 forth in this clause shall not apply to facilities licensed as 99.11 boarding care facilities which are not certified as skilled or 99.12 intermediate care facilities level I or II for reimbursement 99.13 through medical assistance. 99.14 (b)Requiring(1) Charging, soliciting, accepting, or 99.15 receiving from an applicant for admission to the facility, or 99.16the guardian or conservatorfrom anyone acting in behalf of the 99.17 applicant, as a condition of admission,to payexpediting the 99.18 admission, or as a requirement for the individual's continued 99.19 stay, any feeor, depositin excess of $100, gift, money, 99.20 donation, or other consideration not otherwise required as 99.21 payment under the state plan. Nothing in this clause would 99.22 prohibit discharge for nonpayment of services in accordance with 99.23 state and federal regulations; 99.24 (2) requiring an individual, or anyone acting in behalf of 99.25 the individual, to loan any money to the nursing facility, or; 99.26 (3) requiring an individual, or anyone acting in behalf of 99.27 the individual, to promise to leave all or part of the 99.28applicant'sindividual's estate to the facility; or 99.29 (4) requiring a third-party guarantee of payment to the 99.30 facility as a condition of admission, expedited admission, or 99.31 continued stay in the facility. 99.32 (c) requiring any resident of the nursing facility to 99.33 utilize a vendor of health care services chosen by the nursing 99.34 facility. 99.35 (d) Providing differential treatment on the basis of status 99.36 with regard to public assistance. 100.1 (e) Discriminating in admissions, services offered, or room 100.2 assignment on the basis of status with regard to public 100.3 assistance or refusal to purchase special services. Admissions 100.4 discrimination shall include, but is not limited to: 100.5 (1) basing admissions decisions upon assurance by the 100.6 applicant to the nursing facility, or the applicant's guardian 100.7 or conservator, that the applicant is neither eligible for nor 100.8 will seek public assistance for payment of nursing facility care 100.9 costs; and 100.10 (2) engaging in preferential selection from waiting lists 100.11 based on an applicant's ability to pay privately or an 100.12 applicant's refusal to pay for a special service. 100.13 The collection and use by a nursing facility of financial 100.14 information of any applicant pursuant to a preadmission 100.15 screening program established by law shall not raise an 100.16 inference that the nursing facility is utilizing that 100.17 information for any purpose prohibited by this paragraph. 100.18 (f) Requiring any vendor of medical care as defined by 100.19 section 256B.02, subdivision 7, who is reimbursed by medical 100.20 assistance under a separate fee schedule, to pay any amount 100.21 based on utilization or service levels or any portion of the 100.22 vendor's fee to the nursing facility except as payment for 100.23 renting or leasing space or equipment or purchasing support 100.24 services from the nursing facility as limited by section 100.25 256B.433. All agreements must be disclosed to the commissioner 100.26 upon request of the commissioner. Nursing facilities and 100.27 vendors of ancillary services that are found to be in violation 100.28 of this provision shall each be subject to an action by the 100.29 state of Minnesota or any of its subdivisions or agencies for 100.30 treble civil damages on the portion of the fee in excess of that 100.31 allowed by this provision and section 256B.433. Damages awarded 100.32 must include three times the excess payments together with costs 100.33 and disbursements including reasonable attorney's fees or their 100.34 equivalent. 100.35 (g) Refusing, for more than 24 hours, to accept a resident 100.36 returning to the same bed or a bed certified for the same level 101.1 of care, in accordance with a physician's order authorizing 101.2 transfer, after receiving inpatient hospital services. 101.3The prohibitions set forth in clause (b) shall not apply to101.4a retirement facility with more than 325 beds including at least101.5150 licensed nursing facility beds and which:101.6(1) is owned and operated by an organization tax-exempt101.7under section 290.05, subdivision 1, clause (i); and101.8(2) accounts for all of the applicant's assets which are101.9required to be assigned to the facility so that only expenses101.10for the cost of care of the applicant may be charged against the101.11account; and101.12(3) agrees in writing at the time of admission to the101.13facility to permit the applicant, or the applicant's guardian,101.14or conservator, to examine the records relating to the101.15applicant's account upon request, and to receive an audited101.16statement of the expenditures charged against the applicant's101.17individual account upon request; and101.18(4) agrees in writing at the time of admission to the101.19facility to permit the applicant to withdraw from the facility101.20at any time and to receive, upon withdrawal, the balance of the101.21applicant's individual account.101.22 For a period not to exceed 180 days, the commissioner may 101.23 continue to make medical assistance payments to a nursing 101.24 facility or boarding care home which is in violation of this 101.25 section if extreme hardship to the residents would result. In 101.26 these cases the commissioner shall issue an order requiring the 101.27 nursing facility to correct the violation. The nursing facility 101.28 shall have 20 days from its receipt of the order to correct the 101.29 violation. If the violation is not corrected within the 20-day 101.30 period the commissioner may reduce the payment rate to the 101.31 nursing facility by up to 20 percent. The amount of the payment 101.32 rate reduction shall be related to the severity of the violation 101.33 and shall remain in effect until the violation is corrected. 101.34 The nursing facility or boarding care home may appeal the 101.35 commissioner's action pursuant to the provisions of chapter 14 101.36 pertaining to contested cases. An appeal shall be considered 102.1 timely if written notice of appeal is received by the 102.2 commissioner within 20 days of notice of the commissioner's 102.3 proposed action. 102.4 In the event that the commissioner determines that a 102.5 nursing facility is not eligible for reimbursement for a 102.6 resident who is eligible for medical assistance, the 102.7 commissioner may authorize the nursing facility to receive 102.8 reimbursement on a temporary basis until the resident can be 102.9 relocated to a participating nursing facility. 102.10 Certified beds in facilities which do not allow medical 102.11 assistance intake on July 1, 1984, or after shall be deemed to 102.12 be decertified for purposes of section 144A.071 only. 102.13 Sec. 27. Minnesota Statutes 1998, section 256B.48, 102.14 subdivision 1a, is amended to read: 102.15 Subd. 1a. [TERMINATION.] If a nursing facility terminates 102.16 its participation in the medical assistance program, whether 102.17 voluntarily or involuntarily, the commissioner may authorize the 102.18 nursing facility to receive continued medical assistance 102.19 reimbursementonly on a temporary basisuntil medical assistance 102.20 residents can be relocated to nursing facilities participating 102.21 in the medical assistance program. 102.22 Sec. 28. Minnesota Statutes 1998, section 256B.48, 102.23 subdivision 1b, is amended to read: 102.24 Subd. 1b. [EXCEPTION.] Notwithstanding any agreement 102.25 between a nursing facility and the department of human services 102.26 or the provisions of this section or section 256B.411, other 102.27 than subdivision 1a, the commissioner may authorize continued 102.28 medical assistance payments to a nursing facility which ceased 102.29 intake of medical assistance recipients prior to July 1, 1983, 102.30 and which charges private paying residents rates that exceed 102.31 those permitted by subdivision 1, paragraph (a), for (i) 102.32 residents who resided in the nursing facility before July 1, 102.33 1983, or (ii) residents for whom the commissioner or any 102.34 predecessors of the commissioner granted a permanent individual 102.35 waiver prior to October 1, 1983. Nursing facilities seeking 102.36 continued medical assistance payments under this subdivision 103.1 shall make the reports required under subdivision 2, except that 103.2 on or after December 31, 1985, the financial statements required 103.3 need not be audited by or contain the opinion of a certified 103.4 public accountant or licensed public accountant, but need only 103.5 be reviewed by a certified public accountant or licensed public 103.6 accountant. In the event that the state is determined by the 103.7 federal government to be no longer eligible for the federal 103.8 share of medical assistance payments made to a nursing facility 103.9 under this subdivision, the commissioner may cease medical 103.10 assistance payments, under this subdivision, to that nursing 103.11 facility.Between October 1, 1992, and July 1, 1993, a facility103.12governed by this subdivision may elect to resume full103.13participation in the medical assistance program by agreeing to103.14comply with all of the requirements of the medical assistance103.15program, including the rate equalization law in subdivision 1,103.16paragraph (a), and all other requirements established in law or103.17rule, and to resume intake of new medical assistance recipients.103.18 Sec. 29. Minnesota Statutes 1998, section 256B.48, 103.19 subdivision 6, is amended to read: 103.20 Subd. 6. [MEDICARE CERTIFICATION.] (a) [DEFINITION.] For 103.21 purposes of this subdivision, "nursing facility" means a nursing 103.22 facility that is certified as a skilled nursing facility or, 103.23 after September 30, 1990, a nursing facility licensed under 103.24 chapter 144A that is certified as a nursing facility. 103.25 (b) [MEDICARE PARTICIPATION REQUIRED.] All nursing 103.26 facilities shall participate in Medicare part A and part B 103.27 unless, after submitting an application, Medicare certification 103.28 is denied by the federal health care financing administration. 103.29 Medicare review shall be conducted at the time of the annual 103.30 medical assistance review. Charges for Medicare-covered 103.31 services provided to residents who are simultaneously eligible 103.32 for medical assistance and Medicare must be billed to Medicare 103.33 part A or part B before billing medical assistance. Medical 103.34 assistance may be billed only for charges not reimbursed by 103.35 Medicare. 103.36 (c)[UNTIL SEPTEMBER 30, 1990.] Until September 30, 1990, a104.1nursing facility satisfies the requirements of paragraph (b)104.2if: (1) at least 50 percent of the facility's beds that are104.3licensed under section 144A and certified as skilled nursing104.4beds under the medical assistance program are Medicare104.5certified; or (2) if a nursing facility's beds are licensed104.6under section 144A, and some are medical assistance certified as104.7skilled nursing beds and others are medical assistance certified104.8as intermediate care facility I beds, at least 50 percent of the104.9facility's total skilled nursing beds and intermediate care104.10facility I beds or 100 percent of its skilled nursing beds,104.11whichever is less, are Medicare certified.104.12(d)[AFTER SEPTEMBER 30, 1990.] After September 30, 1990, a 104.13 nursing facility satisfies the requirements of paragraph (b) if 104.14 at least 50 percent of the facility's beds certified as nursing 104.15 facility beds under the medical assistance program are Medicare 104.16 certified. 104.17(e)(d) [CONFLICT WITH MEDICARE DISTINCT PART 104.18 REQUIREMENTS.] At the request of a facility, the commissioner of 104.19 human services may reduce the 50 percent Medicare participation 104.20 requirement inparagraphsparagraph (c)and (d)to no less than 104.21 20 percent if the commissioner of health determines that, due to 104.22 the facility's physical plant configuration, the facility cannot 104.23 satisfy Medicare distinct part requirements at the 50 percent 104.24 certification level. To receive a reduction in the 104.25 participation requirement, a facility must demonstrate that the 104.26 reduction will not adversely affect access of Medicare-eligible 104.27 residents to Medicare-certified beds. 104.28(f)(e) [INSTITUTIONS FOR MENTAL DISEASE.] The commissioner 104.29 may grant exceptions to the requirements of paragraph (b) for 104.30 nursing facilities that are designated as institutions for 104.31 mental disease. 104.32(g)(f) [NOTICE OF RIGHTS.] The commissioner shall inform 104.33 recipients of their rights under this subdivision and section 104.34 144.651, subdivision 29. 104.35 Sec. 30. Minnesota Statutes 1998, section 256B.50, 104.36 subdivision 1e, is amended to read: 105.1 Subd. 1e. [ATTORNEY'S FEES AND COSTS.] (a) Notwithstanding 105.2 section 15.472, paragraph (a), for an issue appealed under 105.3 subdivision 1, the prevailing party in a contested case 105.4 proceeding or, if appealed, in subsequent judicial review, must 105.5 be awarded reasonable attorney's fees and costs incurred in 105.6 litigating the appeal, if the prevailing party shows that the 105.7 position of the opposing party was not substantially justified. 105.8 The procedures for awarding fees and costs set forth in section 105.9 15.474 must be followed in determining the prevailing party's 105.10 fees and costs except as otherwise provided in this 105.11 subdivision. For purposes of this subdivision, "costs" means 105.12 subpoena fees and mileage, transcript costs, court reporter 105.13 fees, witness fees, postage and delivery costs, photocopying and 105.14 printing costs, amounts charged the commissioner by the office 105.15 of administrative hearings, and direct administrative costs of 105.16 the department; and "substantially justified" means that a 105.17 position had a reasonable basis in law and fact, based on the 105.18 totality of the circumstances prior to and during the contested 105.19 case proceeding and subsequent review. 105.20 (b) When an award is made to the department under this 105.21 subdivision, attorney fees must be calculated at the cost to the 105.22 department. When an award is made to a provider under this 105.23 subdivision, attorney fees must be calculated at the rate 105.24 charged to the provider except that attorney fees awarded must 105.25 be the lesser of the attorney's normal hourly fee or $100 per 105.26 hour. 105.27 (c) In contested case proceedings involving more than one 105.28 issue, the administrative law judge shall determine what portion 105.29 of each party's attorney fees and costs is related to the issue 105.30 or issues on which it prevailed and for which it is entitled to 105.31 an award. In making that determination, the administrative law 105.32 judge shall consider the amount of time spent on each issue, the 105.33 precedential value of the issue, the complexity of the issue, 105.34 and other factors deemed appropriate by the administrative law 105.35 judge. 105.36 (d) When the department prevails on an issue involving more 106.1 than one provider, the administrative law judge shall allocate 106.2 the total amount of any award for attorney fees and costs among 106.3 the providers. In determining the allocation, the 106.4 administrative law judge shall consider each provider's monetary 106.5 interest in the issue and other factors deemed appropriate by 106.6 the administrative law judge. 106.7 (e) Attorney fees and costs awarded to the department for 106.8 proceedings under this subdivision must not be reported or 106.9 treated as allowable costs on the provider's cost report. 106.10 (f) Fees and costs awarded to a provider for proceedings 106.11 under this subdivision must be reimbursed to themby reporting106.12the amount of fees and costs awarded as allowable costs on the106.13provider's cost report for the reporting year in which they were106.14awarded. Fees and costs reported pursuant to this subdivision106.15must be included in the general and administrative cost category106.16but are not subject to categorical or overall cost limitations106.17established in rule or statutewithin 120 days of the final 106.18 decision on the award of attorney fees and costs. 106.19 (g) If the provider fails to pay the awarded attorney fees 106.20 and costs within 120 days of the final decision on the award of 106.21 attorney fees and costs, the department may collect the amount 106.22 due through any method available to it for the collection of 106.23 medical assistance overpayments to providers. Interest charges 106.24 must be assessed on balances outstanding after 120 days of the 106.25 final decision on the award of attorney fees and costs. The 106.26 annual interest rate charged must be the rate charged by the 106.27 commissioner of revenue for late payment of taxes that is in 106.28 effect on the 121st day after the final decision on the award of 106.29 attorney fees and costs. 106.30 (h) Amounts collected by the commissioner pursuant to this 106.31 subdivision must be deemed to be recoveries pursuant to section 106.32 256.01, subdivision 2, clause (15). 106.33 (i) This subdivision applies to all contested case 106.34 proceedings set on for hearing by the commissioner on or after 106.35 April 29, 1988, regardless of the date the appeal was filed. 106.36 Sec. 31. Minnesota Statutes 1998, section 256B.501, is 107.1 amended by adding a subdivision to read: 107.2 Subd. 13. [ICF/MR RATE INCREASES BEGINNING OCTOBER 1, 107.3 1999, AND OCTOBER 1, 2000.] (a) For the rate year beginning 107.4 October 1, 1999, the commissioner shall make available an 107.5 operating payment rate increase equal to four percent. The 107.6 commissioner shall make available salary adjustments equal to 107.7 4.75 percent in each category except management fees and 107.8 administrator and central office, which shall be used solely to 107.9 increase wages or pay payroll taxes associated with these wage 107.10 increases, and shall use the remainder of the amount 107.11 appropriated by the legislature to increase per diem payment 107.12 rates in all operating rate categories not subject to the 4.75 107.13 percent increase. 107.14 (b) For the rate year beginning October 1, 2000, the 107.15 commissioner shall make available an operating payment rate 107.16 increase equal to three percent. The commissioner shall make 107.17 available salary adjustments equal to 3.5 percent in each 107.18 category except management fees and administrator and central 107.19 office, which shall be used solely to increase wages or pay 107.20 payroll taxes associated with these wage increases, and shall 107.21 use the remainder of the amount appropriated by the legislature 107.22 to increase per diem payment rates in all operating rate 107.23 categories not subject to the 3.5 percent increase. 107.24 (c) Effective October 1, 1999, to September 30, 2001, the 107.25 commissioner shall make available the appropriate salary 107.26 adjustment cost per diem calculated in paragraphs (e) to (j) to 107.27 the total operating cost payment rate of each facility subject 107.28 to reimbursement under this section, section 256B.5011, and Laws 107.29 1993, First Special Session chapter 1, article 4, section 11. 107.30 The salary adjustment cost per diem must be determined according 107.31 to paragraphs (d) to (j). 107.32 (d) A state-operated community service, and any facility 107.33 whose payment rates are governed by closure agreements, 107.34 receivership agreements, or Minnesota Rules, part 9553.0075, are 107.35 not eligible for a salary adjustment otherwise granted under 107.36 this subdivision. For purposes of the salary adjustment per 108.1 diem computation and reviews in this subdivision, the term 108.2 "salary adjustment cost" means the facility's allowable program 108.3 operating cost category employee training expenses, and the 108.4 facility's allowable salaries, payroll taxes, and fringe 108.5 benefits. The term does not include these same salary-related 108.6 costs for both administrative or central office employees. 108.7 For the purpose of determining the amount of salary 108.8 adjustment to be granted under this subdivision, the 108.9 commissioner must use the most recent cost report that has been 108.10 subject to desk audit. 108.11 (e) For the rate year beginning October 1, 1999, each 108.12 facility shall receive a salary adjustment cost per diem equal 108.13 to its salary adjustment costs multiplied by 4.75 percent, and 108.14 then divided by the facility's resident days. 108.15 (f) For the rate year beginning October 1, 2000, each 108.16 facility shall receive a salary adjustment cost per diem equal 108.17 to its salary adjustment costs multiplied by 3.5 percent, and 108.18 then divided by the facility's resident days. 108.19 (g) A facility may apply for the salary adjustment per diem 108.20 calculated under this subdivision. The application must be made 108.21 to the commissioner and contain a plan by which the facility 108.22 will distribute the salary adjustment to employees of the 108.23 facility. For facilities in which the employees are represented 108.24 by an exclusive bargaining representative, an agreement 108.25 negotiated and agreed to by the employer and the exclusive 108.26 bargaining representative may constitute the plan for the salary 108.27 distribution. The commissioner shall review the plan to ensure 108.28 that the salary adjustment per diem is used solely to increase 108.29 the wages of facility employees and pay payroll taxes associated 108.30 with these increased wages. To be eligible, a facility must 108.31 submit its plan for the salary distribution by December 31 of 108.32 each year. A facility may amend its plan for the second rate 108.33 year by submitting a revised plan by December 31, 2000. If a 108.34 facility's plan for salary distribution is effective for its 108.35 employees after October 1 of the year that the funds are 108.36 available, the salary adjustment cost per diem shall be 109.1 effective the same date as its plan. 109.2 (h) Additional costs incurred by facilities as a result of 109.3 this salary adjustment are not allowable costs for purposes of 109.4 the December 31, 1999, or December 31, 2000, cost report. 109.5 (i) In order to apply for a salary adjustment, a facility 109.6 reimbursed under section 256B.5011 or Laws 1993, First Special 109.7 Session chapter 1, article 4, section 11, must report the 109.8 information referred to in paragraph (a) in the application, in 109.9 the manner specified by the commissioner. 109.10 (j) A copy of the approved distribution plan must be made 109.11 available to all employees. This must be done by giving each 109.12 employee a copy or by posting it in an area of the facility to 109.13 which all employees have access. If an employee does not 109.14 receive the salary adjustment described in their facility's 109.15 approved plan and is unable to resolve the problem with the 109.16 facility's management, the employee may contact the employee's 109.17 union representative. If the employee is not covered by a 109.18 collective bargaining agreement, the employee may contact the 109.19 commissioner at a telephone number provided by the commissioner 109.20 and included in the approved plan. 109.21 Sec. 32. Minnesota Statutes 1998, section 256B.5011, 109.22 subdivision 1, is amended to read: 109.23 Subdivision 1. [IN GENERAL.] Effective October 1, 2000, 109.24 the commissioner shall implement aperformance-basedcontracting 109.25 system to replace the current method of setting total cost 109.26 payment rates under section 256B.501 and Minnesota Rules, parts 109.27 9553.0010 to 9553.0080. In determining prospective payment 109.28 rates of intermediate care facilities for persons with mental 109.29 retardation or related conditions, the commissioner shall index 109.30 each facility'stotaloperating payment rate by an inflation 109.31 factor as described insubdivision 3section 256B.5012. The 109.32 commissioner of finance shall include annual inflation 109.33 adjustments in operating costs for intermediate care facilities 109.34 for persons with mental retardation and related conditions as a 109.35 budget change request in each biennial detailed expenditure 109.36 budget submitted to the legislature under section 16A.11. 110.1 Sec. 33. Minnesota Statutes 1998, section 256B.5011, 110.2 subdivision 2, is amended to read: 110.3 Subd. 2. [CONTRACT PROVISIONS.] (a) The 110.4performance-basedservice contract with each intermediate care 110.5 facility must include provisions for: 110.6 (1) modifying payments when significant changes occur in 110.7 the needs of the consumers; 110.8 (2)monitoring service quality using performance indicators110.9that measure consumer outcomes;110.10(3)the establishment and use of continuous quality 110.11 improvement processes using the results attained through service 110.12 quality monitoring; 110.13(4) the annual reporting of facility statistical110.14information on all supervisory personnel, direct care personnel,110.15specialized support personnel, hours, wages and benefits,110.16staff-to-consumer ratios, and staffing patterns110.17 (3) appropriate and necessary statistical information 110.18 required by the commissioner; 110.19(5)(4) annual aggregate facility financial informationor110.20an annual certified audited financial statement, including a110.21balance sheet and income and expense statements for each110.22facility, if a certified audit was prepared; and 110.23(6)(5) additional requirementsand penaltiesfor 110.24 intermediate care facilities not meeting the standards set forth 110.25 in theperformance-basedservice contract. 110.26 (b) The commissioner shall recommend to the legislature by 110.27 January 15, 2000, whether the contract should include service 110.28 quality monitoring that may utilize performance indicators that 110.29 measure consumer and program outcomes. Performance measurement 110.30 shall not increase or duplicate regulatory requirements. 110.31 Sec. 34. [256B.5012] [ICF/MR PAYMENT SYSTEM 110.32 IMPLEMENTATION.] 110.33 Subdivision 1. [TOTAL PAYMENT RATE.] The total payment 110.34 rate effective October 1, 2001, for existing ICF/MR facilities 110.35 is the total of the operating payment rate and the property 110.36 payment rate plus inflation factors as defined in this section. 111.1 The initial rate year shall run from October 1, 2001, through 111.2 December 31, 2002. Subsequent rate years shall run from January 111.3 1 through December 31 beginning in the year 2003. 111.4 Subd. 2. [OPERATING PAYMENT RATE.] (a) The operating 111.5 payment rate equals the facility's total payment rate in effect 111.6 on September 30, 2001, minus the property rate. The operating 111.7 payment rate includes the special operating rate and the 111.8 efficiency incentive in effect as of September 30, 2001. Within 111.9 the limits of appropriations specifically for this purpose, the 111.10 operating payment shall be increased for each rate year by the 111.11 annual percentage change in the Employment Cost Index for 111.12 Private Industry Workers - Total Compensation, as forecasted by 111.13 Data Resources, Inc., in the second quarter of the calendar year 111.14 preceding the start of each rate year. In the case of the 111.15 initial rate year beginning October 1, 2001, and continuing 111.16 through December 31, 2002, the percentage change shall be based 111.17 on the percentage change in the Employment Cost Index for 111.18 Private Industry Workers - Total Compensation for the 15-month 111.19 period beginning October 1, 2001, as forecast by Data Resources, 111.20 Inc., in the first quarter of 2001. 111.21 (b) Effective October 1, 2000, the operating payment rate 111.22 shall be adjusted to reflect an occupancy rate equal to 100 111.23 percent of the facility's capacity days as of September 30, 2000. 111.24 Subd. 3. [PROPERTY PAYMENT RATE.] (a) The property payment 111.25 rate effective October 1, 2000, is based on the facility's 111.26 property payment rate in effect on September 30, 2000. 111.27 Effective October 1, 2000, a facility minimum property rate of 111.28 $8.13 shall be applied to all existing ICF/MR facilities. 111.29 Facilities with a property payment rate effective September 30, 111.30 2000, which is below the minimum property rate shall receive an 111.31 increase effective October 1, 2000, equal to the difference 111.32 between the minimum property payment rate and the property 111.33 payment rate in effect as of September 30, 2000. Facilities 111.34 with a property payment rate at or above the minimum property 111.35 payment rate effective September 30, 2000, shall have no change 111.36 in their property payment rate effective October 1, 2000. 112.1 (b) Within the limits of appropriations specifically for 112.2 this purpose, facility property payment rates shall be increased 112.3 annually for inflation, effective January 1, 2002. The increase 112.4 shall be based on each facility's property payment rate in 112.5 effect on September 30, 2000. Property payment rates effective 112.6 September 30, 2000, shall be arrayed from highest to lowest 112.7 before applying the minimum property payment rate in paragraph 112.8 (a). For property payment rates at the 90th percentile or 112.9 above, the annual inflation increase shall be zero. For 112.10 property payment rates below the 90th percentile but equal to or 112.11 above the 75th percentile, the annual inflation increase shall 112.12 be one percent. For property payment rates below the 75th 112.13 percentile, the annual inflation increase shall be two percent. 112.14 Sec. 35. [256B.5013] [PAYMENT RATE ADJUSTMENTS.] 112.15 Subdivision 1. [VARIABLE RATE ADJUSTMENTS.] When there is 112.16 a documented increase in the resource needs of a current ICF/MR 112.17 recipient or recipients, or a person is admitted to a facility 112.18 who requires additional resources, the county of financial 112.19 responsibility may approve an enhanced rate for one or more 112.20 persons in the facility. Resource needs directly attributable 112.21 to an individual that may be considered under the variable rate 112.22 adjustment include increased direct staff hours and other 112.23 specialized services, equipment, and human resources. The 112.24 guidelines in paragraphs (a) to (d) apply for the payment rate 112.25 adjustments under this section. 112.26 (a) All persons must be screened according to section 112.27 256B.092, subdivisions 7 and 8, prior to implementation of the 112.28 new payment system and annually thereafter. Screening data 112.29 shall be analyzed to develop broad profiles of the functional 112.30 characteristics of recipients. Three components shall be used 112.31 to distinguish recipients based on the following broad profiles: 112.32 (1) functional ability to care for and maintain one's own 112.33 basic needs; 112.34 (2) the intensity of any aggressive or destructive 112.35 behavior; and 112.36 (3) any history of obstructive behavior in combination with 113.1 a diagnosis of psychosis or neurosis. 113.2 The profile groups shall be used to link resource needs to 113.3 funding. The resource profile shall determine the level of 113.4 funding that may be authorized by the county. The county of 113.5 financial responsibility may approve a rate adjustment for an 113.6 individual. The commissioner shall recommend to the legislature 113.7 by January 15, 2000, a methodology using the profile groups to 113.8 determine variable rates. The variable rate must be applied to 113.9 expenses related to increased direct staff hours and other 113.10 specialized services, equipment, and human resources. This 113.11 variable rate component plus the facility's current operating 113.12 payment rate equals the individual's total operating payment 113.13 rate. 113.14 (b) A recipient must be screened by the county of financial 113.15 responsibility using the developmental disabilities screening 113.16 document completed immediately prior to approval of a variable 113.17 rate by the county. A comparison of the updated screening and 113.18 the previous screening must demonstrate an increase in resource 113.19 needs. 113.20 (c) Rate adjustments projected to exceed the authorized 113.21 funding level associated with the person's profile must be 113.22 submitted to the commissioner. 113.23 (d) The new rate approved through this process shall not be 113.24 averaged across all persons living at a facility but shall be an 113.25 individual rate. The county of financial responsibility must 113.26 indicate the projected length of time that the additional 113.27 funding may be needed by the individual. The need to continue 113.28 an individual variable rate must be reviewed at the end of the 113.29 anticipated duration of need but at least annually through the 113.30 completion of the developmental disabilities screening document. 113.31 Subd. 2. [OTHER PAYMENT RATE ADJUSTMENTS.] Facility total 113.32 payment rates may be adjusted by the host county, with 113.33 authorization from a statewide advisory committee, if, through 113.34 the local system needs planning process, it is determined that a 113.35 need exists to amend the package of purchased services with a 113.36 resulting increase or decrease in costs. Except as provided in 114.1 section 252.292, subdivision 4, if a provider demonstrates that 114.2 the loss of revenues caused by the downsizing or closure of a 114.3 facility cannot be absorbed by the facility based on current 114.4 operations, the host county or the provider may submit a request 114.5 to the statewide advisory committee for a facility base rate 114.6 adjustment. 114.7 Subd. 3. [RELOCATION.] (a) Property rates for all 114.8 facilities relocated after December 31, 1997, and up to and 114.9 including October 1, 2000, shall have the full annual costs of 114.10 relocation included in their October 1, 2000, property rate. 114.11 The property rate for the relocated home is subject to the costs 114.12 that were allowable under Minnesota Rules, chapter 9553, and the 114.13 investment per bed limitation for newly constructed or newly 114.14 established class B facilities. 114.15 (b) In ensuing years, all relocated homes shall be subject 114.16 to the investment per bed limit for newly constructed or newly 114.17 established class B facilities under section 256B.501, 114.18 subdivision 11. The limits shall be adjusted on January 1 of 114.19 each year by the percentage increase in the construction index 114.20 published by the Bureau of Economic Analysis of the United 114.21 States Department of Commerce in the Survey of Current Business 114.22 Statistics in October of the previous two years. Facilities 114.23 that are relocated within the investment per bed limit may be 114.24 approved by the statewide advisory committee. Costs for 114.25 relocation of a facility that exceed the investment per bed 114.26 limit must be absorbed by the facility. 114.27 (c) The payment rate shall take effect when the new 114.28 facility is licensed and certified by the commissioner of 114.29 health. Rates for facilities that are relocated after December 114.30 31, 1997, through October 1, 2000, shall be adjusted to reflect 114.31 the full inclusion of the relocation costs, subject to the 114.32 investment per bed limit in paragraph (b). The investment per 114.33 bed limit calculated rate for the year in which the facility was 114.34 relocated shall be the investment per bed limit used. 114.35 Subd. 4. [TEMPORARY RATE ADJUSTMENTS TO ADDRESS OCCUPANCY 114.36 AND ACCESS.] If a facility is operating at less than 100 percent 115.1 occupancy on September 30, 2000, or if a recipient is discharged 115.2 from a facility, the commissioner shall adjust the total payment 115.3 rate for up to 90 days for the remaining recipients. This 115.4 mechanism shall not be used to pay for hospital or therapeutic 115.5 leave days beyond the maximums allowed. Facility payment 115.6 adjustments exceeding 90 days to address a demonstrated need for 115.7 access must be submitted to the statewide advisory committee 115.8 with a local system needs assessment, plan, and budget for 115.9 review and recommendation. 115.10 Sec. 36. [256B.5014] [FINANCIAL REPORTING.] 115.11 All facilities shall maintain financial records and shall 115.12 provide annual income and expense reports to the commissioner of 115.13 human services on a form prescribed by the commissioner no later 115.14 than April 30 of each year in order to receive medical 115.15 assistance payments. The reports for the reporting year ending 115.16 December 31 must include: 115.17 (1) salaries and related expenses, including program 115.18 salaries, administrative salaries, other salaries, payroll 115.19 taxes, and fringe benefits; 115.20 (2) general operating expenses, including supplies, 115.21 training, repairs, purchased services and consultants, 115.22 utilities, food, licenses and fees, real estate taxes, 115.23 insurance, and working capital interest; 115.24 (3) property related costs, including depreciation, capital 115.25 debt interest, rent, and leases; and 115.26 (4) total annual resident days. 115.27 Sec. 37. [256B.5015] [PASS-THROUGH OF TRAINING AND 115.28 HABILITATION SERVICES COSTS.] 115.29 Training and habilitation services costs shall be paid as a 115.30 pass-through payment at the lowest rate paid for the comparable 115.31 services at that site under sections 252.40 to 252.46. The 115.32 pass-through payments for training and habilitation services 115.33 shall be paid separately by the commissioner and shall not be 115.34 included in the computation of the total payment rate. 115.35 Sec. 38. Minnesota Statutes 1998, section 256B.69, 115.36 subdivision 6a, is amended to read: 116.1 Subd. 6a. [NURSING HOME SERVICES.] (a) Notwithstanding 116.2 Minnesota Rules, part 9500.1457, subpart 1, item B, up to 90 116.3 days of nursing facility services as defined in section 116.4 256B.0625, subdivision 2, which are provided in a nursing 116.5 facility certified by the Minnesota department of health for 116.6 services provided and eligible for payment under Medicaid, shall 116.7 be covered under the prepaid medical assistance program for 116.8 individuals who are not residing in a nursing facility at the 116.9 time of enrollment in the prepaid medical assistance program. 116.10Liability for coverage of nursing facility services by a116.11participating health plan is limited to 365 days for any person116.12enrolled under the prepaid medical assistance program.116.13 (b) For individuals enrolled in the Minnesota senior health 116.14 options project authorized under subdivision 23, nursing 116.15 facility services shall be covered according to the terms and 116.16 conditions of the federalwaiveragreement governing that 116.17 demonstration project. 116.18 Sec. 39. Minnesota Statutes 1998, section 256B.69, 116.19 subdivision 6b, is amended to read: 116.20 Subd. 6b. [ELDERLYHOME AND COMMUNITY-BASED WAIVER 116.21 SERVICES.]Notwithstanding Minnesota Rules, part 9500.1457,116.22subpart 1, item C, elderly waiver services shall be covered116.23under the prepaid medical assistance program for all individuals116.24who are eligible according to section 256B.0915.(a) For 116.25 individuals enrolled in the Minnesota senior health options 116.26 project authorized under subdivision 23, elderly waiver services 116.27 shall be covered according to the terms and conditions of the 116.28 federalwaiveragreement governing that demonstration project. 116.29 (b) For individuals under age 65 with physical disabilities 116.30 but without a primary diagnosis of mental illness or 116.31 developmental disabilities, except for related conditions, 116.32 enrolled in the Minnesota senior health options project 116.33 authorized under subdivision 23, home and community-based waiver 116.34 services shall be covered according to the terms and conditions 116.35 of the federal agreement governing that demonstration project. 116.36 Sec. 40. Minnesota Statutes 1998, section 256I.04, 117.1 subdivision 3, is amended to read: 117.2 Subd. 3. [MORATORIUM ON THE DEVELOPMENT OF GROUP 117.3 RESIDENTIAL HOUSING BEDS.] (a) County agencies shall not enter 117.4 into agreements for new group residential housing beds with 117.5 total rates in excess of the MSA equivalent rate except: (1) 117.6 for group residential housing establishments meeting the 117.7 requirements of subdivision 2a, clause (2) with department 117.8 approval; (2) for group residential housing establishments 117.9 licensed under Minnesota Rules, parts 9525.0215 to 9525.0355, 117.10 provided the facility is needed to meet the census reduction 117.11 targets for persons with mental retardation or related 117.12 conditions at regional treatment centers; (3) to ensure 117.13 compliance with the federal Omnibus Budget Reconciliation Act 117.14 alternative disposition plan requirements for inappropriately 117.15 placed persons with mental retardation or related conditions or 117.16 mental illness; (4) up to 80 beds in a single, specialized 117.17 facility located in Hennepin county that will provide housing 117.18 for chronic inebriates who are repetitive users of 117.19 detoxification centers and are refused placement in emergency 117.20 shelters because of their state of intoxication, and planning 117.21 for the specialized facility must have been initiated before 117.22 July 1, 1991, in anticipation of receiving a grant from the 117.23 housing finance agency under section 462A.05, subdivision 20a, 117.24 paragraph (b);or(5) notwithstanding the provisions of 117.25 subdivision 2a, for up to 190 supportive housing units in Anoka, 117.26 Dakota, Hennepin, or Ramsey county for homeless adults with a 117.27 mental illness, a history of substance abuse, or human 117.28 immunodeficiency virus or acquired immunodeficiency syndrome. 117.29 For purposes of this section, "homeless adult" means a person 117.30 who is living on the street or in a shelter or discharged from a 117.31 regional treatment center, community hospital, or residential 117.32 treatment program and has no appropriate housing available and 117.33 lacks the resources and support necessary to access appropriate 117.34 housing. At least 70 percent of the supportive housing units 117.35 must serve homeless adults with mental illness, substance abuse 117.36 problems, or human immunodeficiency virus or acquired 118.1 immunodeficiency syndrome who are about to be or, within the 118.2 previous six months, has been discharged from a regional 118.3 treatment center, or a state-contracted psychiatric bed in a 118.4 community hospital, or a residential mental health or chemical 118.5 dependency treatment program. If a person meets the 118.6 requirements of subdivision 1, paragraph (a), and receives a 118.7 federal or state housing subsidy, the group residential housing 118.8 rate for that person is limited to the supplementary rate under 118.9 section 256I.05, subdivision 1a, and is determined by 118.10 subtracting the amount of the person's countable income that 118.11 exceeds the MSA equivalent rate from the group residential 118.12 housing supplementary rate. A resident in a demonstration 118.13 project site who no longer participates in the demonstration 118.14 program shall retain eligibility for a group residential housing 118.15 payment in an amount determined under section 256I.06, 118.16 subdivision 8, using the MSA equivalent rate. Service funding 118.17 under section 256I.05, subdivision 1a, will end June 30, 1997, 118.18 if federal matching funds are available and the services can be 118.19 provided through a managed care entity. If federal matching 118.20 funds are not available, then service funding will continue 118.21 under section 256I.05, subdivision 1a.; or (6) for group 118.22 residential housing beds in settings meeting the requirements of 118.23 subdivision 2a, paragraph (a), clause (3), which are used 118.24 exclusively for recipients receiving home and community-based 118.25 waiver services under sections 256B.0915, 256B.092, subdivision 118.26 5, 256B.093, and 256B.49, and who resided in a nursing facility 118.27 for the six months immediately prior to the month of entry into 118.28 the group residential housing setting. The group residential 118.29 housing rate for these beds must be set so that the monthly 118.30 group residential housing payment for an individual occupying 118.31 the bed when combined with the nonfederal share of services 118.32 delivered under the waiver for that person does not exceed the 118.33 nonfederal share of the monthly medical assistance payment made 118.34 for the person to the nursing facility in which the person 118.35 resided prior to entry into the group residential housing 118.36 establishment. The rate may not exceed the MSA equivalent rate 119.1 plus $426.37 for any case. 119.2 (b) A county agency may enter into a group residential 119.3 housing agreement for beds with rates in excess of the MSA 119.4 equivalent rate in addition to those currently covered under a 119.5 group residential housing agreement if the additional beds are 119.6 only a replacement of beds with rates in excess of the MSA 119.7 equivalent rate which have been made available due to closure of 119.8 a setting, a change of licensure or certification which removes 119.9 the beds from group residential housing payment, or as a result 119.10 of the downsizing of a group residential housing setting. The 119.11 transfer of available beds from one county to another can only 119.12 occur by the agreement of both counties. 119.13 Sec. 41. Minnesota Statutes 1998, section 256I.05, 119.14 subdivision 1, is amended to read: 119.15 Subdivision 1. [MAXIMUM RATES.] Monthly room and board 119.16 rates negotiated by a county agency for a recipient living in 119.17 group residential housing must not exceed the MSA equivalent 119.18 rate specified under section 256I.03, subdivision 5, with the 119.19 exception that a county agency may negotiate a supplementary 119.20 room and board rate that exceeds the MSA equivalent rateby up119.21to $426.37for recipients of waiver services under title XIX of 119.22 the Social Security Act. This exception is subject to the 119.23 following conditions: 119.24 (1)that the Secretary of Health and Human Services has not119.25approved a state request to include room and board costs which119.26exceed the MSA equivalent rate in an individual's set of waiver119.27services under title XIX of the Social Security Act; or119.28(2) that the Secretary of Health and Human Services has119.29approved the inclusion of room and board costs which exceed the119.30MSA equivalent rate, but in an amount that is insufficient to119.31cover costs which are included in a group residential housing119.32agreement in effect on June 30, 1994; and119.33(3) the amount of the rate that is above the MSA equivalent119.34rate has been approved by the commissioner.the setting is 119.35 licensed by the commissioner of human services under Minnesota 119.36 Rules, parts 9555.5050 to 9555.6265; 120.1 (2) the setting is not the primary residence of the license 120.2 holder and in which the license holder is not the primary 120.3 caregiver; and 120.4 (3) beginning January 1, 2000, the average supplementary 120.5 room and board rate in a county for a calendar year may not 120.6 exceed the average supplementary room and board rate for that 120.7 county in effect on January 1, 2000. If a county has not 120.8 negotiated supplementary room and board rates for any facilities 120.9 located in the county as of January 1, 2000, it may submit a 120.10 supplementary room and board rate request with budget 120.11 information for a facility to the commissioner for approval. 120.12 The county agency may at any time negotiate a higher or lower 120.13 room and board rate than the average supplementary room and 120.14 board ratethat would otherwise be paid under this subdivision. 120.15 Sec. 42. Minnesota Statutes 1998, section 256I.05, 120.16 subdivision 1a, is amended to read: 120.17 Subd. 1a. [SUPPLEMENTARY SERVICE RATES.] (a) Subject to 120.18 the provisions of section 256I.04, subdivision 3, in addition to 120.19 the room and board rate specified in subdivision 1, the county 120.20 agency may negotiate a payment not to exceed $426.37 for other 120.21 services necessary to provide room and board provided by the 120.22 group residence if the residence is licensed by or registered by 120.23 the department of health, or licensed by the department of human 120.24 services to provide services in addition to room and board, and 120.25 if the provider of services is not also concurrently receiving 120.26 funding for services for a recipient under a home and 120.27 community-based waiver under title XIX of the Social Security 120.28 Act; or funding from the medical assistance program under 120.29 section 256B.0627, subdivision 4, for personal care services for 120.30 residents in the setting; or residing in a setting which 120.31 receives funding under Minnesota Rules, parts 9535.2000 to 120.32 9535.3000. If funding is available for other necessary services 120.33 through a home and community-based waiver, or personal care 120.34 services under section 256B.0627, subdivision 4, then the GRH 120.35 rate is limited to the rate set in subdivision 1. Unless 120.36 otherwise provided in law, in no case may the supplementary 121.1 service rate plus the supplementary room and board rate exceed 121.2 $426.37. The registration and licensure requirement does not 121.3 apply to establishments which are exempt from state licensure 121.4 because they are located on Indian reservations and for which 121.5 the tribe has prescribed health and safety requirements. 121.6 Service payments under this section may be prohibited under 121.7 rules to prevent the supplanting of federal funds with state 121.8 funds. The commissioner shall pursue the feasibility of 121.9 obtaining the approval of the Secretary of Health and Human 121.10 Services to provide home and community-based waiver services 121.11 under title XIX of the Social Security Act for residents who are 121.12 not eligible for an existing home and community-based waiver due 121.13 to a primary diagnosis of mental illness or chemical dependency 121.14 and shall apply for a waiver if it is determined to be 121.15 cost-effective. 121.16 (b) The commissioner is authorized to make cost-neutral 121.17 transfers from the GRH fund for beds under this section to other 121.18 funding programs administered by the department after 121.19 consultation with the county or counties in which the affected 121.20 beds are located. The commissioner may also make cost-neutral 121.21 transfers from the GRH fund to county human service agencies for 121.22 beds permanently removed from the GRH census under a plan 121.23 submitted by the county agency and approved by the 121.24 commissioner. The commissioner shall report the amount of any 121.25 transfers under this provision annually to the legislature. 121.26 (c) The provisions of paragraph (b) do not apply to a 121.27 facility that has its reimbursement rate established under 121.28 section 256B.431, subdivision 4, paragraph (c). 121.29 Sec. 43. [ICF/MR REIMBURSEMENT EFFECTIVE OCTOBER 1, 1999.] 121.30 (a) For the rate year beginning October 1, 1999, the 121.31 commissioner of human services shall exempt an intermediate care 121.32 facility for persons with mental retardation from reductions to 121.33 the payment rates under Minnesota Statutes, section 256B.501, 121.34 subdivision 5b, paragraph (d), clause (6), if the facility: 121.35 (1) has had a settle-up payment rate established in the 121.36 reporting year preceding the rate year for the one-time rate 122.1 adjustment; 122.2 (2) is a newly established facility; 122.3 (3) is an A to B conversion that has been converted under 122.4 Minnesota Statutes, section 252.292, since rate year 1990; 122.5 (4) has a payment rate subject to a community conversion 122.6 project under Minnesota Statutes, section 252.292; 122.7 (5) has a payment rate established under Minnesota 122.8 Statutes, section 245A.12 or 245A.13; or 122.9 (6) is a facility created by the relocation of more than 25 122.10 percent of the capacity of a related facility during the 122.11 reporting year. 122.12 (b) Notwithstanding any contrary provision in Minnesota 122.13 Statutes, section 256B.501, for the rate year beginning October 122.14 1, 1999, the commissioner of human services shall, for purposes 122.15 of the spend-up limit, array facilities within each grouping 122.16 established under Minnesota Statutes, section 256B.501, 122.17 subdivision 5b, paragraph (d), clause (4), by each facility's 122.18 cost per resident day. A facility's cost per resident day shall 122.19 be determined by dividing its allowable historical general 122.20 operating cost for the reporting year by the facility's resident 122.21 days for the reporting year. Facilities with a cost per 122.22 resident day at or above the median shall be limited to the 122.23 lesser of: 122.24 (1) the current reporting year's cost per resident day; or 122.25 (2) the prior report year's cost per resident day plus the 122.26 inflation factor established under Minnesota Statutes, section 122.27 256B.501, subdivision 3c, clause (2), increased by three 122.28 percentage points. In no case shall the amount of this 122.29 reduction exceed: (i) three percent for a facility with a 122.30 licensed capacity greater than 16 beds; (ii) two percent for a 122.31 facility with a licensed capacity of nine to 16 beds; and (iii) 122.32 one percent for a facility with a licensed capacity of eight or 122.33 fewer beds. 122.34 (c) The commissioner shall not apply the limits established 122.35 under Minnesota Statutes, section 256B.501, subdivision 5b, 122.36 paragraph (d), clause (8), for the rate year beginning October 123.1 1, 1999. 123.2 (d) Notwithstanding paragraphs (b) and (c), the 123.3 commissioner must utilize facility payment rates based on the 123.4 laws in effect for October 1, 1998, payment rates and use the 123.5 resulting allowable operating cost per diems as the basis for 123.6 the spend-up limits for the rate year beginning October 1, 1999. 123.7 Sec. 44. [DEADLINE EXTENSION.] 123.8 Notwithstanding Minnesota Statutes, section 144A.073, 123.9 subdivision 3, the commissioner of health shall extend approval 123.10 to May 31, 2000, for a total replacement of a 96-bed nursing 123.11 home located in Carlton county previously approved under 123.12 Minnesota Statutes, section 144A.073. 123.13 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 123.14 REGULATIONS.] 123.15 Notwithstanding the provisions of Minnesota Rules, part 123.16 4658.0520, an incontinent resident must be checked according to 123.17 a specific time interval written in the resident's care plan. 123.18 The resident's attending physician must authorize in writing any 123.19 interval longer than two hours. 123.20 (Effective date: Section 45 (State Licensure) is effective 123.21 the day following final enactment.) 123.22 Sec. 46. [REPEALER.] 123.23 (a) Minnesota Statutes 1998, sections 144.0723; and 123.24 256B.5011, subdivision 3, are repealed. 123.25 (b) Minnesota Statutes 1998, section 256B.434, subdivision 123.26 17, is repealed effective July 1, 1999. 123.27 (c) Minnesota Statutes 1998, section 256B.501, subdivision 123.28 3g, is repealed effective October 1, 2000. 123.29 (d) Laws 1997, chapter 203, article 4, section 55, is 123.30 repealed. 123.31 (e) Section 45 is repealed effective July 1, 2001. 123.32 Sec. 47. [EFFECTIVE DATE.] 123.33 When preparing the conference committee report for adoption 123.34 by the legislature, the revisor shall combine all effective date 123.35 notations in this article into this effective date section. 123.36 ARTICLE 4 124.1 HEALTH CARE PROGRAMS 124.2 Section 1. Minnesota Statutes 1998, section 16A.76, 124.3 subdivision 2, is amended to read: 124.4 Subd. 2. [RESERVE FINANCING.] The funds in reserve shall 124.5 be equal to the amount of federal financial participation 124.6 received since July 1, 1995, for services and administrative 124.7 activities funded by the health care access fund up to a reserve 124.8 limit of$150,000,000$80,000,000. Investment income attributed 124.9 to the federal contingency reserve balances shall also be 124.10 included in the total reserve amount. 124.11 Sec. 2. Minnesota Statutes 1998, section 60A.15, 124.12 subdivision 1, is amended to read: 124.13 Subdivision 1. [DOMESTIC AND FOREIGN COMPANIES.] (a) On or 124.14 before April 1, June 1, and December 1 of each year, every 124.15 domestic and foreign company, including town and farmers' mutual 124.16 insurance companies, domestic mutual insurance companies, marine 124.17 insurance companies, health maintenance organizations, community 124.18 integrated service networks, and nonprofit health service plan 124.19 corporations, shall pay to the commissioner of revenue 124.20 installments equal to one-third of the insurer's total estimated 124.21 tax for the current year. Except as provided in paragraphs (d), 124.22 (e), (h), and (i), installments must be based on a sum equal to 124.23 two percent of the premiums described in paragraph (b). 124.24 (b) Installments under paragraph (a), (d), or (e) are 124.25 percentages of gross premiums less return premiums on all direct 124.26 business received by the insurer in this state, or by its agents 124.27 for it, in cash or otherwise, during such year. 124.28 (c) Failure of a company to make payments of at least 124.29 one-third of either (1) the total tax paid during the previous 124.30 calendar year or (2) 80 percent of the actual tax for the 124.31 current calendar year shall subject the company to the penalty 124.32 and interest provided in this section, unless the total tax for 124.33 the current tax year is $500 or less. 124.34 (d) For health maintenance organizations, nonprofit health 124.35 service plan corporations, and community integrated service 124.36 networks, the installments must be based on an amount determined 125.1 under paragraph (h) or (i). 125.2 (e) For purposes of computing installments for town and 125.3 farmers' mutual insurance companies and for mutual property 125.4 casualty companies with total assets on December 31, 1989, of 125.5 $1,600,000,000 or less, the following rates apply: 125.6 (1) for all life insurance, two percent; 125.7 (2) for town and farmers' mutual insurance companies and 125.8 for mutual property and casualty companies with total assets of 125.9 $5,000,000 or less, on all other coverages, one percent; and 125.10 (3) for mutual property and casualty companies with total 125.11 assets on December 31, 1989, of $1,600,000,000 or less, on all 125.12 other coverages, 1.26 percent. 125.13 (f) If the aggregate amount of premium tax payments under 125.14 this section and the fire marshal tax payments under section 125.15 299F.21 made during a calendar year is equal to or exceeds 125.16 $120,000, all tax payments in the subsequent calendar year must 125.17 be paid by means of a funds transfer as defined in section 125.18 336.4A-104, paragraph (a). The funds transfer payment date, as 125.19 defined in section 336.4A-401, must be on or before the date the 125.20 payment is due. If the date the payment is due is not a funds 125.21 transfer business day, as defined in section 336.4A-105, 125.22 paragraph (a), clause (4), the payment date must be on or before 125.23 the funds transfer business day next following the date the 125.24 payment is due. 125.25 (g) Premiums under medical assistance, general assistance 125.26 medical care, the MinnesotaCare program, and the Minnesota 125.27 comprehensive health insurance plan and all payments, revenues, 125.28 and reimbursements received from the federal government for 125.29 Medicare-related coverage as defined in section 62A.31, 125.30 subdivision 3, paragraph (e), are not subject to tax under this 125.31 section. 125.32 (h) For calendar years 1997, 1998,and1999, 2000, and 2001 125.33 the installments for health maintenance organizations, community 125.34 integrated service networks, and nonprofit health service plan 125.35 corporations must be based on an amount equal to one percent of 125.36 premiums described under paragraph (b). Health maintenance 126.1 organizations, community integrated service networks, and 126.2 nonprofit health service plan corporations that have met the 126.3 cost containment goals established under section 62J.04 in the 126.4 individual and small employer market for calendar year 1996 are 126.5 exempt from payment of the tax imposed under this section for 126.6 premiums paid after March 30, 1997, and before April 1, 1998. 126.7 Health maintenance organizations, community integrated service 126.8 networks, and nonprofit health service plan corporations that 126.9 have met the cost containment goals established under section 126.10 62J.04 in the individual and small employer market for calendar 126.11 year 1997 are exempt from payment of the tax imposed under this 126.12 section for premiums paid after March 30, 1998, and before April 126.13 1, 1999. Health maintenance organizations, community integrated 126.14 service networks, and nonprofit health service plan corporations 126.15 that have met the cost containment goals established under 126.16 section 62J.04 in the individual and small employer market for 126.17 calendar year 1998 are exempt from payment of the tax imposed 126.18 under this section for premiums paid after March 30, 1999, and 126.19 before January 1,20002002. 126.20 (i) For calendar years after19992001, the commissioner of 126.21 finance shall determine the balance of the health care access 126.22 fund on September 1 of each year beginning September 1,1999126.23 2001. If the commissioner determines that there is no 126.24 structural deficit for the next fiscal year, no tax shall be 126.25 imposed under paragraph (d) for the following calendar year. If 126.26 the commissioner determines that there will be a structural 126.27 deficit in the fund for the following fiscal year, then the 126.28 commissioner, in consultation with the commissioner of revenue, 126.29 shall determine the amount needed to eliminate the structural 126.30 deficit and a tax shall be imposed under paragraph (d) for the 126.31 following calendar year. The commissioner shall determine the 126.32 rate of the tax as either one-quarter of one percent, one-half 126.33 of one percent, three-quarters of one percent, or one percent of 126.34 premiums described in paragraph (b), whichever is the lowest of 126.35 those rates that the commissioner determines will produce 126.36 sufficient revenue to eliminate the projected structural 127.1 deficit. The commissioner of finance shall publish in the State 127.2 Register by October 1 of each year the amount of tax to be 127.3 imposed for the following calendar year.In determining the127.4structural balance of the health care access fund for fiscal127.5years 2000 and 2001, the commissioner shall disregard the127.6transfer amount from the health care access fund to the general127.7fund for expenditures associated with the services provided to127.8pregnant women and children under the age of two enrolled in the127.9MinnesotaCare program.127.10 (j) In approving the premium rates as required in sections 127.11 62L.08, subdivision 8, and 62A.65, subdivision 3, the 127.12 commissioners of health and commerce shall ensure that any 127.13 exemption from the tax as described in paragraphs (h) and (i) is 127.14 reflected in the premium rate. 127.15 Sec. 3. Minnesota Statutes 1998, section 62A.045, is 127.16 amended to read: 127.17 62A.045 [PAYMENTS ON BEHALF OF ENROLLEES IN GOVERNMENT 127.18 HEALTH PROGRAMS.] 127.19 (a) No health plan issued or renewed to provide coverage to 127.20 a Minnesota resident shall contain any provision denying or 127.21 reducing benefits because services are rendered to a person who 127.22 is eligible for or receiving medical benefits pursuant to title 127.23 XIX of the Social Security Act (Medicaid) in this or any other 127.24 state; chapter 256; 256B; or 256D or services pursuant to 127.25 section 252.27; 256L.01 to 256L.10; 260.251, subdivision 1a; or 127.26 393.07, subdivision 1 or 2. No health carrier providing 127.27 benefits under plans covered by this section shall use 127.28 eligibility for medical programs named in this section as an 127.29 underwriting guideline or reason for nonacceptance of the risk. 127.30 (b) If payment for covered expenses has been made under 127.31 state medical programs for health care items or services 127.32 provided to an individual, and a third party has a legal 127.33 liability to make payments, the rights of payment and appeal of 127.34 an adverse coverage decision for the individual, or in the case 127.35 of a child their responsible relative or caretaker, will be 127.36 subrogated to the stateand/or its authorized agentagency. The 128.1 state agency may assert its subrogation rights to payment under 128.2 this section within three years of the date the service was 128.3 rendered. For purposes of this section, "state agency" includes 128.4 prepaid health plans under contract with the department 128.5 according to sections 256B.69, 256D.03, subdivision 4, paragraph 128.6 (d), and 256L.12; children's mental health collaboratives under 128.7 section 245.493; demonstration projects for persons with 128.8 disabilities under section 256B.77; nursing homes under the 128.9 alternative payment demonstration project under section 128.10 256B.434; and county-based purchasing entities under section 128.11 256B.692. 128.12 (c) Notwithstanding any law to the contrary, when a person 128.13 covered by a health plan receives medical benefits according to 128.14 any statute listed in this section, payment for covered services 128.15 or notice of denial for services billed by the provider must be 128.16 issued directly to the provider. If a person was receiving 128.17 medical benefits through the department of human services at the 128.18 time a service was provided, the provider must indicate this 128.19 benefit coverage on any claim forms submitted by the provider to 128.20 the health carrier for those services. If the commissioner of 128.21 human services notifies the health carrier that the commissioner 128.22 has made payments to the provider, payment for benefits or 128.23 notices of denials issued by the health carrier must be issued 128.24 directly to the commissioner. Submission by the department to 128.25 the health carrier of the claim on a department of human 128.26 services claim form is proper notice and shall be considered 128.27 proof of payment of the claim to the provider and supersedes any 128.28 contract requirements of the health carrier relating to the form 128.29 of submission. Liability to the insured for coverage is 128.30 satisfied to the extent that payments for those benefits are 128.31 made by the health carrier to the provider or the commissioner 128.32 as required by this section. 128.33 (d) When a state agency has acquired the rights of an 128.34 individual eligible for medical programs named in this section 128.35 and has health benefits coverage through a health carrier, the 128.36 health carrier shall not impose requirements that are different 129.1 from requirements applicable to an agent or assignee of any 129.2 other individual covered. 129.3 (e) For the purpose of this section, health plan includes 129.4 coverage offered by community integrated service networks, any 129.5 plan governed under the federal Employee Retirement Income 129.6 Security Act of 1974 (ERISA), United States Code, title 29, 129.7 sections 1001 to 1461, and coverage offered under the exclusions 129.8 listed in section 62A.011, subdivision 3, clauses (2), (6), (9), 129.9 (10), and (12). 129.10 Sec. 4. Minnesota Statutes 1998, section 125A.08, is 129.11 amended to read: 129.12 125A.08 [SCHOOL DISTRICT OBLIGATIONS.] 129.13 (a) As defined in this section, to the extent required by 129.14 federal law as of July 1,19992000, every district must ensure 129.15 the following: 129.16 (1) all students with disabilities are provided the special 129.17 instruction and services which are appropriate to their needs. 129.18 Where the individual education plan team has determined 129.19 appropriate goals and objectives based on the student's needs, 129.20 including the extent to which the student can be included in the 129.21 least restrictive environment, and where there are essentially 129.22 equivalent and effective instruction, related services, or 129.23 assistive technology devices available to meet the student's 129.24 needs, cost to the district may be among the factors considered 129.25 by the team in choosing how to provide the appropriate services, 129.26 instruction, or devices that are to be made part of the 129.27 student's individual education plan. The individual education 129.28 plan team shall consider and may authorize services covered by 129.29 medical assistance according to section 256B.0625, subdivision 129.30 26. The student's needs and the special education instruction 129.31 and services to be provided must be agreed upon through the 129.32 development of an individual education plan. The plan must 129.33 address the student's need to develop skills to live and work as 129.34 independently as possible within the community. By grade 9 or 129.35 age 14, the plan must address the student's needs for transition 129.36 from secondary services to post-secondary education and 130.1 training, employment, community participation, recreation, and 130.2 leisure and home living. In developing the plan, districts must 130.3 inform parents of the full range of transitional goals and 130.4 related services that should be considered. The plan must 130.5 include a statement of the needed transition services, including 130.6 a statement of the interagency responsibilities or linkages or 130.7 both before secondary services are concluded; 130.8 (2) children with a disability under age five and their 130.9 families are provided special instruction and services 130.10 appropriate to the child's level of functioning and needs; 130.11 (3) children with a disability and their parents or 130.12 guardians are guaranteed procedural safeguards and the right to 130.13 participate in decisions involving identification, assessment 130.14 including assistive technology assessment, and educational 130.15 placement of children with a disability; 130.16 (4) eligibility and needs of children with a disability are 130.17 determined by an initial assessment or reassessment, which may 130.18 be completed using existing data under United States Code, title 130.19 20, section 33, et seq.; 130.20 (5) to the maximum extent appropriate, children with a 130.21 disability, including those in public or private institutions or 130.22 other care facilities, are educated with children who are not 130.23 disabled, and that special classes, separate schooling, or other 130.24 removal of children with a disability from the regular 130.25 educational environment occurs only when and to the extent that 130.26 the nature or severity of the disability is such that education 130.27 in regular classes with the use of supplementary services cannot 130.28 be achieved satisfactorily; 130.29 (6) in accordance with recognized professional standards, 130.30 testing and evaluation materials, and procedures used for the 130.31 purposes of classification and placement of children with a 130.32 disability are selected and administered so as not to be 130.33 racially or culturally discriminatory; and 130.34 (7) the rights of the child are protected when the parents 130.35 or guardians are not known or not available, or the child is a 130.36 ward of the state. 131.1 (b) For paraprofessionals employed to work in programs for 131.2 students with disabilities, the school board in each district 131.3 shall ensure that: 131.4 (1) before or immediately upon employment, each 131.5 paraprofessional develops sufficient knowledge and skills in 131.6 emergency procedures, building orientation, roles and 131.7 responsibilities, confidentiality, vulnerability, and 131.8 reportability, among other things, to begin meeting the needs of 131.9 the students with whom the paraprofessional works; 131.10 (2) annual training opportunities are available to enable 131.11 the paraprofessional to continue to further develop the 131.12 knowledge and skills that are specific to the students with whom 131.13 the paraprofessional works, including understanding 131.14 disabilities, following lesson plans, and implementing follow-up 131.15 instructional procedures and activities; and 131.16 (3) a districtwide process obligates each paraprofessional 131.17 to work under the ongoing direction of a licensed teacher and, 131.18 where appropriate and possible, the supervision of a school 131.19 nurse. 131.20 (Effective date: Section 4 (125A.08) is effective July 1, 131.21 2000.) 131.22 Sec. 5. Minnesota Statutes 1998, section 125A.21, 131.23 subdivision 1, is amended to read: 131.24 Subdivision 1. [OBLIGATION TO PAY.] Nothing in sections 131.25 125A.03 to 125A.24 and 125A.65 relieves an insurer or similar 131.26 third party from an otherwise valid obligation to pay, or 131.27 changes the validity of an obligation to pay, for services 131.28 rendered to a child with a disability, and the child's family. 131.29 A school district shall pay the nonfederal share of medical 131.30 assistance services provided according to section 256B.0625, 131.31 subdivision 26. Eligible expenditures must not be made from 131.32 federal funds or funds used to match other federal funds. Any 131.33 federal disallowances are the responsibility of the school 131.34 district. A school district may pay or reimburse copayments, 131.35 coinsurance, deductibles, and other enrollee cost-sharing 131.36 amounts, on behalf of the student or family, in connection with 132.1 health and related services provided under an individual 132.2 educational plan. 132.3 (Effective date: Section 5 (125A.21) is effective July 1, 132.4 2000.) 132.5 Sec. 6. Minnesota Statutes 1998, section 125A.74, 132.6 subdivision 1, is amended to read: 132.7 Subdivision 1. [ELIGIBILITY.] A district may enroll as a 132.8 provider in the medical assistance program and receive medical 132.9 assistance payments for covered special education services 132.10 provided to persons eligible for medical assistance under 132.11 chapter 256B. To receive medical assistance payments, the 132.12 district must pay the nonfederal share of medical assistance 132.13 services provided according to section 256B.0625, subdivision 132.14 26, and comply with relevant provisions of state and federal 132.15 statutes and regulations governing the medical assistance 132.16 program. 132.17 (Effective date: Section 6 (125A.74, subd. 1) is effective 132.18 July 1, 2000.) 132.19 Sec. 7. Minnesota Statutes 1998, section 125A.74, 132.20 subdivision 2, is amended to read: 132.21 Subd. 2. [FUNDING.] A district that provides a covered 132.22 service to an eligible person and complies with relevant 132.23 requirements of the medical assistance program is entitled to 132.24 receive payment for theservice provided, including thatportion 132.25 of thepaymentservices that will subsequently be reimbursed by 132.26 the federal government, in the same manner as other medical 132.27 assistance providers.The school district is not required to132.28provide matching funds or pay part of the costs of the service,132.29as long as the rate charged for the service does not exceed132.30medical assistance limits that apply to all medical assistance132.31providers.132.32 (Effective date: Section 7 (125A.74, subd. 2) is effective 132.33 July 1, 2000.) 132.34 Sec. 8. [214.045] [COORDINATION WITH BOARD OF TEACHING.] 132.35 The commissioner of health and the health-related licensing 132.36 boards must coordinate with the board of teaching when modifying 133.1 licensure requirements for regulated persons in order to have 133.2 consistent regulatory requirements for personnel who perform 133.3 services in schools. 133.4 Sec. 9. Minnesota Statutes 1998, section 245.462, 133.5 subdivision 17, is amended to read: 133.6 Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health 133.7 practitioner" means a person providing services to persons with 133.8 mental illness who is qualified in at least one of the following 133.9 ways: 133.10 (1) holds a bachelor's degree in one of the behavioral 133.11 sciences or related fields from an accredited college or 133.12 university and: 133.13 (i) has at least 2,000 hours of supervised experience in 133.14 the delivery of services to persons with mental illness; or 133.15 (ii) is fluent in the non-English language of the ethnic 133.16 group to which at least 50 percent of the practitioner's clients 133.17 belong, completes 40 hours of training in the delivery of 133.18 services to persons with mental illness, and receives clinical 133.19 supervision from a mental health professional at least once a 133.20 week until the requirement of 2,000 hours of supervised 133.21 experience is met; 133.22 (2) has at least 6,000 hours of supervised experience in 133.23 the delivery of services to persons with mental illness; 133.24 (3) is a graduate student in one of the behavioral sciences 133.25 or related fields and is formally assigned by an accredited 133.26 college or university to an agency or facility for clinical 133.27 training; or 133.28 (4) holds a master's or other graduate degree in one of the 133.29 behavioral sciences or related fields from an accredited college 133.30 or university and has less than 4,000 hours post-master's 133.31 experience in the treatment of mental illness. 133.32 Sec. 10. Minnesota Statutes 1998, section 245.4871, 133.33 subdivision 26, is amended to read: 133.34 Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health 133.35 practitioner" means a person providing services to children with 133.36 emotional disturbances. A mental health practitioner must have 134.1 training and experience in working with children. A mental 134.2 health practitioner must be qualified in at least one of the 134.3 following ways: 134.4 (1) holds a bachelor's degree in one of the behavioral 134.5 sciences or related fields from an accredited college or 134.6 university and: 134.7 (i) has at least 2,000 hours of supervised experience in 134.8 the delivery of mental health services to children with 134.9 emotional disturbances; or 134.10 (ii) is fluent in the non-English language of the ethnic 134.11 group to which at least 50 percent of the practitioner's clients 134.12 belong, completes 40 hours of training in the delivery of 134.13 services to children with emotional disturbances, and receives 134.14 clinical supervision from a mental health professional at least 134.15 once a week until the requirement of 2,000 hours of supervised 134.16 experience is met; 134.17 (2) has at least 6,000 hours of supervised experience in 134.18 the delivery of mental health services to children with 134.19 emotional disturbances; 134.20 (3) is a graduate student in one of the behavioral sciences 134.21 or related fields and is formally assigned by an accredited 134.22 college or university to an agency or facility for clinical 134.23 training; or 134.24 (4) holds a master's or other graduate degree in one of the 134.25 behavioral sciences or related fields from an accredited college 134.26 or university and has less than 4,000 hours post-master's 134.27 experience in the treatment of emotional disturbance. 134.28 Sec. 11. [245.99] [ADULT MENTAL ILLNESS CRISIS HOUSING 134.29 ASSISTANCE PROGRAM.] 134.30 Subdivision 1. [CREATION.] The adult mental illness crisis 134.31 housing assistance program is established. 134.32 Subd. 2. [RENTAL ASSISTANCE.] The program shall pay up to 134.33 90 days of housing assistance for persons with a serious and 134.34 persistent mental illness who require inpatient or residential 134.35 care for stabilization. The commissioner of human services may 134.36 extend the length of assistance on a case-by-case basis. 135.1 Subd. 3. [ELIGIBILITY.] Housing assistance under this 135.2 section is available only to persons of low or moderate income 135.3 as determined by the commissioner of human services. 135.4 Subd. 4. [ADMINISTRATION.] The commissioner may contract 135.5 with organizations or government units experienced in housing 135.6 assistance to operate the program under this section. 135.7 Sec. 12. Minnesota Statutes 1998, section 245A.04, 135.8 subdivision 3a, is amended to read: 135.9 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 135.10 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 135.11 commissioner shall notify the applicant or license holder and 135.12 the individual who is the subject of the study, in writing or by 135.13 electronic transmission, of the results of the study. When the 135.14 study is completed, a notice that the study was undertaken and 135.15 completed shall be maintained in the personnel files of the 135.16 program. For studies on individuals pertaining to a license to 135.17 provide family day care or group family day care, foster care 135.18 for children in the provider's own home, or foster care or day 135.19 care services for adults in the provider's own home, the 135.20 commissioner is not required to provide a separate notice of the 135.21 background study results to the individual who is the subject of 135.22 the study unless the study results in a disqualification of the 135.23 individual. 135.24 The commissioner shall notify the individual studied if the 135.25 information in the study indicates the individual is 135.26 disqualified from direct contact with persons served by the 135.27 program. The commissioner shall disclose the information 135.28 causing disqualification and instructions on how to request a 135.29 reconsideration of the disqualification to the individual 135.30 studied. An applicant or license holder who is not the subject 135.31 of the study shall be informed that the commissioner has found 135.32 information that disqualifies the subject from direct contact 135.33 with persons served by the program. However, only the 135.34 individual studied must be informed of the information contained 135.35 in the subject's background study unless the only basis for the 135.36 disqualification is failure to cooperate, the Data Practices Act 136.1 provides for release of the information, or the individual 136.2 studied authorizes the release of the information. 136.3 (b) If the commissioner determines that the individual 136.4 studied has a disqualifying characteristic, the commissioner 136.5 shall review the information immediately available and make a 136.6 determination as to the subject's immediate risk of harm to 136.7 persons served by the program where the individual studied will 136.8 have direct contact. The commissioner shall consider all 136.9 relevant information available, including the following factors 136.10 in determining the immediate risk of harm: the recency of the 136.11 disqualifying characteristic; the recency of discharge from 136.12 probation for the crimes; the number of disqualifying 136.13 characteristics; the intrusiveness or violence of the 136.14 disqualifying characteristic; the vulnerability of the victim 136.15 involved in the disqualifying characteristic; and the similarity 136.16 of the victim to the persons served by the program where the 136.17 individual studied will have direct contact. The commissioner 136.18 may determine that the evaluation of the information immediately 136.19 available gives the commissioner reason to believe one of the 136.20 following: 136.21 (1) The individual poses an imminent risk of harm to 136.22 persons served by the program where the individual studied will 136.23 have direct contact. If the commissioner determines that an 136.24 individual studied poses an imminent risk of harm to persons 136.25 served by the program where the individual studied will have 136.26 direct contact, the individual and the license holder must be 136.27 sent a notice of disqualification. The commissioner shall order 136.28 the license holder to immediately remove the individual studied 136.29 from direct contact. The notice to the individual studied must 136.30 include an explanation of the basis of this determination. 136.31 (2) The individual poses a risk of harm requiring 136.32 continuous supervision while providing direct contact services 136.33 during the period in which the subject may request a 136.34 reconsideration. If the commissioner determines that an 136.35 individual studied poses a risk of harm that requires continuous 136.36 supervision, the individual and the license holder must be sent 137.1 a notice of disqualification. The commissioner shall order the 137.2 license holder to immediately remove the individual studied from 137.3 direct contact services or assure that the individual studied is 137.4 within sight or hearing of another staff person when providing 137.5 direct contact services during the period in which the 137.6 individual may request a reconsideration of the 137.7 disqualification. If the individual studied does not submit a 137.8 timely request for reconsideration, or the individual submits a 137.9 timely request for reconsideration, but the disqualification is 137.10 not set aside for that license holder, the license holder will 137.11 be notified of the disqualification and ordered to immediately 137.12 remove the individual from any position allowing direct contact 137.13 with persons receiving services from the license holder. 137.14 (3) The individual does not pose an imminent risk of harm 137.15 or a risk of harm requiring continuous supervision while 137.16 providing direct contact services during the period in which the 137.17 subject may request a reconsideration. If the commissioner 137.18 determines that an individual studied does not pose a risk of 137.19 harm that requires continuous supervision, only the individual 137.20 must be sent a notice of disqualification. The license holder 137.21 must be sent a notice that more time is needed to complete the 137.22 individual's background study. If the individual studied 137.23 submits a timely request for reconsideration, and if the 137.24 disqualification is set aside for that license holder, the 137.25 license holder will receive the same notification received by 137.26 license holders in cases where the individual studied has no 137.27 disqualifying characteristic. If the individual studied does 137.28 not submit a timely request for reconsideration, or the 137.29 individual submits a timely request for reconsideration, but the 137.30 disqualification is not set aside for that license holder, the 137.31 license holder will be notified of the disqualification and 137.32 ordered to immediately remove the individual from any position 137.33 allowing direct contact with persons receiving services from the 137.34 license holder. 137.35 (c) County licensing agencies performing duties under this 137.36 subdivision may develop an alternative system for determining 138.1 the subject's immediate risk of harm to persons served by the 138.2 program, providing the notices under paragraph (b), and 138.3 documenting the action taken by the county licensing agency. 138.4 Each county licensing agency's implementation of the alternative 138.5 system is subject to approval by the commissioner. 138.6 Notwithstanding this alternative system, county licensing 138.7 agencies shall complete the requirements of paragraph (a). 138.8 Sec. 13. Minnesota Statutes 1998, section 245A.08, 138.9 subdivision 5, is amended to read: 138.10 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 138.11 considering the findings of fact, conclusions, and 138.12 recommendations of the administrative law judge, the 138.13 commissioner shall issue a final order. The commissioner shall 138.14 consider, but shall not be bound by, the recommendations of the 138.15 administrative law judge. The appellant must be notified of the 138.16 commissioner's final order as required by chapter 14. The 138.17 notice must also contain information about the appellant's 138.18 rights under chapter 14. The institution of proceedings for 138.19 judicial review of the commissioner's final order shall not stay 138.20 the enforcement of the final order except as provided in section 138.21 14.65. A license holder and each controlling individual of a 138.22 license holder whose license has been revoked because of 138.23 noncompliance with applicable law or rule must not be granted a 138.24 license for five years following the revocation. An applicant 138.25 whose application was denied must not be granted a license for 138.26 two years following a denial, unless the applicant's subsequent 138.27 application contains new information which constitutes a 138.28 substantial change in the conditions that caused the previous 138.29 denial. 138.30 Sec. 14. Minnesota Statutes 1998, section 245B.05, 138.31 subdivision 7, is amended to read: 138.32 Subd. 7. [REPORTING INCIDENTS AND EMERGENCIES.] The 138.33 license holder must report the following incidents to the 138.34 consumer's legal representative, caregiver, and case manager 138.35 within 24 hours of the occurrence, or within 24 hours of receipt 138.36 of the information: 139.1 (1) the death of a consumer; 139.2 (2) any medical emergencies, unexpected serious illnesses, 139.3 or accidents that require physician treatment or 139.4 hospitalization; 139.5 (3) a consumer's unauthorized absence; or 139.6 (4) any fires and incidents involving a law enforcement 139.7 agency. 139.8 Death or serious injury of the consumer must also be 139.9 reported to thecommissionerdepartment of human services 139.10 licensing division and the ombudsman, as required under sections 139.11 245.91 and 245.94, subdivision 2a. 139.12 Sec. 15. Minnesota Statutes 1998, section 245B.07, 139.13 subdivision 5, is amended to read: 139.14 Subd. 5. [STAFF ORIENTATION.] (a) Within 60 days of hiring 139.15 staff who provide direct service, the license holder must 139.16 provide 30 hours of staff orientation. Direct care staff must 139.17 complete 15 of the 30 hours orientation before providing any 139.18 unsupervised direct service to a consumer. If the staff person 139.19 has received orientation training from a license holder licensed 139.20 under this chapter, or provides semi-independent living services 139.21 only, the 15-hour requirement may be reduced to eight hours. 139.22 The total orientation of 30 hours may be reduced to 15 hours if 139.23 the staff person has previously received orientation training 139.24 from a license holder licensed under this chapter. 139.25 (b) The 30 hours of orientation must combine supervised 139.26 on-the-job training with coverage of the following material: 139.27 (1) review of the consumer's service plans and risk 139.28 management plan to achieve an understanding of the consumer as a 139.29 unique individual; 139.30 (2) review and instruction on the license holder's policies 139.31 and procedures, including their location and access; 139.32 (3) emergency procedures; 139.33 (4) explanation of specific job functions, including 139.34 implementing objectives from the consumer's individual service 139.35 plan; 139.36 (5) explanation of responsibilities related to section 140.1 245A.65; sections 626.556 and 626.557, governing maltreatment 140.2 reporting and service planning for children and vulnerable 140.3 adults; and section 245.825, governing use of aversive and 140.4 deprivation procedures; 140.5 (6) medication administration as it applies to the 140.6 individual consumer, from a training curriculum developed by a 140.7 health services professional described in section 245B.05, 140.8 subdivision 5, and when the consumer meets the criteria of 140.9 having overriding health care needs, then medication 140.10 administration taught by a health services professional. Staff 140.11 may administer medications only after they demonstrate the 140.12 ability, as defined in the license holder's medication 140.13 administration policy and procedures. Once a consumer with 140.14 overriding health care needs is admitted, staff will be provided 140.15 with remedial training as deemed necessary by the license holder 140.16 and the health professional to meet the needs of that consumer. 140.17 For purposes of this section, overriding health care needs 140.18 means a health care condition that affects the service options 140.19 available to the consumer because the condition requires: 140.20 (i) specialized or intensive medical or nursing 140.21 supervision; and 140.22 (ii) nonmedical service providers to adapt their services 140.23 to accommodate the health and safety needs of the consumer; 140.24 (7) consumer rights; and 140.25 (8) other topics necessary as determined by the consumer's 140.26 individual service plan or other areas identified by the license 140.27 holder. 140.28 (c) The license holder must document each employee's 140.29 orientation received. 140.30 Sec. 16. Minnesota Statutes 1998, section 245B.07, 140.31 subdivision 8, is amended to read: 140.32 Subd. 8. [POLICIES AND PROCEDURES.] The license holder 140.33 must develop and implement the policies and procedures in 140.34 paragraphs (1) to (3). 140.35 (1) policies and procedures that promote consumer health 140.36 and safety by ensuring: 141.1 (i) consumer safety in emergency situations as identified 141.2 in section 245B.05, subdivision 7; 141.3 (ii) consumer health through sanitary practices; 141.4 (iii) safe transportation, when the license holder is 141.5 responsible for transportation of consumers, with provisions for 141.6 handling emergency situations; 141.7 (iv) a system of recordkeeping for both individuals and the 141.8 organization, for review of incidents and emergencies, and 141.9 corrective action if needed; 141.10 (v) a plan for responding to and reporting all emergencies, 141.11 including deaths, medical emergencies, illnesses, accidents, 141.12 missing consumers, fires, severe weather and natural disasters, 141.13 bomb threats, and other threats; 141.14 (vi) safe medication administration as identified in 141.15 section 245B.05, subdivision 5, incorporating an observed skill 141.16 assessment to ensure that staff demonstrate the ability to 141.17 administer medications consistent with the license holder's 141.18 policy and procedures; 141.19 (vii) psychotropic medication monitoring when the consumer 141.20 is prescribed a psychotropic medication, including the use of 141.21 the psychotropic medication use checklist. If the 141.22 responsibility for implementing the psychotropic medication use 141.23 checklist has not been assigned in the individual service plan 141.24 and the consumer lives in a licensed site, the residential 141.25 license holder shall be designated; and 141.26 (viii) criteria for admission or service initiation 141.27 developed by the license holder; 141.28 (2) policies and procedures that protect consumer rights 141.29 and privacy by ensuring: 141.30 (i) consumer data privacy, in compliance with the Minnesota 141.31 Data Practices Act, chapter 13; and 141.32 (ii) that complaint procedures provide consumers with a 141.33 simple process to bring grievances and consumers receive a 141.34 response to the grievance within a reasonable time period. The 141.35 license holder must provide a copy of the program's grievance 141.36 procedure and time lines for addressing grievances. The 142.1 program's grievance procedure must permit consumers served by 142.2 the program and the authorized representatives to bring a 142.3 grievance to the highest level of authority in the program; and 142.4 (3) policies and procedures that promote continuity and 142.5 quality of consumer supports by ensuring: 142.6 (i) continuity of care and service coordination, including 142.7 provisions for service termination, temporary service 142.8 suspension, and efforts made by the license holder to coordinate 142.9 services with other vendors who also provide support to the 142.10 consumer. The policy must include the following requirements: 142.11 (A) the license holder must notify the consumer or 142.12 consumer's legal representative and the consumer's case manager 142.13 in writing of the intended termination or temporary service 142.14 suspension and the consumer's right to seek a temporary order 142.15 staying the termination or suspension of service according to 142.16 the procedures in section 256.045, subdivision 4a or subdivision 142.17 6, paragraph (c); 142.18 (B) notice of the proposed termination of services, 142.19 including those situations that began with a temporary service 142.20 suspension, must be given at least 60 days before the proposed 142.21 termination is to become effective, unless services are142.22temporarily suspended according to the license holder's written142.23temporary service suspension procedures, in which case notice142.24must be given as soon as possible; 142.25 (C) the license holder must provide information requested 142.26 by the consumer or consumer's legal representative or case 142.27 manager when services are temporarily suspended or upon notice 142.28 of termination; 142.29 (D) use of temporary service suspension procedures are 142.30 restricted to situations in which the consumer's behavior causes 142.31 immediate and serious danger to the health and safety of the 142.32 individual or others; 142.33 (E) prior to giving notice of service termination or 142.34 temporary service suspension, the license holder must document 142.35 actions taken to minimize or eliminate the need for service 142.36 termination or temporary service suspension; and 143.1 (F) during the period of temporary service suspension, the 143.2 license holder will work with the appropriate county agency to 143.3 develop reasonable alternatives to protect the individual and 143.4 others; and 143.5 (ii) quality services measured through a program evaluation 143.6 process including regular evaluations of consumer satisfaction 143.7 and sharing the results of the evaluations with the consumers 143.8 and legal representatives. 143.9 Sec. 17. Minnesota Statutes 1998, section 245B.07, 143.10 subdivision 10, is amended to read: 143.11 Subd. 10. [CONSUMER FUNDS.] (a) The license holder must 143.12 ensure that consumers retain the use and availability of 143.13 personal funds or property unless restrictions are justified in 143.14 the consumer's individual service plan. 143.15 (b) The license holder must ensure separation ofresident143.16 consumer funds from funds of the license holder, theresidential143.17 program, or program staff. 143.18 (c) Whenever the license holder assists a consumer with the 143.19 safekeeping of funds or other property, the license holder 143.20 must have written authorization to do so by the consumer or the 143.21 consumer's legal representative and the case manager. In 143.22 addition, the license holder must: 143.23 (1) document receipt and disbursement of the consumer's 143.24 funds or the property, and include the signature of the143.25consumer, conservator, or payee; 143.26 (2)provide a statement at least quarterly itemizing143.27 annually survey, document, and implement the preferences of the 143.28 consumer, consumer's legal representative, and the case manager 143.29 for frequency of receiving a statement that itemizes receipts 143.30 and disbursements ofresidentconsumer funds or other property; 143.31 and 143.32 (3) return to the consumer upon the consumer's request, 143.33 funds and property in the license holder's possession subject to 143.34 restrictions in the consumer's individual service plan, as soon 143.35 as possible, but no later than three working days after the date 143.36 of the request. 144.1 (d) License holders and program staff must not: 144.2 (1) borrow money from a consumer; 144.3 (2) purchase personal items from a consumer; 144.4 (3) sell merchandise or personal services to a consumer; 144.5 (4) require aresidentconsumer to purchase items for which 144.6 the license holder is eligible for reimbursement; or 144.7 (5) useresidentconsumer funds in a manner that would 144.8 violate section 256B.04, or any rules promulgated under that 144.9 section. 144.10 Sec. 18. Minnesota Statutes 1998, section 252.32, 144.11 subdivision 3a, is amended to read: 144.12 Subd. 3a. [REPORTS AND ALLOCATIONS.] (a) The commissioner 144.13 shall specify requirements for quarterly fiscal and annual 144.14 program reports according to section 256.01, subdivision 2, 144.15 paragraph (17). Program reports shall include data which will 144.16 enable the commissioner to evaluate program effectiveness and to 144.17 audit compliance. The commissioner shall reimburse county costs 144.18 on a quarterly basis. 144.19 (b)Beginning January 1, 1998,The commissioner shall 144.20 allocate state funds made available under this section to county 144.21 social service agencies on a calendar year basis. The 144.22 commissioner shall allocate to each county first in amounts 144.23 equal to each county's guaranteed floor as described in clause 144.24 (1), and second, any remaining funds, after the allocation of144.25funds to the newly participating counties as provided for in144.26clause (3), shall be allocated in proportion to each county's144.27total number of families receiving a grant on July 1 of the most144.28recent calendar yearwill be allocated to county agencies to 144.29 support children in their family homes. 144.30 (1) Each county's guaranteed floor shall be calculated as 144.31 follows: 144.32 (i) 95 percent of the county's allocation received in the 144.33 preceding calendar year. For the calendar year 1998 allocation,144.34the preceding calendar year shall be considered to be double the144.35six-month allocation as provided in clause (2); 144.36 (ii) when the amount of funds available for allocation is 145.1 less than the amount available in the preceding year, each 145.2 county's previous year allocation shall be reduced in proportion 145.3 to the reduction in statewide funding, for the purpose of 145.4 establishing the guaranteed floor. 145.5 (2)For the period July 1, 1997, to December 31, 1997, the145.6commissioner shall allocate to each county an amount equal to145.7the actual, state approved grants issued to the families for the145.8month of January 1997, multiplied by six. This six-month145.9allocation shall be combined with the calendar year 1998145.10allocation and be administered as an 18-month allocation.145.11(3) At the commissioner's discretion, funds may be145.12allocated to any nonparticipating county that requests an145.13allocation under this section. Allocations to newly145.14participating counties are dependent upon the availability of145.15funds, as determined by the actual expenditure amount of the145.16participating counties for the most recently completed calendar145.17year.145.18(4)The commissioner shall regularly review the use of 145.19 family support fund allocations by county. The commissioner may 145.20 reallocate unexpended or unencumbered money at any time to those 145.21 counties that have a demonstrated need for additional funding. 145.22 (c) County allocations under this section will be adjusted 145.23 for transfers that occur according to section 256.476 or when 145.24 the county of financial responsibility changes according to 145.25 chapter 256G for eligible recipients. 145.26 Sec. 19. Minnesota Statutes 1998, section 256.015, 145.27 subdivision 1, is amended to read: 145.28 Subdivision 1. [STATE AGENCY HAS LIEN.] When the state 145.29 agency provides, pays for, or becomes liable for medical care or 145.30 furnishes subsistence or other payments to a person, the agency 145.31 shall have a lien for the cost of the care and payments on any 145.32 and all causes of action or recovery rights under any policy, 145.33 plan, or contract providing benefits for health care or injury 145.34 which accrue to the person to whom the care or payments were 145.35 furnished, or to the person's legal representatives, as a result 145.36 of the occurrence that necessitated the medical care, 146.1 subsistence, or other payments. For purposes of this section, 146.2 "state agency" includesauthorized agents of the state agency146.3 prepaid health plans under contract with the commissioner 146.4 according to sections 256B.69, 256D.03, subdivision 4, paragraph 146.5 (d), and 256L.12; children's mental health collaboratives under 146.6 section 245.493; demonstration projects for persons with 146.7 disabilities under section 256B.77; nursing homes under the 146.8 alternative payment demonstration project under section 146.9 256B.434; and county-based purchasing entities under section 146.10 256B.692. 146.11 Sec. 20. Minnesota Statutes 1998, section 256.015, 146.12 subdivision 3, is amended to read: 146.13 Subd. 3. [PROSECUTOR.] The attorney general, or the146.14appropriate county attorney acting at the direction of the146.15attorney general,shall represent thestate agencycommissioner 146.16 to enforce the lien created under this section or, if no action 146.17 has been brought, may initiate and prosecute an independent 146.18 action on behalf of thestate agencycommissioner against a 146.19 person, firm, or corporation that may be liable to the person to 146.20 whom the care or payment was furnished. 146.21 Any prepaid health plan providing services under sections 146.22 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 146.23 children's mental health collaboratives under section 245.493; 146.24 demonstration projects for persons with disabilities under 146.25 section 256B.77; nursing homes under the alternative payment 146.26 demonstration project under section 256B.434; or the 146.27 county-based purchasing entity providing services under section 146.28 256B.692 may retain legal representation to enforce their lien 146.29 created under this section or, if no action has been brought, 146.30 may initiate and prosecute an independent action on their behalf 146.31 against a person, firm, or corporation that may be liable to the 146.32 person to whom the care or payment was furnished. 146.33 Sec. 21. [256.028] [TAX REBATES.] 146.34 Any federal or state tax rebate received by a recipient of 146.35 a public assistance program shall not be counted as income or as 146.36 an asset for purposes of any of the public assistance programs 147.1 under this chapter or any other chapter, including, but not 147.2 limited to, chapter 256B, 256D, 256E, 256I, 256J, or 256L to the 147.3 extent permitted under federal law. 147.4 Sec. 22. Minnesota Statutes 1998, section 256.955, 147.5 subdivision 3, is amended to read: 147.6 Subd. 3. [PRESCRIPTION DRUG COVERAGE.]Coverage under the147.7program is limited to prescription drugs covered under the147.8medical assistance program as described in section 256B.0625,147.9subdivision 13, subject to a maximum deductible of $300147.10annually, except drugs cleared by the FDA shall be available to147.11qualified senior citizens enrolled in the program without147.12restriction when prescribed for medically accepted indication as147.13defined in the federal rebate program under section 1927 of147.14title XIX of the federal Social Security Act.Coverage under 147.15 the program shall be limited to those prescription drugs that: 147.16 (1) are covered under the medical assistance program as 147.17 described in section 256B.0625, subdivision 13; and 147.18 (2) are provided by manufacturers that have fully executed 147.19 senior drug rebate agreements with the commissioner and comply 147.20 with such agreements. 147.21 Sec. 23. Minnesota Statutes 1998, section 256.955, 147.22 subdivision 4, is amended to read: 147.23 Subd. 4. [APPLICATION PROCEDURES AND COORDINATION WITH 147.24 MEDICAL ASSISTANCE.] Applications and information on the program 147.25 must be made available at county social service agencies, health 147.26 care provider offices, and agencies and organizations serving 147.27 senior citizens. Senior citizens shall submit applications and 147.28 any information specified by the commissioner as being necessary 147.29 to verify eligibility directly to the county social service 147.30 agencies: 147.31 (1) beginning January 1, 1999, the county social service 147.32 agency shall determine medical assistance spenddown eligibility 147.33 of individuals who qualify for the senior citizen drug program 147.34 of individuals; and 147.35 (2) program payments will be used to reduce the spenddown 147.36 obligations of individuals who are determined to be eligible for 148.1 medical assistance with a spenddown as defined in section 148.2 256B.056, subdivision 5. 148.3 Seniors who are eligible for medical assistance with a spenddown 148.4 shall be financially responsible for the deductible amount up to 148.5 the satisfaction of the spenddown. No deductible applies once 148.6 the spenddown has been met. Payments to providers for 148.7 prescription drugs for persons eligible under this subdivision 148.8 shall be reduced by the deductible. 148.9 County social service agencies shall determine an 148.10 applicant's eligibility for the program within 30 days from the 148.11 date the application is received. Eligibility begins the month 148.12 after approval. 148.13 Sec. 24. Minnesota Statutes 1998, section 256.955, 148.14 subdivision 7, is amended to read: 148.15 Subd. 7. [COST SHARING.](a) Enrollees shall pay an annual148.16premium of $120.148.17(b)Program enrollees must satisfy a$300$420 annual 148.18 deductible, based upon expenditures for prescription drugs, to 148.19 be paid as follows: 148.20 (1)$25$35 monthly deductible for persons with a monthly 148.21 spenddown; or 148.22 (2)$150$210 biannual deductible for persons with a 148.23 six-month spenddown. 148.24 (Effective date: Section 24 (256.955, subd. 7) is 148.25 effective the day following final enactment.) 148.26 Sec. 25. Minnesota Statutes 1998, section 256.955, 148.27 subdivision 8, is amended to read: 148.28 Subd. 8. [REPORT.] The commissioner shall annually report 148.29 to the legislature on the senior citizen drug program. The 148.30 report must include demographic information on enrollees, 148.31 per-prescription expenditures, total program expenditures, 148.32 hospital and nursing home costs avoided by enrollees, any 148.33 savings to medical assistance and Medicare resulting from the 148.34 provision of prescription drug coverage under Medicare by health 148.35 maintenance organizations, other public and private options for 148.36 drug assistance to the senior population, any hardships caused 149.1 by the annualpremium anddeductible, and any recommendations 149.2 for changes in the senior drug program. 149.3 Sec. 26. Minnesota Statutes 1998, section 256.955, 149.4 subdivision 9, is amended to read: 149.5 Subd. 9. [PROGRAM LIMITATION.] The commissioner shall 149.6 administer the senior drug program so that the costs total no 149.7 more than funds appropriated plus the drug rebate proceeds. 149.8 Senior drug program rebate revenues are appropriated to the 149.9 commissioner and shall be expended to augment funding of the 149.10 senior drug program. New enrollment shall cease if the 149.11 commissioner determines that, given current enrollment, costs of 149.12 the program will exceed appropriated funds and rebate proceeds. 149.13 This section shall be repealed upon federal approval of the 149.14 waiver to allow the commissioner to provide prescription drug 149.15 coverage for qualified Medicare beneficiaries whose income is 149.16 less than 150 percent of the federal poverty guidelines. 149.17 Sec. 27. Minnesota Statutes 1998, section 256.9685, 149.18 subdivision 1a, is amended to read: 149.19 Subd. 1a. [ADMINISTRATIVE RECONSIDERATION.] 149.20 Notwithstanding sections 256B.04, subdivision 15, and 256D.03, 149.21 subdivision 7, the commissioner shall establish an 149.22 administrative reconsideration process for appeals of inpatient 149.23 hospital services determined to be medically unnecessary. A 149.24 physician or hospital may request a reconsideration of the 149.25 decision that inpatient hospital services are not medically 149.26 necessary by submitting a written request for review to the 149.27 commissioner within 30 days after receiving notice of the 149.28 decision. The reconsideration process shall take place prior to 149.29 the procedures of subdivision 1b and shall be conducted by 149.30 physicians that are independent of the case under 149.31 reconsideration. A majority decision by the physicians is 149.32 necessary to make a determination that the services were not 149.33 medically necessary. 149.34 Sec. 28. Minnesota Statutes 1998, section 256.969, 149.35 subdivision 1, is amended to read: 149.36 Subdivision 1. [HOSPITAL COST INDEX.] (a) The hospital 150.1 cost index shall be the change in the Consumer Price Index-All 150.2 Items (United States city average) (CPI-U) forecasted by Data 150.3 Resources, Inc. The commissioner shall use the indices as 150.4 forecasted in the third quarter of the calendar year prior to 150.5 the rate year. The hospital cost index may be used to adjust 150.6 the base year operating payment rate through the rate year on an 150.7 annually compounded basis. 150.8 (b) For fiscal years beginning on or after July 1, 1993, 150.9 the commissioner of human services shall not provide automatic 150.10 annual inflation adjustments for hospital payment rates under 150.11 medical assistance, nor under general assistance medical care, 150.12 except that the inflation adjustments under paragraph (a) for 150.13 medical assistance, excluding general assistance medical care, 150.14 shall apply through calendar year19992001. The index for 150.15 calendar year 2000 shall be reduced 2.5 percentage points to 150.16 recover overprojections of the index from 1994 to 1996. The 150.17 commissioner of finance shall include as a budget change request 150.18 in each biennial detailed expenditure budget submitted to the 150.19 legislature under section 16A.11 annual adjustments in hospital 150.20 payment rates under medical assistance and general assistance 150.21 medical care, based upon the hospital cost index. 150.22 Sec. 29. Minnesota Statutes 1998, section 256B.04, 150.23 subdivision 16, is amended to read: 150.24 Subd. 16. [PERSONAL CARE SERVICES.] (a) Notwithstanding 150.25 any contrary language in this paragraph, the commissioner of 150.26 human services and the commissioner of health shall jointly 150.27 promulgate rules to be applied to the licensure of personal care 150.28 services provided under the medical assistance program. The 150.29 rules shall consider standards for personal care services that 150.30 are based on the World Institute on Disability's recommendations 150.31 regarding personal care services. These rules shall at a 150.32 minimum consider the standards and requirements adopted by the 150.33 commissioner of health under section 144A.45, which the 150.34 commissioner of human services determines are applicable to the 150.35 provision of personal care services, in addition to other 150.36 standards or modifications which the commissioner of human 151.1 services determines are appropriate. 151.2 The commissioner of human services shall establish an 151.3 advisory group including personal care consumers and providers 151.4 to provide advice regarding which standards or modifications 151.5 should be adopted. The advisory group membership must include 151.6 not less than 15 members, of which at least 60 percent must be 151.7 consumers of personal care services and representatives of 151.8 recipients with various disabilities and diagnoses and ages. At 151.9 least 51 percent of the members of the advisory group must be 151.10 recipients of personal care. 151.11 The commissioner of human services may contract with the 151.12 commissioner of health to enforce the jointly promulgated 151.13 licensure rules for personal care service providers. 151.14 Prior to final promulgation of the joint rule the 151.15 commissioner of human services shall report preliminary findings 151.16 along with any comments of the advisory group and a plan for 151.17 monitoring and enforcement by the department of health to the 151.18 legislature by February 15, 1992. 151.19 Limits on the extent of personal care services that may be 151.20 provided to an individual must be based on the 151.21 cost-effectiveness of the services in relation to the costs of 151.22 inpatient hospital care, nursing home care, and other available 151.23 types of care. The rules must provide, at a minimum: 151.24 (1) that agencies be selected to contract with or employ 151.25 and train staff to provide and supervise the provision of 151.26 personal care services; 151.27 (2) that agencies employ or contract with a qualified 151.28 applicant that a qualified recipient proposes to the agency as 151.29 the recipient's choice of assistant; 151.30 (3) that agencies bill the medical assistance program for a 151.31 personal care service by a personal care assistant and 151.32 supervision bythe registered nursea qualified professional 151.33 supervising the personal care assistant unless the recipient 151.34 selects the fiscal agent option under section 256B.0627, 151.35 subdivision 10; 151.36 (4) that agencies establish a grievance mechanism; and 152.1 (5) that agencies have a quality assurance program. 152.2 (b) The commissioner may waive the requirement for the 152.3 provision of personal care services through an agency in a 152.4 particular county, when there are less than two agencies 152.5 providing services in that county and shall waive the 152.6 requirement for personal care assistants required to join an 152.7 agency for the first time during 1993 when personal care 152.8 services are provided under a relative hardship waiver under 152.9 section 256B.0627, subdivision 4, paragraph (b), clause (7), and 152.10 at least two agencies providing personal care services have 152.11 refused to employ or contract with the independent personal care 152.12 assistant. 152.13 Sec. 30. Minnesota Statutes 1998, section 256B.04, is 152.14 amended by adding a subdivision to read: 152.15 Subd. 19. [PERFORMANCE DATA REPORTING UNIT.] The 152.16 commissioner of human services shall establish a performance 152.17 data reporting unit that serves counties and the state. The 152.18 department shall support this unit and provide technical 152.19 assistance and access to the data warehouse. The performance 152.20 data reporting unit, which will operate within the department's 152.21 central office and consist of both county and department staff, 152.22 shall provide performance data reports to individual counties, 152.23 share expertise from counties and the department perspective, 152.24 and participate in joint planning to link with county databases 152.25 and other county data sources in order to provide information on 152.26 services provided to public clients from state, federal, and 152.27 county funding sources. The performance data reporting unit 152.28 shall provide counties both individual and group summary level 152.29 standard or unique reports on health care eligibility and 152.30 services provided to clients for whom they have financial 152.31 responsibility. 152.32 Sec. 31. Minnesota Statutes 1998, section 256B.042, 152.33 subdivision 1, is amended to read: 152.34 Subdivision 1. [LIEN FOR COST OF CARE.] When the state 152.35 agency provides, pays for, or becomes liable for medical care, 152.36 it shall have a lien for the cost of the care upon any and all 153.1 causes of action or recovery rights under any policy, plan, or 153.2 contract providing benefits for health care or injury, which 153.3 accrue to the person to whom the care was furnished, or to the 153.4 person's legal representatives, as a result of the illness or 153.5 injuries which necessitated the medical care. For purposes of 153.6 this section, "state agency" includes prepaid health plans under 153.7 contract with the commissioner according to sections 256B.69, 153.8 256D.03, subdivision 4, paragraph (d), and 256L.12; children's 153.9 mental health collaboratives under section 245.493; 153.10 demonstration projects for persons with disabilities under 153.11 section 256B.77; nursing facilities under the alternative 153.12 payment demonstration project under section 256B.434; and 153.13 county-based purchasing entities under section 256B.692. 153.14 Sec. 32. Minnesota Statutes 1998, section 256B.042, 153.15 subdivision 2, is amended to read: 153.16 Subd. 2. [LIEN ENFORCEMENT.] (a) The state agency may 153.17 perfect and enforce its lien by following the procedures set 153.18 forth in sections 514.69, 514.70 and 514.71, and its verified 153.19 lien statement shall be filed with the appropriate court 153.20 administrator in the county of financial responsibility. The 153.21 verified lien statement shall contain the following: the name 153.22 and address of the person to whom medical care was furnished, 153.23 the date of injury, the name and address of the vendor or 153.24 vendors furnishing medical care, the dates of the service, the 153.25 amount claimed to be due for the care, and, to the best of the 153.26 state agency's knowledge, the names and addresses of all 153.27 persons, firms, or corporations claimed to be liable for damages 153.28 arising from the injuries. This section shall not affect the 153.29 priority of any attorney's lien. 153.30 (b) The state agency is not subject to any limitations 153.31 period referred to in section 514.69 or 514.71 and has one year 153.32 from the date notice is first received by it under subdivision 153.33 4, paragraph (c), even if the notice is untimely, or one year 153.34 from the date medical bills are first paid by the state agency, 153.35 whichever is later, to file its verified lien statement. The 153.36 state agency may commence an action to enforce the lien within 154.1 one year of (1) the date the notice required by subdivision 4, 154.2 paragraph (c), is received or (2) the date the recipient's cause 154.3 of action is concluded by judgment, award, settlement, or 154.4 otherwise, whichever is later.For purposes of this section,154.5"state agency" includes authorized agents of the state agency.154.6 (c) If the notice required in subdivision 4 is not provided 154.7 by any of the parties to the claim at any stage of the claim, 154.8 the state agency will have one year from the date the state 154.9 agency learns of the lack of notice to commence an action. If 154.10 amounts on the claim or cause of action are paid and the amount 154.11 required to be paid to the state agency under subdivision 5, is 154.12 not paid to the state agency, the state agency may commence an 154.13 action to recover on the lien against any or all of the parties 154.14 or entities which have either paid or received the payments. 154.15 Sec. 33. Minnesota Statutes 1998, section 256B.042, 154.16 subdivision 3, is amended to read: 154.17 Subd. 3. The attorney general, or the appropriate county154.18attorney acting at the direction of the attorney general,shall 154.19 represent thestate agencycommissioner to enforce the lien 154.20 created under this section or, if no action has been brought, 154.21 may initiate and prosecute an independent action on behalf of 154.22 thestate agencycommissioner against a person, firm, or 154.23 corporation that may be liable to the person to whom the care 154.24 was furnished. 154.25 Any prepaid health plan providing services under sections 154.26 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 154.27 children's mental health collaboratives under section 245.493; 154.28 demonstration projects for persons with disabilities under 154.29 section 256B.77; nursing homes under the alternative payment 154.30 demonstration project under section 256B.434; or the 154.31 county-based purchasing entity providing services under section 154.32 256B.692 may retain legal representation to enforce their lien 154.33 created under this section or, if no action has been brought, 154.34 may initiate and prosecute an independent action on their behalf 154.35 against a person, firm, or corporation that may be liable to the 154.36 person to whom the care or payment was furnished. 155.1 Sec. 34. Minnesota Statutes 1998, section 256B.055, 155.2 subdivision 3a, is amended to read: 155.3 Subd. 3a. [MFIP-S FAMILIES; FAMILIES ELIGIBLE UNDER PRIOR 155.4 AFDC RULES.] (a) Beginning January 1, 1998, or on the date that 155.5 MFIP-S is implemented in counties, medical assistance may be 155.6 paid for a person receiving public assistance under the MFIP-S 155.7 program. 155.8 (b) Beginning January 1, 1998, medical assistance may be 155.9 paid for a person who would have been eligible for public 155.10 assistance under the income and resource standardsand155.11deprivation requirements, or who would have been eligible but 155.12 for excess income or assets, under the state's AFDC plan in 155.13 effect as of July 16, 1996, as required by the Personal 155.14 Responsibility and Work Opportunity Reconciliation Act of 1996 155.15 (PRWORA), Public Law Number 104-193. 155.16 Sec. 35. Minnesota Statutes 1998, section 256B.056, 155.17 subdivision 4, is amended to read: 155.18 Subd. 4. [INCOME.] To be eligible for medical assistance, 155.19 a person eligible under section 256B.055, subdivision 7, not 155.20 receiving supplemental security income program payments, and 155.21 families and children may have an income up to 133-1/3 percent 155.22 of the AFDC income standard in effect under the July 16, 1996, 155.23 AFDC state plan.For rate years beginning on or after July 1,155.241999, the commissioner shall consider increasingEffective July 155.25 1, 2000, the base AFDC standard in effect on July 16, 1996,by155.26an amount equal to the percent change in the Consumer Price155.27Index for all urban consumers for the previous October compared155.28to one year earliershall be increased by two percent. 155.29 Effective January 1, 2000, and each successive January, 155.30 recipients of supplemental security income may have an income up 155.31 to the supplemental security income standard in effect on that 155.32 date. In computing income to determine eligibility of persons 155.33 who are not residents of long-term care facilities, the 155.34 commissioner shall disregard increases in income as required by 155.35 Public Law Numbers 94-566, section 503; 99-272; and 99-509. 155.36 Veterans aid and attendance benefits and Veterans Administration 156.1 unusual medical expense payments are considered income to the 156.2 recipient. 156.3 Sec. 36. Minnesota Statutes 1998, section 256B.057, 156.4 subdivision 3, is amended to read: 156.5 Subd. 3. [QUALIFIED MEDICARE BENEFICIARIES.] A person who 156.6 is entitled to Part A Medicare benefits, whose income is equal 156.7 to or less than85100 percent of the federal poverty 156.8 guidelines, and whose assets are no more than twice the asset 156.9 limit used to determine eligibility for the supplemental 156.10 security income program, is eligible for medical assistance 156.11 reimbursement of Part A and Part B premiums, Part A and Part B 156.12 coinsurance and deductibles, and cost-effective premiums for 156.13 enrollment with a health maintenance organization or a 156.14 competitive medical plan under section 1876 of the Social 156.15 Security Act.The income limit shall be increased to 90 percent156.16of the federal poverty guidelines on January 1, 1990; and to 100156.17percent on January 1, 1991.Reimbursement of the Medicare 156.18 coinsurance and deductibles, when added to the amount paid by 156.19 Medicare, must not exceed the total rate the provider would have 156.20 received for the same service or services if the person were a 156.21 medical assistance recipient with Medicare coverage. Increases 156.22 in benefits under Title II of the Social Security Act shall not 156.23 be counted as income for purposes of this subdivision until the 156.24 first day of the second full month following publication of the 156.25 change in the federal poverty guidelines. 156.26 Sec. 37. Minnesota Statutes 1998, section 256B.057, is 156.27 amended by adding a subdivision to read: 156.28 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 156.29 assistance may be paid for a person who is employed and who: 156.30 (1) meets the definition of disabled under the supplemental 156.31 security income program; 156.32 (2) meets the asset limits in paragraph (b); and 156.33 (3) pays a premium, if required, under paragraph (c). 156.34 Any spousal income or assets shall be disregarded for purposes 156.35 of eligibility and premium determinations. 156.36 (b) For purposes of determining eligibility under this 157.1 subdivision, a person's assets must not exceed $20,000, 157.2 excluding: 157.3 (1) all assets excluded under section 256B.06; 157.4 (2) retirement accounts, including individual accounts, 157.5 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 157.6 (3) medical expense accounts set up through the person's 157.7 employer. 157.8 (c) A person whose earned and unearned income is equal to 157.9 or greater than 200 percent of federal poverty guidelines for 157.10 the applicable family size must pay a premium to be eligible for 157.11 medical assistance. The premium shall be equal to ten percent 157.12 of the person's gross earned and unearned income above 200 157.13 percent of federal poverty guidelines for the applicable family 157.14 size up to the cost of coverage. 157.15 (d) A person's eligibility and premium shall be determined 157.16 by the local county agency. Premiums must be paid to the 157.17 commissioner. All premiums are dedicated to the commissioner. 157.18 (e) Any required premium shall be determined at application 157.19 and redetermined annually at recertification or when a change in 157.20 income occurs. 157.21 (f) The first premium payment is due upon notification from 157.22 the commissioner of the premium amount required. Premiums may 157.23 be paid in installments at the discretion of the commissioner. 157.24 (g) Nonpayment of the premium shall result in denial or 157.25 termination of medical assistance unless the person demonstrates 157.26 good cause for nonpayment. Good cause exists if the 157.27 requirements specified in Minnesota Rules, part 9506.0040, 157.28 subpart 7, items B to D, are met. Nonpayment shall include 157.29 payment with a returned, refused, or dishonored instrument. The 157.30 commissioner may require a guaranteed form of payment as the 157.31 only means to replace a returned, refused, or dishonored 157.32 instrument. 157.33 Sec. 38. Minnesota Statutes 1998, section 256B.0575, is 157.34 amended to read: 157.35 256B.0575 [AVAILABILITY OF INCOME FOR INSTITUTIONALIZED 157.36 PERSONS.] 158.1 When an institutionalized person is determined eligible for 158.2 medical assistance, the income that exceeds the deductions in 158.3 paragraphs (a) and (b) must be applied to the cost of 158.4 institutional care. 158.5 (a) The following amounts must be deducted from the 158.6 institutionalized person's income in the following order: 158.7 (1) the personal needs allowance under section 256B.35 or, 158.8 for a veteran who does not have a spouse or child, or a 158.9 surviving spouse of a veteran having no child, the amount of an 158.10 improved pension received from the veteran's administration not 158.11 exceeding $90 per month; 158.12 (2) the personal allowance for disabled individuals under 158.13 section 256B.36; 158.14 (3) if the institutionalized person has a legally appointed 158.15 guardian or conservator, five percent of the recipient's gross 158.16 monthly income up to $100 as reimbursement for guardianship or 158.17 conservatorship services; 158.18 (4) a monthly income allowance determined under section 158.19 256B.058, subdivision 2, but only to the extent income of the 158.20 institutionalized spouse is made available to the community 158.21 spouse; 158.22 (5) a monthly allowance for children under age 18 which, 158.23 together with the net income of the children, would provide 158.24 income equal to the medical assistance standard for families and 158.25 children according to section 256B.056, subdivision 4, for a 158.26 family size that includes only the minor children. This 158.27 deduction applies only if the children do not live with the 158.28 community spouse and only to the extent that the deduction is 158.29 not included in the personal needs allowance under section 158.30 256B.35, subdivision 1, as child support garnished under a court 158.31 order; 158.32 (6) a monthly family allowance for other family members, 158.33 equal to one-third of the difference between 122 percent of the 158.34 federal poverty guidelines and the monthly income for that 158.35 family member; 158.36 (7) reparations payments made by the Federal Republic of 159.1 Germany and reparations payments made by the Netherlands for 159.2 victims of Nazi persecution between 1940 and 1945;and159.3 (8) all other exclusions from income for institutionalized 159.4 persons as mandated by federal law; and 159.5 (9) amounts for reasonable expenses incurred for necessary 159.6 medical or remedial care for the institutionalized spouse that 159.7 are not medical assistance covered expenses and that are not 159.8 subject to payment by a third party. 159.9 For purposes of clause (6), "other family member" means a 159.10 person who resides with the community spouse and who is a minor 159.11 or dependent child, dependent parent, or dependent sibling of 159.12 either spouse. "Dependent" means a person who could be claimed 159.13 as a dependent for federal income tax purposes under the 159.14 Internal Revenue Code. 159.15 (b) Income shall be allocated to an institutionalized 159.16 person for a period of up to three calendar months, in an amount 159.17 equal to the medical assistance standard for a family size of 159.18 one if: 159.19 (1) a physician certifies that the person is expected to 159.20 reside in the long-term care facility for three calendar months 159.21 or less; 159.22 (2) if the person has expenses of maintaining a residence 159.23 in the community; and 159.24 (3) if one of the following circumstances apply: 159.25 (i) the person was not living together with a spouse or a 159.26 family member as defined in paragraph (a) when the person 159.27 entered a long-term care facility; or 159.28 (ii) the person and the person's spouse become 159.29 institutionalized on the same date, in which case the allocation 159.30 shall be applied to the income of one of the spouses. 159.31 For purposes of this paragraph, a person is determined to be 159.32 residing in a licensed nursing home, regional treatment center, 159.33 or medical institution if the person is expected to remain for a 159.34 period of one full calendar month or more. 159.35 Sec. 39. Minnesota Statutes 1998, section 256B.061, is 159.36 amended to read: 160.1 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 160.2 (a) If any individual has been determined to be eligible 160.3 for medical assistance, it will be made available for care and 160.4 services included under the plan and furnished in or after the 160.5 third month before the month in which the individual made 160.6 application for such assistance, if such individual was, or upon 160.7 application would have been, eligible for medical assistance at 160.8 the time the care and services were furnished. The commissioner 160.9 may limit, restrict, or suspend the eligibility of an individual 160.10 for up to one year upon that individual's conviction of a 160.11 criminal offense related to application for or receipt of 160.12 medical assistance benefits. 160.13 (b) On the basis of information provided on the completed 160.14 application, an applicant who meets the following criteria shall 160.15 be determined eligible beginning in the month of application: 160.16 (1) whose gross income is less than 90 percent of the 160.17 applicable income standard; 160.18 (2) whose total liquid assets are less than 90 percent of 160.19 the asset limit; 160.20 (3) does not reside in a long-term care facility; and 160.21 (4) meets all other eligibility requirements. 160.22 The applicant must provide all required verifications within 30 160.23 days' notice of the eligibility determination or eligibility 160.24 shall be terminated. 160.25 Sec. 40. Minnesota Statutes 1998, section 256B.0625, is 160.26 amended by adding a subdivision to read: 160.27 Subd. 3b. [TELEMEDICINE.] Medical assistance covers 160.28 telemedicine consultations. Telemedicine consultations must be 160.29 via two-way, interactive video or store and forward technology. 160.30 Store and forward technology includes telemedicine consultations 160.31 that do not occur in real time via synchronous transmissions, 160.32 and that do not require a face-to-face encounter with the 160.33 patient for all or any part of the telemedicine consultation. 160.34 The patient record must include a written opinion from the 160.35 consulting physician providing the telemedicine consultation. A 160.36 communication between two physicians that consists solely of a 161.1 telephone conversation is not a telemedicine consultation. 161.2 Coverage is limited to three telemedicine consultations per 161.3 recipient per calendar week. Telemedicine consultations shall 161.4 be paid at the full allowable rate. 161.5 (Effective date: Section 40 (256B.0625, subd. 3b) is 161.6 effective for services rendered on or after July 1, 1999.) 161.7 Sec. 41. Minnesota Statutes 1998, section 256B.0625, is 161.8 amended by adding a subdivision to read: 161.9 Subd. 3c. [CONSULTATION SERVICES BY PHYSICIANS 161.10 SPECIALIZING IN THE TREATMENT OF CHILD ABUSE AND 161.11 NEGLECT.] Medical assistance covers consultation services by 161.12 physicians specializing in the treatment of child abuse and 161.13 neglect. Alternative media formats may be used when the patient 161.14 is a child being examined for potential abuse or neglect, the 161.15 consulting physician is a specialist in the treatment of child 161.16 abuse and neglect, and the use of two-way, interactive video or 161.17 the occurrence of a second exam would be medically 161.18 contraindicated for the child. 161.19 Sec. 42. Minnesota Statutes 1998, section 256B.0625, 161.20 subdivision 6a, is amended to read: 161.21 Subd. 6a. [HOME HEALTH SERVICES.] Home health services are 161.22 those services specified in Minnesota Rules, part 9505.0290. 161.23 Medical assistance covers home health services at a recipient's 161.24 home residence. Medical assistance does not cover home health 161.25 services for residents of a hospital, nursing facility, or 161.26 intermediate care facility,or a health care facility licensed161.27by the commissioner of health, unless the program is funded161.28under a home and community-based services waiver orunless the 161.29 commissioner of human services has prior authorized skilled 161.30 nurse visits for less than 90 days for a resident at an 161.31 intermediate care facility for persons with mental retardation, 161.32 to prevent an admission to a hospital or nursing facility or 161.33 unless a resident who is otherwise eligible is on leave from the 161.34 facility and the facility either pays for the home health 161.35 services or forgoes the facility per diem for the leave days 161.36 that home health services are used. Home health services must 162.1 be provided by a Medicare certified home health agency. All 162.2 nursing and home health aide services must be provided according 162.3 to section 256B.0627. 162.4 Sec. 43. Minnesota Statutes 1998, section 256B.0625, 162.5 subdivision 8, is amended to read: 162.6 Subd. 8. [PHYSICAL THERAPY.] Medical assistance covers 162.7 physical therapy and related services, including specialized 162.8 maintenance therapy. Services provided by a physical therapy 162.9 assistant shall be reimbursed at the same rate as services 162.10 performed by a physical therapist when the services of the 162.11 physical therapy assistant are provided under the direction of a 162.12 physical therapist who is on the premises. Services provided by 162.13 a physical therapy assistant that are provided under the 162.14 direction of a physical therapist who is not on the premises 162.15 shall be reimbursed at 65 percent of the physical therapist rate. 162.16 Sec. 44. Minnesota Statutes 1998, section 256B.0625, 162.17 subdivision 8a, is amended to read: 162.18 Subd. 8a. [OCCUPATIONAL THERAPY.] Medical assistance 162.19 covers occupational therapy and related services, including 162.20 specialized maintenance therapy. Services provided by an 162.21 occupational therapy assistant shall be reimbursed at the same 162.22 rate as services performed by an occupational therapist when the 162.23 services of the occupational therapy assistant are provided 162.24 under the direction of the occupational therapist who is on the 162.25 premises. Services provided by an occupational therapy 162.26 assistant that are provided under the direction of an 162.27 occupational therapist who is not on the premises shall be 162.28 reimbursed at 65 percent of the occupational therapist rate. 162.29 Sec. 45. Minnesota Statutes 1998, section 256B.0625, is 162.30 amended by adding a subdivision to read: 162.31 Subd. 8b. [SPEECH LANGUAGE PATHOLOGY SERVICES.] Medical 162.32 assistance covers speech language pathology and related 162.33 services, including specialized maintenance therapy. 162.34 Sec. 46. Minnesota Statutes 1998, section 256B.0625, is 162.35 amended by adding a subdivision to read: 162.36 Subd. 8c. [CARE MANAGEMENT; REHABILITATION SERVICES.] (a) 163.1 Effective July 1, 1999, one-time thresholds shall replace annual 163.2 thresholds for provision of rehabilitation services described in 163.3 subdivisions 8, 8a, and 8b. The one-time thresholds will be the 163.4 same in amount and description as the thresholds prescribed by 163.5 the department of human services health care programs provider 163.6 manual for calendar year 1997, except they will not be renewed 163.7 annually, and they will include sensory skills and cognitive 163.8 training skills. 163.9 (b) A care management approach for authorization of 163.10 services beyond the threshold shall be instituted in conjunction 163.11 with the one-time thresholds. The care management approach 163.12 shall require the provider and the department rehabilitation 163.13 reviewer to work together directly through written 163.14 communication, or telephone communication when appropriate, to 163.15 establish a medically necessary care management plan. 163.16 (c) The commissioner shall implement an expedited five-day 163.17 turnaround time to review authorization requests for recipients 163.18 who need emergency rehabilitation services and who have 163.19 exhausted their one-time threshold limit for those services. 163.20 Sec. 47. Minnesota Statutes 1998, section 256B.0625, is 163.21 amended by adding a subdivision to read: 163.22 Subd. 9a. [DENTAL HYGIENIST SERVICES.] Medical assistance 163.23 covers preventive dental services provided by dental hygienists 163.24 if the services are otherwise covered under this chapter as 163.25 dental services, and if the services are within the scope of 163.26 practice of a licensed dental hygienist, as defined in section 163.27 150A.05. 163.28 Sec. 48. Minnesota Statutes 1998, section 256B.0625, 163.29 subdivision 13, is amended to read: 163.30 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 163.31 except for fertility drugs when specifically used to enhance 163.32 fertility, if prescribed by a licensed practitioner and 163.33 dispensed by a licensed pharmacist, by a physician enrolled in 163.34 the medical assistance program as a dispensing physician, or by 163.35 a physician or a nurse practitioner employed by or under 163.36 contract with a community health board as defined in section 164.1 145A.02, subdivision 5, for the purposes of communicable disease 164.2 control. The commissioner, after receiving recommendations from 164.3 professional medical associations and professional pharmacist 164.4 associations, shall designate a formulary committee to advise 164.5 the commissioner on the names of drugs for which payment is 164.6 made, recommend a system for reimbursing providers on a set fee 164.7 or charge basis rather than the present system, and develop 164.8 methods encouraging use of generic drugs when they are less 164.9 expensive and equally effective as trademark drugs. The 164.10 formulary committee shall consist of nine members, four of whom 164.11 shall be physicians who are not employed by the department of 164.12 human services, and a majority of whose practice is for persons 164.13 paying privately or through health insurance, three of whom 164.14 shall be pharmacists who are not employed by the department of 164.15 human services, and a majority of whose practice is for persons 164.16 paying privately or through health insurance, a consumer 164.17 representative, and a nursing home representative. Committee 164.18 members shall serve three-year terms and shall serve without 164.19 compensation. Members may be reappointed once. 164.20 (b) The commissioner shall establish a drug formulary. Its 164.21 establishment and publication shall not be subject to the 164.22 requirements of the Administrative Procedure Act, but the 164.23 formulary committee shall review and comment on the formulary 164.24 contents. The formulary committee shall review and recommend 164.25 drugs which require prior authorization. The formulary 164.26 committee may recommend drugs for prior authorization directly 164.27 to the commissioner, as long as opportunity for public input is 164.28 provided. Prior authorization may be requested by the 164.29 commissioner based on medical and clinical criteria before 164.30 certain drugs are eligible for payment. Before a drug may be 164.31 considered for prior authorization at the request of the 164.32 commissioner: 164.33 (1) the drug formulary committee must develop criteria to 164.34 be used for identifying drugs; the development of these criteria 164.35 is not subject to the requirements of chapter 14, but the 164.36 formulary committee shall provide opportunity for public input 165.1 in developing criteria; 165.2 (2) the drug formulary committee must hold a public forum 165.3 and receive public comment for an additional 15 days; and 165.4 (3) the commissioner must provide information to the 165.5 formulary committee on the impact that placing the drug on prior 165.6 authorization will have on the quality of patient care and 165.7 information regarding whether the drug is subject to clinical 165.8 abuse or misuse. Prior authorization may be required by the 165.9 commissioner before certain formulary drugs are eligible for 165.10 payment. The formulary shall not include: 165.11 (i) drugs or products for which there is no federal 165.12 funding; 165.13 (ii) over-the-counter drugs, except for antacids, 165.14 acetaminophen, family planning products, aspirin, insulin, 165.15 products for the treatment of lice, vitamins for adults with 165.16 documented vitamin deficiencies, vitamins for children under the 165.17 age of seven and pregnant or nursing women, and any other 165.18 over-the-counter drug identified by the commissioner, in 165.19 consultation with the drug formulary committee, as necessary, 165.20 appropriate, and cost-effective for the treatment of certain 165.21 specified chronic diseases, conditions or disorders, and this 165.22 determination shall not be subject to the requirements of 165.23 chapter 14; 165.24 (iii) anorectics, except that medically necessary 165.25 anorectics shall be covered for a recipient previously diagnosed 165.26 as having pickwickian syndrome and currently diagnosed as having 165.27 diabetes and being morbidly obese; 165.28 (iv) drugs for which medical value has not been 165.29 established; and 165.30 (v) drugs from manufacturers who have not signed a rebate 165.31 agreement with the Department of Health and Human Services 165.32 pursuant to section 1927 of title XIX of the Social Security Act 165.33and who have not signed an agreement with the state for drugs165.34purchased pursuant to the senior citizen drug program165.35established under section 256.955. 165.36 The commissioner shall publish conditions for prohibiting 166.1 payment for specific drugs after considering the formulary 166.2 committee's recommendations. 166.3 (c) The basis for determining the amount of payment shall 166.4 be the lower of the actual acquisition costs of the drugs plus a 166.5 fixed dispensing fee; the maximum allowable cost set by the 166.6 federal government or by the commissioner plus the fixed 166.7 dispensing fee; or the usual and customary price charged to the 166.8 public. The pharmacy dispensing fee shall be $3.65. Actual 166.9 acquisition cost includes quantity and other special discounts 166.10 except time and cash discounts. The actual acquisition cost of 166.11 a drug shall be estimated by the commissioner, at average 166.12 wholesale price minus nine percent. The maximum allowable cost 166.13 of a multisource drug may be set by the commissioner and it 166.14 shall be comparable to, but no higher than, the maximum amount 166.15 paid by other third-party payors in this state who have maximum 166.16 allowable cost programs. The commissioner shall set maximum 166.17 allowable costs for multisource drugs that are not on the 166.18 federal upper limit list as described in United States Code, 166.19 title 42, chapter 7, section 1396r-8(e), the Social Security 166.20 Act, and Code of Federal Regulations, title 42, part 447, 166.21 section 447.332. Establishment of the amount of payment for 166.22 drugs shall not be subject to the requirements of the 166.23 Administrative Procedure Act. An additional dispensing fee of 166.24 $.30 may be added to the dispensing fee paid to pharmacists for 166.25 legend drug prescriptions dispensed to residents of long-term 166.26 care facilities when a unit dose blister card system, approved 166.27 by the department, is used. Under this type of dispensing 166.28 system, the pharmacist must dispense a 30-day supply of drug. 166.29 The National Drug Code (NDC) from the drug container used to 166.30 fill the blister card must be identified on the claim to the 166.31 department. The unit dose blister card containing the drug must 166.32 meet the packaging standards set forth in Minnesota Rules, part 166.33 6800.2700, that govern the return of unused drugs to the 166.34 pharmacy for reuse. The pharmacy provider will be required to 166.35 credit the department for the actual acquisition cost of all 166.36 unused drugs that are eligible for reuse. Over-the-counter 167.1 medications must be dispensed in the manufacturer's unopened 167.2 package. The commissioner may permit the drug clozapine to be 167.3 dispensed in a quantity that is less than a 30-day supply. 167.4 Whenever a generically equivalent product is available, payment 167.5 shall be on the basis of the actual acquisition cost of the 167.6 generic drug, unless the prescriber specifically indicates 167.7 "dispense as written - brand necessary" on the prescription as 167.8 required by section 151.21, subdivision 2. 167.9 (d) For purposes of this subdivision, "multisource drugs" 167.10 means covered outpatient drugs, excluding innovator multisource 167.11 drugs for which there are two or more drug products, which: 167.12 (1) are related as therapeutically equivalent under the 167.13 Food and Drug Administration's most recent publication of 167.14 "Approved Drug Products with Therapeutic Equivalence 167.15 Evaluations"; 167.16 (2) are pharmaceutically equivalent and bioequivalent as 167.17 determined by the Food and Drug Administration; and 167.18 (3) are sold or marketed in Minnesota. 167.19 "Innovator multisource drug" means a multisource drug that was 167.20 originally marketed under an original new drug application 167.21 approved by the Food and Drug Administration. 167.22 Sec. 49. Minnesota Statutes 1998, section 256B.0625, 167.23 subdivision 19c, is amended to read: 167.24 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 167.25 personal care services provided by an individual who is 167.26 qualified to provide the services according to subdivision 19a 167.27 and section 256B.0627, where the services are prescribed by a 167.28 physician in accordance with a plan of treatment and are 167.29 supervised bya registered nursethe recipient under the fiscal 167.30 agent option according to section 256B.0627, subdivision 10, or 167.31 a qualified professional. "Qualified professional" means a 167.32 mental health professional as defined in section 245.462, 167.33 subdivision 18, or 245.4871, subdivision 26; or a registered 167.34 nurse as defined in sections 148.171 to 148.285. As part of the 167.35 assessment, the county public health nurse will consult with the 167.36 recipient or responsible party and identify the most appropriate 168.1 person to provide supervision of the personal care assistant. 168.2 The qualified professional shall perform the duties described in 168.3 Minnesota Rules, part 9505.0335, subpart 4. 168.4 Sec. 50. Minnesota Statutes 1998, section 256B.0625, 168.5 subdivision 26, is amended to read: 168.6 Subd. 26. [SPECIAL EDUCATION SERVICES.] (a) Medical 168.7 assistance covers medical services identified in a recipient's 168.8 individualized education plan and covered under the medical 168.9 assistance state plan. Covered services include occupational 168.10 therapy, physical therapy, speech-language therapy, clinical 168.11 psychological services, nursing services, school psychological 168.12 services, school social work services, personal care assistants 168.13 serving as management aides, assistive technology devices, 168.14 transportation services, and other services covered under the 168.15 medical assistance state plan. Mental health services eligible 168.16 for medical assistance reimbursement must be provided through a 168.17 children's mental health collaborative where a collaborative 168.18 exists. The services may be provided by a Minnesota school 168.19 district that is enrolled as a medical assistance provider or 168.20 its subcontractor, and only if the services meet all the 168.21 requirements otherwise applicable if the service had been 168.22 provided by a provider other than a school district, in the 168.23 following areas: medical necessity, physician's orders, 168.24 documentation, personnel qualifications, and prior authorization 168.25 requirements. The nonfederal share of costs for services 168.26 provided under this subdivision is the responsibility of the 168.27 local school district as provided in section 125A.74. Services 168.28 listed in a child's individual education plan are eligible for 168.29 medical assistance reimbursement only if those services meet 168.30 criteria for federal financial participation under the Medicaid 168.31 program. 168.32 (b) Approval of health-related services for inclusion in 168.33 the individual education plan does not require prior 168.34 authorization for purposes of reimbursement under this chapter. 168.35 The commissioner may require physician review and approval of 168.36 the plan not more than once annually or upon any modification of 169.1 the individual education plan that reflects a change in 169.2 health-related services. 169.3 (c) Services of a speech-language pathologist provided 169.4 under this section are covered notwithstanding Minnesota Rules, 169.5 part 9505.0390, subpart 1, item L, if the person: 169.6 (1) holds a masters degree in speech-language pathology; 169.7 (2) is licensed by the Minnesota board of teaching as an 169.8 educational speech-language pathologist; and 169.9 (3) either has a certificate of clinical competence from 169.10 the American Speech and Hearing Association, has completed the 169.11 equivalent educational requirements and work experience 169.12 necessary for the certificate or has completed the academic 169.13 program and is acquiring supervised work experience to qualify 169.14 for the certificate. 169.15 (d) Medical assistance coverage for medically necessary 169.16 services provided under other subdivisions in this section may 169.17 not be denied solely on the basis that the same or similar 169.18 services are covered under this subdivision. 169.19 (e) The commissioner shall develop and implement package 169.20 rates, bundled rates, or per diem rates for special education 169.21 services under which separately covered services are grouped 169.22 together and billed as a unit in order to reduce administrative 169.23 complexity. 169.24 (f) The commissioner shall develop a cost-based payment 169.25 structure for payment of these services. 169.26 (g) Effective July 1, 2000, medical assistance services 169.27 provided under an individual education plan or an individual 169.28 family service plan by local school districts shall not count 169.29 against medical assistance authorization thresholds for that 169.30 child. 169.31 (Effective date: Section 50 (256B.0625, subd. 26) is 169.32 effective July 1, 2000.) 169.33 Sec. 51. Minnesota Statutes 1998, section 256B.0625, 169.34 subdivision 28, is amended to read: 169.35 Subd. 28. [CERTIFIED NURSE PRACTITIONER SERVICES.] Medical 169.36 assistance covers services performed by a certified pediatric 170.1 nurse practitioner, a certified family nurse practitioner, a 170.2 certified adult nurse practitioner, a certified 170.3 obstetric/gynecological nurse practitioner, a certified neonatal 170.4 nurse practitioner, or a certified geriatric nurse practitioner 170.5 in independent practice, if the services are otherwise covered 170.6 under this chapter as a physician service, are provided on an 170.7 inpatient basis and are not part of the cost for inpatient 170.8 services included in the operating payment rate, andif the170.9service isare within the scope of practice of the nurse 170.10 practitioner's license as a registered nurse, as defined in 170.11 section 148.171. 170.12 Sec. 52. Minnesota Statutes 1998, section 256B.0625, 170.13 subdivision 30, is amended to read: 170.14 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 170.15 covers rural health clinic services, federally qualified health 170.16 center services, nonprofit community health clinic services, 170.17 public health clinic services, and the services of a clinic 170.18 meeting the criteria established in rule by the commissioner. 170.19 Rural health clinic services and federally qualified health 170.20 center services mean services defined in United States Code, 170.21 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 170.22 health clinic and federally qualified health center services 170.23 shall be made according to applicable federal law and regulation. 170.24 (b) A federally qualified health center that is beginning 170.25 initial operation shall submit an estimate of budgeted costs and 170.26 visits for the initial reporting period in the form and detail 170.27 required by the commissioner. A federally qualified health 170.28 center that is already in operation shall submit an initial 170.29 report using actual costs and visits for the initial reporting 170.30 period. Within 90 days of the end of its reporting period, a 170.31 federally qualified health center shall submit, in the form and 170.32 detail required by the commissioner, a report of its operations, 170.33 including allowable costs actually incurred for the period and 170.34 the actual number of visits for services furnished during the 170.35 period, and other information required by the commissioner. 170.36 Federally qualified health centers that file Medicare cost 171.1 reports shall provide the commissioner with a copy of the most 171.2 recent Medicare cost report filed with the Medicare program 171.3 intermediary for the reporting year which support the costs 171.4 claimed on their cost report to the state. 171.5 (c) In order to continue cost-based payment under the 171.6 medical assistance program according to paragraphs (a) and (b), 171.7 a federally qualified health center or rural health clinic must 171.8 apply for designation as an essential community provider within 171.9 six months of final adoption of rules by the department of 171.10 health according to section 62Q.19, subdivision 7. For those 171.11 federally qualified health centers and rural health clinics that 171.12 have applied for essential community provider status within the 171.13 six-month time prescribed, medical assistance payments will 171.14 continue to be made according to paragraphs (a) and (b) for the 171.15 first three years after application. For federally qualified 171.16 health centers and rural health clinics that either do not apply 171.17 within the time specified above or who have had essential 171.18 community provider status for three years, medical assistance 171.19 payments for health services provided by these entities shall be 171.20 according to the same rates and conditions applicable to the 171.21 same service provided by health care providers that are not 171.22 federally qualified health centers or rural health clinics. 171.23This paragraph takes effect only if the Minnesota health care171.24reform waiver is approved by the federal government, and remains171.25in effect for as long as the Minnesota health care reform waiver171.26remains in effect. When the waiver expires, this paragraph171.27expires, and the commissioner of human services shall publish a171.28notice in the State Register and notify the revisor of statutes.171.29 (d) Effective July 1, 1999, the provisions of paragraph (c) 171.30 requiring a federally qualified health center or a rural health 171.31 clinic to make application for an essential community provider 171.32 designation in order to have cost-based payments made according 171.33 to paragraphs (a) and (b) no longer apply. 171.34 (e) Effective January 1, 2000, payments made according to 171.35 paragraphs (a) and (b) shall be limited to the cost phase-out 171.36 schedule of the Balanced Budget Act of 1997. 172.1 Sec. 53. Minnesota Statutes 1998, section 256B.0625, 172.2 subdivision 32, is amended to read: 172.3 Subd. 32. [NUTRITIONAL PRODUCTS.](a)Medical assistance 172.4 covers nutritional products needed for nutritional 172.5 supplementation because solid food or nutrients thereof cannot 172.6 be properly absorbed by the body or needed for treatment of 172.7 phenylketonuria, hyperlysinemia, maple syrup urine disease, a 172.8 combined allergy to human milk, cow's milk, and soy formula, or 172.9 any other childhood or adult diseases, conditions, or disorders 172.10 identified by the commissioner as requiring a similarly 172.11 necessary nutritional product. Nutritional products needed for 172.12 the treatment of a combined allergy to human milk, cow's milk, 172.13 and soy formula require prior authorization. Separate payment 172.14 shall not be made for nutritional products for residents of 172.15 long-term care facilities. Payment for dietary requirements is 172.16 a component of the per diem rate paid to these facilities. 172.17(b) The commissioner shall designate a nutritional172.18supplementation products advisory committee to advise the172.19commissioner on nutritional supplementation products for which172.20payment is made. The committee shall consist of nine members,172.21one of whom shall be a physician, one of whom shall be a172.22pharmacist, two of whom shall be registered dietitians, one of172.23whom shall be a public health nurse, one of whom shall be a172.24representative of a home health care agency, one of whom shall172.25be a provider of long-term care services, and two of whom shall172.26be consumers of nutritional supplementation products. Committee172.27members shall serve two-year terms and shall serve without172.28compensation.172.29(c) The advisory committee shall review and recommend172.30nutritional supplementation products which require prior172.31authorization. The commissioner shall develop procedures for172.32the operation of the advisory committee so that the advisory172.33committee operates in a manner parallel to the drug formulary172.34committee.172.35 Sec. 54. Minnesota Statutes 1998, section 256B.0625, 172.36 subdivision 35, is amended to read: 173.1 Subd. 35. [FAMILY COMMUNITY SUPPORT SERVICES.] Medical 173.2 assistance covers family community support services as defined 173.3 in section 245.4871, subdivision 17. In addition to the 173.4 provisions of section 245.4871, and to the extent authorized by 173.5 rules promulgated by the state agency, medical assistance covers 173.6 the following services as family community support services: 173.7 (1) services identified in an individual treatment plan 173.8 when provided by a trained behavioral aide under the direction 173.9 of a mental health practitioner or mental health professional; 173.10 (2) mental health crisis intervention and crisis 173.11 stabilization services provided outside of hospital inpatient 173.12 settings; and 173.13 (3) the therapeutic components of preschool and therapeutic 173.14 camp programs. 173.15 Sec. 55. Minnesota Statutes 1998, section 256B.0625, is 173.16 amended by adding a subdivision to read: 173.17 Subd. 41. [MENTAL HEALTH PROFESSIONAL.] Notwithstanding 173.18 Minnesota Rules, part 9505.0175, subpart 28, the definition of a 173.19 mental health professional shall include a person who is 173.20 qualified as specified in section 245.462, subdivision 18, 173.21 clause (5); or 245.4871, subdivision 27, clause (5), for the 173.22 purpose of this section and Minnesota Rules, parts 9505.0170 to 173.23 9505.0475. 173.24 Sec. 56. Minnesota Statutes 1998, section 256B.0625, is 173.25 amended by adding a subdivision to read: 173.26 Subd. 42. [LANGUAGE INTERPRETER SERVICES.] (a) Medical 173.27 assistance covers language interpreter services provided in 173.28 conjunction with another covered health service. 173.29 (b) The commissioner shall establish reimbursement 173.30 standards for interpreter services as follows: 173.31 (1) a per visit maximum rate shall be established; and 173.32 (2) services shall be reimbursed in 15-minute increments. 173.33 Sec. 57. Minnesota Statutes 1998, section 256B.0627, 173.34 subdivision 1, is amended to read: 173.35 Subdivision 1. [DEFINITION.] (a) "Assessment" means a 173.36 review and evaluation of a recipient's need for home care 174.1 services conducted in person. Assessments for private duty 174.2 nursing shall be conducted by a registered private duty nurse. 174.3 Assessments for home health agency services shall be conducted 174.4 by a home health agency nurse. Assessments for personal 174.5 care assistant services shall be conducted by the county public 174.6 health nurse or a certified public health nurse under contract 174.7 with the county.An initial assessment for personal care174.8services is conducted on individuals who are requesting personal174.9care services or for those consumers who have never had a public174.10health nurse assessment. The initialA face-to-face assessment 174.11 must include: aface-to-facehealth status assessment and 174.12 determination ofbaselineneed, evaluation of service outcomes, 174.13 collection ofinitialcase data, identification of appropriate 174.14 services and service plan development or modification, 174.15 coordination ofinitialservices, referrals and follow-up to 174.16 appropriate payers and community resources, completion of 174.17 required reports, obtaining service authorization, and consumer 174.18 education. Areassessment visitface-to-face assessment for 174.19 personal care services is conducted on those recipients who have 174.20 never had a county public health nurse assessment. A 174.21 face-to-face assessment must occur at least annually or when 174.22 there is a significant change inconsumerthe recipient's 174.23 conditionandor when there is a change in the need for personal 174.24 care assistant services.The reassessment visitA service 174.25 update may substitute for the annual face-to-face assessment 174.26 when there is not a significant change in recipient condition or 174.27 a change in the need for personal care assistant service. A 174.28 service update or review for temporary increase includes a 174.29 review of initial baseline data, evaluation of service outcomes, 174.30 redetermination of service need, modification of service plan 174.31 and appropriate referrals, update of initial forms, obtaining 174.32 service authorization, and on going consumer education. 174.33 Assessments for medical assistance home care services for mental 174.34 retardation or related conditions and alternative care services 174.35 for developmentally disabled home and community-based waivered 174.36 recipients may be conducted by the county public health nurse to 175.1 ensure coordination and avoid duplication. Assessments must be 175.2 completed on forms provided by the commissioner within 30 days 175.3 of a request for home care services by a recipient or 175.4 responsible party. 175.5 (b) "Care plan" means a written description of personal 175.6 care assistant services developed by theagency nursequalified 175.7 professional with the recipient or responsible party to be used 175.8 by the personal care assistant with a copy provided to the 175.9 recipient or responsible party. 175.10 (c) "Home care services" means a health service, determined 175.11 by the commissioner as medically necessary, that is ordered by a 175.12 physician and documented in a service plan that is reviewed by 175.13 the physician at least once every6062 days for the provision 175.14 of home health services, or private duty nursing, or at least 175.15 once every 365 days for personal care. Home care services are 175.16 provided to the recipient at the recipient's residence that is a 175.17 place other than a hospital or long-term care facility or as 175.18 specified in section 256B.0625. 175.19 (d) "Medically necessary" has the meaning given in 175.20 Minnesota Rules, parts 9505.0170 to 9505.0475. 175.21 (e) "Personal care assistant" means a person who: (1) is 175.22 at least 18 years old, except for persons 16 to 18 years of age 175.23 who participated in a related school-based job training program 175.24 or have completed a certified home health aide competency 175.25 evaluation; (2) is able to effectively communicate with the 175.26 recipient and personal care provider organization; (3) effective 175.27 July 1, 1996, has completed one of the training requirements as 175.28 specified in Minnesota Rules, part 9505.0335, subpart 3, items A 175.29 to D; (4) has the ability to, and provides covered personal care 175.30 services according to the recipient's care plan, responds 175.31 appropriately to recipient needs, and reports changes in the 175.32 recipient's condition to the supervisingregistered nurse175.33 qualified professional; (5) is not a consumer of personal care 175.34 services; and (6) is subject to criminal background checks and 175.35 procedures specified in section 245A.04.An individual who has175.36been convicted of a crime specified in Minnesota Rules, part176.14668.0020, subpart 14, or a comparable crime in another176.2jurisdiction is disqualified from being a personal care176.3assistant, unless the individual meets the rehabilitation176.4criteria specified in Minnesota Rules, part 4668.0020, subpart176.515.176.6 (f) "Personal care provider organization" means an 176.7 organization enrolled to provide personal care services under 176.8 the medical assistance program that complies with the 176.9 following: (1) owners who have a five percent interest or more, 176.10 and managerial officials are subject to a background study as 176.11 provided in section 245A.04. This applies to currently enrolled 176.12 personal care provider organizations and those agencies seeking 176.13 enrollment as a personal care provider organization. An 176.14 organization will be barred from enrollment if an owner or 176.15 managerial official of the organization has been convicted of a 176.16 crime specified in section 245A.04, or a comparable crime in 176.17 another jurisdiction, unless the owner or managerial official 176.18 meets the reconsideration criteria specified in section 245A.04; 176.19 (2) the organization must maintain a surety bond and liability 176.20 insurance throughout the duration of enrollment and provides 176.21 proof thereof. The insurer must notify the department of human 176.22 services of the cancellation or lapse of policy; and (3) the 176.23 organization must maintain documentation of services as 176.24 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 176.25 as evidence of compliance with personal care assistant training 176.26 requirements. 176.27 (g) "Responsible party" means an individual residing with a 176.28 recipient of personal care services who is capable of providing 176.29 the supportive care necessary to assist the recipient to live in 176.30 the community, is at least 18 years old, and is not a personal 176.31 care assistant. Responsible parties who are parents of minors 176.32 or guardians of minors or incapacitated persons may delegate the 176.33 responsibility to another adult during a temporary absence of at 176.34 least 24 hours but not more than six months. The person 176.35 delegated as a responsible party must be able to meet the 176.36 definition of responsible party, except that the delegated 177.1 responsible party is required to reside with the recipient only 177.2 while serving as the responsible party. Foster care license 177.3 holders may be designated the responsible party for residents of 177.4 the foster care home if case management is provided as required 177.5 in section 256B.0625, subdivision 19a. For persons who, as of 177.6 April 1, 1992, are sharing personal care services in order to 177.7 obtain the availability of 24-hour coverage, an employee of the 177.8 personal care provider organization may be designated as the 177.9 responsible party if case management is provided as required in 177.10 section 256B.0625, subdivision 19a. 177.11 (h) "Service plan" means a written description of the 177.12 services needed based on the assessment developed by the nurse 177.13 who conducts the assessment together with the recipient or 177.14 responsible party. The service plan shall include a description 177.15 of the covered home care services, frequency and duration of 177.16 services, and expected outcomes and goals. The recipient and 177.17 the provider chosen by the recipient or responsible party must 177.18 be given a copy of the completed service plan within 30 calendar 177.19 days of the request for home care services by the recipient or 177.20 responsible party. 177.21 (i) "Skilled nurse visits" are provided in a recipient's 177.22 residence under a plan of care or service plan that specifies a 177.23 level of care which the nurse is qualified to provide. These 177.24 services are: 177.25 (1) nursing services according to the written plan of care 177.26 or service plan and accepted standards of medical and nursing 177.27 practice in accordance with chapter 148; 177.28 (2) services which due to the recipient's medical condition 177.29 may only be safely and effectively provided by a registered 177.30 nurse or a licensed practical nurse; 177.31 (3) assessments performed only by a registered nurse; and 177.32 (4) teaching and training the recipient, the recipient's 177.33 family, or other caregivers requiring the skills of a registered 177.34 nurse or licensed practical nurse. 177.35 Sec. 58. Minnesota Statutes 1998, section 256B.0627, 177.36 subdivision 2, is amended to read: 178.1 Subd. 2. [SERVICES COVERED.] Home care services covered 178.2 under this section include: 178.3 (1) nursing services under section 256B.0625, subdivision 178.4 6a; 178.5 (2) private duty nursing services under section 256B.0625, 178.6 subdivision 7; 178.7 (3) home health aide services under section 256B.0625, 178.8 subdivision 6a; 178.9 (4) personal care services under section 256B.0625, 178.10 subdivision 19a; 178.11 (5)nursingsupervision of personal care assistant services 178.12 provided by a qualified professional under section 256B.0625, 178.13 subdivision 19a;and178.14 (6) consulting professional of personal care assistant 178.15 services under the fiscal agent option as specified in 178.16 subdivision 10; 178.17 (7) face-to-face assessments by county public health nurses 178.18 for services under section 256B.0625, subdivision 19a; and 178.19 (8) service updates and review of temporary increases for 178.20 personal care assistant services by the county public health 178.21 nurse for services under section 256B.0625, subdivision 19a. 178.22 Sec. 59. Minnesota Statutes 1998, section 256B.0627, 178.23 subdivision 4, is amended to read: 178.24 Subd. 4. [PERSONAL CARE SERVICES.] (a) The personal care 178.25 services that are eligible for payment are the following: 178.26 (1) bowel and bladder care; 178.27 (2) skin care to maintain the health of the skin; 178.28 (3) repetitive maintenance range of motion, muscle 178.29 strengthening exercises, and other tasks specific to maintaining 178.30 a recipient's optimal level of function; 178.31 (4) respiratory assistance; 178.32 (5) transfers and ambulation; 178.33 (6) bathing, grooming, and hairwashing necessary for 178.34 personal hygiene; 178.35 (7) turning and positioning; 178.36 (8) assistance with furnishing medication that is 179.1 self-administered; 179.2 (9) application and maintenance of prosthetics and 179.3 orthotics; 179.4 (10) cleaning medical equipment; 179.5 (11) dressing or undressing; 179.6 (12) assistance with eating and meal preparation and 179.7 necessary grocery shopping; 179.8 (13) accompanying a recipient to obtain medical diagnosis 179.9 or treatment; 179.10 (14) assisting, monitoring, or prompting the recipient to 179.11 complete the services in clauses (1) to (13); 179.12 (15) redirection, monitoring, and observation that are 179.13 medically necessary and an integral part of completing the 179.14 personal care services described in clauses (1) to (14); 179.15 (16) redirection and intervention for behavior, including 179.16 observation and monitoring; 179.17 (17) interventions for seizure disorders, including 179.18 monitoring and observation if the recipient has had a seizure 179.19 that requires intervention within the past three months; 179.20 (18) tracheostomy suctioning using a clean procedure if the 179.21 procedure is properly delegated by a registered nurse. Before 179.22 this procedure can be delegated to a personal care assistant, a 179.23 registered nurse must determine that the tracheostomy suctioning 179.24 can be accomplished utilizing a clean rather than a sterile 179.25 procedure and must ensure that the personal care assistant has 179.26 been taught the proper procedure; and 179.27 (19) incidental household services that are an integral 179.28 part of a personal care service described in clauses (1) to (18). 179.29 For purposes of this subdivision, monitoring and observation 179.30 means watching for outward visible signs that are likely to 179.31 occur and for which there is a covered personal care service or 179.32 an appropriate personal care intervention. For purposes of this 179.33 subdivision, a clean procedure refers to a procedure that 179.34 reduces the numbers of microorganisms or prevents or reduces the 179.35 transmission of microorganisms from one person or place to 179.36 another. A clean procedure may be used beginning 14 days after 180.1 insertion. 180.2 (b) The personal care services that are not eligible for 180.3 payment are the following: 180.4 (1) services not ordered by the physician; 180.5 (2) assessments by personal care provider organizations or 180.6 by independently enrolled registered nurses; 180.7 (3) services that are not in the service plan; 180.8 (4) services provided by the recipient's spouse, legal 180.9 guardian for an adult or child recipient, or parent of a 180.10 recipient under age 18; 180.11 (5) services provided by a foster care provider of a 180.12 recipient who cannot direct the recipient's own care, unless 180.13 monitored by a county or state case manager under section 180.14 256B.0625, subdivision 19a; 180.15 (6) services provided by the residential or program license 180.16 holder in a residence for more than four persons; 180.17 (7) services that are the responsibility of a residential 180.18 or program license holder under the terms of a service agreement 180.19 and administrative rules; 180.20 (8) sterile procedures; 180.21 (9) injections of fluids into veins, muscles, or skin; 180.22 (10) services provided by parents of adult recipients, 180.23 adult children, oradultsiblings of the recipient, unless these 180.24 relatives meet one of the following hardship criteria and the 180.25 commissioner waives this requirement: 180.26 (i) the relative resigns from a part-time or full-time job 180.27 to provide personal care for the recipient; 180.28 (ii) the relative goes from a full-time to a part-time job 180.29 with less compensation to provide personal care for the 180.30 recipient; 180.31 (iii) the relative takes a leave of absence without pay to 180.32 provide personal care for the recipient; 180.33 (iv) the relative incurs substantial expenses by providing 180.34 personal care for the recipient; or 180.35 (v) because of labor conditions, special language needs, or 180.36 intermittent hours of care needed, the relative is needed in 181.1 order to provide an adequate number of qualified personal care 181.2 assistants to meet the medical needs of the recipient; 181.3 (11) homemaker services that are not an integral part of a 181.4 personal care services; 181.5 (12) home maintenance, or chore services; 181.6 (13) services not specified under paragraph (a); and 181.7 (14) services not authorized by the commissioner or the 181.8 commissioner's designee. 181.9 Sec. 60. Minnesota Statutes 1998, section 256B.0627, 181.10 subdivision 5, is amended to read: 181.11 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 181.12 payments for home care services shall be limited according to 181.13 this subdivision. 181.14 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 181.15 recipient may receive the following home care services during a 181.16 calendar year: 181.17 (1)any initial assessmentup to two face-to-face 181.18 assessments to determine a recipient's need for personal care 181.19 assistant services; 181.20 (2)up to two reassessments per yearone service update 181.21 done to determine a recipient's need for personal care services; 181.22 and 181.23 (3) up to five skilled nurse visits. 181.24 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 181.25 services above the limits in paragraph (a) must receive the 181.26 commissioner's prior authorization, except when: 181.27 (1) the home care services were required to treat an 181.28 emergency medical condition that if not immediately treated 181.29 could cause a recipient serious physical or mental disability, 181.30 continuation of severe pain, or death. The provider must 181.31 request retroactive authorization no later than five working 181.32 days after giving the initial service. The provider must be 181.33 able to substantiate the emergency by documentation such as 181.34 reports, notes, and admission or discharge histories; 181.35 (2) the home care services were provided on or after the 181.36 date on which the recipient's eligibility began, but before the 182.1 date on which the recipient was notified that the case was 182.2 opened. Authorization will be considered if the request is 182.3 submitted by the provider within 20 working days of the date the 182.4 recipient was notified that the case was opened; 182.5 (3) a third-party payor for home care services has denied 182.6 or adjusted a payment. Authorization requests must be submitted 182.7 by the provider within 20 working days of the notice of denial 182.8 or adjustment. A copy of the notice must be included with the 182.9 request; 182.10 (4) the commissioner has determined that a county or state 182.11 human services agency has made an error; or 182.12 (5) the professional nurse determines an immediate need for 182.13 up to 40 skilled nursing or home health aide visits per calendar 182.14 year and submits a request for authorization within 20 working 182.15 days of the initial service date, and medical assistance is 182.16 determined to be the appropriate payer. 182.17 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 182.18 authorization will be evaluated according to the same criteria 182.19 applied to prior authorization requests. 182.20 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 182.21 section 256B.0627, subdivision 1, paragraph (a), shall be 182.22 conducted initially, and at least annually thereafter, in person 182.23 with the recipient and result in a completed service plan using 182.24 forms specified by the commissioner. Within 30 days of 182.25 recipient or responsible party request for home care services, 182.26 the assessment, the service plan, and other information 182.27 necessary to determine medical necessity such as diagnostic or 182.28 testing information, social or medical histories, and hospital 182.29 or facility discharge summaries shall be submitted to the 182.30 commissioner. For personal care services: 182.31 (1) The amount and type of service authorized based upon 182.32 the assessment and service plan will follow the recipient if the 182.33 recipient chooses to change providers. 182.34 (2) If the recipient's medical need changes, the 182.35 recipient's provider may assess the need for a change in service 182.36 authorization and request the change from the county public 183.1 health nurse. Within 30 days of the request, the public health 183.2 nurse will determine whether to request the change in services 183.3 based upon the provider assessment, or conduct a home visit to 183.4 assess the need and determine whether the change is appropriate. 183.5 (3) To continue to receive personal care services after the 183.6 first year, the recipient or the responsible party, in 183.7 conjunction with the public health nurse, may complete a service 183.8 update on forms developed by the commissioner according to 183.9 criteria and procedures in subdivision 1.The service update183.10may substitute for the annual reassessment described in183.11subdivision 1.183.12 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 183.13 commissioner's designee, shall review the assessment,the183.14 service update, request for temporary services, service plan, 183.15 and any additional information that is submitted. The 183.16 commissioner shall, within 30 days after receiving a complete 183.17 request, assessment, and service plan, authorize home care 183.18 services as follows: 183.19 (1) [HOME HEALTH SERVICES.] All home health services 183.20 provided by a licensed nurse or a home health aide must be prior 183.21 authorized by the commissioner or the commissioner's designee. 183.22 Prior authorization must be based on medical necessity and 183.23 cost-effectiveness when compared with other care options. When 183.24 home health services are used in combination with personal care 183.25 and private duty nursing, the cost of all home care services 183.26 shall be considered for cost-effectiveness. The commissioner 183.27 shall limit nurse and home health aide visits to no more than 183.28 one visit each per day. 183.29 (2) [PERSONAL CARE SERVICES.] (i) All personal care 183.30 services andregistered nursesupervision by a qualified 183.31 professional must be prior authorized by the commissioner or the 183.32 commissioner's designee except for the assessments established 183.33 in paragraph (a). The amount of personal care services 183.34 authorized must be based on the recipient's home care rating. A 183.35 child may not be found to be dependent in an activity of daily 183.36 living if because of the child's age an adult would either 184.1 perform the activity for the child or assist the child with the 184.2 activity and the amount of assistance needed is similar to the 184.3 assistance appropriate for a typical child of the same age. 184.4 Based on medical necessity, the commissioner may authorize: 184.5 (A) up to two times the average number of direct care hours 184.6 provided in nursing facilities for the recipient's comparable 184.7 case mix level; or 184.8 (B) up to three times the average number of direct care 184.9 hours provided in nursing facilities for recipients who have 184.10 complex medical needs or are dependent in at least seven 184.11 activities of daily living and need physical assistance with 184.12 eating or have a neurological diagnosis; or 184.13 (C) up to 60 percent of the average reimbursement rate, as 184.14 of July 1, 1991, for care provided in a regional treatment 184.15 center for recipients who have Level I behavior, plus any 184.16 inflation adjustment as provided by the legislature for personal 184.17 care service; or 184.18 (D) up to the amount the commissioner would pay, as of July 184.19 1, 1991, plus any inflation adjustment provided for home care 184.20 services, for care provided in a regional treatment center for 184.21 recipients referred to the commissioner by a regional treatment 184.22 center preadmission evaluation team. For purposes of this 184.23 clause, home care services means all services provided in the 184.24 home or community that would be included in the payment to a 184.25 regional treatment center; or 184.26 (E) up to the amount medical assistance would reimburse for 184.27 facility care for recipients referred to the commissioner by a 184.28 preadmission screening team established under section 256B.0911 184.29 or 256B.092; and 184.30 (F) a reasonable amount of time for the provision of 184.31nursingsupervision by a qualified professional of personal care 184.32 services. 184.33 (ii) The number of direct care hours shall be determined 184.34 according to the annual cost report submitted to the department 184.35 by nursing facilities. The average number of direct care hours, 184.36 as established by May 1, 1992, shall be calculated and 185.1 incorporated into the home care limits on July 1, 1992. These 185.2 limits shall be calculated to the nearest quarter hour. 185.3 (iii) The home care rating shall be determined by the 185.4 commissioner or the commissioner's designee based on information 185.5 submitted to the commissioner by the county public health nurse 185.6 on forms specified by the commissioner. The home care rating 185.7 shall be a combination of current assessment tools developed 185.8 under sections 256B.0911 and 256B.501 with an addition for 185.9 seizure activity that will assess the frequency and severity of 185.10 seizure activity and with adjustments, additions, and 185.11 clarifications that are necessary to reflect the needs and 185.12 conditions of recipients who need home care including children 185.13 and adults under 65 years of age. The commissioner shall 185.14 establish these forms and protocols under this section and shall 185.15 use an advisory group, including representatives of recipients, 185.16 providers, and counties, for consultation in establishing and 185.17 revising the forms and protocols. 185.18 (iv) A recipient shall qualify as having complex medical 185.19 needs if the care required is difficult to perform and because 185.20 of recipient's medical condition requires more time than 185.21 community-based standards allow or requires more skill than 185.22 would ordinarily be required and the recipient needs or has one 185.23 or more of the following: 185.24 (A) daily tube feedings; 185.25 (B) daily parenteral therapy; 185.26 (C) wound or decubiti care; 185.27 (D) postural drainage, percussion, nebulizer treatments, 185.28 suctioning, tracheotomy care, oxygen, mechanical ventilation; 185.29 (E) catheterization; 185.30 (F) ostomy care; 185.31 (G) quadriplegia; or 185.32 (H) other comparable medical conditions or treatments the 185.33 commissioner determines would otherwise require institutional 185.34 care. 185.35 (v) A recipient shall qualify as having Level I behavior if 185.36 there is reasonable supporting evidence that the recipient 186.1 exhibits, or that without supervision, observation, or 186.2 redirection would exhibit, one or more of the following 186.3 behaviors that cause, or have the potential to cause: 186.4 (A) injury to the recipient's own body; 186.5 (B) physical injury to other people; or 186.6 (C) destruction of property. 186.7 (vi) Time authorized for personal care relating to Level I 186.8 behavior in subclause (v), items (A) to (C), shall be based on 186.9 the predictability, frequency, and amount of intervention 186.10 required. 186.11 (vii) A recipient shall qualify as having Level II behavior 186.12 if the recipient exhibits on a daily basis one or more of the 186.13 following behaviors that interfere with the completion of 186.14 personal care services under subdivision 4, paragraph (a): 186.15 (A) unusual or repetitive habits; 186.16 (B) withdrawn behavior; or 186.17 (C) offensive behavior. 186.18 (viii) A recipient with a home care rating of Level II 186.19 behavior in subclause (vii), items (A) to (C), shall be rated as 186.20 comparable to a recipient with complex medical needs under 186.21 subclause (iv). If a recipient has both complex medical needs 186.22 and Level II behavior, the home care rating shall be the next 186.23 complex category up to the maximum rating under subclause (i), 186.24 item (B). 186.25 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 186.26 nursing services shall be prior authorized by the commissioner 186.27 or the commissioner's designee. Prior authorization for private 186.28 duty nursing services shall be based on medical necessity and 186.29 cost-effectiveness when compared with alternative care options. 186.30 The commissioner may authorize medically necessary private duty 186.31 nursing services in quarter-hour units when: 186.32 (i) the recipient requires more individual and continuous 186.33 care than can be provided during a nurse visit; or 186.34 (ii) the cares are outside of the scope of services that 186.35 can be provided by a home health aide or personal care assistant. 186.36 The commissioner may authorize: 187.1 (A) up to two times the average amount of direct care hours 187.2 provided in nursing facilities statewide for case mix 187.3 classification "K" as established by the annual cost report 187.4 submitted to the department by nursing facilities in May 1992; 187.5 (B) private duty nursing in combination with other home 187.6 care services up to the total cost allowed under clause (2); 187.7 (C) up to 16 hours per day if the recipient requires more 187.8 nursing than the maximum number of direct care hours as 187.9 established in item (A) and the recipient meets the hospital 187.10 admission criteria established under Minnesota Rules, parts 187.11 9505.0500 to 9505.0540. 187.12 The commissioner may authorize up to 16 hours per day of 187.13 medically necessary private duty nursing services or up to 24 187.14 hours per day of medically necessary private duty nursing 187.15 services until such time as the commissioner is able to make a 187.16 determination of eligibility for recipients who are 187.17 cooperatively applying for home care services under the 187.18 community alternative care program developed under section 187.19 256B.49, or until it is determined by the appropriate regulatory 187.20 agency that a health benefit plan is or is not required to pay 187.21 for appropriate medically necessary health care services. 187.22 Recipients or their representatives must cooperatively assist 187.23 the commissioner in obtaining this determination. Recipients 187.24 who are eligible for the community alternative care program may 187.25 not receive more hours of nursing under this section than would 187.26 otherwise be authorized under section 256B.49. 187.27 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 187.28 ventilator-dependent, the monthly medical assistance 187.29 authorization for home care services shall not exceed what the 187.30 commissioner would pay for care at the highest cost hospital 187.31 designated as a long-term hospital under the Medicare program. 187.32 For purposes of this clause, home care services means all 187.33 services provided in the home that would be included in the 187.34 payment for care at the long-term hospital. 187.35 "Ventilator-dependent" means an individual who receives 187.36 mechanical ventilation for life support at least six hours per 188.1 day and is expected to be or has been dependent for at least 30 188.2 consecutive days. 188.3 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 188.4 or the commissioner's designee shall determine the time period 188.5 for which a prior authorization shall be effective. If the 188.6 recipient continues to require home care services beyond the 188.7 duration of the prior authorization, the home care provider must 188.8 request a new prior authorization. Under no circumstances, 188.9 other than the exceptions in paragraph (b), shall a prior 188.10 authorization be valid prior to the date the commissioner 188.11 receives the request or for more than 12 months. A recipient 188.12 who appeals a reduction in previously authorized home care 188.13 services may continue previously authorized services, other than 188.14 temporary services under paragraph (h), pending an appeal under 188.15 section 256.045. The commissioner must provide a detailed 188.16 explanation of why the authorized services are reduced in amount 188.17 from those requested by the home care provider. 188.18 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 188.19 the commissioner's designee shall determine the medical 188.20 necessity of home care services, the level of caregiver 188.21 according to subdivision 2, and the institutional comparison 188.22 according to this subdivision, the cost-effectiveness of 188.23 services, and the amount, scope, and duration of home care 188.24 services reimbursable by medical assistance, based on the 188.25 assessment, primary payer coverage determination information as 188.26 required, the service plan, the recipient's age, the cost of 188.27 services, the recipient's medical condition, and diagnosis or 188.28 disability. The commissioner may publish additional criteria 188.29 for determining medical necessity according to section 256B.04. 188.30 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 188.31 The agency nurse, the independently enrolled private duty nurse, 188.32 or county public health nurse may request a temporary 188.33 authorization for home care services by telephone. The 188.34 commissioner may approve a temporary level of home care services 188.35 based on the assessment, and service or care plan information, 188.36 and primary payer coverage determination information as required. 189.1 Authorization for a temporary level of home care services 189.2 including nurse supervision is limited to the time specified by 189.3 the commissioner, but shall not exceed 45 days, unless extended 189.4 because the county public health nurse has not completed the 189.5 required assessment and service plan, or the commissioner's 189.6 determination has not been made. The level of services 189.7 authorized under this provision shall have no bearing on a 189.8 future prior authorization. 189.9 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 189.10 Home care services provided in an adult or child foster care 189.11 setting must receive prior authorization by the department 189.12 according to the limits established in paragraph (a). 189.13 The commissioner may not authorize: 189.14 (1) home care services that are the responsibility of the 189.15 foster care provider under the terms of the foster care 189.16 placement agreement and administrative rules. Requests for home 189.17 care services for recipients residing in a foster care setting 189.18 must include the foster care placement agreement and 189.19 determination of difficulty of care; 189.20 (2) personal care services when the foster care license 189.21 holder is also the personal care provider or personal care 189.22 assistant unless the recipient can direct the recipient's own 189.23 care, or case management is provided as required in section 189.24 256B.0625, subdivision 19a; 189.25 (3) personal care services when the responsible party is an 189.26 employee of, or under contract with, or has any direct or 189.27 indirect financial relationship with the personal care provider 189.28 or personal care assistant, unless case management is provided 189.29 as required in section 256B.0625, subdivision 19a; 189.30 (4) home care services when the number of foster care 189.31 residents is greater than four unless the county responsible for 189.32 the recipient's foster placement made the placement prior to 189.33 April 1, 1992, requests that home care services be provided, and 189.34 case management is provided as required in section 256B.0625, 189.35 subdivision 19a; or 189.36 (5) home care services when combined with foster care 190.1 payments, other than room and board payments that exceed the 190.2 total amount that public funds would pay for the recipient's 190.3 care in a medical institution. 190.4 Sec. 61. Minnesota Statutes 1998, section 256B.0627, 190.5 subdivision 8, is amended to read: 190.6 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES; SHARED190.7CARE.] (a) Medical assistance payments for shared personal care 190.8 assistanceshared careservices shall be limited according to 190.9 this subdivision. 190.10 (b) Recipients of personal care assistant services may 190.11 share staff and the commissioner shall provide a rate system for 190.12 shared personal care assistant services. For two persons 190.13 sharingcareservices, the rate paid to a provider shall not 190.14 exceed 1-1/2 times the rate paid for serving a single 190.15 individual, and for three persons sharingcareservices, the 190.16 rate paid to a provider shall not exceed twice the rate paid for 190.17 serving a single individual. These rates apply only to 190.18 situations in which all recipients were present and received 190.19 sharedcareservices on the date for which the service is 190.20 billed. No more than three persons may receive sharedcare190.21 services from a personal care assistant in a single setting. 190.22 (c) Sharedcareservice is the provision of personal care 190.23 services by a personal care assistant to two or three recipients 190.24 at the same time and in the same setting. For the purposes of 190.25 this subdivision, "setting" means: 190.26 (1) the home or foster care home of one of the individual 190.27 recipients; or 190.28 (2) a child care program in which all recipients served by 190.29 one personal care assistant are participating, which is licensed 190.30 under chapter 245A or operated by a local school district or 190.31 private school. 190.32 The provisions of this subdivision do not apply when a 190.33 personal care assistant is caring for multiple recipients in 190.34 more than one setting. 190.35 (d) The recipient or the recipient's responsible party, in 190.36 conjunction with the county public health nurse, shall determine: 191.1 (1) whether sharedcarepersonal care assistant services is 191.2 an appropriate option based on the individual needs and 191.3 preferences of the recipient; and 191.4 (2) the amount of sharedcareservices allocated as part of 191.5 the overall authorization of personal care services. 191.6 The recipient or the responsible party, in conjunction with 191.7 the supervisingregistered nursequalified professional, shall 191.8approvearrange the setting,and grouping, and arrangementof 191.9 sharedcareservices based on the individual needs and 191.10 preferences of the recipients. Decisions on the selection of 191.11 recipients to sharecareservices must be based on the ages of 191.12 the recipients, compatibility, and coordination of their care 191.13 needs. 191.14 (e) The following items must be considered by the recipient 191.15 or the responsible party and the supervisingnursequalified 191.16 professional, and documented in the recipient'scare planhealth 191.17 service record: 191.18 (1) the additional qualifications needed by the personal 191.19 care assistant to provide care to several recipients in the same 191.20 setting; 191.21 (2) the additional training and supervision needed by the 191.22 personal care assistant to ensure that the needs of the 191.23 recipient are met appropriately and safely. The provider must 191.24 provide on-site supervision by aregistered nursequalified 191.25 professional within the first 14 days of sharedcareservices, 191.26 and monthly thereafter; 191.27 (3) the setting in which the sharedcareservices will be 191.28 provided; 191.29 (4) the ongoing monitoring and evaluation of the 191.30 effectiveness and appropriateness of the service and process 191.31 used to make changes in service or setting; and 191.32 (5) a contingency plan which accounts for absence of the 191.33 recipient in a sharedcareservices setting due to illness or 191.34 other circumstances and staffing contingencies. 191.35 (f) The provider must offer the recipient or the 191.36 responsible party the option of shared orindividualone-on-one 192.1 personal care assistantcareservices. The recipient or the 192.2 responsible party can withdraw from participating in a shared 192.3careservices arrangement at any time. 192.4 (g) In addition to documentation requirements under 192.5 Minnesota Rules, part 9505.2175, a personal care provider must 192.6 meet documentation requirements for shared personal 192.7 care assistant services and must document the following in the 192.8 health service record for each individual recipient sharingcare192.9 services: 192.10 (1)authorizationpermission by the recipient or the 192.11 recipient's responsible party, if any, for the maximum number of 192.12 sharedcareservices hours per week chosen by the recipient; 192.13 (2)authorizationpermission by the recipient or the 192.14 recipient's responsible party, if any, for personal 192.15 care assistant services provided outside the recipient's 192.16 residence; 192.17 (3)authorizationpermission by the recipient or the 192.18 recipient's responsible party, if any, for others to receive 192.19 sharedcareservices in the recipient's residence; 192.20 (4) revocation by the recipient or the recipient's 192.21 responsible party, if any, of the sharedcareservice 192.22 authorization, or the sharedcareservice to be provided to 192.23 others in the recipient's residence, or the sharedcareservice 192.24 to be provided outside the recipient's residence; 192.25 (5) supervision of the sharedcarepersonal care assistant 192.26 services by thesupervisory nursequalified professional, 192.27 including the date, time of day, number of hours spent 192.28 supervising the provision of sharedcareservices, whether the 192.29 supervision was face-to-face or another method of supervision, 192.30 changes in the recipient's condition, sharedcareservices 192.31 scheduling issues and recommendations; 192.32 (6) documentation by thepersonal care assistantqualified 192.33 professional of telephone calls or other discussions with 192.34 thesupervisory nursepersonal care assistant regarding services 192.35 being provided to the recipient; and 192.36 (7) daily documentation of the sharedcareservices 193.1 provided by each identified personal care assistant including: 193.2 (i) the names of each recipient receiving sharedcare193.3 services together; 193.4 (ii) the setting for theday's careshared services, 193.5 including the starting and ending times that the recipient 193.6 received sharedcareservices; and 193.7 (iii) notes by the personal care assistant regarding 193.8 changes in the recipient's condition, problems that may arise 193.9 from the sharing ofcareservices, scheduling issues, care 193.10 issues, and other notes as required by thesupervising nurse193.11 qualified professional. 193.12 (h) Unless otherwise provided in this subdivision, all 193.13 other statutory and regulatory provisions relating to personal 193.14 care services apply to sharedcareservices. 193.15 Nothing in this subdivision shall be construed to reduce 193.16 the total number of hours authorized for an individual recipient. 193.17 Sec. 62. Minnesota Statutes 1998, section 256B.0627, is 193.18 amended by adding a subdivision to read: 193.19 Subd. 9. [FLEXIBLE USE OF PERSONAL CARE ASSISTANT 193.20 HOURS.] (a) The commissioner may allow for the flexible use of 193.21 personal care assistant hours. "Flexible use" means the 193.22 scheduled use of authorized hours of personal care assistant 193.23 services, which vary within the length of the service 193.24 authorization in order to more effectively meet the needs and 193.25 schedule of the recipient. Recipients may use their approved 193.26 hours flexibly within the service authorization period for 193.27 medically necessary covered services specified in the assessment 193.28 required in subdivision 1. The flexible use of authorized hours 193.29 does not increase the total amount of authorized hours available 193.30 to a recipient as determined under subdivision 5. The 193.31 commissioner shall not authorize additional personal care 193.32 assistant services to supplement a service authorization that is 193.33 exhausted before the end date under a flexible service use plan, 193.34 unless the county public health nurse determines a change in 193.35 condition and a need for increased services is established. 193.36 (b) The recipient or responsible party, together with the 194.1 county public health nurse, shall determine whether flexible use 194.2 is an appropriate option based on the needs and preferences of 194.3 the recipient or responsible party, and, if appropriate, must 194.4 ensure that the allocation of hours covers the ongoing needs of 194.5 the recipient over the entire service authorization period. As 194.6 part of the assessment and service planning process, the 194.7 recipient or responsible party must work with the county public 194.8 health nurse to develop a written month-to-month plan of the 194.9 projected use of personal care assistant services that is part 194.10 of the service plan and ensures that the: 194.11 (1) health and safety needs of the recipient will be met; 194.12 (2) total annual authorization will not exceed before the 194.13 end date; and 194.14 (3) how actual use of hours will be monitored. 194.15 (c) If the actual use of personal care assistant service 194.16 varies significantly from the use projected in the plan, the 194.17 written plan must be promptly updated by the recipient or 194.18 responsible party and the county public health nurse. 194.19 (d) The recipient or responsible party, together with the 194.20 provider, must work to monitor and document the use of 194.21 authorized hours and ensure that a recipient is able to manage 194.22 services effectively throughout the authorized period. The 194.23 provider must ensure that the month-to-month plan is 194.24 incorporated into the care plan. Upon request of the recipient 194.25 or responsible party, the provider must furnish regular updates 194.26 to the recipient or responsible party on the amount of personal 194.27 care assistant services used. 194.28 (e) The recipient or responsible party can revoke the 194.29 authorization for flexible use of hours by notifying the 194.30 provider and county public health nurse in writing. 194.31 (f) If the requirements in paragraphs (a) to (e) have not 194.32 substantially been met, the commissioner shall deny, revoke, or 194.33 suspend the authorization to use authorized hours flexibly. The 194.34 recipient or responsible party may appeal the commissioner's 194.35 action according to section 256.045. The denial, revocation, or 194.36 suspension to use the flexible hours option shall not affect the 195.1 recipient's authorized level of personal care assistant services 195.2 as determined under subdivision 5. 195.3 Sec. 63. Minnesota Statutes 1998, section 256B.0627, is 195.4 amended by adding a subdivision to read: 195.5 Subd. 10. [FISCAL AGENT OPTION AVAILABLE FOR PERSONAL CARE 195.6 ASSISTANT SERVICES.] (a) "Fiscal agent option" is an option that 195.7 allows the recipient to: 195.8 (1) use a fiscal agent instead of a personal care provider 195.9 organization; 195.10 (2) supervise the personal care assistant; and 195.11 (3) use a consulting professional. 195.12 The commissioner may allow a recipient of personal care 195.13 assistant services to use a fiscal agent to assist the recipient 195.14 in paying and accounting for medically necessary covered 195.15 personal care assistant services authorized in subdivision 4 and 195.16 within the payment parameters of subdivision 5, unless otherwise 195.17 provided in this subdivision, all other statutory and regulatory 195.18 provisions relating to personal care services apply to a 195.19 recipient using the fiscal agent option. 195.20 (b) The recipient or responsible party shall: 195.21 (1) hire and terminate the personal care assistant and 195.22 consulting professional with the fiscal agent; 195.23 (2) recruit the personal care assistant and consulting 195.24 professional and orient and train the personal care assistant in 195.25 areas that do not require professional delegation as determined 195.26 by the county public health nurse; 195.27 (3) supervise and evaluate the personal care assistant in 195.28 areas that do not require professional delegation as determined 195.29 by the county public health nurse; 195.30 (4) cooperate with a consulting professional and implement 195.31 recommendations pertaining to the health and safety of the 195.32 recipient; 195.33 (5) hire a qualified professional to train and supervise 195.34 the performance of delegated tasks done by the personal care 195.35 assistant; 195.36 (6) monitor services and verify in writing the hours worked 196.1 by the personal care assistant and the consulting professional; 196.2 (7) develop and revise a care plan with assistance from a 196.3 consulting professional; 196.4 (8) verify and document the credentials of the consulting 196.5 professional; and 196.6 (9) enter into a written agreement as specified in 196.7 paragraph (f). 196.8 (c) The duties of the fiscal agent shall be to: 196.9 (1) bill the medical assistance program for personal care 196.10 assistant and consulting professional services; 196.11 (2) request and secure background checks on personal care 196.12 assistants and consulting professionals according to section 196.13 245A.04; 196.14 (3) pay the personal care assistant and consulting 196.15 professional based on actual hours of services provided; 196.16 (4) withhold and pay all applicable federal and state 196.17 taxes; 196.18 (5) verify and document hours worked by the personal care 196.19 assistant and consulting professional; 196.20 (6) make the arrangements and pay unemployment insurance, 196.21 taxes, workers' compensation, liability insurance, and other 196.22 benefits, if any; 196.23 (7) enroll in the medical assistance program as a fiscal 196.24 agent; and 196.25 (8) enter into a written agreement as specified in 196.26 paragraph (f) before services are provided. 196.27 (d) The fiscal agent: 196.28 (1) may not be related to the recipient, consulting 196.29 professional, or the personal care assistant; 196.30 (2) must ensure arm's length transactions with the 196.31 recipient and personal care assistant; and 196.32 (3) shall be considered a joint employer of the personal 196.33 care assistant and consulting professional to the extent 196.34 specified in this section. 196.35 The fiscal agent or owners of the entity that provides 196.36 fiscal agent services under this subdivision must pass a 197.1 criminal background check as required in section 256B.0627, 197.2 subdivision 1, paragraph (e). 197.3 (e) The consulting professional providing assistance to the 197.4 recipient shall meet the qualifications specified in section 197.5 256B.0625, subdivision 19c. The consulting professional shall 197.6 assist the recipient in developing and revising a plan to meet 197.7 the recipient's assessed needs and supervise the performance of 197.8 delegated tasks, as determined by the public health nurse. In 197.9 performing this function, the consulting professional must visit 197.10 the recipient in the recipient's home at least once annually. 197.11 The consulting professional must report to the local county 197.12 public health nurse concerns relating to the health and safety 197.13 of the recipient, and any suspected abuse, neglect, or financial 197.14 exploitation of the recipient to the appropriate authorities. 197.15 (f) The fiscal agent, recipient, or responsible party, 197.16 personal care assistant, and consulting professional shall enter 197.17 into a written agreement before services are started. The 197.18 agreement shall include: 197.19 (1) the duties of the recipient, consulting professional, 197.20 personal care assistant, and fiscal agent based on paragraphs 197.21 (a) to (e); 197.22 (2) the salary and benefits for the personal care assistant 197.23 and those providing professional consultation; 197.24 (3) the administrative fee of the fiscal agent and services 197.25 paid for with that fee, including background check fees; 197.26 (4) procedures to respond to billing or payment complaints; 197.27 and 197.28 (5) procedures for hiring and terminating the personal care 197.29 assistant and those providing professional consultation. 197.30 (g) The rates paid for personal care services and fiscal 197.31 agency services under this subdivision shall be the same rates 197.32 paid for personal care services and qualified professional 197.33 services under subdivision 2 respectively. Except for the 197.34 administrative fee of the fiscal agent specified in paragraph 197.35 (f), the remainder of the rates paid to the fiscal agent must be 197.36 used to pay for the salary and benefits for the personal care 198.1 assistant or those providing professional consultation. 198.2 (h) As part of the assessment defined in subdivision 1, the 198.3 following conditions must be met to use or continue use of a 198.4 fiscal agent: 198.5 (1) the recipient must be able to direct the recipient's 198.6 own care, or the responsible party for the recipient must be 198.7 readily available to direct the care of the personal care 198.8 assistant; 198.9 (2) the recipient or responsible party must be 198.10 knowledgeable of the health care needs of the recipient and be 198.11 able to effectively communicate those needs; 198.12 (3) a face-to-face assessment must be conducted by the 198.13 local county public health nurse at least annually or when there 198.14 is a significant change in the recipient's condition or change 198.15 in the need for personal care assistant services. The county 198.16 public health nurse will determine the services that require 198.17 professional delegation, if any, and the amount and frequency of 198.18 related supervision; 198.19 (4) the recipient cannot select the shared services option 198.20 as specified in subdivision 8; and 198.21 (5) parties must be in compliance with the written 198.22 agreement specified in paragraph (e). 198.23 (i) The commissioner shall deny, revoke, or suspend the 198.24 authorization to use the fiscal agent option if: 198.25 (1) it has been determined by the consulting professional 198.26 or local county public health nurse that the use of this option 198.27 jeopardizes the recipient's health and safety; 198.28 (2) the parties have failed to comply with the written 198.29 agreement specified in paragraph (e); or 198.30 (3) the use of the option has led to abusive or fraudulent 198.31 billing for personal care assistant services. 198.32 The recipient or responsible party may appeal the 198.33 commissioner's action according to section 256.045. The denial, 198.34 revocation, or suspension to use the fiscal agent option shall 198.35 not affect the recipient's authorized level of personal care 198.36 assistant services as determined in subdivision 5. 199.1 (Effective date: Section 63 (256B.0627, subd. 10) is 199.2 effective upon federal approval.) 199.3 Sec. 64. Minnesota Statutes 1998, section 256B.0627, is 199.4 amended by adding a subdivision to read: 199.5 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 199.6 Medical assistance payments for shared private duty nursing 199.7 services by a private duty nurse shall be limited according to 199.8 this subdivision. For the purposes of this section, "private 199.9 duty nursing agency" means an agency licensed under chapter 144A 199.10 to provide private duty nursing services. 199.11 (b) Recipients of private duty nursing services may share 199.12 nursing staff and the commissioner shall provide a rate 199.13 methodology for shared private duty nursing. For two persons 199.14 sharing nursing care, the rate paid to a provider shall not 199.15 exceed 1.5 times the nonwaivered private duty nursing rates paid 199.16 for serving a single individual who is not ventilator dependent, 199.17 by a registered nurse or licensed practical nurse. These rates 199.18 apply only to situations in which both recipients are present 199.19 and receive shared private duty nursing care on the date for 199.20 which the service is billed. No more than two persons may 199.21 receive shared private duty nursing services from a private duty 199.22 nurse in a single setting. 199.23 (c) Shared private duty nursing care is the provision of 199.24 nursing services by a private duty nurse to two recipients at 199.25 the same time and in the same setting. For the purposes of this 199.26 subdivision, "setting" means: 199.27 (1) the home or foster care home of one of the individual 199.28 recipients; or 199.29 (2) a child care program licensed under chapter 245A or 199.30 operated by a local school district or private school; or 199.31 (3) an adult day care service licensed under chapter 245A. 199.32 This subdivision does not apply when a private duty nurse 199.33 is caring for multiple recipients in more than one setting. 199.34 (d) The recipient or the recipient's legal representative, 199.35 and the recipient's physician, in conjunction with the home 199.36 health care agency, shall determine: 200.1 (1) whether shared private duty nursing care is an 200.2 appropriate option based on the individual needs and preferences 200.3 of the recipient; and 200.4 (2) the amount of shared private duty nursing services 200.5 authorized as part of the overall authorization of nursing 200.6 services. 200.7 (e) The recipient or the recipient's legal representative, 200.8 in conjunction with the private duty nursing agency, shall 200.9 approve the setting, grouping, and arrangement of shared private 200.10 duty nursing care based on the individual needs and preferences 200.11 of the recipients. Decisions on the selection of recipients to 200.12 share services must be based on the ages of the recipients, 200.13 compatibility, and coordination of their care needs. 200.14 (f) The following items must be considered by the recipient 200.15 or the recipient's legal representative and the private duty 200.16 nursing agency, and documented in the recipient's health service 200.17 record: 200.18 (1) the additional training needed by the private duty 200.19 nurse to provide care to several recipients in the same setting 200.20 and to ensure that the needs of the recipients are met 200.21 appropriately and safely; 200.22 (2) the setting in which the shared private duty nursing 200.23 care will be provided; 200.24 (3) the ongoing monitoring and evaluation of the 200.25 effectiveness and appropriateness of the service and process 200.26 used to make changes in service or setting; 200.27 (4) a contingency plan which accounts for absence of the 200.28 recipient in a shared private duty nursing setting due to 200.29 illness or other circumstances; 200.30 (5) staffing backup contingencies in the event of employee 200.31 illness or absence; and 200.32 (6) arrangements for additional assistance to respond to 200.33 urgent or emergency care needs of the recipients. 200.34 (g) The provider must offer the recipient or responsible 200.35 party the option of shared or one-on-one private duty nursing 200.36 services. The recipient or responsible party can withdraw from 201.1 participating in a shared service arrangement at any time. 201.2 (h) The private duty nursing agency must document the 201.3 following in the health service record for each individual 201.4 recipient sharing private duty nursing care: 201.5 (1) permission by the recipient or the recipient's legal 201.6 representative for the maximum number of shared nursing care 201.7 hours per week chosen by the recipient; 201.8 (2) permission by the recipient or the recipient's legal 201.9 representative for shared private duty nursing services provided 201.10 outside the recipient's residence; 201.11 (3) permission by the recipient or the recipient's legal 201.12 representative for others to receive shared private duty nursing 201.13 services in the recipient's residence; 201.14 (4) revocation by the recipient or the recipient's legal 201.15 representative of the shared private duty nursing care 201.16 authorization, or the shared care to be provided to others in 201.17 the recipient's residence, or the shared private duty nursing 201.18 services to be provided outside the recipient's residence; and 201.19 (5) daily documentation of the shared private duty nursing 201.20 services provided by each identified private duty nurse, 201.21 including: 201.22 (i) the names of each recipient receiving shared private 201.23 duty nursing services together; 201.24 (ii) the setting for the shared services, including the 201.25 starting and ending times that the recipient received shared 201.26 private duty nursing care; and 201.27 (iii) notes by the private duty nurse regarding changes in 201.28 the recipient's condition, problems that may arise from the 201.29 sharing of private duty nursing services, and scheduling and 201.30 care issues. 201.31 (i) Unless otherwise provided in this subdivision, all 201.32 other statutory and regulatory provisions relating to private 201.33 duty nursing services apply to shared private duty nursing 201.34 services. 201.35 Nothing in this subdivision shall be construed to reduce 201.36 the total number of private duty nursing hours authorized for an 202.1 individual recipient under subdivision 5. 202.2 Sec. 65. Minnesota Statutes 1998, section 256B.0635, 202.3 subdivision 3, is amended to read: 202.4 Subd. 3. [MEDICAL ASSISTANCE FOR MFIP-S PARTICIPANTS WHO 202.5 OPT TO DISCONTINUE MONTHLY CASH ASSISTANCE.]Upon federal202.6approval,Medical assistance is available to persons who 202.7received MFIP-S in at least three of the six months preceding202.8the month in which the person optedopt to discontinue receiving 202.9 MFIP-S cash assistance under section 256J.31, subdivision 12. A 202.10 person who is eligible for medical assistance under this section 202.11 may receive medical assistance without reapplication as long as 202.12 the person meets MFIP-S eligibility requirements, unless the202.13assistance unit does not include a dependent child. Medical 202.14 assistance may be paid pursuant to subdivisions 1 and 2 for 202.15 persons who are no longer eligible for MFIP-S due to increased 202.16 employment or child support. A person may be eligible for 202.17 MinnesotaCare due to increased employment or child support, and 202.18 as such must be informed of the option to transition onto 202.19 MinnesotaCare. 202.20 Sec. 66. Minnesota Statutes 1998, section 256B.064, 202.21 subdivision 1a, is amended to read: 202.22 Subd. 1a. [GROUNDS FORMONETARY RECOVERY ANDSANCTIONS 202.23 AGAINST VENDORS.] The commissioner mayseek monetary recovery202.24andimpose sanctions againstvendorsa vendor of medical care 202.25 for any of the following: fraud, theft, or abuse in connection 202.26 with the provision of medical care to recipients of public 202.27 assistance; a pattern of presentment of false or duplicate 202.28 claims or claims for services not medically necessary; a pattern 202.29 of making false statements of material facts for the purpose of 202.30 obtaining greater compensation than that to which the vendor is 202.31 legally entitled; suspension or termination as a Medicare 202.32 vendor; refusal to grant the state agency access during regular 202.33 business hours to examine all records necessary to disclose the 202.34 extent of services provided to program recipients and 202.35 appropriateness of claims for payment; failure to comply with a 202.36 commissioner's order to repay an overpayment; failure to comply 203.1 with a settlement agreement; failure to comply with the 203.2 disclosure requirements of section 256B.0646; and any reason for 203.3 which a vendor could be excluded from participation in the 203.4 Medicare program under section 1128, 1128A, or 1866(b)(2) of the 203.5 Social Security Act. The determination of services not 203.6 medically necessary may be made by the commissioner in 203.7 consultation with a peer advisory task force appointed by the 203.8 commissioner on the recommendation of appropriate professional 203.9 organizations. The task force expires as provided in section 203.10 15.059, subdivision 5. 203.11 Sec. 67. Minnesota Statutes 1998, section 256B.064, 203.12 subdivision 1b, is amended to read: 203.13 Subd. 1b. [SANCTIONS AVAILABLE.] The commissioner may 203.14 impose the following sanctions for the conduct described in 203.15 subdivision 1a:referral to the appropriate state licensing203.16board,suspension or withholding of payments to a vendor,and 203.17 suspending or terminating participation in the 203.18 program. Regardless of imposition of sanctions, the 203.19 commissioner may make a referral to the appropriate state 203.20 licensing board. 203.21 Sec. 68. Minnesota Statutes 1998, section 256B.064, 203.22 subdivision 1c, is amended to read: 203.23 Subd. 1c. [GROUNDS FOR AND METHODS OF MONETARY RECOVERY.] 203.24 The commissioner may obtain monetary recovery from a vendor who 203.25 has been improperly paid either as a result of conduct described 203.26 in subdivision 1a or as a result of a vendor or department 203.27 error, regardless of whether the error was 203.28 intentional. Patterns need not be proven as a precondition to 203.29 monetary recovery of erroneous or false claims, duplicate 203.30 claims, claims for services not medically necessary, or claims 203.31 based on false statements. The commissioner may obtain monetary 203.32 recovery using methods, including but not limited to the 203.33 following: assessing and recovering money improperly paid and 203.34 debiting from future payments any money improperly 203.35 paid.Patterns need not be proven as a precondition to monetary203.36recovery of erroneous or false claims, duplicate claims, claims204.1for services not medically necessary, or claims based on false204.2statements.The commissioner shall charge interest on money to 204.3 be recovered if the recovery is to be made by installment 204.4 payments or debits, except when the monetary recovery is of an 204.5 overpayment that resulted from a department error. The interest 204.6 charged shall be the rate established by the commissioner of 204.7 revenue under section 270.75. 204.8 Sec. 69. Minnesota Statutes 1998, section 256B.064, is 204.9 amended by adding a subdivision to read: 204.10 Subd. 1e. [SANCTIONS AND MONETARY RECOVERY AGAINST RELATED 204.11 VENDORS.] In a situation where the commissioner is authorized by 204.12 this section to impose sanctions against or make monetary 204.13 recovery from a vendor of medical care, the commissioner may 204.14 also take such action against other vendors that have common 204.15 control or ownership with the vendor. A vendor has common 204.16 control or ownership with another vendor if: 204.17 (1) one or more persons have a direct or indirect ownership 204.18 or control interest in both vendors; 204.19 (2) one vendor has a direct or indirect ownership or 204.20 control interest in the other vendor; 204.21 (3) the vendors have interlocking management or ownership; 204.22 interrelated business interests among family members; or shared 204.23 facilities, equipment, and use of employees; or 204.24 (4) one of the vendors is a new business entity created in 204.25 connection with the termination of the other vendor, and the 204.26 vendors have the same or similar management, ownership, or 204.27 principal employees. 204.28 Sec. 70. Minnesota Statutes 1998, section 256B.064, 204.29 subdivision 2, is amended to read: 204.30 Subd. 2. [IMPOSITION OF MONETARY RECOVERY AND SANCTIONS.] 204.31 (a) The commissioner shall determine any monetary amounts to be 204.32 recovered andthe sanctionsanctions to be imposed upon a vendor 204.33 of medical carefor conduct described by subdivision 1aunder 204.34 this section. Except as provided in paragraph (b), neither a 204.35 monetary recovery nor a sanction will be imposed by the 204.36 commissioner without prior notice and an opportunity for a 205.1 hearing, according to chapter 14, on the commissioner's proposed 205.2 action, provided that the commissioner may suspend or reduce 205.3 payment to a vendor of medical care, except a nursing home or 205.4 convalescent care facility, after notice and prior to the 205.5 hearing if in the commissioner's opinion that action is 205.6 necessary to protect the public welfare and the interests of the 205.7 program. 205.8 (b) Except for a nursing home or convalescent care 205.9 facility, the commissioner may withhold or reduce payments to a 205.10 vendor of medical care without providing advance notice of such 205.11 withholding or reduction ifeitherany of the following occurs: 205.12 (1) the vendor is convicted of a crime involving the 205.13 conduct described in subdivision 1a;or205.14 (2) the commissioner receives reliable evidence of fraud or 205.15 willful misrepresentation by the vendor.; or 205.16 (3) the vendor has requested that prior authorization for 205.17 the vendor's clients be changed to another provider, and: 205.18 (i) the vendor is under investigation for fraud; 205.19 (ii) the vendor has received or is appealing a notice of 205.20 agency action seeking monetary recovery under this section; or 205.21 (iii) the vendor has an established overpayment debt owed 205.22 to the commissioner. 205.23 (c) The commissioner must send notice of the withholding or 205.24 reduction of payments under paragraph (b) within five days of 205.25 taking such action. The notice must: 205.26 (1) state that payments are being withheld according to 205.27 paragraph (b); 205.28 (2) except in the case of a conviction for conduct 205.29 described in subdivision 1a, state that the withholding is for a 205.30 temporary period and cite the circumstances under which 205.31 withholding will be terminated; 205.32 (3) identify the types of claims to which the withholding 205.33 applies; and 205.34 (4) inform the vendor of the right to submit written 205.35 evidence for consideration by the commissioner. 205.36 The withholding or reduction of payments will not continue 206.1 after the commissioner determines there is insufficient evidence 206.2 of fraud or willful misrepresentation by the vendor, or after 206.3 legal proceedings relating to the alleged fraud or willful 206.4 misrepresentation are completed, unless the commissioner has 206.5 sent notice of intention to impose monetary recovery or 206.6 sanctions under paragraph (a). 206.7 (d) Upon receipt of a notice under paragraph (a) that a 206.8 monetary recovery or sanction is to be imposed, a vendor may 206.9 request a contested case, as defined in section 14.02, 206.10 subdivision 3, by filing with the commissioner a written request 206.11 of appeal. The appeal request must be received by the 206.12 commissioner no later than 30 days after the date the 206.13 notification of monetary recovery or sanction was mailed to the 206.14 vendor. The appeal request must specify: 206.15 (1) each disputed item, the reason for the dispute, and an 206.16 estimate of the dollar amount involved for each disputed item; 206.17 (2) the computation that the vendor believes is correct; 206.18 (3) the authority in statute or rule upon which the vendor 206.19 relies for each disputed item; 206.20 (4) the name and address of the person or entity with whom 206.21 contacts may be made regarding the appeal; and 206.22 (5) other information required by the commissioner. 206.23 Sec. 71. [256B.0646] [OWNERSHIP AND CONTROL DISCLOSURE.] 206.24 Subdivision 1. [DEFINITIONS.] The definitions in this 206.25 subdivision apply to this chapter and chapter 256. 206.26 (a) "Indirect ownership interest" means an ownership 206.27 interest in an entity that has an ownership interest in a vendor 206.28 of medical care. Indirect ownership interest also includes an 206.29 ownership interest in an entity that has an indirect ownership 206.30 interest in a vendor of medical care. 206.31 (b) "Managing employee" means a general manager, business 206.32 manager, administrator, director, or other individual who for 206.33 pay or otherwise exercises operational or managerial control 206.34 over, or directly or indirectly conducts the day-to-day 206.35 operation of, a vendor of medical care. 206.36 (c) "Ownership interest" means the possession of equity in 207.1 the capital, stock, or profits of a vendor of medical care. 207.2 (d) "Person" means an individual, corporation, partnership, 207.3 association, or legal entity, however organized. 207.4 (e) "Person with ownership or control interest" means a 207.5 person that: 207.6 (1) has an ownership interest equal to five percent or more 207.7 in a vendor of medical care; 207.8 (2) has an indirect ownership interest equal to five 207.9 percent or more in a vendor of medical care; 207.10 (3) has a combination of direct and indirect ownership 207.11 interests equal to five percent or more in a vendor of medical 207.12 care; 207.13 (4) owns an interest of five percent or more in any 207.14 mortgage, deed of trust, note, or other obligation secured by a 207.15 vendor of medical care, if that interest equals at least five 207.16 percent of the value of the property or assets of a vendor of 207.17 medical care; 207.18 (5) is an officer or director of a vendor of medical care 207.19 that is organized as a corporation; 207.20 (6) is a partner of a vendor of medical care that is 207.21 organized as a partnership; or 207.22 (7) is a managing employee of a vendor of medical care. 207.23 (f) "Provider" means a vendor of medical care who is 207.24 enrolled as a provider in the medical assistance program, 207.25 general assistance program, or MinnesotaCare. 207.26 Subd. 2. [DETERMINATION OF OWNERSHIP OR CONTROL.] (a) A 207.27 prospective or current program provider must disclose the 207.28 information on ownership and control specified in paragraph 207.29 (b). The information must be disclosed on a form provided by 207.30 the commissioner. The disclosure form must be submitted: 207.31 (1) no later than December 31, 1999, if the provider is 207.32 enrolled in the program on the effective date of this section; 207.33 (2) when a vendor applies for enrollment as a program 207.34 provider; 207.35 (3) when an enrolled provider requests a change of address 207.36 or provider name; and 208.1 (4) when required by a schedule established by the 208.2 commissioner for the regular updating of disclosures. The 208.3 schedule must not require updating of disclosures more 208.4 frequently than once a year. 208.5 (b) A disclosure of information on ownership and control 208.6 required by paragraph (a) shall consist of the following 208.7 information about the prospective or current program provider: 208.8 (1) the name and address of each person or entity with an 208.9 ownership or control interest in the provider; 208.10 (2) the name and address of each of the provider's managing 208.11 employees; 208.12 (3) whether any of the persons named due to clause (1) or 208.13 (2) are related to one another as spouses, siblings, parents, 208.14 child, aunt, uncle, niece, nephew, grandchild, or grandparent, 208.15 and, if so, the names of the persons and their relationship; 208.16 (4) the names of any other program providers or vendors in 208.17 which a person named due to clause (1) also has an ownership or 208.18 control interest; and 208.19 (5) for any entity named due to clause (1) that is a 208.20 corporation, the names and addresses of its officers and 208.21 directors. In addition, for each such corporation, the 208.22 following must be attached to the disclosure: a full and 208.23 complete copy of its articles of incorporation and bylaws and 208.24 any amendments and, if a corporation is foreign to this state, a 208.25 copy of its certificate of authority to do business in this 208.26 state. 208.27 (c) Failure to disclose the information on ownership and 208.28 control when required by paragraph (a) shall be grounds for 208.29 denial or termination of provider enrollment. 208.30 Sec. 72. Minnesota Statutes 1998, section 256B.0917, 208.31 subdivision 8, is amended to read: 208.32 Subd. 8. [LIVING-AT-HOME/BLOCK NURSE PROGRAM GRANT.] (a) 208.33 The organization awarded the contract under subdivision 7, shall 208.34 develop and administer a grant program to establish or expand up 208.35 to2730 community-based organizations that will implement 208.36 living-at-home/block nurse programs that are designed to enable 209.1 senior citizens to live as independently as possible in their 209.2 homes and in their communities. At least one-half of the 209.3 programs must be in counties outside the seven-county 209.4 metropolitan area. Nonprofit organizations and units of local 209.5 government are eligible to apply for grants to establish the 209.6 community organizations that will implement living-at-home/block 209.7 nurse programs. In awarding grants, the organization awarded 209.8 the contract under subdivision 7 shall give preference to 209.9 nonprofit organizations and units of local government from 209.10 communities that: 209.11 (1) have high nursing home occupancy rates; 209.12 (2) have a shortage of health care professionals; 209.13 (3) are located in counties adjacent to, or are located in, 209.14 counties with existing living-at-home/block nurse programs; and 209.15 (4) meet other criteria established by LAH/BN, Inc., in 209.16 consultation with the commissioner. 209.17 (b) Grant applicants must also meet the following criteria: 209.18 (1) the local community demonstrates a readiness to 209.19 establish a community model of care, including the formation of 209.20 a board of directors, advisory committee, or similar group, of 209.21 which at least two-thirds is comprised of community citizens 209.22 interested in community-based care for older persons; 209.23 (2) the program has sponsorship by a credible, 209.24 representative organization within the community; 209.25 (3) the program has defined specific geographic boundaries 209.26 and defined its organization, staffing and coordination/delivery 209.27 of services; 209.28 (4) the program demonstrates a team approach to 209.29 coordination and care, ensuring that the older adult 209.30 participants, their families, the formal and informal providers 209.31 are all part of the effort to plan and provide services; and 209.32 (5) the program provides assurances that all community 209.33 resources and funding will be coordinated and that other funding 209.34 sources will be maximized, including a person's own resources. 209.35 (c) Grant applicants must provide a minimum of five percent 209.36 of total estimated development costs from local community 210.1 funding. Grants shall be awarded for four-year periods, and the 210.2 base amount shall not exceed $80,000 per applicant for the grant 210.3 period. The organization under contract may increase the grant 210.4 amount for applicants from communities that have socioeconomic 210.5 characteristics that indicate a higher level of need for 210.6 assistance. Subject to the availability of funding, grants and 210.7 grant renewals awarded or entered into on or after July 1, 1997, 210.8 shall be renewed by LAH/BN, Inc. every four years, unless 210.9 LAH/BN, Inc. determines that the grant recipient has not 210.10 satisfactorily operated the living-at-home/block nurse program 210.11 in compliance with the requirements of paragraphs (b) and (d). 210.12 Grants provided to living-at-home/block nurse programs under 210.13 this paragraph may be used for both program development and the 210.14 delivery of services. 210.15 (d) Each living-at-home/block nurse program shall be 210.16 designed by representatives of the communities being served to 210.17 ensure that the program addresses the specific needs of the 210.18 community residents. The programs must be designed to: 210.19 (1) incorporate the basic community, organizational, and 210.20 service delivery principles of the living-at-home/block nurse 210.21 program model; 210.22 (2) provide senior citizens with registered nurse directed 210.23 assessment, provision and coordination of health and personal 210.24 care services on a sliding fee basis as an alternative to 210.25 expensive nursing home care; 210.26 (3) provide information, support services, homemaking 210.27 services, counseling, and training for the client and family 210.28 caregivers; 210.29 (4) encourage the development and use of respite care, 210.30 caregiver support, and in-home support programs, such as adult 210.31 foster care and in-home adult day care; 210.32 (5) encourage neighborhood residents and local 210.33 organizations to collaborate in meeting the needs of senior 210.34 citizens in their communities; 210.35 (6) recruit, train, and direct the use of volunteers to 210.36 provide informal services and other appropriate support to 211.1 senior citizens and their caregivers; and 211.2 (7) provide coordination and management of formal and 211.3 informal services to senior citizens and their families using 211.4 less expensive alternatives. 211.5 Sec. 73. Minnesota Statutes 1998, section 256B.37, 211.6 subdivision 2, is amended to read: 211.7 Subd. 2. [CIVIL ACTION FOR RECOVERY.] To recover under 211.8 this section, the attorney general, or the appropriate county211.9attorney, acting upon direction from the attorney general,may 211.10 institute or join a civil action to enforce the subrogation 211.11 rights of the commissioner established under this section. 211.12 Any prepaid health plan providing services under sections 211.13 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 211.14 children's mental health collaboratives under section 245.493; 211.15 demonstration projects for persons with disabilities under 211.16 section 256B.77; nursing homes under the alternative payment 211.17 demonstration project under section 256B.434; or the 211.18 county-based purchasing entity providing services under section 211.19 256B.692 may retain legal representation to enforce the 211.20 subrogation rights created under this section or, if no action 211.21 has been brought, may initiate and prosecute an independent 211.22 action on their behalf against a person, firm, or corporation 211.23 that may be liable to the person to whom the care or payment was 211.24 furnished. 211.25 Sec. 74. Minnesota Statutes 1998, section 256B.501, 211.26 subdivision 8a, is amended to read: 211.27 Subd. 8a. [PAYMENT FOR PERSONS WITH SPECIAL NEEDS FOR 211.28 CRISIS INTERVENTION SERVICES.]State-operated,Community-based 211.29 crisis servicesprovided in accordance with section 252.50,211.30subdivision 7, toauthorized by the commissioner or the 211.31 commissioner's designee for a resident of an intermediate care 211.32 facility for persons with mental retardation (ICF/MR) reimbursed 211.33 under this section shall be paid by medical assistance in 211.34 accordance with the paragraphs (a) to(h)(g). 211.35 (a) "Crisis services" means the specialized services listed 211.36 in clauses (1) to (3) provided to prevent the recipient from 212.1 requiring placement in a more restrictive institutional setting 212.2 such as an inpatient hospital or regional treatment center and 212.3 to maintain the recipient in the present community setting. 212.4 (1) The crisis services provider shall assess the 212.5 recipient's behavior and environment to identify factors 212.6 contributing to the crisis. 212.7 (2) The crisis services provider shall develop a 212.8 recipient-specific intervention plan in coordination with the 212.9 service planning team and provide recommendations for revisions 212.10 to the individual service plan if necessary to prevent or 212.11 minimize the likelihood of future crisis situations. The 212.12 intervention plan shall include a transition plan to aid the 212.13 recipient in returning to the community-based ICF/MR if the 212.14 recipient is receiving residential crisis services. 212.15 (3) The crisis services provider shall consult with and 212.16 provide training and ongoing technical assistance to the 212.17 recipient's service providers to aid in the implementation of 212.18 the intervention plan and revisions to the individual service 212.19 plan. 212.20 (b) "Residential crisis services" means crisis services 212.21 that are provided to a recipient admitted tothe crisis services212.22foster care settingan alternative, state-licensed site approved 212.23 by the commissioner, because the ICF/MR receiving reimbursement 212.24 under this section is not able, as determined by the 212.25 commissioner, to provide the intervention and protection of the 212.26 recipient and others living with the recipient that is necessary 212.27 to prevent the recipient from requiring placement in a more 212.28 restrictive institutional setting. 212.29 (c) Residential crisis services providers mustbe licensed212.30bymaintain a license from the commissionerunder section212.31245A.03 to provide foster care, must exclusively providefor the 212.32 residence when providing crisis services for short-term crisis 212.33 intervention, and must not be located in a private residence. 212.34 (d) Payment ratesare determined annually for each crisis212.35services provider based on cost of care for each provider as212.36defined in section 246.50. Interim payment rates are calculated213.1on a per diem basis by dividing the projected cost of providing213.2care by the projected number of contact days for the fiscal213.3year, as estimated by the commissioner. Final payment rates are213.4calculated by dividing the actual cost of providing care by the213.5actual number of contact days in the applicable fiscal213.6yearshall be established consistent with county negotiated 213.7 crisis intervention services. 213.8 (e)Payment shall be made for each contact day. "Contact213.9day" means any day in which the crisis services provider has213.10face-to-face contact with the recipient or any of the213.11recipient's medical assistance service providers for the purpose213.12of providing crisis services as defined in paragraph (c).213.13(f)Payment for residential crisis services is limited to 213.14 21 days, unless an additional period is authorized by the 213.15 commissioner or part of an approved regional plan.The213.16additional period may not exceed 21 days.213.17(g)(f) Payment for crisis services shall be made only for 213.18 services provided while the ICF/MR receiving reimbursement under 213.19 this section: 213.20 (1) has a shared services agreement with the crisis 213.21 services provider in effectin accordance withunder section 213.22 246.57; and 213.23 (2)has reassigned payment for the provision of the crisis213.24services under this subdivision to the commissioner in213.25accordance with Code of Federal Regulations, title 42, section213.26447.10(e); and213.27(3)has executed a cooperative agreement with the crisis 213.28 services provider to implement the intervention plan and 213.29 revisions to the individual service plan as necessary to prevent 213.30 or minimize the likelihood of future crisis situations, to 213.31 maintain the recipient in the present community setting, and to 213.32 prevent the recipient from requiring a more restrictive 213.33 institutional setting. 213.34(h)(g) Payment to the ICF/MR receiving reimbursement under 213.35 this section shall be made for up to 18 therapeutic leave days 213.36 during which the recipient is receiving residential crisis 214.1 services, if the ICF/MR is otherwise eligible to receive payment 214.2 for a therapeutic leave day under Minnesota Rules, part 214.3 9505.0415. Payment under this paragraph shall be terminated if 214.4 the commissioner determines that the ICF/MR is not meeting the 214.5 terms of thecooperativeshared service agreement under 214.6 paragraph(g)(f) or that the recipient will not return to the 214.7 ICF/MR. 214.8 Sec. 75. Minnesota Statutes 1998, section 256B.69, 214.9 subdivision 3a, is amended to read: 214.10 Subd. 3a. [COUNTY AUTHORITY.] (a) The commissioner, when 214.11 implementing the general assistance medical care, or medical 214.12 assistance prepayment program within a county, must include the 214.13 county board in the process of development, approval, and 214.14 issuance of the request for proposals to provide services to 214.15 eligible individuals within the proposed county. County boards 214.16 must be given reasonable opportunity to make recommendations 214.17 regarding the development, issuance, review of responses, and 214.18 changes needed in the request for proposals. The commissioner 214.19 must provide county boards the opportunity to review each 214.20 proposal based on the identification of community needs under 214.21 chapters 145A and 256E and county advocacy activities. If a 214.22 county board finds that a proposal does not address certain 214.23 community needs, the county board and commissioner shall 214.24 continue efforts for improving the proposal and network prior to 214.25 the approval of the contract. The county board shall make 214.26 recommendations regarding the approval of local networks and 214.27 their operations to ensure adequate availability and access to 214.28 covered services. The provider or health plan must respond 214.29 directly to county advocates and the state prepaid medical 214.30 assistance ombudsperson regarding service delivery and must be 214.31 accountable to the state regarding contracts with medical 214.32 assistance and general assistance medical care funds. The 214.33 county board may recommend a maximum number of participating 214.34 health plans after considering the size of the enrolling 214.35 population; ensuring adequate access and capacity; considering 214.36 the client and county administrative complexity; and considering 215.1 the need to promote the viability of locally developed health 215.2 plans. The county board or a single entity representing a group 215.3 of county boards and the commissioner shall mutually select 215.4 health plans for participation at the time of initial 215.5 implementation of the prepaid medical assistance program in that 215.6 county or group of counties and at the time of contract renewal. 215.7 The commissioner shall also seek input for contract requirements 215.8 from the county or single entity representing a group of county 215.9 boards at each contract renewal and incorporate those 215.10 recommendations into the contract negotiation process. The 215.11 commissioner, in conjunction with the county board, shall 215.12 actively seek to develop a mutually agreeable timetable prior to 215.13 the development of the request for proposal, but counties must 215.14 agree to initial enrollment beginning on or before January 1, 215.15 1999, in either the prepaid medical assistance and general 215.16 assistance medical care programs or county-based purchasing 215.17 under section 256B.692. At least 90 days before enrollment in 215.18 the medical assistance and general assistance medical care 215.19 prepaid programs begins in a county in which the prepaid 215.20 programs have not been established, the commissioner shall 215.21 provide a report to the chairs of senate and house committees 215.22 having jurisdiction over state health care programs which 215.23 verifies that the commissioner complied with the requirements 215.24 for county involvement that are specified in this subdivision. 215.25 (b) The commissioner shall seek a federal waiver to allow a 215.26 fee-for-service plan option to MinnesotaCare enrollees. The 215.27 commissioner shall develop an increase of the premium fees 215.28 required under section 256L.06 up to 20 percent of the premium 215.29 fees for the enrollees who elect the fee-for-service option. 215.30 Prior to implementation, the commissioner shall submit this fee 215.31 schedule to the chair and ranking minority member of the senate 215.32 health care committee, the senate health care and family 215.33 services funding division, the house of representatives health 215.34 and human services committee, and the house of representatives 215.35 health and human services finance division. 215.36 (c) At the option of the county board, the board may 216.1 develop contract requirements related to the achievement of 216.2 local public health goals to meet the health needs of medical 216.3 assistance and general assistance medical care enrollees. These 216.4 requirements must be reasonably related to the performance of 216.5 health plan functions and within the scope of the medical 216.6 assistance and general assistance medical care benefit sets. If 216.7 the county board and the commissioner mutually agree to such 216.8 requirements, the department shall include such requirements in 216.9 all health plan contracts governing the prepaid medical 216.10 assistance and general assistance medical care programs in that 216.11 county at initial implementation of the program in that county 216.12 and at the time of contract renewal. The county board may 216.13 participate in the enforcement of the contract provisions 216.14 related to local public health goals. 216.15 (d) For counties in which prepaid medical assistance and 216.16 general assistance medical care programs have not been 216.17 established, the commissioner shall not implement those programs 216.18 if a county board submits acceptable and timely preliminary and 216.19 final proposals under section 256B.692, until county-based 216.20 purchasing is no longer operational in that county. For 216.21 counties in which prepaid medical assistance and general 216.22 assistance medical care programs are in existence on or after 216.23 September 1, 1997, the commissioner must terminate contracts 216.24 with health plans according to section 256B.692, subdivision 5, 216.25 if the county board submits and the commissioner accepts 216.26 preliminary and final proposals according to that subdivision. 216.27 The commissioner is not required to terminate contracts that 216.28 begin on or after September 1, 1997, according to section 216.29 256B.692 until two years have elapsed from the date of initial 216.30 enrollment. 216.31 (e) In the event that a county board or a single entity 216.32 representing a group of county boards and the commissioner 216.33 cannot reach agreement regarding: (i) the selection of 216.34 participating health plans in that county; (ii) contract 216.35 requirements; or (iii) implementation and enforcement of county 216.36 requirements including provisions regarding local public health 217.1 goals, the commissioner shall resolve all disputes after taking 217.2 into account the recommendations of a three-person mediation 217.3 panel. The panel shall be composed of one designee of the 217.4 president of the association of Minnesota counties, one designee 217.5 of the commissioner of human services, and one designee of the 217.6 commissioner of health. 217.7 (f) If a county which elects to implement county-based 217.8 purchasing ceases to implement county-based purchasing, it is 217.9 prohibited from assuming the responsibility of county-based 217.10 purchasing for a period of five years from the date it 217.11 discontinues purchasing. 217.12 (g) Notwithstanding the requirement in this subdivision 217.13 that a county must agree to initial enrollment on or before 217.14 January 1, 1999, the commissioner shall grant a delayof up to217.15nine monthsin the implementation of the county-based purchasing 217.16 authorized in section 256B.692 until federal waiver authority 217.17 and approval has been granted, if the county or group of 217.18 counties has submitted a preliminary proposal for county-based 217.19 purchasing by September 1, 1997, has not already implemented the 217.20 prepaid medical assistance program before January 1, 1998, and 217.21 has submitted a written request for the delay to the 217.22 commissioner by July 1, 1998. In order for the delay to be 217.23 continued, the county or group of counties must also submit to 217.24 the commissioner the following information by December 1, 1998. 217.25 The information must: 217.26 (1) identify the proposed date of implementation,not later217.27than October 1, 1999as determined under section 256B.692, 217.28 subdivision 5; 217.29 (2) include copies of the county board resolutions which 217.30 demonstrate the continued commitment to the implementation of 217.31 county-based purchasing by the proposed date. County board 217.32 authorization may remain contingent on the submission of a final 217.33 proposal which meets the requirements of section 256B.692, 217.34 subdivision 5, paragraph (b); 217.35 (3) demonstrate actions taken for the establishment of a 217.36 governance structure between the participating counties and 218.1 describe how the fiduciary responsibilities of county-based 218.2 purchasing will be allocated between the counties, if more than 218.3 one county is involved in the proposal; 218.4 (4) describe how the risk of a deficit will be managed in 218.5 the event expenditures are greater than total capitation 218.6 payments. This description must identify how any of the 218.7 following strategies will be used: 218.8 (i) risk contracts with licensed health plans; 218.9 (ii) risk arrangements with providers who are not licensed 218.10 health plans; 218.11 (iii) risk arrangements with other licensed insurance 218.12 entities; and 218.13 (iv) funding from other county resources; 218.14 (5) include, if county-based purchasing will not contract 218.15 with licensed health plans or provider networks, letters of 218.16 interest from local providers in at least the categories of 218.17 hospital, physician, mental health, and pharmacy which express 218.18 interest in contracting for services. These letters must 218.19 recognize any risk transfer identified in clause (4), item (ii); 218.20 and 218.21 (6) describe the options being considered to obtain the 218.22 administrative services required in section 256B.692, 218.23 subdivision 3, clauses (3) and (5). 218.24 (h) For counties which receive a delay under this 218.25 subdivision, the final proposals required under section 218.26 256B.692, subdivision 5, paragraph (b), must be submitted at 218.27 least six months prior to the requested implementation date. 218.28 Authority to implement county-based purchasing remains 218.29 contingent on approval of the final proposal as required under 218.30 section 256B.692. 218.31 (i) If the commissioner is unable to provide 218.32 county-specific, individual-level fee-for-service claims to 218.33 counties by June 4, 1998, the commissioner shall grant a delay 218.34 under paragraph (g) of up to 12 months in the implementation of 218.35 county-based purchasing, and shall require implementation not 218.36 later than January 1, 2000. In order to receive an extension of 219.1 the proposed date of implementation under this paragraph, a 219.2 county or group of counties must submit a written request for 219.3 the extension to the commissioner by August 1, 1998, must submit 219.4 the information required under paragraph (g) by December 1, 219.5 1998, and must submit a final proposal as provided under 219.6 paragraph (h). 219.7 (j) Notwithstanding other requirements of this subdivision, 219.8 the commissioner shall not require the implementation of the 219.9 county-based purchasing authorized in section 256B.692 until six 219.10 months after federal waiver approval has been obtained for 219.11 county-based purchasing if the county or counties have submitted 219.12 the final plan as required in section 256B.692, subdivision 5. 219.13 The commissioner shall allow the county or counties who 219.14 submitted information under section 256B.692, subdivision 5, to 219.15 submit supplemental or additional information which was not 219.16 possible to submit by April 1, 1999. A county or counties shall 219.17 continue to submit the required information and substantive 219.18 detail necessary to obtain a prompt response and waiver 219.19 approval. If amendments to the final plan are necessary due to 219.20 the terms and conditions of the waiver approval, the 219.21 commissioner shall allow the county or group of counties 60 days 219.22 to make the necessary amendment to the final plan and shall not 219.23 require implementation of the county-based purchasing until six 219.24 months after the revised final plan has been submitted. 219.25 Sec. 76. Minnesota Statutes 1998, section 256B.69, is 219.26 amended by adding a subdivision to read: 219.27 Subd. 3b. [PROVISION OF DATA TO COUNTY BOARDS.] The 219.28 commissioner, in consultation with representatives of county 219.29 boards of commissioners, shall identify program information and 219.30 data necessary on an ongoing basis for county boards to: 219.31 (1) make recommendations to the commissioner related to 219.32 state purchasing under the prepaid medical assistance program; 219.33 and 219.34 (2) effectively administer county-based purchasing. 219.35 This information and data must include, but is not limited to, 219.36 county-specific fee-for-service and prepaid health plan claims 220.1 information. This data must not include identifiable 220.2 individual-level claims. 220.3 Sec. 77. Minnesota Statutes 1998, section 256B.69, is 220.4 amended by adding a subdivision to read: 220.5 Subd. 4b. [INDIVIDUAL EDUCATION PLAN AND INDIVIDUALIZED 220.6 FAMILY SERVICE PLAN SERVICES.] The commissioner shall amend the 220.7 federal waiver allowing the state to separate out individual 220.8 education plan and individualized family service plan services 220.9 for children enrolled in the prepaid medical assistance program 220.10 and the MinnesotaCare program. Effective July 1, 1999, or upon 220.11 federal approval, medical assistance coverage of eligible 220.12 individual education plan and individualized family service plan 220.13 services shall not be included in the capitated services for 220.14 children enrolled in health plans through the prepaid medical 220.15 assistance program and the MinnesotaCare program. Upon federal 220.16 approval, local school districts shall bill the commissioner for 220.17 these services, and claims shall be paid on a fee-for-service 220.18 basis. 220.19 Sec. 78. Minnesota Statutes 1998, section 256B.69, 220.20 subdivision 5b, is amended to read: 220.21 Subd. 5b. [PROSPECTIVE REIMBURSEMENT RATES.] (a) For 220.22 prepaid medical assistance and general assistance medical care 220.23 program contract rates set by the commissioner under subdivision 220.24 5 and effective on or after January 1, 1998, capitation rates 220.25 for nonmetropolitan counties shall on a weighted average be no 220.26 less than 88 percent of the capitation rates for metropolitan 220.27 counties, excluding Hennepin county. The commissioner shall 220.28 make a pro rata adjustment in capitation rates paid to counties 220.29 other than nonmetropolitan counties in order to make this 220.30 provision budget neutral. 220.31 (b) For prepaid medical assistance program contract rates 220.32 set by the commissioner under subdivision 5 and effective on or 220.33 after January 1, 2001, capitation rates for nonmetropolitan 220.34 counties shall, on a weighted average, be no less than 89 220.35 percent of the capitation rates for metropolitan counties, 220.36 excluding Hennepin county. 221.1 Sec. 79. Minnesota Statutes 1998, section 256B.69, is 221.2 amended by adding a subdivision to read: 221.3 Subd. 5e. [MEDICAL EDUCATION AND RESEARCH PAYMENTS.] For 221.4 the calendar years 1999, 2000, and 2001, a hospital that 221.5 participates in funding the federal share of the medical 221.6 education and research trust fund payment under Laws 1998, 221.7 chapter 407, article 1, section 3, shall not be held liable for 221.8 any amounts attributable to this payment above the charge limit 221.9 of section 256.969, subdivision 3a. The commissioner of human 221.10 services shall assume liability for any corresponding federal 221.11 share of the payments above the charge limit. 221.12 Sec. 80. Minnesota Statutes 1998, section 256B.692, 221.13 subdivision 2, is amended to read: 221.14 Subd. 2. [DUTIES OF THE COMMISSIONER OF HEALTH.] (a) 221.15 Notwithstanding chapters 62D and 62N, a county that elects to 221.16 purchase medical assistance and general assistance medical care 221.17 in return for a fixed sum without regard to the frequency or 221.18 extent of services furnished to any particular enrollee is not 221.19 required to obtain a certificate of authority under chapter 62D 221.20 or 62N. The county board of commissioners is the governing body 221.21 of a county-based purchasing program. In a multicounty 221.22 arrangement, the governing body is a joint powers board 221.23 established under section 471.59. 221.24 (b) A county that elects to purchase medical assistance and 221.25 general assistance medical care services under this section must 221.26 satisfy the commissioner of health that the requirements for 221.27 assurance of consumer protection, provider protection, and 221.28 fiscal solvency of chapter 62D, applicable to health maintenance 221.29 organizations, or chapter 62N, applicable to community 221.30 integrated service networks, will be met. 221.31 (c) A county must also assure the commissioner of health 221.32 that the requirements of sections 62J.041; 62J.48; 62J.71 to 221.33 62J.73; 62M.01 to 62M.16; all applicable provisions of chapter 221.34 62Q, including sections 62Q.07; 62Q.075; 62Q.105; 62Q.1055; 221.35 62Q.106; 62Q.11; 62Q.12; 62Q.135; 62Q.14; 62Q.145; 62Q.19; 221.36 62Q.23, paragraph (c); 62Q.30; 62Q.43; 62Q.47; 62Q.50; 62Q.52 to 222.1 62Q.56; 62Q.58; 62Q.64; and 72A.201 will be met. 222.2 (d) All enforcement and rulemaking powers available under 222.3 chapters 62D, 62J, 62M, 62N, and 62Q are hereby granted to the 222.4 commissioner of health with respect to counties that purchase 222.5 medical assistance and general assistance medical care services 222.6 under this section. 222.7 (e) The commissioner, in consultation with county 222.8 government, shall develop administrative and financial reporting 222.9 requirements for county-based purchasing programs relating to 222.10 sections 62D.041, 62D.042, 62D.045, 62D.08, 62N.28, 62N.29, and 222.11 62N.31, and other sections as necessary, that are specific to 222.12 county administrative, accounting, and reporting systems and 222.13 consistent with other statutory requirements of counties. 222.14 Sec. 81. Minnesota Statutes 1998, section 256B.75, is 222.15 amended to read: 222.16 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 222.17 (a) For outpatient hospital facility fee payments for 222.18 services rendered on or after October 1, 1992, the commissioner 222.19 of human services shall pay the lower of (1) submitted charge, 222.20 or (2) 32 percent above the rate in effect on June 30, 1992, 222.21 except for those services for which there is a federal maximum 222.22 allowable payment. Effective for services rendered on or after 222.23 January 1, 2000, payment rates for nonsurgical outpatient 222.24 hospital facility fees and emergency room facility fees shall be 222.25 increased by eight percent over the rates in effect on December 222.26 31, 1999, except for those services for which there is a federal 222.27 maximum allowable payment. Services for which there is a 222.28 federal maximum allowable payment shall be paid at the lower of 222.29 (1) submitted charge, or (2) the federal maximum allowable 222.30 payment. Total aggregate payment for outpatient hospital 222.31 facility fee services shall not exceed the Medicare upper 222.32 limit. If it is determined that a provision of this section 222.33 conflicts with existing or future requirements of the United 222.34 States government with respect to federal financial 222.35 participation in medical assistance, the federal requirements 222.36 prevail. The commissioner may, in the aggregate, prospectively 223.1 reduce payment rates to avoid reduced federal financial 223.2 participation resulting from rates that are in excess of the 223.3 Medicare upper limitations. 223.4 (b) Notwithstanding paragraph (a), payment for outpatient, 223.5 emergency, and ambulatory surgery hospital facility fee services 223.6 for critical access hospitals designated under section 144.1483, 223.7 clause (11), shall be paid on a cost-based payment system that 223.8 is based on the cost-finding methods and allowable costs of the 223.9 Medicare program. 223.10 (Effective date: Section 81 (256B.75, paragraph (b)) is 223.11 effective for services rendered on or after July 1, 1999.) 223.12 Sec. 82. Minnesota Statutes 1998, section 256B.76, is 223.13 amended to read: 223.14 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 223.15 (a)The physician reimbursement increase provided in223.16section 256B.74, subdivision 2, shall not be implemented.223.17 Effective for services rendered on or after October 1, 1992, the 223.18 commissioner shall make payments for physician services as 223.19 follows: 223.20 (1) payment for level one Health Care Finance 223.21 Administration's common procedural coding system (HCPCS) codes 223.22 titled "office and other outpatient services," "preventive 223.23 medicine new and established patient," "delivery, antepartum, 223.24 and postpartum care," "critical care," Caesarean delivery and 223.25 pharmacologic management provided to psychiatric patients, and 223.26 HCPCS level three codes for enhanced services for prenatal high 223.27 risk, shall be paid at the lower of (i) submitted charges, or 223.28 (ii) 25 percent above the rate in effect on June 30, 1992. If 223.29 the rate on any procedure code within these categories is 223.30 different than the rate that would have been paid under the 223.31 methodology in section 256B.74, subdivision 2, then the larger 223.32 rate shall be paid; 223.33 (2) payments for all other services shall be paid at the 223.34 lower of (i) submitted charges, or (ii) 15.4 percent above the 223.35 rate in effect on June 30, 1992;and223.36 (3) all physician rates shall be converted from the 50th 224.1 percentile of 1982 to the 50th percentile of 1989, less the 224.2 percent in aggregate necessary to equal the above increases 224.3 except that payment rates for home health agency services shall 224.4 be the rates in effect on September 30, 1992.; 224.5 (4) effective for services rendered on or after January 1, 224.6 2000, payment rates for physician and professional services 224.7 shall be increased by 3.5 percent over the rates in effect on 224.8 December 31, 1999, except for home health agency services; and 224.9 (5) the increases in clause (4) shall be implemented 224.10 January 1, 2000, for managed care. 224.11 (b)The dental reimbursement increase provided in section224.12256B.74, subdivision 5, shall not be implemented.Effective for 224.13 services rendered on or after October 1, 1992, the commissioner 224.14 shall make payments for dental services as follows: 224.15 (1) dental services shall be paid at the lower of (i) 224.16 submitted charges, or (ii) 25 percent above the rate in effect 224.17 on June 30, 1992;and224.18 (2) dental rates shall be converted from the 50th 224.19 percentile of 1982 to the 50th percentile of 1989, less the 224.20 percent in aggregate necessary to equal the above increases.; 224.21 (3) effective for services rendered on or after January 1, 224.22 2000, payment rates for dental services shall be increased by 224.23 3.5 percent over the rates in effect on December 31, 1999; 224.24 (4) the commissioner shall increase payments by 20 percent 224.25 over the October 1, 1999, fee-for-service rates, for those 224.26 fee-for-service providers for whom public programs under medical 224.27 assistance, general assistance medical care, and MinnesotaCare 224.28 account for 20 percent or more of their practice; 224.29 (5) the commissioner shall award grants to community 224.30 clinics or other nonprofit community organizations which will 224.31 increase the availability of dental services to public program 224.32 recipients. These grants may be used to fund the costs related 224.33 to coordinating access for recipients, developing and 224.34 implementing patient care criteria, establishing new or 224.35 upgrading existing facilities, acquiring furnishings or 224.36 equipment, recruiting new providers, or other development costs 225.1 that will improve access to dental care in that region. The 225.2 commissioner shall consider the following in awarding the 225.3 grants: (i) potential to successfully increase access to an 225.4 underserved population; (ii) the ability to raise matching 225.5 funds; (iii) the long-term viability of the project to improve 225.6 access beyond the period of initial funding; (iv) the efficiency 225.7 in the use of the funding; and (v) the experience of the 225.8 proposers in providing services to the target population. The 225.9 commissioner shall monitor the grants and may terminate a grant 225.10 if the grantee does not increase dental access for public 225.11 program recipients; 225.12 (6) the commissioner shall fund two initiatives to improve 225.13 dental access that will allow the commissioner to increase rates 225.14 if the percentage of public program recipients with at least one 225.15 dental visit per year increases; 225.16 (7) beginning October 1, 1999, the payment for tooth 225.17 sealants and fluoride treatments shall be the lower of (i) 225.18 submitted charge, or (ii) 80 percent of median 1997 charges; and 225.19 (8) the increases listed in clauses (3), (4), and (7) shall 225.20 be implemented January 1, 2000, for managed care. 225.21 (c) An entity that operates both a Medicare certified 225.22 comprehensive outpatient rehabilitation facility and a facility 225.23 which was certified prior to January 1, 1993, that is licensed 225.24 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 225.25 whom at least 33 percent of the clients receiving rehabilitation 225.26 services in the most recent calendar year are medical assistance 225.27 recipients, shall be reimbursed by the commissioner for 225.28 rehabilitation services at rates that are 38 percent greater 225.29 than the maximum reimbursement rate allowed under paragraph (a), 225.30 clause (2), when those services are (1) provided within the 225.31 comprehensive outpatient rehabilitation facility and (2) 225.32 provided to residents of nursing facilities owned by the entity. 225.33 Sec. 83. [256B.765] [PROVIDER RATE INCREASES.] 225.34 (a) Effective July 1, 2001, within the limits of 225.35 appropriations specifically for this purpose, the commissioner 225.36 shall provide an annual inflation adjustment for the providers 226.1 listed in paragraph (c). The index for the inflation adjustment 226.2 must be based on the change in the Employment Cost Index for 226.3 Private Industry Workers - Total Compensation forecasted by Data 226.4 Resources, Inc., as forecasted in the fourth quarter of the 226.5 calendar year preceding the fiscal year. The commissioner shall 226.6 increase reimbursement or allocation rates by the percentage of 226.7 this adjustment, and county boards shall adjust provider 226.8 contracts as needed. 226.9 (b) The commissioner of finance shall include an annual 226.10 inflationary adjustment in reimbursement rates for the providers 226.11 listed in paragraph (c) using the inflation factor specified in 226.12 paragraph (a) as a budget change request in each biennial 226.13 detailed expenditure budget submitted to the legislature under 226.14 section 16A.11. 226.15 (c) The annual adjustment under paragraph (a) shall be 226.16 provided for home and community-based waiver services for 226.17 persons with mental retardation or related conditions under 226.18 section 256B.501; home and community-based waiver services for 226.19 the elderly under section 256B.0915; waivered services under 226.20 community alternatives for disabled individuals under section 226.21 256B.49; community alternative care waivered services under 226.22 section 256B.49; traumatic brain injury waivered services under 226.23 section 256B.49; nursing services and home health services under 226.24 section 256B.0625, subdivision 6a; personal care services and 226.25 nursing supervision of personal care services under section 226.26 256B.0625, subdivision 19a; private duty nursing services under 226.27 section 256B.0625, subdivision 7; day training and habilitation 226.28 services for adults with mental retardation or related 226.29 conditions under sections 252.40 to 252.46; physical therapy 226.30 services under sections 256B.0625, subdivision 8, and 256D.03, 226.31 subdivision 4; occupational therapy services under sections 226.32 256B.0625, subdivision 8a, and 256D.03, subdivision 4; 226.33 speech-language therapy services under section 256D.03, 226.34 subdivision 4, and Minnesota Rules, part 9505.0390; respiratory 226.35 therapy services under section 256D.03, subdivision 4, and 226.36 Minnesota Rules, part 9505.0295; alternative care services under 227.1 section 256B.0913; adult residential program grants under 227.2 Minnesota Rules, parts 9535.2000 to 9535.3000; adult and family 227.3 community support grants under Minnesota Rules, parts 9535.1700 227.4 to 9535.1760; semi-independent living services under section 227.5 252.275 including SILS funding under county social services 227.6 grants formerly funded under chapter 256I; and community support 227.7 services for deaf and hard-of-hearing adults with mental illness 227.8 who use or wish to use sign language as their primary means of 227.9 communication. 227.10 (d) At least 75 percent of the rate increase provided under 227.11 this section must be used to increase the wages and benefits of 227.12 employees other than administrators and central office 227.13 employees. Providers must submit a plan to the commissioner 227.14 annually describing how the increase is being utilized. 227.15 Sec. 84. Minnesota Statutes 1998, section 256B.77, 227.16 subdivision 7a, is amended to read: 227.17 Subd. 7a. [ELIGIBLE INDIVIDUALS.] (a) Persons are eligible 227.18 for the demonstration project as provided in this subdivision. 227.19 (b) "Eligible individuals" means those persons living in 227.20 the demonstration site who are eligible for medical assistance 227.21 and are disabled based on a disability determination under 227.22 section 256B.055, subdivisions 7 and 12, or who are eligible for 227.23 medical assistance and have been diagnosed as having: 227.24 (1) serious and persistent mental illness as defined in 227.25 section 245.462, subdivision 20; 227.26 (2) severe emotional disturbance as defined in section 227.27245.487245.4871, subdivision 6; or 227.28 (3) mental retardation, or being a mentally retarded person 227.29 as defined in section 252A.02, or a related condition as defined 227.30 in section 252.27, subdivision 1a. 227.31 Other individuals may be included at the option of the county 227.32 authority based on agreement with the commissioner. 227.33 (c)Eligible individuals residing on a federally recognized227.34Indian reservation may be excluded from participation in the227.35demonstration project at the discretion of the tribal government227.36based on agreement with the commissioner, in consultation with228.1the county authority.228.2(d)Eligible individuals include individuals in excluded 228.3 time status, as defined in chapter 256G. Enrollees in excluded 228.4 time at the time of enrollment shall remain in excluded time 228.5 status as long as they live in the demonstration site and shall 228.6 be eligible for 90 days after placement outside the 228.7 demonstration site if they move to excluded time status in a 228.8 county within Minnesota other than their county of financial 228.9 responsibility. 228.10(e)(d) A person who is a sexual psychopathic personality 228.11 as defined in section 253B.02, subdivision 18a, or a sexually 228.12 dangerous person as defined in section 253B.02, subdivision 18b, 228.13 is excluded from enrollment in the demonstration project. 228.14 Sec. 85. Minnesota Statutes 1998, section 256B.77, is 228.15 amended by adding a subdivision to read: 228.16 Subd. 7b. [AMERICAN INDIAN RECIPIENTS.] (a) Beginning on 228.17 or after July 1, 1999, for American Indian recipients of medical 228.18 assistance who are required to enroll with a county 228.19 administrative entity or service delivery organization under 228.20 subdivision 7, medical assistance shall cover health care 228.21 services provided at American Indian health services facilities 228.22 and facilities operated by a tribe or tribal organization under 228.23 funding authorized by United States Code, title 25, sections 228.24 450f to 450n, or title III of the Indian Self-Determination and 228.25 Education Assistance Act, Public Law Number 93-638, if those 228.26 services would otherwise be covered under section 256B.0625. 228.27 Payments for services provided under this subdivision shall be 228.28 made on a fee-for-service basis, and may, at the option of the 228.29 tribe or tribal organization, be made according to rates 228.30 authorized under sections 256.969, subdivision 16, and 228.31 256B.0625, subdivision 34. Implementation of this purchasing 228.32 model is contingent on federal approval. 228.33 (b) The commissioner of human services, in consultation 228.34 with tribal governments, shall develop a plan for tribes to 228.35 assist in the enrollment process for American Indian recipients 228.36 enrolled in the demonstration project for people with 229.1 disabilities under this section. This plan also shall address 229.2 how tribes will be included in ensuring the coordination of care 229.3 for American Indian recipients between Indian health service or 229.4 tribal providers and other providers. 229.5 (c) For purposes of this subdivision, "American Indian" has 229.6 the meaning given to persons to whom services will be provided 229.7 for in Code of Federal Regulations, title 42, section 36.12. 229.8 Sec. 86. Minnesota Statutes 1998, section 256B.77, 229.9 subdivision 8, is amended to read: 229.10 Subd. 8. [RESPONSIBILITIES OF THE COUNTY ADMINISTRATIVE 229.11 ENTITY.] (a) The county administrative entity shall meet the 229.12 requirements of this subdivision, unless the county authority or 229.13 the commissioner, with written approval of the county authority, 229.14 enters into a service delivery contract with a service delivery 229.15 organization for any or all of the requirements contained in 229.16 this subdivision. 229.17 (b) The county administrative entity shall enroll eligible 229.18 individuals regardless of health or disability status. 229.19 (c) The county administrative entity shall provide all 229.20 enrollees timely access to the medical assistance benefit set. 229.21 Alternative services and additional services are available to 229.22 enrollees at the option of the county administrative entity and 229.23 may be provided if specified in the personal support plan. 229.24 County authorities are not required to seek prior authorization 229.25 from the department as required by the laws and rules governing 229.26 medical assistance. 229.27 (d) The county administrative entity shall cover necessary 229.28 services as a result of an emergency without prior 229.29 authorization, even if the services were rendered outside of the 229.30 provider network. 229.31 (e) The county administrative entity shall authorize 229.32 necessary and appropriate services when needed and requested by 229.33 the enrollee or the enrollee's legal representative in response 229.34 to an urgent situation. Enrollees shall have 24-hour access to 229.35 urgent care services coordinated by experienced disability 229.36 providers who have information about enrollees' needs and 230.1 conditions. 230.2 (f) The county administrative entity shall accept the 230.3 capitation payment from the commissioner in return for the 230.4 provision of services for enrollees. 230.5 (g) The county administrative entity shall maintain 230.6 internal grievance and complaint procedures, including an 230.7 expedited informal complaint process in which the county 230.8 administrative entity must respond to verbal complaints within 230.9 ten calendar days, and a formal grievance process, in which the 230.10 county administrative entity must respond to written complaints 230.11 within 30 calendar days. 230.12 (h) The county administrative entity shall provide a 230.13 certificate of coverage, upon enrollment, to each enrollee and 230.14 the enrollee's legal representative, if any, which describes the 230.15 benefits covered by the county administrative entity, any 230.16 limitations on those benefits, and information about providers 230.17 and the service delivery network. This information must also be 230.18 made available to prospective enrollees. This certificate must 230.19 be approved by the commissioner. 230.20 (i) The county administrative entity shall present evidence 230.21 of an expedited process to approve exceptions to benefits, 230.22 provider network restrictions, and other plan limitations under 230.23 appropriate circumstances. 230.24 (j) The county administrative entity shall provide 230.25 enrollees or their legal representatives with written notice of 230.26 their appeal rights under subdivision 16, and of ombudsman and 230.27 advocacy programs under subdivisions 13 and 14, at the following 230.28 times: upon enrollment, upon submission of a written complaint, 230.29 when a service is reduced, denied, or terminated, or when 230.30 renewal of authorization for ongoing service is refused. 230.31 (k) The county administrative entity shall determine 230.32 immediate needs, including services, support, and assessments, 230.33 within 30 calendar daysofafter enrollment, or within a shorter 230.34 time frame if specified in the intergovernmental contract. 230.35 (l) The county administrative entity shall assess the need 230.36 for services of new enrollees within 60 calendar daysofafter 231.1 enrollment, or within a shorter time frame if specified in the 231.2 intergovernmental contract, and periodically reassess the need 231.3 for services for all enrollees. 231.4 (m) The county administrative entity shall ensure the 231.5 development of a personal support plan for each person within 60 231.6 calendar days of enrollment, or within a shorter time frame if 231.7 specified in the intergovernmental contract, unless otherwise 231.8 agreed to by the enrollee and the enrollee's legal 231.9 representative, if any. Until a personal support plan is 231.10 developed and agreed to by the enrollee, enrollees must have 231.11 access to the same amount, type, setting, duration, and 231.12 frequency of covered services that they had at the time of 231.13 enrollment unless other covered services are needed. For an 231.14 enrollee who is not receiving covered services at the time of 231.15 enrollment and for enrollees whose personal support plan is 231.16 being revised, access to the medical assistance benefit set must 231.17 be assured until a personal support plan is developed or 231.18 revised. If an enrollee chooses not to develop a personal 231.19 support plan, the enrollee will be subject to the network and 231.20 prior authorization requirements of the county administrative 231.21 entity or service delivery organization 60 days after 231.22 enrollment. An enrollee can choose to have a personal support 231.23 plan developed at any time. The personal support plan must be 231.24 based on choices, preferences, and assessed needs and strengths 231.25 of the enrollee. The service coordinator shall develop the 231.26 personal support plan, in consultation with the enrollee or the 231.27 enrollee's legal representative and other individuals requested 231.28 by the enrollee. The personal support plan must be updated as 231.29 needed or as requested by the enrollee. Enrollees may choose 231.30 not to have a personal support plan. 231.31 (n) The county administrative entity shall ensure timely 231.32 authorization, arrangement, and continuity of needed and covered 231.33 supports and services. 231.34 (o) The county administrative entity shall offer service 231.35 coordination that fulfills the responsibilities under 231.36 subdivision 12 and is appropriate to the enrollee's needs, 232.1 choices, and preferences, including a choice of service 232.2 coordinator. 232.3 (p) The county administrative entity shall contract with 232.4 schools and other agencies as appropriate to provide otherwise 232.5 covered medically necessary medical assistance services as 232.6 described in an enrollee's individual family support plan, as 232.7 described in sections 125A.26 to 125A.48, or individual 232.8 education plan, as described in chapter 125A. 232.9 (q) The county administrative entity shall develop and 232.10 implement strategies, based on consultation with affected 232.11 groups, to respect diversity and ensure culturally competent 232.12 service delivery in a manner that promotes the physical, social, 232.13 psychological, and spiritual well-being of enrollees and 232.14 preserves the dignity of individuals, families, and their 232.15 communities. 232.16 (r) When an enrollee changes county authorities, county 232.17 administrative entities shall ensure coordination with the 232.18 entity that is assuming responsibility for administering the 232.19 medical assistance benefit set to ensure continuity of supports 232.20 and services for the enrollee. 232.21 (s) The county administrative entity shall comply with 232.22 additional requirements as specified in the intergovernmental 232.23 contract. 232.24 (t) To the extent that alternatives are approved under 232.25 subdivision 17, county administrative entities must provide for 232.26 the health and safety of enrollees and protect the rights to 232.27 privacy and to provide informed consent. 232.28 Sec. 87. Minnesota Statutes 1998, section 256B.77, is 232.29 amended by adding a subdivision to read: 232.30 Subd. 27. [SERVICE COORDINATION TRANSITION.] Demonstration 232.31 sites designated under subdivision 5, with the permission of an 232.32 eligible individual, may implement the provisions of subdivision 232.33 12 beginning 60 calendar days prior to an individual's 232.34 enrollment. This implementation may occur prior to the 232.35 enrollment of eligible individuals, but is restricted to 232.36 eligible individuals. 233.1 Sec. 88. Minnesota Statutes 1998, section 256D.03, 233.2 subdivision 3, is amended to read: 233.3 Subd. 3. [GENERAL ASSISTANCE MEDICAL CARE; ELIGIBILITY.] 233.4 (a) General assistance medical care may be paid for any person 233.5 who is not eligible for medical assistance under chapter 256B, 233.6 including eligibility for medical assistance based on a 233.7 spenddown of excess income according to section 256B.056, 233.8 subdivision 5, or MinnesotaCare as defined in paragraph (b), 233.9 except as provided in paragraph (c); and: 233.10 (1) who is receiving assistance under section 256D.05, 233.11 except for families with children who are eligible under 233.12 Minnesota family investment program-statewide (MFIP-S), who is 233.13 having a payment made on the person's behalf under sections 233.14 256I.01 to 256I.06, or who resides in group residential housing 233.15 as defined in chapter 256I and can meet a spenddown using the 233.16 cost of remedial services received through group residential 233.17 housing; or 233.18 (2)(i) who is a resident of Minnesota; and whose equity in 233.19 assets is not in excess of $1,000 per assistance unit. Exempt 233.20 assets, the reduction of excess assets, and the waiver of excess 233.21 assets must conform to the medical assistance program in chapter 233.22 256B, with the following exception: the maximum amount of 233.23 undistributed funds in a trust that could be distributed to or 233.24 on behalf of the beneficiary by the trustee, assuming the full 233.25 exercise of the trustee's discretion under the terms of the 233.26 trust, must be applied toward the asset maximum; and 233.27 (ii) who has countable income not in excess of the 233.28 assistance standards established in section 256B.056, 233.29 subdivision 4, or whose excess income is spent down according to 233.30 section 256B.056, subdivision 5, using a six-month budget 233.31 period. The method for calculating earned income disregards and 233.32 deductions for a person who resides with a dependent child under 233.33 age 21 shall follow section 256B.056, subdivision 1a. However, 233.34 if a disregard of $30 and one-third of the remainder has been 233.35 applied to the wage earner's income, the disregard shall not be 233.36 applied again until the wage earner's income has not been 234.1 considered in an eligibility determination for general 234.2 assistance, general assistance medical care, medical assistance, 234.3 or MFIP-S for 12 consecutive months. The earned income and work 234.4 expense deductions for a person who does not reside with a 234.5 dependent child under age 21 shall be the same as the method 234.6 used to determine eligibility for a person under section 234.7 256D.06, subdivision 1, except the disregard of the first $50 of 234.8 earned income is not allowed; 234.9 (3) who would be eligible for medical assistance except 234.10 that the person resides in a facility that is determined by the 234.11 commissioner or the federal Health Care Financing Administration 234.12 to be an institution for mental diseases; or 234.13 (4) who is ineligible for medical assistance under chapter 234.14 256B or general assistance medical care under any other 234.15 provision of this section, and is receiving care and 234.16 rehabilitation services from a nonprofit center established to 234.17 serve victims of torture. These individuals are eligible for 234.18 general assistance medical care only for the period during which 234.19 they are receiving services from the center. During this period 234.20 of eligibility, individuals eligible under this clause shall not 234.21 be required to participate in prepaid general assistance medical 234.22 care. 234.23 (b) Beginning January 1, 2000, applicants or recipients who 234.24 meet all eligibility requirements of MinnesotaCare as defined in 234.25 sections 256L.01 to 256L.16, and are: 234.26 (i) adults with dependent children under 21 whose gross 234.27 family income is equal to or less than 275 percent of the 234.28 federal poverty guidelines; or 234.29 (ii) adults without children with earned income and whose 234.30 family gross income is between 75 percent of the federal poverty 234.31 guidelines and the amount set by section 256L.04, subdivision 7, 234.32 shall be terminated from general assistance medical care upon 234.33 enrollment in MinnesotaCare. 234.34 (c) For services rendered on or after July 1, 1997, 234.35 eligibility is limited to one month prior to application if the 234.36 person is determined eligible in the prior month. A 235.1 redetermination of eligibility must occur every 12 months. 235.2 Beginning January 1, 2000, Minnesota health care program 235.3 applications completed by recipients and applicants who are 235.4 persons described in paragraph (b), may be returned to the 235.5 county agency to be forwarded to the department of human 235.6 services or sent directly to the department of human services 235.7 for enrollment in MinnesotaCare. If all other eligibility 235.8 requirements of this subdivision are met, eligibility for 235.9 general assistance medical care shall be available in any month 235.10 during which a MinnesotaCare eligibility determination and 235.11 enrollment are pending. Upon notification of eligibility for 235.12 MinnesotaCare, notice of termination for eligibility for general 235.13 assistance medical care shall be sent to an applicant or 235.14 recipient. If all other eligibility requirements of this 235.15 subdivision are met, eligibility for general assistance medical 235.16 care shall be available until enrollment in MinnesotaCare 235.17 subject to the provisions of paragraph (e). 235.18 (d) The date of an initial Minnesota health care program 235.19 application necessary to begin a determination of eligibility 235.20 shall be the date the applicant has provided a name, address, 235.21 and social security number, signed and dated, to the county 235.22 agency or the department of human services. If the applicant is 235.23 unable to provide an initial application when health care is 235.24 delivered due to a medical condition or disability, a health 235.25 care provider may act on the person's behalf to complete the 235.26 initial application. The applicant must complete the remainder 235.27 of the application and provide necessary verification before 235.28 eligibility can be determined. The county agency must assist 235.29 the applicant in obtaining verification if necessary. On the 235.30 basis of information provided on the completed application, an 235.31 applicant who meets the following criteria shall be determined 235.32 eligible beginning in the month of application: 235.33 (1) has gross income less than 90 percent of the applicable 235.34 income standard; 235.35 (2) has liquid assets that total within $300 of the asset 235.36 standard; 236.1 (3) does not reside in a long-term care facility; and 236.2 (4) meets all other eligibility requirements. 236.3 The applicant must provide all required verifications within 30 236.4 days' notice of the eligibility determination or eligibility 236.5 shall be terminated. 236.6 (e) County agencies are authorized to use all automated 236.7 databases containing information regarding recipients' or 236.8 applicants' income in order to determine eligibility for general 236.9 assistance medical care or MinnesotaCare. Such use shall be 236.10 considered sufficient in order to determine eligibility and 236.11 premium payments by the county agency. 236.12 (f) General assistance medical care is not available for a 236.13 person in a correctional facility unless the person is detained 236.14 by law for less than one year in a county correctional or 236.15 detention facility as a person accused or convicted of a crime, 236.16 or admitted as an inpatient to a hospital on a criminal hold 236.17 order, and the person is a recipient of general assistance 236.18 medical care at the time the person is detained by law or 236.19 admitted on a criminal hold order and as long as the person 236.20 continues to meet other eligibility requirements of this 236.21 subdivision. 236.22 (g) General assistance medical care is not available for 236.23 applicants or recipients who do not cooperate with the county 236.24 agency to meet the requirements of medical assistance. General 236.25 assistance medical care is limited to payment of emergency 236.26 services only for applicants or recipients as described in 236.27 paragraph (b), whose MinnesotaCare coverage is denied or 236.28 terminated for nonpayment of premiums as required by sections 236.29 256L.06 and 256L.07. 236.30 (h) In determining the amount of assets of an individual, 236.31 there shall be included any asset or interest in an asset, 236.32 including an asset excluded under paragraph (a), that was given 236.33 away, sold, or disposed of for less than fair market value 236.34 within the 60 months preceding application for general 236.35 assistance medical care or during the period of eligibility. 236.36 Any transfer described in this paragraph shall be presumed to 237.1 have been for the purpose of establishing eligibility for 237.2 general assistance medical care, unless the individual furnishes 237.3 convincing evidence to establish that the transaction was 237.4 exclusively for another purpose. For purposes of this 237.5 paragraph, the value of the asset or interest shall be the fair 237.6 market value at the time it was given away, sold, or disposed 237.7 of, less the amount of compensation received. For any 237.8 uncompensated transfer, the number of months of ineligibility, 237.9 including partial months, shall be calculated by dividing the 237.10 uncompensated transfer amount by the average monthly per person 237.11 payment made by the medical assistance program to skilled 237.12 nursing facilities for the previous calendar year. The 237.13 individual shall remain ineligible until this fixed period has 237.14 expired. The period of ineligibility may exceed 30 months, and 237.15 a reapplication for benefits after 30 months from the date of 237.16 the transfer shall not result in eligibility unless and until 237.17 the period of ineligibility has expired. The period of 237.18 ineligibility begins in the month the transfer was reported to 237.19 the county agency, or if the transfer was not reported, the 237.20 month in which the county agency discovered the transfer, 237.21 whichever comes first. For applicants, the period of 237.22 ineligibility begins on the date of the first approved 237.23 application. 237.24 (i) When determining eligibility for any state benefits 237.25 under this subdivision, the income and resources of all 237.26 noncitizens shall be deemed to include their sponsor's income 237.27 and resources as defined in the Personal Responsibility and Work 237.28 Opportunity Reconciliation Act of 1996, title IV, Public Law 237.29 Number 104-193, sections 421 and 422, and subsequently set out 237.30 in federal rules. 237.31 (j)(1) An undocumented noncitizen or a nonimmigrant is 237.32 ineligible for general assistance medical care other than 237.33 emergency services. For purposes of this subdivision, a 237.34 nonimmigrant is an individual in one or more of the classes 237.35 listed in United States Code, title 8, section 1101(a)(15), and 237.36 an undocumented noncitizen is an individual who resides in the 238.1 United States without the approval or acquiescence of the 238.2 Immigration and Naturalization Service. 238.3 (2) This paragraph does not apply to a child under age 18, 238.4 to a Cuban or Haitian entrant as defined in Public Law Number 238.5 96-422, section 501(e)(1) or (2)(a), or to a noncitizen who is 238.6 aged, blind, or disabled as defined in Code of Federal 238.7 Regulations, title 42, sections 435.520, 435.530, 435.531, 238.8 435.540, and 435.541, or effective October 1, 1998, to an 238.9 individual eligible for general assistance medical care under 238.10 paragraph (a), clause (4), who cooperates with the Immigration 238.11 and Naturalization Service to pursue any applicable immigration 238.12 status, including citizenship, that would qualify the individual 238.13 for medical assistance with federal financial participation. 238.14 (3) For purposes of this paragraph, "emergency services" 238.15 has the meaning given in Code of Federal Regulations, title 42, 238.16 section 440.255(b)(1), except that it also means services 238.17 rendered because of suspected or actual pesticide poisoning. 238.18 (k) Notwithstanding any other provision of law, a 238.19 noncitizen who is ineligible for medical assistance due to the 238.20 deeming of a sponsor's income and resources, is ineligible for 238.21 general assistance medical care. 238.22 Sec. 89. Minnesota Statutes 1998, section 256D.03, 238.23 subdivision 4, is amended to read: 238.24 Subd. 4. [GENERAL ASSISTANCE MEDICAL CARE; SERVICES.] (a) 238.25 For a person who is eligible under subdivision 3, paragraph (a), 238.26 clause (3), general assistance medical care covers, except as 238.27 provided in paragraph (c): 238.28 (1) inpatient hospital services; 238.29 (2) outpatient hospital services; 238.30 (3) services provided by Medicare certified rehabilitation 238.31 agencies; 238.32 (4) prescription drugs and other products recommended 238.33 through the process established in section 256B.0625, 238.34 subdivision 13; 238.35 (5) equipment necessary to administer insulin and 238.36 diagnostic supplies and equipment for diabetics to monitor blood 239.1 sugar level; 239.2 (6) eyeglasses and eye examinations provided by a physician 239.3 or optometrist; 239.4 (7) hearing aids; 239.5 (8) prosthetic devices; 239.6 (9) laboratory and X-ray services; 239.7 (10) physician's services; 239.8 (11) medical transportation; 239.9 (12) chiropractic services as covered under the medical 239.10 assistance program; 239.11 (13) podiatric services; 239.12 (14) dental services; 239.13 (15) outpatient services provided by a mental health center 239.14 or clinic that is under contract with the county board and is 239.15 established under section 245.62; 239.16 (16) day treatment services for mental illness provided 239.17 under contract with the county board; 239.18 (17) prescribed medications for persons who have been 239.19 diagnosed as mentally ill as necessary to prevent more 239.20 restrictive institutionalization; 239.21 (18) psychological services, medical supplies and 239.22 equipment, and Medicare premiums, coinsurance and deductible 239.23 payments; 239.24 (19) medical equipment not specifically listed in this 239.25 paragraph when the use of the equipment will prevent the need 239.26 for costlier services that are reimbursable under this 239.27 subdivision; 239.28 (20) services performed by a certified pediatric nurse 239.29 practitioner, a certified family nurse practitioner, a certified 239.30 adult nurse practitioner, a certified obstetric/gynecological 239.31 nurse practitioner, a certified neonatal nurse practitioner, or 239.32 a certified geriatric nurse practitioner in independent 239.33 practice, if the services are otherwise covered under this 239.34 chapter as a physician service, are provided on an inpatient 239.35 basis and are not part of the cost for inpatient services 239.36 included in the operating payment rate, and if the service is 240.1 within the scope of practice of the nurse practitioner's license 240.2 as a registered nurse, as defined in section 148.171;and240.3 (21) services of a certified public health nurse or a 240.4 registered nurse practicing in a public health nursing clinic 240.5 that is a department of, or that operates under the direct 240.6 authority of, a unit of government, if the service is within the 240.7 scope of practice of the public health nurse's license as a 240.8 registered nurse, as defined in section 148.171; 240.9 (22) telemedicine consultations via two-way, interactive 240.10 video or store and forward technology. Store and forward 240.11 technology includes telemedicine consultations that do not occur 240.12 in real time via synchronous transmissions and that do not 240.13 require a face-to-face encounter with the patient for all or any 240.14 part of any such telemedicine consultation. The patient record 240.15 must include a written opinion from the consulting physician 240.16 providing the telemedicine consultation. A communication 240.17 between two physicians that consists solely of a telephone 240.18 conversation is not a telemedicine consultation. Coverage is 240.19 limited to three telemedicine consultations per recipient per 240.20 calendar week. Telemedicine consultations shall be paid at the 240.21 full allowable rate; and 240.22 (23) language interpreter services provided in conjunction 240.23 with another covered health service. Interpreter services 240.24 provided under this subdivision must satisfy the requirements of 240.25 section 256B.0625, subdivision 42. 240.26 (b) Except as provided in paragraph (c), for a recipient 240.27 who is eligible under subdivision 3, paragraph (a), clause (1) 240.28 or (2), general assistance medical care covers the services 240.29 listed in paragraph (a) with the exception of special 240.30 transportation services. 240.31 (c) Gender reassignment surgery and related services are 240.32 not covered services under this subdivision unless the 240.33 individual began receiving gender reassignment services prior to 240.34 July 1, 1995. 240.35 (d) In order to contain costs, the commissioner of human 240.36 services shall select vendors of medical care who can provide 241.1 the most economical care consistent with high medical standards 241.2 and shall where possible contract with organizations on a 241.3 prepaid capitation basis to provide these services. The 241.4 commissioner shall consider proposals by counties and vendors 241.5 for prepaid health plans, competitive bidding programs, block 241.6 grants, or other vendor payment mechanisms designed to provide 241.7 services in an economical manner or to control utilization, with 241.8 safeguards to ensure that necessary services are provided. 241.9 Before implementing prepaid programs in counties with a county 241.10 operated or affiliated public teaching hospital or a hospital or 241.11 clinic operated by the University of Minnesota, the commissioner 241.12 shall consider the risks the prepaid program creates for the 241.13 hospital and allow the county or hospital the opportunity to 241.14 participate in the program in a manner that reflects the risk of 241.15 adverse selection and the nature of the patients served by the 241.16 hospital, provided the terms of participation in the program are 241.17 competitive with the terms of other participants considering the 241.18 nature of the population served. Payment for services provided 241.19 pursuant to this subdivision shall be as provided to medical 241.20 assistance vendors of these services under sections 256B.02, 241.21 subdivision 8, and 256B.0625. For payments made during fiscal 241.22 year 1990 and later years, the commissioner shall consult with 241.23 an independent actuary in establishing prepayment rates, but 241.24 shall retain final control over the rate methodology. 241.25 Notwithstanding the provisions of subdivision 3, an individual 241.26 who becomes ineligible for general assistance medical care 241.27 because of failure to submit income reports or recertification 241.28 forms in a timely manner, shall remain enrolled in the prepaid 241.29 health plan and shall remain eligible for general assistance 241.30 medical care coverage through the last day of the month in which 241.31 the enrollee became ineligible for general assistance medical 241.32 care. 241.33(e) The commissioner of human services may reduce payments241.34provided under sections 256D.01 to 256D.21 and 261.23 in order241.35to remain within the amount appropriated for general assistance241.36medical care, within the following restrictions:242.1(i) For the period July 1, 1985 to December 31, 1985,242.2reductions below the cost per service unit allowable under242.3section 256.966, are permitted only as follows: payments for242.4inpatient and outpatient hospital care provided in response to a242.5primary diagnosis of chemical dependency or mental illness may242.6be reduced no more than 30 percent; payments for all other242.7inpatient hospital care may be reduced no more than 20 percent.242.8Reductions below the payments allowable under general assistance242.9medical care for the remaining general assistance medical care242.10services allowable under this subdivision may be reduced no more242.11than ten percent.242.12(ii) For the period January 1, 1986 to December 31, 1986,242.13reductions below the cost per service unit allowable under242.14section 256.966 are permitted only as follows: payments for242.15inpatient and outpatient hospital care provided in response to a242.16primary diagnosis of chemical dependency or mental illness may242.17be reduced no more than 20 percent; payments for all other242.18inpatient hospital care may be reduced no more than 15 percent.242.19Reductions below the payments allowable under general assistance242.20medical care for the remaining general assistance medical care242.21services allowable under this subdivision may be reduced no more242.22than five percent.242.23(iii) For the period January 1, 1987 to June 30, 1987,242.24reductions below the cost per service unit allowable under242.25section 256.966 are permitted only as follows: payments for242.26inpatient and outpatient hospital care provided in response to a242.27primary diagnosis of chemical dependency or mental illness may242.28be reduced no more than 15 percent; payments for all other242.29inpatient hospital care may be reduced no more than ten242.30percent. Reductions below the payments allowable under medical242.31assistance for the remaining general assistance medical care242.32services allowable under this subdivision may be reduced no more242.33than five percent.242.34(iv) For the period July 1, 1987 to June 30, 1988,242.35reductions below the cost per service unit allowable under242.36section 256.966 are permitted only as follows: payments for243.1inpatient and outpatient hospital care provided in response to a243.2primary diagnosis of chemical dependency or mental illness may243.3be reduced no more than 15 percent; payments for all other243.4inpatient hospital care may be reduced no more than five percent.243.5Reductions below the payments allowable under medical assistance243.6for the remaining general assistance medical care services243.7allowable under this subdivision may be reduced no more than243.8five percent.243.9(v) For the period July 1, 1988 to June 30, 1989,243.10reductions below the cost per service unit allowable under243.11section 256.966 are permitted only as follows: payments for243.12inpatient and outpatient hospital care provided in response to a243.13primary diagnosis of chemical dependency or mental illness may243.14be reduced no more than 15 percent; payments for all other243.15inpatient hospital care may not be reduced. Reductions below243.16the payments allowable under medical assistance for the243.17remaining general assistance medical care services allowable243.18under this subdivision may be reduced no more than five percent.243.19(f)(e) There shall be no copayment required of any 243.20 recipient of benefits for any services provided under this 243.21 subdivision. A hospital receiving a reduced payment as a result 243.22 of this section may apply the unpaid balance toward satisfaction 243.23 of the hospital's bad debts. 243.24(g)(f) Any county may, from its own resources, provide 243.25 medical payments for which state payments are not made. 243.26(h)(g) Chemical dependency services that are reimbursed 243.27 under chapter 254B must not be reimbursed under general 243.28 assistance medical care. 243.29(i)(h) The maximum payment for new vendors enrolled in the 243.30 general assistance medical care program after the base year 243.31 shall be determined from the average usual and customary charge 243.32 of the same vendor type enrolled in the base year. 243.33(j)(i) The conditions of payment for services under this 243.34 subdivision are the same as the conditions specified in rules 243.35 adopted under chapter 256B governing the medical assistance 243.36 program, unless otherwise provided by statute or rule. 244.1 (Effective date: Section 89 (256D.03, subd. 4) is 244.2 effective for services rendered on or after July 1, 1999.) 244.3 Sec. 90. Minnesota Statutes 1998, section 256D.03, 244.4 subdivision 8, is amended to read: 244.5 Subd. 8. [PRIVATE INSURANCE POLICIES.] (a) Private 244.6 accident and health care coverage for medical services is 244.7 primary coverage and must be exhausted before general assistance 244.8 medical care is paid. When a person who is otherwise eligible 244.9 for general assistance medical care has private accident or 244.10 health care coverage, including a prepaid health plan, the 244.11 private health care benefits available to the person must be 244.12 used first and to the fullest extent. General assistance 244.13 medical care payment will not be made when either covered 244.14 charges are paid in full by a third party or the provider has an 244.15 agreement to accept payment for less than charges as payment in 244.16 full. Payment for patients that are simultaneously covered by 244.17 general assistance medical care and a liable third party other 244.18 than Medicare will be determined as the lesser of clauses (1) to 244.19 (3): 244.20 (1) the patient liability according to the provider/insurer 244.21 agreement; 244.22 (2) covered charges minus the third party payment amount; 244.23 or 244.24 (3) the general assistance medical care rate minus the 244.25 third party payment amount. 244.26 A negative difference will not be implemented. 244.27 (b) When a parent or a person with an obligation of support 244.28 has enrolled in a prepaid health care plan under section 244.29 518.171, subdivision 1, the commissioner of human services shall 244.30 limit the recipient of general assistance medical care to the 244.31 benefits payable under that prepaid health care plan to the 244.32 extent that services available under general assistance medical 244.33 care are also available under the prepaid health care plan. 244.34 (c) Upon furnishing general assistance medical care or 244.35 general assistance to any person having private accident or 244.36 health care coverage, or having a cause of action arising out of 245.1 an occurrence that necessitated the payment of assistance, the 245.2 state agency shall be subrogated, to the extent of the cost of 245.3 medical care, subsistence, or other payments furnished, to any 245.4 rights the person may have under the terms of the coverage or 245.5 under the cause of action. For purposes of this subdivision, 245.6 "state agency" includes prepaid health plans under contract with 245.7 the commissioner according to sections 256B.69, 256D.03, 245.8 subdivision 4, paragraph (d), and 256L.12; children's mental 245.9 health collaboratives under section 245.493; demonstration 245.10 projects for persons with disabilities under section 256B.77; 245.11 nursing homes under the alternative payment demonstration 245.12 project under section 256B.434; and county-based purchasing 245.13 entities under section 256B.692. 245.14 This right of subrogation includes all portions of the 245.15 cause of action, notwithstanding any settlement allocation or 245.16 apportionment that purports to dispose of portions of the cause 245.17 of action not subject to subrogation. 245.18 (d) To recover under this section, the attorney generalor245.19the appropriate county attorney, acting upon direction from the245.20attorney general,may institute or join a civil action to 245.21 enforce the subrogation rights the commissioner established 245.22 under this section. 245.23 Any prepaid health plan providing services under sections 245.24 256B.69, 256D.03, subdivision 4, paragraph (d), and 256L.12; 245.25 children's mental health collaboratives under section 245.493; 245.26 demonstration projects for persons with disabilities under 245.27 section 256B.77; nursing homes under the alternative payment 245.28 demonstration project under section 256B.434; or the 245.29 county-based purchasing entity providing services under section 245.30 256B.692 may retain legal representation to enforce the 245.31 subrogation rights created under this section or, if no action 245.32 has been brought, may initiate and prosecute an independent 245.33 action on their behalf against a person, firm, or corporation 245.34 that may be liable to the person to whom the care or payment was 245.35 furnished. 245.36 (e) The state agency must be given notice of monetary 246.1 claims against a person, firm, or corporation that may be liable 246.2 in damages, or otherwise obligated to pay part or all of the 246.3 costs related to an injury when the state agency has paid or 246.4 become liable for the cost of care or payments related to the 246.5 injury. Notice must be given as follows: 246.6 (i) Applicants for general assistance or general assistance 246.7 medical care shall notify the state or county agency of any 246.8 possible claims when they submit the application. Recipients of 246.9 general assistance or general assistance medical care shall 246.10 notify the state or county agency of any possible claims when 246.11 those claims arise. 246.12 (ii) A person providing medical care services to a 246.13 recipient of general assistance medical care shall notify the 246.14 state agency when the person has reason to believe that a third 246.15 party may be liable for payment of the cost of medical care. 246.16 (iii) A person who is party to a claim upon which the state 246.17 agency may be entitled to subrogation under this section shall 246.18 notify the state agency of its potential subrogation claim 246.19 before filing a claim, commencing an action, or negotiating a 246.20 settlement. A person who is a party to a claim includes the 246.21 plaintiff, the defendants, and any other party to the cause of 246.22 action. 246.23 Notice given to the county agency is not sufficient to meet 246.24 the requirements of paragraphs (b) and (c). 246.25 (f) Upon any judgment, award, or settlement of a cause of 246.26 action, or any part of it, upon which the state agency has a 246.27 subrogation right, including compensation for liquidated, 246.28 unliquidated, or other damages, reasonable costs of collection, 246.29 including attorney fees, must be deducted first. The full 246.30 amount of general assistance or general assistance medical care 246.31 paid to or on behalf of the person as a result of the injury 246.32 must be deducted next and paid to the state agency. The rest 246.33 must be paid to the public assistance recipient or other 246.34 plaintiff. The plaintiff, however, must receive at least 246.35 one-third of the net recovery after attorney fees and collection 246.36 costs. 247.1 Sec. 91. Minnesota Statutes 1998, section 256L.03, 247.2 subdivision 5, is amended to read: 247.3 Subd. 5. [COPAYMENTS AND COINSURANCE.] The MinnesotaCare 247.4 benefit plan shall include the following copayments and 247.5 coinsurance requirements for all enrollees except parents and 247.6 relative caretakers of children under the age of 21 in 247.7 households with income at or below 175 percent of the federal 247.8 poverty guidelines and pregnant women and children under the age 247.9 of 21: 247.10 (1) ten percent of the paid charges for inpatient hospital 247.11 services for adult enrollees, subject to an annual inpatient 247.12 out-of-pocket maximum of $1,000 per individual and $3,000 per 247.13 family; 247.14 (2) $3 per prescription for adult enrollees; 247.15 (3) $25 for eyeglasses for adult enrollees; and 247.16 (4) effective July 1, 1998, 50 percent of the 247.17 fee-for-service rate for adult dental care services other than 247.18 preventive care services for persons eligible under section 247.19 256L.04, subdivisions 1 to 7, with income equal to or less than 247.20 175 percent of the federal poverty guidelines. 247.21 Effective July 1, 1997, adult enrollees with family gross 247.22 income that exceeds 175 percent of the federal poverty 247.23 guidelines and who are not pregnant shall be financially 247.24 responsible for the coinsurance amount and amounts which exceed 247.25 the $10,000 inpatient hospital benefit limit. 247.26 When a MinnesotaCare enrollee becomes a member of a prepaid 247.27 health plan, or changes from one prepaid health plan to another 247.28 during a calendar year, any charges submitted towards the 247.29 $10,000 annual inpatient benefit limit, and any out-of-pocket 247.30 expenses incurred by the enrollee for inpatient services, that 247.31 were submitted or incurred prior to enrollment, or prior to the 247.32 change in health plans, shall be disregarded. 247.33 Sec. 92. Minnesota Statutes 1998, section 256L.03, 247.34 subdivision 6, is amended to read: 247.35 Subd. 6. [LIEN.] When the state agency provides, pays for, 247.36 or becomes liable for covered health services, the agency shall 248.1 have a lien for the cost of the covered health services upon any 248.2 and all causes of action accruing to the enrollee, or to the 248.3 enrollee's legal representatives, as a result of the occurrence 248.4 that necessitated the payment for the covered health services. 248.5 All liens under this section shall be subject to the provisions 248.6 of section 256.015. For purposes of this subdivision, "state 248.7 agency" includesauthorized agents of the state agencyprepaid 248.8 health plans under contract with the commissioner according to 248.9 sections 256B.69, 256D.03, subdivision 4, paragraph (d), and 248.10 256L.12; and county-based purchasing entities under section 248.11 256B.692. 248.12 Sec. 93. Minnesota Statutes 1998, section 256L.04, 248.13 subdivision 2, is amended to read: 248.14 Subd. 2. [COOPERATION IN ESTABLISHING THIRD-PARTY 248.15 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 248.16 eligible for MinnesotaCare, individuals and families must 248.17 cooperate with the state agency to identify potentially liable 248.18 third-party payers and assist the state in obtaining third-party 248.19 payments. "Cooperation" includes, but is not limited to, 248.20 identifying any third party who may be liable for care and 248.21 services provided under MinnesotaCare to the enrollee, providing 248.22 relevant information to assist the state in pursuing a 248.23 potentially liable third party, and completing forms necessary 248.24 to recover third-party payments. 248.25 (b) A parent, guardian, relative caretaker, or child 248.26 enrolled in the MinnesotaCare program must cooperate with the 248.27 department of human services and the local agency in 248.28 establishing the paternity of an enrolled child and in obtaining 248.29 medical care support and payments for the child and any other 248.30 person for whom the person can legally assign rights, in 248.31 accordance with applicable laws and rules governing the medical 248.32 assistance program. A child shall not be ineligible for or 248.33 disenrolled from the MinnesotaCare program solely because the 248.34 child's parent, relative caretaker, or guardian fails to 248.35 cooperate in establishing paternity or obtaining medical support. 248.36 Sec. 94. Minnesota Statutes 1998, section 256L.04, 249.1 subdivision 7, is amended to read: 249.2 Subd. 7. [SINGLE ADULTS AND HOUSEHOLDS WITH NO CHILDREN.] 249.3 The definition of eligible persons includes all individuals and 249.4 households with no children who have gross family incomes that 249.5 are equal to or less than175275 percent of the federal poverty 249.6 guidelines. 249.7 (Effective date: Section 94 (256L.04, subd. 7) is 249.8 effective July 1, 2000.) 249.9 Sec. 95. Minnesota Statutes 1998, section 256L.04, 249.10 subdivision 8, is amended to read: 249.11 Subd. 8. [APPLICANTS POTENTIALLY ELIGIBLE FOR MEDICAL 249.12 ASSISTANCE.] (a) Individuals who receive supplemental security 249.13 income or retirement, survivors, or disability benefits due to a 249.14 disability, or other disability-based pension, who qualify under 249.15 subdivision 7, but who are potentially eligible for medical 249.16 assistance without a spenddown shall be allowed to enroll in 249.17 MinnesotaCare for a period of 60 days, so long as the applicant 249.18 meets all other conditions of eligibility. The commissioner 249.19 shall identify and refer the applications of such individuals to 249.20 their county social service agency. The county and the 249.21 commissioner shall cooperate to ensure that the individuals 249.22 obtain medical assistance coverage for any months for which they 249.23 are eligible. 249.24 (b) The enrollee must cooperate with the county social 249.25 service agency in determining medical assistance eligibility 249.26 within the 60-day enrollment period. Enrollees who do not 249.27 cooperate with medical assistance within the 60-day enrollment 249.28 period shall be disenrolled from the plan within one calendar 249.29 month. Persons disenrolled for nonapplication for medical 249.30 assistance may not reenroll until they have obtained a medical 249.31 assistance eligibility determination. Persons disenrolled for 249.32 noncooperation with medical assistance may not reenroll until 249.33 they have cooperated with the county agency and have obtained a 249.34 medical assistance eligibility determination. 249.35 (c) Beginning January 1, 2000, counties that choose to 249.36 become MinnesotaCare enrollment sites shall consider 250.1 MinnesotaCare applicationsof individuals described in paragraph250.2(a)to also be applications for medical assistanceand shall250.3first determine whether medical assistance eligibility exists. 250.4Adults with children with family income under 175 percent of the250.5federal poverty guidelines for the applicable family size,250.6pregnant women, and children who qualify under subdivision 1250.7 Applicants who are potentially eligible for medical assistance 250.8without a spenddown, except for those described in paragraph 250.9 (a), may choose to enroll in either MinnesotaCare or medical 250.10 assistance. 250.11 (d) The commissioner shall redetermine provider payments 250.12 made under MinnesotaCare to the appropriate medical assistance 250.13 payments for those enrollees who subsequently become eligible 250.14 for medical assistance. 250.15 Sec. 96. Minnesota Statutes 1998, section 256L.04, 250.16 subdivision 11, is amended to read: 250.17 Subd. 11. [MINNESOTACARE OUTREACH.] (a) The commissioner 250.18 shall award grants to public or private organizations to provide 250.19 information on the importance of maintaining insurance coverage 250.20 and on how to obtain coverage through the MinnesotaCare program 250.21 in areas of the state with high uninsured populations. 250.22 (b) In awarding the grants, the commissioner shall consider 250.23 the following: 250.24 (1) geographic areas and populations with high uninsured 250.25 rates; 250.26 (2) the ability to raise matching funds; and 250.27 (3) the ability to contact or serve eligible populations. 250.28 The commissioner shall monitor the grants and may terminate 250.29 a grant if the outreach effort does not increasethe250.30MinnesotaCare programenrollment in medical assistance, general 250.31 assistance medical care, or the MinnesotaCare program. 250.32 Sec. 97. Minnesota Statutes 1998, section 256L.04, 250.33 subdivision 13, is amended to read: 250.34 Subd. 13. [FAMILIES WITHGRANDPARENTS,RELATIVE 250.35 CARETAKERS, FOSTER PARENTS, OR LEGAL GUARDIANS.] Beginning 250.36 January 1, 1999, in families that include agrandparent,251.1 relative caretaker as defined in the medical assistance program, 251.2 foster parent, or legal guardian, thegrandparent,relative 251.3 caretaker, foster parent, or legal guardian may apply as a 251.4 family or may apply separately for the children. If the 251.5 caretaker applies separately for the children, only the 251.6 children's income is counted and the provisions of subdivision 251.7 1, paragraph (b), do not apply. If thegrandparent,relative 251.8 caretaker, foster parent, or legal guardian applies with the 251.9 children, their income is included in the gross family income 251.10 for determining eligibility and premium amount. 251.11 Sec. 98. Minnesota Statutes 1998, section 256L.05, is 251.12 amended by adding a subdivision to read: 251.13 Subd. 3c. [RETROACTIVE COVERAGE.] Notwithstanding 251.14 subdivision 3, the effective date of coverage shall be the first 251.15 day of the month following termination from medical assistance 251.16 or general assistance medical care for families and individuals 251.17 who are eligible for MinnesotaCare and who submitted a written 251.18 request to the commissioner for MinnesotaCare within 30 days of 251.19 receiving notification of termination from medical assistance or 251.20 general assistance medical care. 251.21 Sec. 99. Minnesota Statutes 1998, section 256L.05, 251.22 subdivision 4, is amended to read: 251.23 Subd. 4. [APPLICATION PROCESSING.] The commissioner of 251.24 human services shall determine an applicant's eligibility for 251.25 MinnesotaCare no more than 30 days from the date that the 251.26 application is received by the department of human services. 251.27 Beginning January 1, 2000, this requirement also applies to 251.28 local county human services agencies that determine eligibility 251.29 for MinnesotaCare. Once annually at application or 251.30 reenrollment, to prevent processing delays, applicants or 251.31 enrollees who, from the information provided on the application, 251.32 appear to meet eligibility requirements shall be enrolled upon 251.33 timely payment of premiums. The enrollee must provide all 251.34 required verifications within 30 days ofenrollmentnotification 251.35 of the eligibility determination or coverage from the program 251.36 shall be terminated. Enrollees who are determined to be 252.1 ineligible when verifications are provided shall be disenrolled 252.2 from the program. 252.3 Sec. 100. Minnesota Statutes 1998, section 256L.06, 252.4 subdivision 3, is amended to read: 252.5 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 252.6 Premiums are dedicated to the commissioner for MinnesotaCare. 252.7 (b) The commissioner shall develop and implement procedures 252.8 to: (1) require enrollees to report changes in income; (2) 252.9 adjust sliding scale premium payments, based upon changes in 252.10 enrollee income; and (3) disenroll enrollees from MinnesotaCare 252.11 for failure to pay required premiums.Beginning July 1, 1998,252.12 Failure to pay includes payment with a dishonored checkand, a 252.13 returned automatic bank withdrawal, or a refused credit card or 252.14 debit card payment. The commissioner may demand a guaranteed 252.15 form of payment, including a cashier's check or a money order, 252.16 as the only means to replace a dishonoredcheck, returned, or 252.17 refused payment. 252.18 (c) Premiums are calculated on a calendar month basis and 252.19 may be paid on a monthly, quarterly, or annual basis, with the 252.20 first payment due upon notice from the commissioner of the 252.21 premium amount required. The commissioner shall inform 252.22 applicants and enrollees of these premium payment options. 252.23 Premium payment is required before enrollment is complete and to 252.24 maintain eligibility in MinnesotaCare. 252.25 (d) Nonpayment of the premium will result in disenrollment 252.26 from the plan within one calendar month after the due date. 252.27 Persons disenrolled for nonpayment or who voluntarily terminate 252.28 coverage from the program may not reenroll until four calendar 252.29 months have elapsed. Persons disenrolled for nonpayment who pay 252.30 all past due premiums as well as current premiums due, within 20 252.31 days of disenrollment, shall be reenrolled for the next month. 252.32 Persons disenrolled for nonpayment or who voluntarily terminate 252.33 coverage from the program may not reenroll for four calendar 252.34 months unless the person demonstrates good cause for 252.35 nonpayment. Good cause does not exist if a person chooses to 252.36 pay other family expenses instead of the premium. The 253.1 commissioner shall define good cause in rule. 253.2 Sec. 101. Minnesota Statutes 1998, section 256L.07, is 253.3 amended to read: 253.4 256L.07 [ELIGIBILITY FORSUBSIDIZED PREMIUMS BASED ON253.5SLIDING SCALEMINNESOTACARE.] 253.6 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 253.7 enrolled in the original children's health plan as of September 253.8 30, 1992, children who enrolled in the MinnesotaCare program 253.9 after September 30, 1992, pursuant to Laws 1992, chapter 549, 253.10 article 4, section 17, and children who have family gross 253.11 incomes that are equal to or less than 150 percent of the 253.12 federal poverty guidelines are eligiblefor subsidized premium253.13paymentswithout meeting the requirements of subdivision 2, as 253.14 long as they maintain continuous coverage in the MinnesotaCare 253.15 program or medical assistance. Children who apply for 253.16 MinnesotaCare on or after the implementation date of the 253.17 employer-subsidized health coverage program as described in Laws 253.18 1998, chapter 407, article 5, section 45, who have family gross 253.19 incomes that are equal to or less than 150 percent of the 253.20 federal poverty guidelines, must meet the requirements of 253.21 subdivision 2 to be eligible for MinnesotaCare. 253.22 (b) Families and individuals enrolled in MinnesotaCare 253.23 under section 256L.04, subdivision 1 or 7, whose income 253.24 increases above 275 percent of the federal poverty guidelines, 253.25 are no longer eligible for the program and shall be disenrolled 253.26 by the commissioner.Individuals enrolled in MinnesotaCare253.27under section 256L.04, subdivision 7, whose income increases253.28above 175 percent of the federal poverty guidelines are no253.29longer eligible for the program and shall be disenrolled by the253.30commissioner.For persons disenrolled under this subdivision, 253.31 MinnesotaCare coverage terminates the last day of the calendar 253.32 month following the month in which the commissioner determines 253.33 that the income of a family or individual, determined over a253.34four-month period as required by section 256L.15, subdivision 2,253.35 exceeds program income limits. 253.36 (c) Notwithstanding paragraph (b), individuals and families 254.1 may remain enrolled in MinnesotaCare if ten percent of their 254.2 annual income is less than the annual premium for a policy with 254.3 a $500 deductible available through the Minnesota comprehensive 254.4 health association. Individuals and families who are no longer 254.5 eligible for MinnesotaCare under this subdivision shall be given 254.6 an 18-month notice period from the date that ineligibility is 254.7 determined before disenrollment. 254.8 (Effective date: Section 101 (256L.07, subd. 1) is 254.9 effective July 1, 2000.) 254.10 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 254.11 COVERAGE.] (a) To be eligiblefor subsidized premium payments254.12based on a sliding scale, a family or individual must not have 254.13 access to subsidized health coverage through an employer and 254.14 must not have had access to employer-subsidized coverage through 254.15 a current employer for 18 months prior to application or 254.16 reapplication. A family or individual whose employer-subsidized 254.17 coverage is lost due to an employer terminating health care 254.18 coverage as an employee benefit during the previous 18 months is 254.19 not eligible. 254.20 (b) For purposes of this requirement, subsidized health 254.21 coverage means health coverage for which the employer pays at 254.22 least 50 percent of the cost of coverage for the employee or 254.23 dependent, or a higher percentage as specified by the 254.24 commissioner. Children are eligible for employer-subsidized 254.25 coverage through either parent, including the noncustodial 254.26 parent. The commissioner must treat employer contributions to 254.27 Internal Revenue Code Section 125 plans and any other employer 254.28 benefits intended to pay health care costs as qualified employer 254.29 subsidies toward the cost of health coverage for employees for 254.30 purposes of this subdivision. 254.31 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 254.32 individuals enrolled in the MinnesotaCare program must have no 254.33 health coverage while enrolled or for at least four months prior 254.34 to application and renewal. Children enrolled in the original 254.35 children's health plan and children in families with income 254.36 equal to or less than 150 percent of the federal poverty 255.1 guidelines, who have other health insurance, are eligible if the 255.2other health coverage meets the requirements of Minnesota Rules,255.3part 9506.0020, subpart 3, item B.coverage: 255.4 (1) lacks two or more of the following: 255.5 (i) basic hospital insurance; 255.6 (ii) medical-surgical insurance; 255.7 (iii) prescription drug coverage; 255.8 (iv) dental coverage; or 255.9 (v) vision coverage; 255.10 (2) requires a deductible of $100 or more per person per 255.11 year; or 255.12 (3) lacks coverage because the child has exceeded the 255.13 maximum coverage for a particular diagnosis or the policy 255.14 excludes a particular diagnosis. 255.15 The commissioner may change this eligibility criterion for 255.16 sliding scale premiums in order to remain within the limits of 255.17 available appropriations. The requirement of no health coverage 255.18 does not apply to newborns. The requirement of no other health 255.19 coverage for at least four months prior to application does not 255.20 apply to families with children when a parent has been 255.21 determined to be in need of chemical dependency treatment 255.22 pursuant to an assessment conducted by the county under section 255.23 626.556, subdivision 10, or a case plan under section 257.071 or 255.24 260.191, subdivision 1e. 255.25 (b)For purposes of this section,Medical assistance, 255.26 general assistance medical care, and civilian health and medical 255.27 program of the uniformed service, CHAMPUS, are not considered 255.28 insurance or health coverage for purposes of the four-month 255.29 requirement described in this subdivision. 255.30 (c) For purposes of thissectionsubdivision, Medicare Part 255.31 A or B coverage under title XVIII of the Social Security Act, 255.32 United States Code, title 42, sections 1395c to 1395w-4, is 255.33 considered health coverage. An applicant or enrollee may not 255.34 refuse Medicare coverage to establish eligibility for 255.35 MinnesotaCare. 255.36 (d) Applicants who were recipients of medical assistance or 256.1 general assistance medical care within one month of application 256.2 must meet the provisions of this subdivision and subdivision 2. 256.3 (e) This subdivision does not apply to children who are no 256.4 longer eligible for the subsidized employer health coverage 256.5 program described in chapter 256M due to employment termination. 256.6 (Effective date: Section 101 (256L.07, subd. 3) is 256.7 effective 30 days following federal approval of the state plan 256.8 under title XXI and of the section 1115 waiver request in 256.9 section 117, paragraph (a).) 256.10 Subd. 4. [FAMILIES WITH CHILDREN IN NEED OF CHEMICAL 256.11 DEPENDENCY TREATMENT.] Premiums for families with children when 256.12 a parent has been determined to be in need of chemical 256.13 dependency treatment pursuant to an assessment conducted by the 256.14 county under section 626.556, subdivision 10, or a case plan 256.15 under section 257.071 or 260.191, subdivision 1e, who are 256.16 eligible for MinnesotaCare under section 256L.04, subdivision 1, 256.17 shall be paid by the county of residence of the person in need 256.18 of treatment for one year from the date the family is determined 256.19 to be eligible or if the family is currently enrolled in 256.20 MinnesotaCare from the date the person is determined to be in 256.21 need of chemical dependency treatment. Upon renewal, the family 256.22 is responsible for any premiums owed under section 256L.15. If 256.23 the family is not currently enrolled in MinnesotaCare, the local 256.24 county human services agency shall determine whether the family 256.25 appears to meet the eligibility requirements and shall assist 256.26 the family in applying for the MinnesotaCare program. 256.27 Sec. 102. Minnesota Statutes 1998, section 256L.15, 256.28 subdivision 1, is amended to read: 256.29 Subdivision 1. [PREMIUM DETERMINATION.] Families with 256.30 children and individuals shall pay a premium determined 256.31 according to a sliding fee based onthe cost of coverage asa 256.32 percentage of the family's gross family income. Pregnant women 256.33 and children under age two are exempt from the provisions of 256.34 section 256L.06, subdivision 3, paragraph (b), clause (3), 256.35 requiring disenrollment for failure to pay premiums. For 256.36 pregnant women, this exemption continues until the first day of 257.1 the month following the 60th day postpartum. Women who remain 257.2 enrolled during pregnancy or the postpartum period, despite 257.3 nonpayment of premiums, shall be disenrolled on the first of the 257.4 month following the 60th day postpartum for the penalty period 257.5 that otherwise applies under section 256L.06, unless they begin 257.6 paying premiums. 257.7 Sec. 103. Minnesota Statutes 1998, section 256L.15, 257.8 subdivision 1b, is amended to read: 257.9 Subd. 1b. [PAYMENTS NONREFUNDABLE.] Only MinnesotaCare 257.10 premiumsare not refundablepaid for future months of coverage 257.11 for which a health plan capitation fee has not been paid may be 257.12 refunded. 257.13 Sec. 104. Minnesota Statutes 1998, section 256L.15, 257.14 subdivision 2, is amended to read: 257.15 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 257.16 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 257.17 establish a sliding fee scale to determine the percentage of 257.18 gross individual or family income that households at different 257.19 income levels must pay to obtain coverage through the 257.20 MinnesotaCare program. The sliding fee scale must be based on 257.21 the enrollee's gross individual or family incomeduring the257.22previous four months. The sliding fee scale must contain 257.23 separate tables based on enrollment of one, two, or three or 257.24 more persons. The sliding fee scale begins with a premium of 257.25 1.5 percent of gross individual or family income for individuals 257.26 or families with incomes below the limits for the medical 257.27 assistance program for families and children in effect on 257.28 January 1, 1999, and proceeds through the following evenly 257.29 spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 257.30 percent. These percentages are matched to evenly spaced income 257.31 steps ranging from the medical assistance income limit for 257.32 families and children in effect on January 1, 1999, to 275 257.33 percent of the federal poverty guidelines for the applicable 257.34 family size, up to a family size of five. The sliding fee scale 257.35 for a family of five must be used for families of more than 257.36 five. The sliding fee scale and percentages are not subject to 258.1 the provisions of chapter 14. If a family or individual reports 258.2 increased income after enrollment, premiums shall not be 258.3 adjusted until eligibility renewal. 258.4 (b) Enrolled individuals and families whose gross annual 258.5 income increases above 275 percent of the federal poverty 258.6 guideline shall pay the maximum premium. The maximum premium is 258.7 defined as a base charge for one, two, or three or more 258.8 enrollees so that if all MinnesotaCare cases paid the maximum 258.9 premium, the total revenue would equal the total cost of 258.10 MinnesotaCare medical coverage and administration. In this 258.11 calculation, administrative costs shall be assumed to equal ten 258.12 percent of the total. The costs of medical coverage for 258.13 pregnant women and children under age two and the enrollees in 258.14 these groups shall be excluded from the total. The maximum 258.15 premium for two enrollees shall be twice the maximum premium for 258.16 one, and the maximum premium for three or more enrollees shall 258.17 be three times the maximum premium for one. 258.18 Sec. 105. Minnesota Statutes 1998, section 256L.15, 258.19 subdivision 3, is amended to read: 258.20 Subd. 3. [EXCEPTIONS TO SLIDING SCALE.] An annual premium 258.21 of $48 is required for all children in families with income at 258.22 or less than 150 percent of federal poverty guidelines. The 258.23 commissioner may reduce the annual premium to $30 for families 258.24 who choose to pay the premium on an annual basis. 258.25 SUBSIDIZED EMPLOYER HEALTH COVERAGE PROGRAM 258.26 Sec. 106. [256M.01] [DEFINITIONS.] 258.27 Subdivision 1. [APPLICABILITY.] For purposes of this 258.28 chapter, the terms defined in this section have the meanings 258.29 given them. 258.30 Subd. 2. [COMMISSIONER.] "Commissioner" means the 258.31 commissioner of human services. 258.32 Subd. 3. [EMPLOYER-SUBSIDIZED HEALTH 258.33 COVERAGE.] "Employer-subsidized health coverage" has the meaning 258.34 provided in section 256L.07, subdivision 2, paragraph (b). 258.35 (Effective date: Section 106 (256M.01) is effective 30 258.36 days following federal approval of the state plan under title 259.1 XXI and of the section 1115 waiver request in section 117, 259.2 paragraph (a).) 259.3 Sec. 107. [256M.03] [ELIGIBILITY FOR EMPLOYER-SUBSIDIZED 259.4 COVERAGE.] 259.5 Subdivision 1. [GENERAL REQUIREMENTS.] (a) A child who is 259.6 under the age of 19 and whose family gross income is equal to or 259.7 less than 275 percent of the federal poverty guidelines for the 259.8 applicable family size and who would otherwise be eligible for 259.9 coverage under the MinnesotaCare program, except for the 259.10 insurance-related barriers to enrollment under section 256L.07, 259.11 subdivisions 2 and 3, is eligible for subsidized payment of the 259.12 employee share of the employer-subsidized dependent health 259.13 coverage available to the child's family in accordance with 259.14 section 256M.05. 259.15 (b) To be eligible under this section, a child must not be 259.16 covered under employer-subsidized dependent health coverage at 259.17 the time of application. 259.18 Subd. 2. [EMPLOYER-SUBSIDIZED HEALTH COVERAGE.] To be 259.19 eligible for the premium payment under this chapter, the 259.20 employer-subsidized coverage offered to employees must meet the 259.21 benchmark coverage selected by the commissioner in accordance 259.22 with section 2103 of title XXI of the Social Security Act, 259.23 unless federal approval is received for the number two qualified 259.24 plan described in section 62E.06 or its actuarial equivalent. 259.25 The commissioner shall select the benchmark option with the 259.26 lowest actuarial value in section 2103(b) of title XXI of the 259.27 Social Security Act. 259.28 Subd. 3. [LOW-COST HEALTH PLAN OPTION.] If an employer 259.29 offers more than one health plan option to employees, 259.30 eligibility for subsidized premium payments shall be limited to 259.31 the lowest cost health plan option offered that serves the 259.32 geographic area in which the eligible child resides. 259.33 Subd. 4. [PROBATIONARY PERIOD.] If an employer has a 259.34 probationary period during which an employee or an employee's 259.35 dependent is not eligible for employer-subsidized health 259.36 coverage, the employee's dependent shall not be considered 260.1 eligible under this section until the employer's probationary 260.2 period is over. 260.3 (Effective date: Section 107 (256M.03) is effective 30 260.4 days following approval of the state plan under title XXI and of 260.5 the section 1115 waiver request described in section 117, 260.6 paragraph (a).) 260.7 Sec. 108. [256M.05] [PAYMENTS.] 260.8 Subdivision 1. [PREMIUMS.] Children who are eligible under 260.9 section 256M.03 shall pay a premium in accordance with the 260.10 MinnesotaCare sliding premium scale as specified in section 260.11 256L.15, except that children in families with income at or 260.12 below 150 percent of the federal poverty guidelines for the 260.13 applicable family size, shall not be required to pay an amount 260.14 in excess of the maximum monthly charge allowable under title 260.15 XXI of the Social Security Act, section 2103(e)(3)(A). The 260.16 commissioner shall inform the employer and the employee of the 260.17 premium owed by each eligible employee and the subsidy amount to 260.18 be paid by the department of human services. The employee shall 260.19 pay the employer the premium owed. The employer may deduct the 260.20 premium from the employee's paycheck. 260.21 Subd. 2. [PAYMENT TO EMPLOYER.] The commissioner shall pay 260.22 the employer the difference between the premiums paid by the 260.23 employee as specified under subdivision 1 and the cost of the 260.24 employee share of the employer-subsidized health coverage. 260.25 Payment of the employee share is limited to the amount of the 260.26 premium attributable to the cost of dependent coverage for the 260.27 eligible children, unless the amount of the premium for 260.28 dependent coverage does not differentiate between adult and 260.29 child dependents. 260.30 Subd. 3. [PAYMENTS TO HEALTH CARE PROVIDERS.] Any 260.31 copayments, deductibles, or coinsurance owed on behalf of an 260.32 eligible child under the employer's health plan shall be paid by 260.33 the commissioner to the health care provider. Payment shall be 260.34 made according to the usual and customary charges established 260.35 under the employer's health plan. The family is responsible for 260.36 notifying the health care provider that they are covered under 261.1 the subsidized employer health coverage program. The provider 261.2 must bill the commissioner for any copayment, deductible, or 261.3 coinsurance owed by the family for covered services provided to 261.4 the eligible child by the health care provider. Upon the 261.5 submission of a bill, the commissioner must promptly pay the 261.6 provider the amount of any copay, deductible, or coinsurance 261.7 owed on behalf of an eligible child plus an administrative fee 261.8 equal to one percent of the total amount paid by the 261.9 commissioner. 261.10 (Effective date: Section 108 (256M.05) is effective 30 261.11 days following federal approval of the state plan under title 261.12 XXI and of the section 1115 waiver request in section 117, 261.13 paragraph (a).) 261.14 Sec. 109. [256M.07] [APPLICATIONS.] 261.15 Subdivision 1. [AVAILABILITY.] Applicants may apply to the 261.16 commissioner or to the licensed insurance broker who provides 261.17 employee benefits to their employer. The licensed insurance 261.18 broker shall accept applications and forward them to the 261.19 commissioner for processing. 261.20 Subd. 2. [PROCESSING.] The commissioner shall determine an 261.21 applicant's initial eligibility. Applicants who from the 261.22 information provided on the application appear to meet the 261.23 eligibility requirements shall be enrolled without income 261.24 verification. 261.25 Subd. 3. [RENEWAL OF ELIGIBILITY.] An enrollee's 261.26 eligibility must be renewed every 12 months. Renewal of 261.27 eligibility may be completed by the licensed insurance broker. 261.28 Renewal applications must include income verification 261.29 information. 261.30 Subd. 4. [OUTREACH.] Any licensed insurance broker who 261.31 refers a family to the MinnesotaCare program in the process of 261.32 determining eligibility under this section shall be paid by the 261.33 commissioner a one-time application fee of $25 per referral if 261.34 any member of the family is determined to be eligible for the 261.35 MinnesotaCare program. 261.36 Subd. 5. [ADMINISTRATION.] The commissioner may contract 262.1 with a private entity to administer the subsidized employer 262.2 health coverage program. 262.3 (Effective date: Section 109 (256M.07) is effective 30 262.4 days following federal approval of the state plan under title 262.5 XXI and of the section 1115 waiver request in section 117, 262.6 paragraph (a).) 262.7 Sec. 110. Minnesota Statutes 1998, section 626.556, 262.8 subdivision 10i, is amended to read: 262.9 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 262.10 DETERMINATION OF MALTREATMENT.] (a) An individual or facility 262.11 that the commissioner or a local social service agency 262.12 determines has maltreated a child, or the child's designee, 262.13 regardless of the determination, who contests the investigating 262.14 agency's final determination regarding maltreatment, may request 262.15 the investigating agency to reconsider its final determination 262.16 regarding maltreatment. The request for reconsideration must be 262.17 submitted in writing to the investigating agency within 15 262.18 calendar days after receipt of notice of the final determination 262.19 regarding maltreatment. 262.20 (b) If the investigating agency denies the request or fails 262.21 to act upon the request within 15 calendar days after receiving 262.22 the request for reconsideration, the person or facility entitled 262.23 to a fair hearing under section 256.045 may submit to the 262.24 commissioner of human services a written request for a hearing 262.25 under that section. 262.26 (c) If, as a result of the reconsideration, the 262.27 investigating agency changes the final determination of 262.28 maltreatment, that agency shall notify the parties specified in 262.29 subdivisions 10b, 10d, and 10f. 262.30 (d) If an individual or facility contests the investigating 262.31 agency's final determination regarding maltreatment by 262.32 requesting a fair hearing under section 256.045, the 262.33 commissioner of human services shall assure that the hearing is 262.34 conducted and a decision is reached within 90 days of receipt of 262.35 the request for a hearing. The time for action on the decision 262.36 may be extended for as many days as the hearing is postponed or 263.1 the record is held open for the benefit of either party. 263.2 Sec. 111. Laws 1995, chapter 178, article 2, section 46, 263.3 subdivision 10, is amended to read: 263.4 Subd. 10. [ADDITIONAL WAIVER REQUEST FOR EMPLOYED DISABLED 263.5 PERSONS.] The commissioner shall seek a federal waiver in order 263.6 to implement a work incentive for disabled personseligible for263.7medical assistancewho are not residents of long-term care 263.8 facilities when determining their eligibility for medical 263.9 assistance. The waiver shall request authorization to establish 263.10 a medical assistance earned income disregard for employed 263.11 disabled persons who, but for earned income, are eligible for 263.12 SSDI and whoreceiverequire personal care assistance under the 263.13 Medical Assistance Program. The disregard shall be equivalent 263.14 to the threshold amount applied to persons who qualify under 263.15 section 1619(b) of the Social Security Act, except that when a 263.16 disabled person's earned income reaches the maximum income 263.17 permitted at the threshold under section 1619(b), the person 263.18 shall retain medical assistance eligibility and must contribute 263.19 to the costs of medical care on a sliding fee basis. 263.20 Sec. 112. [CHARITY CARE DATA COLLECTION.] 263.21 The commissioner of health shall determine a definition for 263.22 charity care and bad debt that distinguishes these two terms for 263.23 inpatient and ambulatory care. The commissioner shall use these 263.24 definitions as a basis for collecting data on uncompensated care 263.25 in hospitals, surgical centers, and health care clinics located 263.26 within the seven-county metropolitan area. 263.27 Sec. 113. [MINNESOTACARE APPLICATION SIMPLIFICATION.] 263.28 The commissioner of human services shall develop a one page 263.29 preapplication form for the MinnesotaCare program and may 263.30 develop a pilot project that involves using this form in 263.31 community health clinics, community health offices, and 263.32 disproportionate share hospitals to determine the feasibility of 263.33 using a one page application form for MinnesotaCare. As part of 263.34 this pilot project, the commissioner shall track the number of 263.35 individuals determined to be eligible from the preapplication 263.36 form, the number determined to be eligible upon the completion 264.1 of the full application, and for families with children the cost 264.2 of providing the care to those found eligible. 264.3 Sec. 114. [EXPANSION OF SPECIAL EDUCATION SERVICES.] 264.4 The commissioner of human services shall examine 264.5 opportunities to expand the scope of providers eligible for 264.6 reimbursement for medical assistance services listed in a 264.7 child's individual education plan based on state and federal 264.8 requirements for provider qualifications. The commissioner 264.9 shall complete these activities, in consultation with the 264.10 commissioner of children, families, and learning, by December 264.11 1999 and seek necessary federal approval. 264.12 Sec. 115. [HOME-BASED MENTAL HEALTH SERVICES.] 264.13 By January 1, 2000, the commissioner of human services 264.14 shall amend Minnesota Rules under the expedited process of 264.15 Minnesota Statutes, section 14.389, to effect the following 264.16 changes: 264.17 (1) amend Minnesota Rules, part 9505.0324, subpart 2, to 264.18 permit a county board to contract with any agency qualified 264.19 under Minnesota Rules, part 9505.0324, subparts 4 and 5, as an 264.20 eligible provider of home-based mental health services; 264.21 (2) amend Minnesota Rules, part 9505.0324, subpart 2, to 264.22 permit children's mental health collaboratives approved by the 264.23 children's cabinet under Minnesota Statutes, section 245.493, to 264.24 provide or to contract with any agency qualified under Minnesota 264.25 Rules, part 9505.0324, subparts 4 and 5, as an eligible provider 264.26 of home-based mental health services. 264.27 Sec. 116. [AMENDING MEDICAL ASSISTANCE RULES.] 264.28 By January 1, 2001, the commissioner of human services 264.29 shall amend Minnesota Rules, parts 9505.0323; 9505.0324; 264.30 9505.0326; and 9505.0327, as necessary to implement the changes 264.31 outlined in Minnesota Statutes, section 256B.0625, subdivision 264.32 35. 264.33 Sec. 117. [WAIVER REQUEST.] 264.34 (a) The commissioner of human services shall seek federal 264.35 approval for a waiver under section 1115 of the Social Security 264.36 Act to obtain federal financial participation under title XIX 265.1 for children in the subsidized employer health coverage program 265.2 whose premium obligation under the MinnesotaCare sliding premium 265.3 scale would exceed five percent of gross family income. 265.4 (b) The commissioner of human services shall seek federal 265.5 approval for a waiver under section 1115 of the Social Security 265.6 Act to allow, at the family's option, federal financial 265.7 participation under title XIX for subsidized employer health 265.8 coverage for a Medicaid-eligible child who has a sibling 265.9 eligible for the subsidized employer health coverage program. 265.10 (c) The commissioner of human services shall seek federal 265.11 approval for a waiver under title XXI of the Social Security Act 265.12 for authority to obtain federal financial participation for 265.13 health coverage for the employee's spouse when an employer 265.14 offers family coverage. 265.15 (d) The commissioner of human services shall seek federal 265.16 approval for a modification of the health care reform waiver 265.17 under section 1115 of the Social Security Act to permit the use 265.18 of copayments instead of premium payments for low-income 265.19 enrollees in the MinnesotaCare program. 265.20 Sec. 118. [MEDICARE SUPPLEMENTAL COVERAGE FOR LOW-INCOME 265.21 SENIORS.] 265.22 The commissioner of health, in consultation with the 265.23 commissioners of human services and commerce, shall study the 265.24 extent and type of Medicare supplemental coverage for low-income 265.25 seniors. The commissioner shall also study the qualified 265.26 Medicare beneficiaries eligible under Minnesota Statutes, 265.27 section 256B.057, subdivision 3, in terms of developing a 265.28 comprehensive set of services to supplement Medicare that these 265.29 individuals may need to ensure independence and control of their 265.30 lives. The commissioner shall make recommendations on the 265.31 cost-effectiveness of expanding the benefits offered to 265.32 qualified Medicare beneficiaries including the feasibility of 265.33 the state providing health care coverage options to low-income 265.34 seniors that would provide a comprehensive set of services and 265.35 would build on existing or new Medicare products. The 265.36 commissioner shall also study the fiscal impact of mandating 266.1 coverage for Medicare supplemental products to include long-term 266.2 care services, including home health services, homemaker 266.3 services, and nursing facilities services and the fiscal 266.4 implications of the state paying the premiums for this coverage 266.5 for low-income seniors, including potential savings to the 266.6 medical assistance program. The commissioner shall report to 266.7 the legislature on the findings of the study with any 266.8 recommendations by January 15, 2000. 266.9 Sec. 119. [DENTAL ACCESS STUDY.] 266.10 The commissioner of human services, in consultation with 266.11 the commissioner of health, dental care providers, community 266.12 clinics, client advocacy groups, and counties, shall review the 266.13 dental access problem, evaluate the effects of the dental access 266.14 initiatives adopted by the 1999 legislature, and make 266.15 recommendations on other actions that could improve dental 266.16 access for public program recipients. The commissioner shall 266.17 submit a progress report by January 15, 2000, and a final report 266.18 to the legislature by January 15, 2001. 266.19 Sec. 120. [REPORT ON RATE SETTING AND RISK ADJUSTMENT.] 266.20 The commissioner of human services shall report to the 266.21 legislature, by January 15, 2000, on the current rate setting 266.22 process for state prepaid health care programs, rate setting and 266.23 risk adjustment methods in other states, and the results of the 266.24 application of risk adjustment on a trial basis in Minnesota for 266.25 calendar year 1999. The report must also present an analysis of 266.26 the feasibility of requiring prepaid health plans to report 266.27 vendor costs rather than charges, an analysis of capitation rate 266.28 equalization for MinnesotaCare and the prepaid medical 266.29 assistance program, an analysis of the fiscal impact on state 266.30 and county government if Minnesota Statutes 1998, section 266.31 256B.69, subdivision 5d is repealed, and recommendations for 266.32 providing actuarial and market analyses related to setting 266.33 prepaid health plan rates to the legislature on a timely basis 266.34 that would allow this information to be used in the 266.35 appropriations process. 266.36 Sec. 121. [REPORT ON PREPAID MEDICAL ASSISTANCE PROGRAM.] 267.1 The commissioner of human services shall present 267.2 recommendations to the legislature, by December 15, 1999, on 267.3 methods for implementing county board authority under the 267.4 prepaid medical assistance program. 267.5 Sec. 122. [PHYSICIAN AND PROFESSIONAL SERVICES PAYMENT 267.6 METHODOLOGY CONVERSION.] 267.7 The commissioner of human services shall submit a proposal 267.8 to the legislature by January 15, 2000, detailing the medical 267.9 assistance physician and professional services payment 267.10 methodology conversion to resource based relative value scale. 267.11 Sec. 123. [REPEALER.] 267.12 Minnesota Statutes 1998, sections 256B.74, subdivisions 2 267.13 and 5; and 462A.208, are repealed. 267.14 Sec. 124. [EFFECTIVE DATE.] 267.15 When preparing the conference committee report for adoption 267.16 by the legislature, the revisor shall combine all effective date 267.17 notations in this article into this effective date section. 267.18 ARTICLE 5 267.19 STATE-OPERATED SERVICES; 267.20 CHEMICAL DEPENDENCY; MENTAL HEALTH; LAND CONVEYANCES 267.21 Section 1. Minnesota Statutes 1998, section 16C.10, 267.22 subdivision 5, is amended to read: 267.23 Subd. 5. [SPECIFIC PURCHASES.] The solicitation process 267.24 described in this chapter is not required for acquisition of the 267.25 following: 267.26 (1) merchandise for resale purchased under policies 267.27 determined by the commissioner; 267.28 (2) farm and garden products which, as determined by the 267.29 commissioner, may be purchased at the prevailing market price on 267.30 the date of sale; 267.31 (3) goods and services from the Minnesota correctional 267.32 facilities; 267.33 (4) goods and services from rehabilitation facilities and 267.34 sheltered workshops that are certified by the commissioner of 267.35 economic security; 267.36 (5) goods and services for use by a community-based 268.1residentialfacility operated by the commissioner of human 268.2 services; 268.3 (6) goods purchased at auction or when submitting a sealed 268.4 bid at auction provided that before authorizing such an action, 268.5 the commissioner consult with the requesting agency to determine 268.6 a fair and reasonable value for the goods considering factors 268.7 including, but not limited to, costs associated with submitting 268.8 a bid, travel, transportation, and storage. This fair and 268.9 reasonable value must represent the limit of the state's bid; 268.10 and 268.11 (7) utility services where no competition exists or where 268.12 rates are fixed by law or ordinance. 268.13 Sec. 2. Minnesota Statutes 1998, section 245.462, 268.14 subdivision 4, is amended to read: 268.15 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 268.16 "Casemanagermanagement service provider" meansan individuala 268.17 case manager or case manager associate employed by the county or 268.18 other entity authorized by the county board to provide case 268.19 management services specified in section 245.4711. 268.20 A case manager must have a bachelor's degree in one of the 268.21 behavioral sciences or related fields including, but not limited 268.22 to, social work, psychology, or nursing from an accredited 268.23 college or universityand. A case manager must have at least 268.24 2,000 hours of supervised experience in the delivery of services 268.25 to adults with mental illness, must be skilled in the process of 268.26 identifying and assessing a wide range of client needs, and must 268.27 be knowledgeable about local community resources and how to use 268.28 those resources for the benefit of the client.The case manager268.29shall meet in person with a mental health professional at least268.30once each month to obtain clinical supervision of the case268.31manager's activities. Case managers with a bachelor's degree268.32but without 2,000 hours of supervised experience in the delivery268.33of services to adults with mental illness must complete 40 hours268.34of training approved by the commissioner of human services in268.35case management skills and in the characteristics and needs of268.36adults with serious and persistent mental illness and must269.1receive clinical supervision regarding individual service269.2delivery from a mental health professional at least once each269.3week until the requirement of 2,000 hours of supervised269.4experience is met. Clinical supervision must be documented in269.5the client record.269.6 (b) Supervision for a case manager during the first year of 269.7 service providing case management services shall be one hour per 269.8 week of clinical supervision from a case management supervisor. 269.9 After the first year, the case manager shall receive regular 269.10 ongoing supervision totaling 38 hours per year, of which at 269.11 least one hour per month must be clinical supervision regarding 269.12 individual service delivery with a case management supervisor. 269.13 The remainder may be provided by a case manager with two years 269.14 of experience. Group supervision may not constitute more than 269.15 one-half of the required supervision hours. Clinical 269.16 supervision must be documented in the client record. 269.17 (c) A case manager with a bachelor's degree who is not 269.18 licensed, registered, or certified by a health-related licensing 269.19 board must receive 30 hours of continuing education and training 269.20 in mental illness and mental health services annually. 269.21 (d) A case manager with a bachelor's degree but without 269.22 2,000 hours of supervised experience described in paragraph (a), 269.23 must complete 40 hours of training approved by the commissioner 269.24 covering case management skills and the characteristics and 269.25 needs of adults with serious and persistent mental illness. 269.26 (e) Case managers without a bachelor's degree must meet one 269.27 of the requirements in clauses (1) to (3): 269.28 (1) have three or four years of experience as a case 269.29 manager associate; 269.30 (2) be a registered nurse without a bachelor's degree and 269.31 have a combination of specialized training in psychiatry and 269.32 work experience consisting of community interaction and 269.33 involvement or community discharge planning in a mental health 269.34 setting totaling three years; or 269.35 (3) be a person who qualified as a case manager under the 269.36 1998 department of human services federal waiver provision and 270.1 meet the continuing education and mentoring requirements in this 270.2 section. 270.3 (f) A case manager associate must work under the direction 270.4 of a case manager or case management supervisor and must be 21 270.5 years of age. A case manager associate must also have a high 270.6 school diploma and meet one of the following criteria: 270.7 (1) have an associate of arts degree in one of the 270.8 behavioral sciences or human services; 270.9 (2) be a registered nurse without a bachelor's degree; 270.10 (3) within the previous ten years, have three years of life 270.11 experience with serious and persistent mental illness as defined 270.12 in section 245.462, subdivision 20, or as a child had severe 270.13 emotional disturbance, as defined in section 245.4871, 270.14 subdivision 6, or three years of life experience as a primary 270.15 caregiver to an adult with serious and persistent mental illness 270.16 within the previous ten years; 270.17 (4) have 6,000 hours work experience as a nondegreed state 270.18 hospital technician; or 270.19 (5) be a mental health practitioner as defined in section 270.20 245.462, subdivision 17, clause (2). 270.21 Individuals meeting one of the criteria in clauses (1) to 270.22 (4) may qualify as a case manager after four years of supervised 270.23 work experience as a case manager associate. Individuals 270.24 meeting the criteria in clause (5) may qualify as a case manager 270.25 after three years of supervised experience as a case manager 270.26 associate. 270.27 Case management associates must have 40 hours preservice 270.28 training under paragraph (d) and receive at least 40 hours of 270.29 continuing education in mental illness and mental health 270.30 services annually. Case manager associates shall receive at 270.31 least five hours of mentoring per week from a case management 270.32 mentor. A "case management mentor" means a qualified, 270.33 practicing case manager or case management supervisor who 270.34 teaches or advises and provides intensive training and clinical 270.35 supervision to one or more case manager associates. Mentoring 270.36 may occur while providing direct services to consumers in the 271.1 office or in the field and may be provided to individuals or 271.2 groups of case manager associates. At least two mentoring hours 271.3 per week must be individual and face-to-face. 271.4 (g) A case management supervisor must meet the criteria for 271.5 mental health professionals, as specified in section 245.462, 271.6 subdivision 18. 271.7Until June 30, 1999,(h) An immigrant who does not have the 271.8 qualifications specified in this subdivision may provide case 271.9 management services to adult immigrants with serious and 271.10 persistent mental illness who are members of the same ethnic 271.11 group as the case manager if the person: (1) is currently 271.12 enrolled in and is actively pursuing credits toward the 271.13 completion of a bachelor's degree in one of the behavioral 271.14 sciences or a related field including, but not limited to, 271.15 social work, psychology, or nursing from an accredited college 271.16 or university; (2) completes 40 hours of training as specified 271.17 in this subdivision; and (3) receives clinical supervision at 271.18 least once a week until the requirements of this subdivision are 271.19 met. 271.20(b) The commissioner may approve waivers submitted by271.21counties to allow case managers without a bachelor's degree but271.22with 6,000 hours of supervised experience in the delivery of271.23services to adults with mental illness if the person:271.24(1) meets the qualifications for a mental health271.25practitioner in subdivision 26;271.26(2) has completed 40 hours of training approved by the271.27commissioner in case management skills and in the271.28characteristics and needs of adults with serious and persistent271.29mental illness; and271.30(3) demonstrates that the 6,000 hours of supervised271.31experience are in identifying functional needs of persons with271.32mental illness, coordinating assessment information and making271.33referrals to appropriate service providers, coordinating a271.34variety of services to support and treat persons with mental271.35illness, and monitoring to ensure appropriate provision of271.36services. The county board is responsible to verify that all272.1qualifications, including content of supervised experience, have272.2been met.272.3 Sec. 3. Minnesota Statutes 1998, section 245.462, 272.4 subdivision 17, is amended to read: 272.5 Subd. 17. [MENTAL HEALTH PRACTITIONER.] "Mental health 272.6 practitioner" means a person providing services to persons with 272.7 mental illness who is qualified in at least one of the following 272.8 ways: 272.9 (1) holds a bachelor's degree in one of the behavioral 272.10 sciences or related fields from an accredited college or 272.11 university and: 272.12 (i) has at least 2,000 hours of supervised experience in 272.13 the delivery of services to persons with mental illness; or 272.14 (ii) is fluent in the non-English language of the ethnic 272.15 group to which at least 50 percent of the practitioner's clients 272.16 belong, completes 40 hours of training in the delivery of 272.17 services to persons with mental illness, and receives clinical 272.18 supervision from a mental health professional at least once a 272.19 week until the requirement of 2,000 hours of supervised 272.20 experience is met; 272.21 (2) has at least 6,000 hours of supervised experience in 272.22 the delivery of services to persons with mental illness; 272.23 (3) is a graduate student in one of the behavioral sciences 272.24 or related fields and is formally assigned by an accredited 272.25 college or university to an agency or facility for clinical 272.26 training; or 272.27 (4) holds a master's or other graduate degree in one of the 272.28 behavioral sciences or related fields from an accredited college 272.29 or university and has less than 4,000 hours post-master's 272.30 experience in the treatment of mental illness. 272.31 Sec. 4. Minnesota Statutes 1998, section 245.4711, 272.32 subdivision 1, is amended to read: 272.33 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 272.34 (a) By January 1, 1989, the county board shall provide case 272.35 management services for all adults with serious and persistent 272.36 mental illness who are residents of the county and who request 273.1 or consent to the services and to each adult for whom the court 273.2 appoints a case manager. Staffing ratios must be sufficient to 273.3 serve the needs of the clients. The case manager must meet the 273.4 requirements in section 245.462, subdivision 4. 273.5 (b) Case management services provided to adults with 273.6 serious and persistent mental illness eligible for medical 273.7 assistance must be billed to the medical assistance program 273.8 under sections 256B.02, subdivision 8, and 256B.0625. 273.9 (c) Case management services are eligible for reimbursement 273.10 under the medical assistance program. Costs associated with 273.11 mentoring, supervision, and continuing education may be included 273.12 in the reimbursement rate methodology used for case management 273.13 services under the medical assistance program. 273.14 Sec. 5. Minnesota Statutes 1998, section 245.4712, 273.15 subdivision 2, is amended to read: 273.16 Subd. 2. [DAY TREATMENT SERVICES PROVIDED.] (a) Day 273.17 treatment services must be developed as a part of the community 273.18 support services available to adults with serious and persistent 273.19 mental illness residing in the county. Adults may be required 273.20 to pay a fee according to section 245.481. Day treatment 273.21 services must be designed to: 273.22 (1) provide a structured environment for treatment; 273.23 (2) provide support for residing in the community; 273.24 (3) prevent placement in settings that are more intensive, 273.25 costly, or restrictive than necessary and appropriate to meet 273.26 client need; 273.27 (4) coordinate with or be offered in conjunction with a 273.28 local education agency's special education program; and 273.29 (5) operate on a continuous basis throughout the year. 273.30 (b) For purposes of complying with medical assistance 273.31 requirements, an adult day treatment program may choose among 273.32 the methods of clinical supervision specified in: 273.33 (1) Minnesota Rules, part 9505.0323, subpart 1, item F; 273.34 (2) Minnesota Rules, part 9505.0324, subpart 6, item F; or 273.35 (3) Minnesota Rules, part 9520.0800, subparts 2 to 6. 273.36 A day treatment program may demonstrate compliance with 274.1 these clinical supervision requirements by obtaining 274.2 certification from the commissioner under Minnesota Rules, parts 274.3 9520.0750 to 9520.0870, or by documenting in its own records 274.4 that it complies with one of the above methods. 274.5 (c) County boards may request a waiver from including day 274.6 treatment services if they can document that: 274.7 (1) an alternative plan of care exists through the county's 274.8 community support services for clients who would otherwise need 274.9 day treatment services; 274.10 (2) day treatment, if included, would be duplicative of 274.11 other components of the community support services; and 274.12 (3) county demographics and geography make the provision of 274.13 day treatment services cost ineffective and infeasible. 274.14 Sec. 6. Minnesota Statutes 1998, section 245.4871, 274.15 subdivision 4, is amended to read: 274.16 Subd. 4. [CASEMANAGERMANAGEMENT SERVICE PROVIDER.] (a) 274.17 "Casemanagermanagement service provider" meansan individuala 274.18 case manager or case manager associate employed by the county or 274.19 other entity authorized by the county board to provide case 274.20 management services specified in subdivision 3 for the child 274.21 with severe emotional disturbance and the child's family. A 274.22 case manager must have experience and training in working with 274.23 children. 274.24 (b) A case manager must: 274.25 (1) have at least a bachelor's degree in one of the 274.26 behavioral sciences or a related field including, but not 274.27 limited to, social work, psychology, or nursing from an 274.28 accredited college or university; 274.29 (2) have at least 2,000 hours of supervised experience in 274.30 the delivery of mental health services to children; 274.31 (3) have experience and training in identifying and 274.32 assessing a wide range of children's needs; and 274.33 (4) be knowledgeable about local community resources and 274.34 how to use those resources for the benefit of children and their 274.35 families. 274.36 (c) The case manager may be a member of any professional 275.1 discipline that is part of the local system of care for children 275.2 established by the county board. 275.3 (d) The case managermust meet in person with a mental275.4health professional at least once each month to obtain clinical275.5supervisionshall receive regular ongoing supervision totaling 275.6 38 hours per year, of which at least one hour per month must be 275.7 clinical supervision regarding individual service delivery with 275.8 a case management supervisor. The remainder may be provided by 275.9 a case manager with two years of experience. Group supervision 275.10 may not constitute more than one-half of the required 275.11 supervision hours. 275.12 (e) Case managers with a bachelor's degree but without 275.13 2,000 hours of supervised experience in the delivery of mental 275.14 health services to children with emotional disturbance must: 275.15 (1) begin 40 hours of training approved by the commissioner 275.16 of human services in case management skills and in the 275.17 characteristics and needs of children with severe emotional 275.18 disturbance before beginning to provide case management 275.19 services; and 275.20 (2) receive clinical supervision regarding individual 275.21 service delivery from a mental health professional at leastonce275.22 one hour each week until the requirement of 2,000 hours of 275.23 experience is met. 275.24 (f) Clinical supervision must be documented in the child's 275.25 record. When the case manager is not a mental health 275.26 professional, the county board must provide or contract for 275.27 needed clinical supervision. 275.28 (g) The county board must ensure that the case manager has 275.29 the freedom to access and coordinate the services within the 275.30 local system of care that are needed by the child. 275.31 (h) Case managers who have a bachelor's degree but are not 275.32 licensed, registered, or certified by a health-related licensing 275.33 board must receive 30 hours of continuing education and training 275.34 in severe emotional disturbance and mental health services 275.35 annually. 275.36 (i) Case managers without a bachelor's degree must meet one 276.1 of the requirements in clauses (1) to (3): 276.2 (1) have three or four years of experience as a case 276.3 manager associate; 276.4 (2) be a registered nurse without a bachelor's degree who 276.5 has a combination of specialized training in psychiatry and work 276.6 experience consisting of community interaction and involvement 276.7 or community discharge planning in a mental health setting 276.8 totaling three years; or 276.9 (3) be a person who qualified as a case manager under the 276.10 1998 department of human services federal waiver provision and 276.11 meets the continuing education and mentoring requirements in 276.12 this section. 276.13 (j) A case manager associate (CMA) must work under the 276.14 direction of a case manager or case management supervisor and 276.15 must be 21 years of age. A case manager associate must also 276.16 have a high school diploma and meet one of the following 276.17 criteria: 276.18 (1) have an associate of arts degree in one of the 276.19 behavioral sciences or human services; 276.20 (2) be a registered nurse without a bachelor's degree; 276.21 (3) have three years of life experience as a primary 276.22 caregiver to a child with serious emotional disturbance as 276.23 defined in section 245.4871, subdivision 6, within the last ten 276.24 years; 276.25 (4) have 6,000 hours work experience as a nondegreed state 276.26 hospital technician; or 276.27 (5) be a mental health practitioner as defined in section 276.28 245.462, subdivision 17, clause (2). 276.29 Individuals meeting one of the criteria in clauses (1) to 276.30 (4) may qualify as a case manager after four years of supervised 276.31 work experience as a case manager associate. Individuals 276.32 meeting the criteria in clause (5) may qualify as a case manager 276.33 after three years of supervised experience as a case manager 276.34 associate. 276.35 Case manager associates must have 40 hours of preservice 276.36 training under paragraph (e), clause (1), and receive at least 277.1 40 hours of continuing education in severe emotional disturbance 277.2 and mental health service annually. Case manager associates 277.3 shall receive at least five hours of mentoring per week from a 277.4 case management mentor. A "case management mentor" means a 277.5 qualified, practicing case manager or case management supervisor 277.6 who teaches or advises and provides intensive training and 277.7 clinical supervision to one or more case manager associates. 277.8 Mentoring may occur while providing direct services to consumers 277.9 in the office or in the field and may be provided to individuals 277.10 or groups of case manager associates. At least two mentoring 277.11 hours per week must be individual and face-to-face. 277.12 (k) A case management supervisor must meet the criteria for 277.13 a mental health professional as specified in section 245.4871, 277.14 subdivision 27. 277.15Until June 30, 1999,(l) An immigrant who does not have the 277.16 qualifications specified in this subdivision may provide case 277.17 management services to child immigrants with severe emotional 277.18 disturbance of the same ethnic group as the immigrant if the 277.19 person: 277.20 (1) is currently enrolled in and is actively pursuing 277.21 credits toward the completion of a bachelor's degree in one of 277.22 the behavioral sciences or related fields at an accredited 277.23 college or university; 277.24 (2) completes 40 hours of training as specified in this 277.25 subdivision; and 277.26 (3) receives clinical supervision at least once a week 277.27 until the requirements of obtaining a bachelor's degree and 277.28 2,000 hours of supervised experience are met. 277.29(i) The commissioner may approve waivers submitted by277.30counties to allow case managers without a bachelor's degree but277.31with 6,000 hours of supervised experience in the delivery of277.32services to children with severe emotional disturbance if the277.33person:277.34(1) meets the qualifications for a mental health277.35practitioner in subdivision 26;277.36(2) has completed 40 hours of training approved by the278.1commissioner in case management skills and in the278.2characteristics and needs of children with severe emotional278.3disturbance; and278.4(3) demonstrates that the 6,000 hours of supervised278.5experience are in identifying functional needs of children with278.6severe emotional disturbance, coordinating assessment278.7information and making referrals to appropriate service278.8providers, coordinating a variety of services to support and278.9treat children with severe emotional disturbance, and monitoring278.10to ensure appropriate provision of services. The county board278.11is responsible to verify that all qualifications, including278.12content of supervised experience, have been met.278.13 Sec. 7. Minnesota Statutes 1998, section 245.4871, 278.14 subdivision 26, is amended to read: 278.15 Subd. 26. [MENTAL HEALTH PRACTITIONER.] "Mental health 278.16 practitioner" means a person providing services to children with 278.17 emotional disturbances. A mental health practitioner must have 278.18 training and experience in working with children. A mental 278.19 health practitioner must be qualified in at least one of the 278.20 following ways: 278.21 (1) holds a bachelor's degree in one of the behavioral 278.22 sciences or related fields from an accredited college or 278.23 university and: 278.24 (i) has at least 2,000 hours of supervised experience in 278.25 the delivery of mental health services to children with 278.26 emotional disturbances; or 278.27 (ii) is fluent in the non-English language of the ethnic 278.28 group to which at least 50 percent of the practitioner's clients 278.29 belong, completes 40 hours of training in the delivery of 278.30 services to children with emotional disturbances, and receives 278.31 clinical supervision from a mental health professional at least 278.32 once a week until the requirement of 2,000 hours of supervised 278.33 experience is met; 278.34 (2) has at least 6,000 hours of supervised experience in 278.35 the delivery of mental health services to children with 278.36 emotional disturbances; 279.1 (3) is a graduate student in one of the behavioral sciences 279.2 or related fields and is formally assigned by an accredited 279.3 college or university to an agency or facility for clinical 279.4 training; or 279.5 (4) holds a master's or other graduate degree in one of the 279.6 behavioral sciences or related fields from an accredited college 279.7 or university and has less than 4,000 hours post-master's 279.8 experience in the treatment of emotional disturbance. 279.9 Sec. 8. Minnesota Statutes 1998, section 245.4881, 279.10 subdivision 1, is amended to read: 279.11 Subdivision 1. [AVAILABILITY OF CASE MANAGEMENT SERVICES.] 279.12 (a) By April 1, 1992, the county board shall provide case 279.13 management services for each child with severe emotional 279.14 disturbance who is a resident of the county and the child's 279.15 family who request or consent to the services. Staffing ratios 279.16 must be sufficient to serve the needs of the clients. The case 279.17 manager must meet the requirements in section 245.4871, 279.18 subdivision 4. 279.19 (b) Except as permitted by law and the commissioner under 279.20 demonstration projects, case management services provided to 279.21 children with severe emotional disturbance eligible for medical 279.22 assistance must be billed to the medical assistance program 279.23 under sections 256B.02, subdivision 8, and 256B.0625. 279.24 (c) Case management services are eligible for reimbursement 279.25 under the medical assistance program. Costs of mentoring, 279.26 supervision, and continuing education may be included in the 279.27 reimbursement rate methodology used for case management services 279.28 under the the medical assistance program. 279.29 Sec. 9. [246.0136] [TRANSITION OF REGIONAL TREATMENT 279.30 CENTERS AND OTHER STATE-OPERATED SERVICES.] 279.31 Beginning with the 2000-2001 biennium the commissioner of 279.32 human services is directed to establish enterprise activities 279.33 within state-operated services. Enterprise activities are 279.34 defined as the range of services needed by people with 279.35 disabilities, which are delivered by state employees, and are 279.36 fully funded by public or private third-party health insurance 280.1 or other revenue sources that are available to the client that 280.2 provide reimbursement for the care provided. State-operated 280.3 services shall specialize in caring for vulnerable people for 280.4 whom no other providers are available or for whom state-operated 280.5 services may be the provider selected by the payer. The 280.6 commissioner shall determine prior to the biennial budget 280.7 request the programs or services within state-operated services 280.8 that may be transitioned to enterprise activities. Prior to the 280.9 implementation of the enterprise activity, the commissioner 280.10 shall demonstrate that there is public or private third-party 280.11 health insurance or other revenue available to the individuals 280.12 served, that the revenues collected fully fund the services, and 280.13 that there are sufficient funds for cash flow purposes. In 280.14 subsequent biennia the base state appropriation for 280.15 state-operated services will be reduced proportionate to the 280.16 size of the enterprise activity. Implementation of enterprise 280.17 activities shall not limit access to services by vulnerable 280.18 populations served by state-operated services. 280.19 Implementation will include consultation with stakeholders 280.20 including county boards, county social service agencies, 280.21 consumers, families, advocates, local mental health advisory 280.22 councils, local private and public providers, representatives of 280.23 state public employee bargaining units, and other affected state 280.24 and local agencies. All enterprise activities must conform with 280.25 collective bargaining agreements negotiated on behalf of 280.26 employees by their exclusive representatives. Implementation 280.27 shall include consideration of: 280.28 (1) creating public or private partnerships to facilitate 280.29 client access to needed services; 280.30 (2) administrative simplification and efficiencies 280.31 throughout the state-operated services system; 280.32 (3) creating a public group practice for state-operated 280.33 medical staff to increase flexibility in meeting client needs 280.34 and maximize third-party reimbursement; 280.35 (4) converting or disposing of buildings not utilized and 280.36 surplus land; and 281.1 (5) exploring the efficiencies and benefits of establishing 281.2 state-operated services as an independent state agency. 281.3 The commissioner of human services shall submit a report to 281.4 the legislature each January throughout a six-year 281.5 implementation period. 281.6 Sec. 10. Minnesota Statutes 1998, section 246.18, 281.7 subdivision 6, is amended to read: 281.8 Subd. 6. [COLLECTIONS DEDICATED.]Except for281.9state-operated programs and services funded through a direct281.10appropriation from the legislature, money received within the281.11regional treatment center system for the following281.12state-operated services is dedicated to the commissioner for the281.13provision of those services:281.14(1) community-based residential and day training and281.15habilitation services for mentally retarded persons;281.16(2) community health clinic services;281.17(3) accredited hospital outpatient department services;281.18(4) certified rehabilitation agency and rehabilitation281.19hospital services; or281.20(5) community-based transitional support services for281.21adults with serious and persistent mental illness.Except for 281.22 state-operated programs funded through a direct appropriation 281.23 from the legislature, any state-operated program or service 281.24 established and operated as an enterprise activity, shall retain 281.25 the revenues earned in an interest-bearing account. 281.26 When the commissioner determines the intent to transition 281.27 from a direct appropriation to enterprise activity, all 281.28 collections for the targeted state-operated service shall be 281.29 retained and deposited into an interest-bearing account. At the 281.30 end of the fiscal year, prior to establishing the enterprise 281.31 activity, collections up to the amount of the appropriation for 281.32 the targeted service shall be deposited to the general fund. 281.33 All funds in excess of the amount of the appropriation will be 281.34 retained and used by the enterprise activity for cash flow 281.35 purposes. 281.36 These funds must be deposited in the state treasury in a 282.1 revolving account and funds in the revolving account are 282.2 appropriated to the commissioner to operate the services 282.3 authorized, and any unexpended balances do not cancel but are 282.4 available until spent. 282.5 Sec. 11. Minnesota Statutes 1998, section 252.46, 282.6 subdivision 6, is amended to read: 282.7 Subd. 6. [VARIANCES.] (a) A variance from the minimum or 282.8 maximum payment rates in subdivisions 2 and 3 may be granted by 282.9 the commissioner when the vendor requests and the county board 282.10 submits to the commissioner a written variance request on forms 282.11 supplied by the commissioner with the recommended payment rates. 282.12 (b) A variance to the rate maximum may be utilized for 282.13 costs associated with compliance with state administrative 282.14 rules, compliance with court orders, capital costs required for 282.15 continued licensure, increased insurance costs, start-up and 282.16 conversion costs for supported employment, direct service staff 282.17 salaries and benefits, transportation, and other program related 282.18 costs whenanyone of thecriteriacriterion in clauses (1) to 282.19 (4) is also met: 282.20(1) change is necessary to comply with licensing citations;282.21(2) a licensed vendor currently serving fewer than 70282.22persons with payment rates of 80 percent or less of the282.23statewide average rates and with clients meeting the behavioral282.24or medical criteria under clause (3) approved by the282.25commissioner as a significant program change under section282.26252.28;282.27(3)(1) A determination of need under section 252.28 is 282.28 approved for a significant program changeis approved by the282.29commissioner under section 252.28that is necessary for a vendor 282.30 to provide authorized services toa new client or clients with282.31very severe self-injurious or assaultive behavior, or medical282.32conditions requiring delivery of physician-prescribed medical282.33interventions requiring one-to-one staffing for at least 15282.34minutes each time they are performed, or to a new client or282.35clients directly discharged to the vendor's program from a282.36regional treatment center; or283.1(4) there is a need to maintain required staffing levels in283.2order to provide authorized services approved by the283.3commissioner under section 252.28, that is necessitated by a283.4significant and permanent decrease in licensed capacity or283.5clientele.283.6The county shall review the adequacy of services provided283.7by vendors whose payment rates are 80 percent or more of the283.8statewide average rates and 50 percent or more of the vendor's283.9clients meet the behavioral or medical criteria in clause (3).283.10A variance under this paragraph may be approved only if the283.11costs to the medical assistance program do not exceed the283.12medical assistance costs for all clients served by the283.13alternatives and all clients remaining in the existing services.283.14 one or more clients who meet one or more of the following 283.15 criteria: 283.16 (a) the client is a new client and: 283.17 (i) exhibits severe behavior as indicated on the screening 283.18 document; 283.19 (ii) periodically requires one-to-one staff time for at 283.20 least 15 minutes at a time to deliver physician prescribed 283.21 medical interventions; or 283.22 (iii) has been discharged directly to the vendor's program 283.23 from a regional treatment center or the Minnesota extended 283.24 treatment option. 283.25 (b) the client is an existing client who has developed one 283.26 of the following changed circumstances which increases costs 283.27 that are not covered by the vendor's current rate, and for whom 283.28 a significant program change is necessary to ensure the 283.29 continued provision of authorized services to that client: 283.30 (i) severe behavior as indicated on the screening document; 283.31 (ii) a medical condition periodically requiring one-to-one 283.32 staff time for at least 15 minutes at a time to deliver 283.33 physician prescribed medical interventions; or 283.34 (iii) a permanent decrease in skill functioning, as 283.35 verified by medical reports or assessments; 283.36 (2) A licensing determination requires a program change 284.1 that the vendor cannot comply with due to funding restraints; 284.2 (3) A determination of need under section 252.28 is 284.3 approved for a significant and permanent decrease in licensed 284.4 capacity and the vendor demonstrates the need to retain certain 284.5 staffing levels to serve the remaining clients; or 284.6 (4) In cases where conditions in clauses (1) to (3) do not 284.7 apply, but a determination of need under section 252.28 is 284.8 approved for an unusual circumstance which exists that 284.9 significantly impacts the type or amount of services delivered, 284.10 as evidenced by documentation presented by the vendor and with 284.11 the concurrence of the commissioner. 284.12(b)(c) A variance to the rate minimum may be granted when: 284.13 (1) the county board contracts for increased services from 284.14 a vendor and for some or all individuals receiving services from 284.15 the vendor lower per unit fixed costs result; or 284.16 (2) when the actual costs of delivering authorized service 284.17 over a 12-month contract period have decreased. 284.18(c)(d) The written variance request under this subdivision 284.19 must include documentation that all the following criteria have 284.20 been met: 284.21 (1) The commissioner and the county board have both 284.22 conducted a review and have identified a need for a change in 284.23 the payment rates and recommended an effective date for the 284.24 change in the rate. 284.25 (2) The vendor documents efforts to reallocate current 284.26 staff and any additional staffing needs cannot be met by using 284.27 temporary special needs rate exceptions under Minnesota Rules, 284.28 parts 9510.1020 to 9510.1140. 284.29 (3) The vendor documents that financial resources have been 284.30 reallocated before applying for a variance. No variance may be 284.31 granted for equipment, supplies, or other capital expenditures 284.32 when depreciation expense for repair and replacement of such 284.33 items is part of the current rate. 284.34 (4) For variances related to loss of clientele, the vendor 284.35 documents the other program and administrative expenses, if any, 284.36 that have been reduced. 285.1 (5) The county board submits verification of the conditions 285.2 for which the variance is requested, a description of the nature 285.3 and cost of the proposed changes, and how the county will 285.4 monitor the use of money by the vendor to make necessary changes 285.5 in services. 285.6 (6) The county board's recommended payment rates do not 285.7 exceed 95 percent of the greater of 125 percent of the current 285.8 statewide median or 125 percent of the regional average payment 285.9 rates, whichever is higher, for each of the regional commission 285.10 districts under sections 462.381 to 462.396 in which the vendor 285.11 is located except for the following: when a variance is 285.12 recommended to allow authorized service delivery to new clients 285.13 with severeself-injurious or assaultivebehaviors or with 285.14 medical conditions requiring delivery of physician prescribed 285.15 medical interventions, or to persons being directly discharged 285.16 from a regional treatment center or Minnesota extended treatment 285.17 options to the vendor's program, those persons must be assigned 285.18 a payment rate of 200 percent of the current statewide average 285.19 rates. All other clients receiving services from the vendor 285.20 must be assigned a payment rate equal to the vendor's current 285.21 rate unless the vendor's current rate exceeds 95 percent of 125 285.22 percent of the statewide median or 125 percent of the regional 285.23 average payment rates, whichever is higher. When the vendor's 285.24 rates exceed 95 percent of 125 percent of the statewide median 285.25 or 125 percent of the regional average rates, the maximum rates 285.26 assigned to all other clients must be equal to the greater of 95 285.27 percent of 125 percent of the statewide median or 125 percent of 285.28 the regional average rates. The maximum payment rate that may 285.29 be recommended for the vendor under these conditions is 285.30 determined by multiplying the number of clients at each limit by 285.31 the rate corresponding to that limit and then dividing the sum 285.32 by the total number of clients. 285.33(d)(e) The commissioner shall have 60 calendar days from 285.34 the date of the receipt of the complete request to accept or 285.35 reject it, or the request shall be deemed to have been granted. 285.36 If the commissioner rejects the request, the commissioner shall 286.1 state in writing the specific objections to the request and the 286.2 reasons for its rejection. 286.3 Sec. 12. Minnesota Statutes 1998, section 253B.045, is 286.4 amended by adding a subdivision to read: 286.5 Subd. 5. [HEALTH PLAN COMPANY; DEFINITION.] For purposes 286.6 of this section, "health plan company" has the meaning given it 286.7 in section 62Q.01, subdivision 4, and also includes a 286.8 demonstration provider as defined in section 256B.69, 286.9 subdivision 2, paragraph (b), a county or group of counties 286.10 participating in county-based purchasing according to section 286.11 256B.692, and a children's mental health collaborative under 286.12 contract to provide medical assistance for individuals enrolled 286.13 in the prepaid medical assistance and MinnesotaCare programs 286.14 according to sections 245.493 to 245.496. 286.15 Sec. 13. Minnesota Statutes 1998, section 253B.045, is 286.16 amended by adding a subdivision to read: 286.17 Subd. 6. [COVERAGE.] A health plan company must provide 286.18 coverage, according to the terms of the policy, contract, or 286.19 certificate of coverage, for all medically necessary covered 286.20 services as determined by section 62Q.53 provided to an enrollee 286.21 that are ordered by the court under this chapter. 286.22 Sec. 14. Minnesota Statutes 1998, section 253B.07, 286.23 subdivision 1, is amended to read: 286.24 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 286.25 filing a petition for commitment of or early intervention for a 286.26 proposed patient, an interested person shall apply to the 286.27 designated agency in the county of the proposed patient's 286.28 residence or presence for conduct of a preliminary 286.29 investigation, except when the proposed patient has been 286.30 acquitted of a crime under section 611.026 and the county 286.31 attorney is required to file a petition for commitment. The 286.32 designated agency shall appoint a screening team to conduct an 286.33 investigation which shall include: 286.34 (i) a personal interview with the proposed patient and 286.35 other individuals who appear to have knowledge of the condition 286.36 of the proposed patient. If the proposed patient is not 287.1 interviewed, reasons must be documented; 287.2 (ii) identification and investigation of specific alleged 287.3 conduct which is the basis for application; 287.4 (iii) identification, exploration, and listing of the 287.5 reasons for rejecting or recommending alternatives to 287.6 involuntary placement;and287.7 (iv) in the case of a commitment based on mental illness, 287.8 the following information, if it is known or available: 287.9 information that may be relevant to the administration of 287.10 neuroleptic medications, if necessary, including the existence 287.11 of a declaration under section 253B.03, subdivision 6d, or a 287.12 health care directive under chapter 145C or a guardian, 287.13 conservator, proxy, or agent with authority to make health care 287.14 decisions for the proposed patient; information regarding the 287.15 capacity of the proposed patient to make decisions regarding 287.16 administration of neuroleptic medication; and whether the 287.17 proposed patient is likely to consent or refuse consent to 287.18 administration of the medication.; and 287.19 (v) seeking input from the proposed patient's health plan 287.20 company to provide the court with information about services the 287.21 enrollee needs and the "least restrictive alternatives." 287.22 (b) In conducting the investigation required by this 287.23 subdivision, the screening team shall have access to all 287.24 relevant medical records of proposed patients currently in 287.25 treatment facilities. Data collected pursuant to this clause 287.26 shall be considered private data on individuals. The 287.27 prepetition screening report is not admissible in any court 287.28 proceedings unrelated to the commitment proceedings. 287.29 (c) When the prepetition screening team recommends 287.30 commitment, a written report shall be sent to the county 287.31 attorney for the county in which the petition is to be filed. 287.32 (d) The prepetition screening team shall refuse to support 287.33 a petition if the investigation does not disclose evidence 287.34 sufficient to support commitment. Notice of the prepetition 287.35 screening team's decision shall be provided to the prospective 287.36 petitioner. 288.1 (e) If the interested person wishes to proceed with a 288.2 petition contrary to the recommendation of the prepetition 288.3 screening team, application may be made directly to the county 288.4 attorney, who may determine whether or not to proceed with the 288.5 petition. Notice of the county attorney's determination shall 288.6 be provided to the interested party. 288.7 (f) If the proposed patient has been acquitted of a crime 288.8 under section 611.026, the county attorney shall apply to the 288.9 designated county agency in the county in which the acquittal 288.10 took place for a preliminary investigation unless substantially 288.11 the same information relevant to the proposed patient's current 288.12 mental condition, as could be obtained by a preliminary 288.13 investigation, is part of the court record in the criminal 288.14 proceeding or is contained in the report of a mental examination 288.15 conducted in connection with the criminal proceeding. If a 288.16 court petitions for commitment pursuant to the rules of criminal 288.17 or juvenile procedure or a county attorney petitions pursuant to 288.18 acquittal of a criminal charge under section 611.026, the 288.19 prepetition investigation, if required by this section, shall be 288.20 completed within seven days after the filing of the petition. 288.21 Sec. 15. Minnesota Statutes 1998, section 253B.185, is 288.22 amended by adding a subdivision to read: 288.23 Subd. 5. [AFTERCARE AND CASE MANAGEMENT.] The state, in 288.24 collaboration with the designated agency, is responsible for 288.25 arranging and funding the aftercare and case management services 288.26 for persons under commitment as sexual psychopathic 288.27 personalities and sexually dangerous persons discharged after 288.28 July 1, 1999. 288.29 Sec. 16. Minnesota Statutes 1998, section 254B.01, is 288.30 amended by adding a subdivision to read: 288.31 Subd. 7. [ROOM AND BOARD RATE.] "Room and board rate" 288.32 means a rate set for shelter, fuel, food, utilities, household 288.33 supplies, and other costs necessary to provide room and board 288.34 for a person in need of chemical dependency services. 288.35 Sec. 17. Minnesota Statutes 1998, section 254B.03, 288.36 subdivision 2, is amended to read: 289.1 Subd. 2. [CHEMICAL DEPENDENCYSERVICESFUND PAYMENT.] (a) 289.2 Payment from the chemical dependency fund is limited to payments 289.3 for services other than detoxification that, if located outside 289.4 of federally recognized tribal lands, would be required to be 289.5 licensed by the commissioner as a chemical dependency treatment 289.6 or rehabilitation program under sections 245A.01 to 245A.16, and 289.7 services other than detoxification provided in another state 289.8 that would be required to be licensed as a chemical dependency 289.9 program if the program were in the state. Out of state vendors 289.10 must also provide the commissioner with assurances that the 289.11 program complies substantially with state licensing requirements 289.12 and possesses all licenses and certifications required by the 289.13 host state to provide chemical dependency treatment.Hospitals289.14may apply for and receive licenses to be eligible vendors,289.15notwithstanding the provisions of section 245A.03.Except for 289.16 chemical dependency transitional rehabilitation programs, 289.17 vendors receiving payments from the chemical dependency fund 289.18 must not require copayment from a recipient of benefits for 289.19 services provided under this subdivision. Payment from the 289.20 chemical dependency fund shall be made for necessary room and 289.21 board costs provided by vendors certified according to section 289.22 254B.05, or in a community hospital licensed by the commissioner 289.23 of the department of health according to sections 144.50 to 289.24 144.56 to a client who is: 289.25 (1) determined to meet the criteria for placement in a 289.26 residential chemical dependency treatment program according to 289.27 rules adopted under section 254A.03, subdivision 3; and 289.28 (2) concurrently receiving a chemical dependency treatment 289.29 service in a program licensed by the commissioner and reimbursed 289.30 by the chemical dependency fund. 289.31 (b) A county may, from its own resources, provide chemical 289.32 dependency services for which state payments are not made. A 289.33 county may elect to use the same invoice procedures and obtain 289.34 the same state payment services as are used for chemical 289.35 dependency services for which state payments are made under this 289.36 section if county payments are made to the state in advance of 290.1 state payments to vendors. When a county uses the state system 290.2 for payment, the commissioner shall make monthly billings to the 290.3 county using the most recent available information to determine 290.4 the anticipated services for which payments will be made in the 290.5 coming month. Adjustment of any overestimate or underestimate 290.6 based on actual expenditures shall be made by the state agency 290.7 by adjusting the estimate for any succeeding month. 290.8 (c) The commissioner shall coordinate chemical dependency 290.9 services and determine whether there is a need for any proposed 290.10 expansion of chemical dependency treatment services. The 290.11 commissioner shall deny vendor certification to any provider 290.12 that has not received prior approval from the commissioner for 290.13 the creation of new programs or the expansion of existing 290.14 program capacity. The commissioner shall consider the 290.15 provider's capacity to obtain clients from outside the state 290.16 based on plans, agreements, and previous utilization history, 290.17 when determining the need for new treatment services. 290.18 Sec. 18. Minnesota Statutes 1998, section 254B.05, 290.19 subdivision 1, is amended to read: 290.20 Subdivision 1. [LICENSURE REQUIRED.] Programs licensed by 290.21 the commissioner are eligible vendors. Hospitals may apply for 290.22 and receive licenses to be eligible vendors, notwithstanding the 290.23 provisions of section 245A.03. American Indian programs located 290.24 on federally recognized tribal lands that provide chemical 290.25 dependency primary treatment, extended care, transitional 290.26 residence, or outpatient treatment services, and are licensed by 290.27 tribal government are eligible vendors. Detoxification programs 290.28 are not eligible vendors. Programs that are not licensed as a 290.29 chemical dependency residential or nonresidential treatment 290.30 program by the commissioner or by tribal government are not 290.31 eligible vendors. To be eligible for payment under the 290.32 Consolidated Chemical Dependency Treatment Fund, a vendor of a 290.33 chemical dependency service must participate in the Drug and 290.34 Alcohol Abuse Normative Evaluation System and the treatment 290.35 accountability plan. 290.36 Effective January 1, 2000, vendors of room and board are 291.1 eligible for chemical dependency fund payment if the vendor: 291.2 (1) is certified by the county or tribal governing body as 291.3 having rules prohibiting residents bringing chemicals into the 291.4 facility or using chemicals while residing in the facility and 291.5 provide consequences for infractions of those rules; 291.6 (2) has a current contract with a county or tribal 291.7 governing body; 291.8 (3) is determined to meet applicable health and safety 291.9 requirements; 291.10 (4) is not a jail or prison; and 291.11 (5) is not concurrently receiving funds under chapter 256I 291.12 for the recipient. 291.13 Sec. 19. Minnesota Statutes 1998, section 256B.0625, 291.14 subdivision 20, is amended to read: 291.15 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 291.16 extent authorized by rule of the state agency, medical 291.17 assistance covers case management services to persons with 291.18 serious and persistent mental illness and children with severe 291.19 emotional disturbance. Services provided under this section 291.20 must meet the relevant standards in sections 245.461 to 291.21 245.4888, the Comprehensive Adult and Children's Mental Health 291.22 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 291.23 9505.0322, excluding subpart 10. 291.24 (b) Entities meeting program standards set out in rules 291.25 governing family community support services as defined in 291.26 section 245.4871, subdivision 17, are eligible for medical 291.27 assistance reimbursement for case management services for 291.28 children with severe emotional disturbance when these services 291.29 meet the program standards in Minnesota Rules, parts 9520.0900 291.30 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 291.31 (c) Medical assistance and MinnesotaCare payment for mental 291.32 health case management shall be made on a monthly basis. In 291.33 order to receive payment for an eligible child, the provider 291.34 must document at least a face-to-face contact with the child, 291.35 the child's parents, or the child's legal representative. To 291.36 receive payment for an eligible adult, the provider must 292.1 document: 292.2 (1) at least a face-to-face contact with the adult or the 292.3 adult's legal representative; or 292.4 (2) at least a telephone contact with the adult or the 292.5 adult's legal representative and document a face-to-face contact 292.6 with the adult or the adult's legal representative within the 292.7 preceding two months. 292.8 (d) Payment for mental health case management provided by 292.9 county or state staff shall be based on the monthly rate 292.10 methodology under section 256B.094, subdivision 6, paragraph 292.11 (b), with separate rates calculated for child welfare and mental 292.12 health, and within mental health, separate rates for children 292.13 and adults. 292.14 (e) Payment for mental health case management provided by 292.15 county-contracted vendors shall be based on a monthly rate 292.16 negotiated by the host county. The negotiated rate must not 292.17 exceed the rate charged by the vendor for the same service to 292.18 other payers. If the service is provided by a team of 292.19 contracted vendors, the county may negotiate a team rate with a 292.20 vendor who is a member of the team. The team shall determine 292.21 how to distribute the rate among its members. No reimbursement 292.22 received by contracted vendors shall be returned to the county, 292.23 except to reimburse the county for advance funding provided by 292.24 the county to the vendor. 292.25 (f) If the service is provided by a team which includes 292.26 contracted vendors and county or state staff, the costs for 292.27 county or state staff participation in the team shall be 292.28 included in the rate for county-provided services. In this 292.29 case, the contracted vendor and the county may each receive 292.30 separate payment for services provided by each entity in the 292.31 same month. In order to prevent duplication of services, the 292.32 county must document, in the recipient's file, the need for team 292.33 case management and a description of the roles of the team 292.34 members. 292.35 (g) The commissioner shall calculate the nonfederal share 292.36 of actual medical assistance and general assistance medical care 293.1 payments for each county, based on the higher of calendar year 293.2 1995 or 1996, by service date, project that amount forward to 293.3 1999, and transfer one-half of the result from medical 293.4 assistance and general assistance medical care to each county's 293.5 mental health grants under sections 245.4886 and 256E.12 for 293.6 calendar year 1999. The annualized minimum amount added to each 293.7 county's mental health grant shall be $3,000 per year for 293.8 children and $5,000 per year for adults. The commissioner may 293.9 reduce the statewide growth factor in order to fund these 293.10 minimums. The annualized total amount transferred shall become 293.11 part of the base for future mental health grants for each county. 293.12 (h) Any net increase in revenue to the county as a result 293.13 of the change in this section must be used to provide expanded 293.14 mental health services as defined in sections 245.461 to 293.15 245.4888, the Comprehensive Adult and Children's Mental Health 293.16 Acts, excluding inpatient and residential treatment. For 293.17 adults, increased revenue may also be used for services and 293.18 consumer supports which are part of adult mental health projects 293.19 approved under Laws 1997, chapter 203, article 7, section 25. 293.20 For children, increased revenue may also be used for respite 293.21 care and nonresidential individualized rehabilitation services 293.22 as defined in section 245.492, subdivisions 17 and 23. 293.23 "Increased revenue" has the meaning given in Minnesota Rules, 293.24 part 9520.0903, subpart 3. 293.25 (i) Notwithstanding section 256B.19, subdivision 1, the 293.26 nonfederal share of costs for mental health case management 293.27 shall be provided by the recipient's county of responsibility, 293.28 as defined in sections 256G.01 to 256G.12, from sources other 293.29 than federal funds or funds used to match other federal funds. 293.30 (j) The commissioner may suspend, reduce, or terminate the 293.31 reimbursement to a provider that does not meet the reporting or 293.32 other requirements of this section. The county of 293.33 responsibility, as defined in sections 256G.01 to 256G.12, is 293.34 responsible for any federal disallowances. The county may share 293.35 this responsibility with its contracted vendors. 293.36 (k) The commissioner shall set aside a portion of the 294.1 federal funds earned under this section to repay the special 294.2 revenue maximization account under section 256.01, subdivision 294.3 2, clause (15). The repayment is limited to: 294.4 (1) the costs of developing and implementing this section; 294.5 and 294.6 (2) programming the information systems. 294.7 (l) Notwithstanding section 256.025, subdivision 2, 294.8 payments to counties for case management expenditures under this 294.9 section shall only be made from federal earnings from services 294.10 provided under this section. Payments to contracted vendors 294.11 shall include both the federal earnings and the county share. 294.12 (m) Notwithstanding section 256B.041, county payments for 294.13 the cost of mental health case management services provided by 294.14 county or state staff shall not be made to the state treasurer. 294.15 For the purposes of mental health case management services 294.16 provided by county or state staff under this section, the 294.17 centralized disbursement of payments to counties under section 294.18 256B.041 consists only of federal earnings from services 294.19 provided under this section. 294.20 (n) Case management services under this subdivision do not 294.21 include therapy, treatment, legal, or outreach services. 294.22 (o) If the recipient is a resident of a nursing facility, 294.23 intermediate care facility, or hospital, and the recipient's 294.24 institutional care is paid by medical assistance, payment for 294.25 case management services under this subdivision is limited to 294.26 the last 30 days of the recipient's residency in that facility 294.27 and may not exceed more than two months in a calendar year. 294.28 (p) Payment for case management services under this 294.29 subdivision shall not duplicate payments made under other 294.30 program authorities for the same purpose. 294.31 (q) By July 1, 2000, the commissioner shall evaluate the 294.32 effectiveness of the changes required by this section, including 294.33 changes in number of persons receiving mental health case 294.34 management, changes in hours of service per person, and changes 294.35 in caseload size. 294.36 (r) For each calendar year beginning with the calendar year 295.1 2001, the annualized amount of state funds for each county 295.2 determined under paragraph (g) shall be adjusted by the county's 295.3 percentage change in the average number of clients per month who 295.4 received case management under this section during the fiscal 295.5 year that ended six months prior to the calendar year in 295.6 question, in comparison to the prior fiscal year. 295.7 (s) For counties receiving the minimum allocation of $3,000 295.8 or $5,000 described in paragraph (g), the adjustment in 295.9 paragraph (r) shall be determined so that the county receives 295.10 the higher of the following amounts: 295.11 (1) a continuation of the minimum allocation in paragraph 295.12 (g); or 295.13 (2) an amount based on that county's average number of 295.14 clients per month who received case management under this 295.15 section during the fiscal year that ended six months prior to 295.16 the calendar year in question, in comparison to the prior fiscal 295.17 year, times the average statewide grant per person per month for 295.18 counties not receiving the minimum allocation. 295.19 (t) The adjustments in paragraphs (r) and (s) shall be 295.20 calculated separately for children and adults. 295.21 Sec. 20. Laws 1995, chapter 207, article 8, section 41, as 295.22 amended by Laws 1997, chapter 203, article 7, section 25, is 295.23 amended to read: 295.24 Sec. 41. [PILOT PROJECTSINITIATIVES TOTESTPROVIDE 295.25 ALTERNATIVES TO DELIVERY OF ADULT MENTAL HEALTH SERVICES.] 295.26 Subdivision 1. [AUTHORIZATION FORPILOT PROJECTSADULT 295.27 MENTAL HEALTH INITIATIVES.] The commissioner of human services 295.28 may approvepilot projectsadult mental health initiatives to 295.29testprovide alternatives to orthe enhancedenhance 295.30 coordination of the delivery of mental health services required 295.31 under the Minnesota comprehensive adult mental health act, 295.32 Minnesota Statutes, sections 245.461 to 245.486. 295.33 Subd. 2. [PROGRAM DESIGN AND IMPLEMENTATION.] (a) The 295.34pilot projectsadult mental health initiatives shall be 295.35 established to design, plan, and improve the mental health 295.36 service delivery system for adults with serious and persistent 296.1 mental illness that would: 296.2 (1) provide an expanded array of services from which 296.3 clients can choose services appropriate to their needs; 296.4 (2) be based on purchasing strategies that improve access 296.5 and coordinate services without cost shifting; 296.6 (3) incorporate existing state facilities and resources 296.7 into the community mental health infrastructure through creative 296.8 partnerships with local vendors; and 296.9 (4) utilize existing categorical funding streams and 296.10 reimbursement sources in combined and creative ways, except 296.11 appropriations to regional treatment centers and all funds that 296.12 are attributable to the operation of state-operated services are 296.13 excluded unless appropriated specifically by the legislature for 296.14 a purpose consistent with this section. 296.15 (b) Allprojectsinitiatives funded by January 1, 1997, 296.16 must complete the planning phase and be operational by June 30, 296.17 1997; all projects funded by January 1, 1998, must be 296.18 operational by June 30, 1998. 296.19 Subd. 3. [PROGRAM EVALUATION.] Evaluation of eachproject296.20 initiative will be based on outcome evaluation criteria 296.21 negotiated with each project prior to implementation. 296.22 Subd. 4. [NOTICE OF PROJECT DISCONTINUATION.] Eachproject296.23 initiative may be discontinued for any reason by theproject's296.24 initiative's managing entity or the commissioner of human 296.25 services, after 90 days' written notice to the other party. 296.26 Subd. 5. [PLANNING FORPILOT PROJECTSADULT MENTAL HEALTH 296.27 INITIATIVES.] Each local plan fora pilot projectan initiative 296.28 must be developed under the direction of the county board, or 296.29 multiple county boards acting jointly, as the local mental 296.30 health authority. The planning process for each 296.31pilotinitiative shall include, but not be limited to, mental 296.32 health consumers, families, advocates, local mental health 296.33 advisory councils, local and state providers, representatives of 296.34 state and local public employee bargaining units, and the 296.35 department of human services. As part of the planning process, 296.36 the county board or boards shall designate a managing entity 297.1 responsible for receipt of funds and management of thepilot297.2projectinitiative. 297.3 Subd. 6. [DUTIES OF COMMISSIONER.] (a) For purposes of the 297.4pilot projectsadult mental health initiatives, the commissioner 297.5 shall facilitate integration of funds or other resources as 297.6 needed and requested by eachprojectinitiative. These 297.7 resources may include: 297.8 (1) residential services funds administered under Minnesota 297.9 Rules, parts 9535.2000 to 9535.3000, in an amount to be 297.10 determined by mutual agreement between theproject's297.11 initiative's managing entity and the commissioner of human 297.12 services after an examination of the county's historical 297.13 utilization of facilities located both within and outside of the 297.14 county and licensed under Minnesota Rules, parts 9520.0500 to 297.15 9520.0690; 297.16 (2) community support services funds administered under 297.17 Minnesota Rules, parts 9535.1700 to 9535.1760; 297.18 (3) other mental health special project funds; 297.19 (4) medical assistance, general assistance medical care, 297.20 MinnesotaCare and group residential housing if requested by the 297.21project'sinitiative's managing entity, and if the commissioner 297.22 determines this would be consistent with the state's overall 297.23 health care reform efforts; and 297.24 (5) regional treatment center nonfiscal resources to the 297.25 extent agreed to by theproject'sinitiative's managing entity 297.26 and the regional treatment center. 297.27 (b) The commissioner shall consider the following criteria 297.28 in awarding start-up and implementation grants for thepilot297.29projectsadult mental health initiatives: 297.30 (1) the ability of the proposedprojectsinitiatives to 297.31 accomplish the objectives described in subdivision 2; 297.32 (2) the size of the target population to be served; and 297.33 (3) geographical distribution. 297.34 (c)The commissioner shall review overall status of the297.35projects at least every two years and recommend any legislative297.36changes needed by January 15 of each odd-numbered year.298.1(d)The commissioner may waive administrative rule 298.2 requirements which are incompatible with the implementation of 298.3 thepilot projectadult mental health initiatives. 298.4(e)(d) The commissioner may exempt the participating 298.5 counties from fiscal sanctions for noncompliance with 298.6 requirements in laws and rules which are incompatible with the 298.7 implementation of thepilot projectadult mental health 298.8 initiative. 298.9(f)(e) The commissioner may award grants to an entity 298.10 designated by a county board or group of county boards to pay 298.11 for start-up and implementation costs of thepilot projectadult 298.12 mental health initiative. 298.13 Subd. 7. [DUTIES OF COUNTY BOARD.] The county board, or 298.14 other entity which is approved to administera pilot projectan 298.15 adult mental health initiative, shall: 298.16 (1) administer the project in a manner which is consistent 298.17 with the objectives described in subdivision 2 and the planning 298.18 process described in subdivision 5; 298.19 (2) assure that no one is denied services for which they 298.20 would otherwise be eligible; and 298.21 (3) provide the commissioner of human services with timely 298.22 and pertinent information through the following methods: 298.23 (i) submission of community social services act plans and 298.24 plan amendments; 298.25 (ii) submission of social services expenditure and grant 298.26 reconciliation reports, based on a coding format to be 298.27 determined by mutual agreement between theproject's298.28 initiative's managing entity and the commissioner; and 298.29 (iii) submission of data and participation in an evaluation 298.30 of thepilot projectsadult mental health initiatives, to be 298.31 designed cooperatively by the commissioner and theprojects298.32 initiatives. 298.33 Sec. 21. Laws 1998, chapter 407, article 7, section 2, 298.34 subdivision 3, is amended to read: 298.35 Subd. 3. [LAND DESCRIPTION.] That part of the Northeast 298.36 Quarter (NE l/4) of Section3029, Township 45 North, Range 30 299.1 West, Crow Wing county, Minnesota, described as follows: 299.2 Commencing at the southeast corner of said Northeast 299.3 quarter; thence North 00 degrees 46 minutes 05 seconds 299.4 West, bearing based on the Crow Wing county Coordinate 299.5 Database NAD 83/94, 1520.06 feet along the east line of 299.6 said Northeast quarter to the point of beginning; thence 299.7 continue North 00 degrees 46 minutes 05 seconds West 634.14 299.8 feet along said east line of the Northeast quarter; thence 299.9 South 89 degrees 13 minutes 20 seconds West 550.00 feet; 299.10 thence South 18 degrees 57 minutes 23 seconds East 115.59 299.11 feet; thence South 42 degrees 44 minutes 39 seconds East 299.12 692.37 feet; thence South 62 degrees 46 minutes 19 seconds 299.13 East 20.24 feet; thence North 89 degrees 13 minutes 55 299.14 seconds East 33.00 feet to the point of beginning. 299.15 Containing 4.69 acres, more or less. Subject to the 299.16 right-of-way of the Township road along the east side 299.17 thereof, subject to other easements, reservations, and 299.18 restrictions of record, if any. 299.19 Sec. 22. [ESTABLISHMENT AND PURPOSE OF THE SUPPORTIVE 299.20 HOUSING AND MANAGED CARE PILOT PROJECT.] 299.21 Subdivision 1. [ESTABLISHMENT AND PURPOSE.] If funding is 299.22 available, the commissioner of human services may establish a 299.23 supportive housing and managed care pilot project to determine 299.24 whether integrating the delivery of housing, supportive 299.25 services, and health care into a single, flexible program will 299.26 reduce public expenditures on homeless individuals, increase 299.27 their employment rates, and provide a new alternative to 299.28 providing services to a hard-to-serve population. 299.29 The commissioner of human services may create a block grant 299.30 program for counties for the purpose of providing rent subsidies 299.31 and supportive services to eligible individuals. Minimum 299.32 project and application requirements may be developed by the 299.33 commissioner in cooperation with counties and their nonprofit 299.34 partners with the goal to provide the maximum flexibility in 299.35 program design. If any funds are available, the funds must be 299.36 coordinated with health care services for eligible individuals. 300.1 Subd. 2. [COUNTY ELIGIBILITY.] If the commissioner 300.2 establishes the pilot project under subdivision 1, a county may 300.3 request funding for the purposes of the pilot project if the 300.4 county: 300.5 (1) agrees to develop, in cooperation with nonprofit 300.6 partners, a supportive housing and managed care pilot project 300.7 that integrates the delivery of housing, support services, and 300.8 health care for eligible individuals or agrees to contract with 300.9 an existing integrated program; and 300.10 (2) develops a method for evaluating the quality of the 300.11 integrated services provided and the amount of any resulting 300.12 cost savings to the county and state. 300.13 Subd. 3. [PARTICIPANT ELIGIBILITY.] In order to be 300.14 eligible for the pilot project, a county must determine that an 300.15 individual: 300.16 (1) meets the eligibility requirements of the group 300.17 residential housing program under Minnesota Statutes, section 300.18 256I.04, subdivision 1; 300.19 (2) is a homeless person or a person at risk of 300.20 homelessness. For purposes of this pilot project, "homeless 300.21 person" means a person who is living, or at imminent risk of 300.22 living, on the street, in a shelter, or is evicted from a 300.23 dwelling or discharged from a regional human services center, 300.24 community hospital, or residential treatment program, and has no 300.25 appropriate housing available and lacks the resources necessary 300.26 to access permanent housing as determined by the county 300.27 requesting funding under the pilot project; and 300.28 (3) is a person with mental illness, a history of substance 300.29 abuse, or a person with HIV. 300.30 Subd. 4. [FUNDING.] If the commissioner establishes the 300.31 pilot project under subdivision 1, a county may request funding 300.32 from the commissioner for a specified number of eligible 300.33 participants for the pilot project. The commissioner shall 300.34 review the request for compliance with subdivisions 1 to 3 and 300.35 may approve or disapprove the request. The commissioner shall 300.36 transfer funding to be allocated to participating counties as a 301.1 block grant and paid on a monthly basis. 301.2 Subd. 5. [REPORT.] If the commissioner establishes the 301.3 pilot project under subdivision 1, participating counties and 301.4 the commissioner of human services shall collaborate to prepare 301.5 and issue an annual report beginning December 1, 2001, to the 301.6 appropriate committee chairs in the senate and house on the use 301.7 of state resources, including other funds leveraged for this 301.8 initiative, the status of individuals being served in the pilot 301.9 project, and the cost-effectiveness of the pilot project. The 301.10 commissioner shall provide data that may be needed to evaluate 301.11 the pilot project to counties that request the data. 301.12 Subd. 6. [SUNSET.] The pilot project shall sunset June 30, 301.13 2005. 301.14 Sec. 23. [CONVEYANCE OF STATE LANDS TO COUNTY OF ISANTI.] 301.15 (a) Notwithstanding Minnesota Statutes, sections 94.09 to 301.16 94.16, the commissioner of human services, through the 301.17 commissioner of administration, may transfer to the county of 301.18 Isanti the lands described in paragraph (c), for no 301.19 consideration. The commissioner of human services and the 301.20 county may attach to the transfer conditions that they agree are 301.21 appropriate, including conditions that relate to water and sewer 301.22 service. The deed to convey the property must contain a clause 301.23 that the property shall revert to the state if the property 301.24 ceases to be used for a public purpose. 301.25 (b) The conveyance must be in a form approved by the 301.26 attorney general. 301.27 (c) The land that may be transferred consists of 21.9 301.28 acres, more or less, and is described as follows: 301.29 That part of the Southwest Quarter of the Southeast Quarter 301.30 and that part of Government Lot 4, both in Section 32, 301.31 Township 36, Range 23, Isanti County, Minnesota, described 301.32 jointly as follows: Commencing at the southwest corner of 301.33 the Southwest Quarter of the Southeast Quarter of Section 301.34 32; thence North 89 degrees 45 minutes 12 seconds East, 301.35 assumed bearing, along the south line of said SW 1/4 of SE 301.36 1/4, a distance of 609.48 feet; thence North 1 degree 30 302.1 minutes 30 seconds West, a distance of 149.17 feet to the 302.2 point of beginning of the parcel to be herein described; 302.3 thence continuing North 1 degrees 30 minutes 30 seconds 302.4 West, a distance of 1113.59 feet; thence South 89 degrees 302.5 59 minutes 36 seconds West, a distance of 496.41 feet; 302.6 thence southwesterly along a tangential curve concave to 302.7 the southeast, radius 318.10 feet, central angle 90 degrees 302.8 16 minutes 37 seconds, for an arc length of 501.21 feet; 302.9 thence South 0 degrees 17 minutes 01 seconds East, tangent 302.10 to said curve, for a distance of 86.59 feet; thence 302.11 southerly along a tangential curve concave to the west, 302.12 radius 398.10 feet, central angle 29 degrees 47 minutes 02 302.13 seconds, for an arc length of 206.94 feet; thence south 29 302.14 degrees 30 minutes 01 seconds West, tangent to said curve, 302.15 for a distance of 34.23 feet; thence southerly along a 302.16 tangential curve concave to the east, radius 318.10 feet, 302.17 central angle 29 degrees 49 minutes 32 seconds, for an arc 302.18 length of 165.59 feet; thence South 0 degrees 19 minutes 31 302.19 seconds East, tangent to said curve for a distance of 302.20 320.65 feet to the point of intersection with a line that 302.21 bears West (North 90 degrees 00 minutes West) from the 302.22 point of beginning; thence East (North 90 degrees 00 302.23 minutes East), a distance of 951.22 feet to the point of 302.24 beginning. 302.25 Subject to the existing city of Cambridge water main 302.26 easement. 302.27 (d) The county of Isanti may use the land for economic 302.28 development. Economic development is a public purpose within 302.29 the meaning of the term as used in Laws 1990, chapter 610, 302.30 article 1, section 12, subdivision 5, and sales or conveyances 302.31 to private parties shall be considered economic development. 302.32 Property conveyed by the state under this section shall not 302.33 revert to the state if it is conveyed or otherwise encumbered by 302.34 the county as part of the county economic development activity. 302.35 Sec. 24. [CONVEYANCE OF STATE LAND TO CITY OF CAMBRIDGE.] 302.36 (a) Notwithstanding Minnesota Statutes, sections 94.09 to 303.1 94.16, the commissioner of human services, through the 303.2 commissioner of administration, may transfer to the city of 303.3 Cambridge the lands described in paragraph (c), for no 303.4 consideration. The commissioner of human services and the city 303.5 may attach to the transfer conditions that they agree are 303.6 appropriate, including conditions that relate to water and sewer 303.7 service. The deed to convey the property must contain a clause 303.8 that the property shall revert to the state if the property 303.9 ceases to be used for a public purpose. 303.10 (b) The conveyance must be in a form approved by the 303.11 attorney general. 303.12 (c) Subject to the right-of-way for state trunk highway No. 303.13 293 and south Dellwood street and subject to other easements, 303.14 reservations, road or street right-of-ways, and restrictions of 303.15 record, if any, the land to be conveyed may include all or part 303.16 of any of the parcels described as follows: 303.17 (1) that part of the Northeast Quarter of the Northeast 303.18 Quarter of Section 5, Township 35, Range 23, Isanti County, 303.19 Minnesota, lying north of a line drawn parallel with and 50 303.20 feet north of the center line of State Highway No. 293, as 303.21 laid out and constructed and lying westerly of the 303.22 following described line: 303.23 Commencing at a point where the West line of the 303.24 right-of-way of the Great Northern Railway Company 303.25 (presently the Burlington Northern and Santa Fe Railway) 303.26 intersects the North line of said Section 5, said point now 303.27 being the intersection of the North line of said Section 5 303.28 with the center line of State Trunk Highway No. 65 as now 303.29 laid out and constructed (presently known as South Main 303.30 Street); thence on a bearing of West and along the North 303.31 line of said Section 5 a distance of 539.5 feet to the 303.32 point of beginning of the line to be herein described; 303.33 thence on a bearing of South, a distance of 451.75 feet to 303.34 the point of intersection with a line drawn parallel with 303.35 and distant 50 feet north of the center line of State 303.36 Highway No. 293, as laid out and constructed and there 304.1 terminating. Containing 1/4 acre, more or less. 304.2 (2) that part of the Northwest Quarter of the Southeast 304.3 Quarter and that part of Governments Lots 3 and 4, all in 304.4 Section 32, Township 36, Range 23, Isanti County, 304.5 Minnesota, described jointly as follows: 304.6 Commencing at the East quarter corner of Section 32, 304.7 Township 36, Range 23, Isanti County, Minnesota; thence 304.8 South 89 degrees 44 minutes 35 seconds West, assumed 304.9 bearing, along the east-west quarter line of said Section 304.10 32, a distance of 2251.43 feet; thence South 1 degree 48 304.11 minutes 40 seconds East, a distance of 344.47 feet to the 304.12 south line of Lot 30 of Auditor's Subdivision No. 9; thence 304.13 South 89 degrees 35 minutes 5 seconds West, along said 304.14 south line and the westerly projection thereof, a distance 304.15 of 740.00 feet to the point of beginning of the parcel to 304.16 be herein described; thence North 89 degrees 35 minutes, 05 304.17 seconds East, retracing the last described course, a 304.18 distance of 534.66 feet to the northwest corner of the 304.19 recorded plat of RIVERWOOD VILLAGE; thence South 2 degrees 304.20 40 minutes 50 seconds East, a distance of 338.38 feet, 304.21 along the westerly line of said RIVERWOOD VILLAGE to the 304.22 southwest corner of said RIVERWOOD VILLAGE; thence North 89 304.23 degrees 44 minutes 50 seconds East, along the south line of 304.24 said RIVERWOOD VILLAGE, a distance of 1074.56 feet; thence 304.25 South 3 degrees 35 minutes 15 seconds East, a distance of 304.26 258.66 feet; thence southwesterly along a tangential curve 304.27 concave to the northwest, radius 318.10 feet, central angle 304.28 93 degrees 34 minutes 51 seconds for an arc length of 304.29 519.56 feet; thence South 89 degrees 59 minutes 37 seconds 304.30 West tangent to said curve for a distance of 825.86 feet; 304.31 thence southwesterly along a tangential curve concave to 304.32 the southeast, radius 398.10 feet, central angle 70 degrees 304.33 55 minutes 13 seconds, for an arc length of 492.76 feet; 304.34 thence South 89 degrees 51 minutes 30 seconds West, not 304.35 tangent to the last described curve for a distance of 304.36 523.31 feet; thence South 1 degree 57 minutes 33 seconds 305.1 West, a distance of 29.59 feet; thence South 89 degrees 57 305.2 minutes 55 seconds West, a distance of 1020 feet, more or 305.3 less, to the easterly shoreline of the Rum River; thence 305.4 northerly along said easterly shoreline to the point of 305.5 intersection with a line that bears North 45 degrees 24 305.6 minutes 55 seconds West from the point of beginning; thence 305.7 South 45 degrees 24 minutes 55 seconds East, along said 305.8 line, a distance of 180 feet, more or less, to the point of 305.9 beginning. Containing 48 acres, more or less. 305.10 (3) that part of the Northwest Quarter of the Northeast 305.11 Quarter and that part of the Northeast Quarter of the 305.12 Northwest Quarter, both in Section 5, Township 35, Range 305.13 23, Isanti County, Minnesota, described jointly as follows: 305.14 Beginning at the northwest corner of the NW 1/4 of NE 1/4 305.15 of Section 5; thence North 89 degrees 45 minutes 12 seconds 305.16 East, assumed bearing, along the north line of said NW 1/4 305.17 of NE 1/4, a distance of 1321.82 feet to the northeast 305.18 corner of said NW 1/4 of NE 1/4 thence South 4 degrees 04 305.19 minutes 02 seconds West, along the east line of said NW 1/4 305.20 of NE 1/4, a distance of 452.83 feet; thence South 89 305.21 degrees 45 minutes 02 seconds West, a distance of 1393.6 305.22 feet; thence northwesterly, along a nontangential curve 305.23 concave to the northeast, radius 318.17 feet, central angle 305.24 75 degrees 28 minutes 03 seconds, for an arc length of 305.25 419.08 feet (the chord of said curve bears North 38 degrees 305.26 03 minutes 32 seconds West and has a length of 389.44 305.27 feet); thence North 0 degrees 19 minutes 31 seconds West, 305.28 tangent to said curve, for a distance of 142.65 feet to the 305.29 north line of the NE 1/4 of NW 1/4 of said Section 5; 305.30 thence North 89 degrees 32 minutes 15 seconds East, along 305.31 said north line, a distance of 344.81 feet to the point of 305.32 beginning. Containing 16 acres, more or less. 305.33 (4) that part of the Southwest Quarter of the Southeast 305.34 Quarter, that part of the Northwest Quarter of the 305.35 Southeast Quarter and that part of Government Lot 4, all in 305.36 Section 32, Township 36, Range 23, Isanti County, 306.1 Minnesota, described jointly as follows: 306.2 Beginning at the southwest corner of the SW 1/4 of SE 1/4 306.3 of Section 32; thence North 89 degrees 45 minutes 12 306.4 seconds East, assumed bearing, along the south line of said 306.5 SW 1/4 of SE 1/4, a distance of 1321.82 feet to the 306.6 southeast corner of said SW 1/4 of SE 1/4 thence North 2 306.7 degrees 40 minutes 49 seconds West, along the east line of 306.8 said SW 1/4 of SE 1/4 and along the east line of the NW 1/4 306.9 of SE 1/4, a distance of 1465.32 feet; thence southwesterly 306.10 along a nontangential curve concave to the northwest, 306.11 radius 398.10 feet, central angle 60 degrees 52 minutes 54 306.12 seconds, for an arc length of 423.02 feet (said curve has a 306.13 chord that bears South 59 degrees 33 minutes 09 seconds 306.14 West and a chord length of 403.40 feet); thence South 89 306.15 degrees 59 minutes 37 seconds West, tangent to said curve, 306.16 for a distance of 825.68 feet; thence southwesterly along a 306.17 tangential curve concave to the southeast, radius 318.10 306.18 feet, central angle 90 degrees 16 minutes 37 seconds, for 306.19 an arc length of 501.21 feet; thence South 0 degrees 17 306.20 minutes 01 seconds East, tangent to said curve, for a 306.21 distance of 86.59 feet; thence southerly along a tangential 306.22 curve concave to the West, radius 398.10 feet, central 306.23 angle 29 degrees 47 minutes 02 seconds, for an arc length 306.24 of 206.94 feet; thence South 29 degrees 30 minutes 01 306.25 seconds West tangent to said curve, for a distance of 34.23 306.26 feet; thence southerly along a tangential curve concave to 306.27 the east, radius 318.20 feet, central angle 29 degrees 49 306.28 minutes 32 seconds for an arc length of 165.59 feet; thence 306.29 South 0 degrees 19 minutes 31 seconds East, tangent to said 306.30 curve, for a distance of 475.17 feet to the south line of 306.31 Government Lot 4, Section 32; thence North 89 degrees 32 306.32 minutes 15 seconds East, along said south line, a distance 306.33 of 344.81 feet to the point of beginning. Containing 44.9 306.34 acres, more or less. 306.35 EXCEPTING THEREFROM that parcel described on Quit Claim 306.36 Deed from the State of Minnesota to Wilfred R. and June E. 307.1 Norman, filed in Book 92 of Deeds, page 647, in the office 307.2 of the County Recorder, Isanti County, Minnesota. 307.3 ALSO EXCEPTING THEREFROM that parcel described on Quit 307.4 Claim Deed from the State of Minnesota to Frank C. Brody 307.5 and Lorraine D.S. Brody, filed in Book 102 of Deeds, page 307.6 232, in the office of the County Recorder, Isanti County, 307.7 Minnesota. 307.8 (d) The city of Cambridge may use the land for economic 307.9 development. Economic development is a public purpose within 307.10 the meaning of the term as used in Laws 1990, chapter 610, 307.11 article 1, section 12, subdivision 5, and sales or conveyances 307.12 to private parties shall be considered economic development. 307.13 Property conveyed by the state under this section shall not 307.14 revert to the state if it is conveyed or otherwise encumbered by 307.15 the city as a part of the city economic development activity. 307.16 Sec. 25. [CONVEYANCE OF CITY LAND TO STATE OF MINNESOTA.] 307.17 (a) The commissioner of administration may accept all, or 307.18 any part of, the land described in paragraph (d) from the city 307.19 of Cambridge, after the city council passes a resolution which 307.20 declares the property is surplus to its needs. 307.21 (b) The conveyance shall be in a form approved by the 307.22 attorney general. 307.23 (c) The conveyance may be subject to a scenic easement, as 307.24 defined in Minnesota Statutes, section 103F.311, subdivision 6. 307.25 The easement shall be under the custodial control of the 307.26 commissioner of natural resources and only required on the 307.27 portion of conveyed land that is designated for inclusion in the 307.28 wild and scenic river system under Minnesota Statutes, section 307.29 103F.325. The scenic easement shall allow for continued use of 307.30 any existing structures located within the easement and for 307.31 development of walking paths or trails within the easement. 307.32 (d) Subject to the right-of-way for state trunk highway No. 307.33 293, and subject to other easements, reservations, street 307.34 right-of-ways, and restrictions of record, if any, the land to 307.35 be conveyed may include all, or part of, the parcel described as 307.36 follows: 308.1 That part of Government Lot 4 and that part of the 308.2 Northeast Quarter of the Northwest Quarter, all in Section 308.3 5, Township 35, Range 23, Isanti County, Minnesota, 308.4 described jointly as follows: Commencing at the Northeast 308.5 corner of the Northwest Quarter of Section 5, thence South 308.6 89 degrees 47 minutes 10 seconds West, assumed bearing 308.7 along the north line of the Northwest Quarter of Section 5, 308.8 a distance of 656.00 feet to the point of beginning of the 308.9 parcel to be herein described, thence South 00 degrees 03 308.10 minutes 35 seconds East, a distance of 350.00 feet, thence 308.11 South 89 degrees 47 minutes 10 seconds West, parallel with 308.12 the north line of said Northwest Quarter of Section 5 to 308.13 the easterly shoreline of the Rum River, thence 308.14 northeasterly along said easterly shoreline to the north 308.15 line of the Northwest Quarter of Section 5, thence North 89 308.16 degrees 47 minutes 10 seconds East, along said north line 308.17 to the point of beginning. 308.18 ARTICLE 6 308.19 ASSISTANCE PROGRAMS 308.20 Section 1. Minnesota Statutes 1998, section 256D.051, 308.21 subdivision 2a, is amended to read: 308.22 Subd. 2a. [DUTIES OF COMMISSIONER.] In addition to any 308.23 other duties imposed by law, the commissioner shall: 308.24 (1) based on this section and section 256D.052 and Code of 308.25 Federal Regulations, title 7, section 273.7, supervise the 308.26 administration of food stamp employment and training services to 308.27 county agencies; 308.28 (2) disburse money appropriated for food stamp employment 308.29 and training services to county agencies based upon the county's 308.30 costs as specified in section256D.06256D.051, subdivision 6c; 308.31 (3) accept and supervise the disbursement of any funds that 308.32 may be provided by the federal government or from other sources 308.33 for use in this state for food stamp employment and training 308.34 services; 308.35 (4) cooperate with other agencies including any agency of 308.36 the United States or of another state in all matters concerning 309.1 the powers and duties of the commissioner under this section and 309.2 section 256D.052; and 309.3 (5) in cooperation with the commissioner of economic 309.4 security, ensure that each component of an employment and 309.5 training program carried out under this section is delivered 309.6 through a statewide workforce development system, unless the 309.7 component is not available locally through such a system. 309.8 Sec. 2. Minnesota Statutes 1998, section 256D.051, is 309.9 amended by adding a subdivision to read: 309.10 Subd. 6c. [PROGRAM FUNDING.] Within the limits of 309.11 available resources, the commissioner shall reimburse the actual 309.12 costs of county agencies and their employment and training 309.13 service providers for the provision of food stamp employment and 309.14 training services, including participant support services, 309.15 direct program services, and program administrative activities. 309.16 No more than 15 percent of program funds may be used for 309.17 administrative activities. The county agency may expend county 309.18 funds in excess of the limits of this subdivision without state 309.19 reimbursement. 309.20 Program funds shall be allocated based on the county's 309.21 average number of food stamp cases as compared to the statewide 309.22 total number of such cases. The average number of cases shall 309.23 be based on counts of cases as of March 31, June 30, September 309.24 30, and December 31 of the previous calendar year. The 309.25 commissioner may reallocate unexpended money appropriated under 309.26 this section to those county agencies that demonstrate a need 309.27 for additional funds. 309.28 Sec. 3. Minnesota Statutes 1998, section 256D.053, 309.29 subdivision 1, is amended to read: 309.30 Subdivision 1. [PROGRAM ESTABLISHED.]For the period of309.31July 1, 1998, to June 30, 1999,The Minnesota food assistance 309.32 program is established to provide food assistance to legal 309.33 noncitizens residing in this state who are ineligible to 309.34 participate in the federal Food Stamp Program solely due to the 309.35 provisions of section 402 or 403 of Public Law Number 104-193, 309.36 as authorized by Title VII of the 1997 Emergency Supplemental 310.1 Appropriations Act, Public Law Number 105-18, and as amended by 310.2 Public Law Number 105-185. 310.3 Sec. 4. Minnesota Statutes 1998, section 256D.06, 310.4 subdivision 5, is amended to read: 310.5 Subd. 5. Any applicant, otherwise eligible for general 310.6 assistance and possibly eligible for maintenance benefits from 310.7 any other source shall (a) make application for those benefits 310.8 within 30 days of the general assistance application; and (b) 310.9 execute an interim assistance authorization agreement on a form 310.10 as directed by the commissioner. The commissioner shall review 310.11 a denial of an application for other maintenance benefits and 310.12 may require a recipient of general assistance to file an appeal 310.13 of the denial if appropriate. If found eligible for benefits 310.14 from other sources, and a payment received from another source 310.15 relates to the period during which general assistance was also 310.16 being received, the recipient shall be required to reimburse the 310.17 county agency for the interim assistance paid. Reimbursement 310.18 shall not exceed the amount of general assistance paid during 310.19 the time period to which the other maintenance benefits apply 310.20 and shall not exceed the state standard applicable to that time 310.21 period. The commissioner shall adopt rules authorizing county 310.22 agencies or other client representatives to retain from the 310.23 amount recovered under an interim assistance agreement 25 310.24 percent plus actual reasonable fees, costs, and disbursements of 310.25 appeals and litigation, of providing special assistance to the 310.26 recipient in processing the recipient's claim for maintenance 310.27 benefits from another source. The money retained under this 310.28 section shall be from the state share of the recovery. The 310.29 commissioner or the county agency may contract with qualified 310.30 persons to provide the special assistance. The rules adopted by 310.31 the commissioner shall include the methods by which county 310.32 agencies shall identify, refer, and assist recipients who may be 310.33 eligible for benefits under federal programs for the disabled. 310.34 This subdivision does not require repayment of per diem payments 310.35 made to shelters for battered women pursuant to section 256D.05, 310.36 subdivision 3. 311.1 Sec. 5. Minnesota Statutes 1998, section 256J.08, 311.2 subdivision 11, is amended to read: 311.3 Subd. 11. [CAREGIVER.] "Caregiver" means a minor child's 311.4 natural or adoptive parent or parents and stepparent who live in 311.5 the home with the minor child. For purposes of determining 311.6 eligibility for this program, caregiver also means any of the 311.7 following individuals, if adults, who live with and provide care 311.8 and support to a minor child when the minor child's natural or 311.9 adoptive parent or parents or stepparents do not reside in the 311.10 same home: legal custodian or guardian, grandfather, 311.11 grandmother, brother, sister, half-brother, half-sister, 311.12 stepbrother, stepsister, uncle, aunt, first cousin or first 311.13 cousin once removed, nephew, niece, person of preceding 311.14 generation as denoted by prefixes of "great," "great-great," or 311.15 "great-great-great," or a spouse of any person named in the 311.16 above groups even after the marriage ends by death or divorce. 311.17 Sec. 6. Minnesota Statutes 1998, section 256J.08, 311.18 subdivision 24, is amended to read: 311.19 Subd. 24. [DISREGARD.] "Disregard" means earned income 311.20 that is not counted when determining initial eligibility or 311.21 ongoing eligibility and calculating the amount of the assistance 311.22 payment for participants. The commissioner shall determine the 311.23 amount of the disregard according to section 256J.24, 311.24 subdivision 10. 311.25 Sec. 7. Minnesota Statutes 1998, section 256J.08, is 311.26 amended by adding a subdivision to read: 311.27 Subd. 28a. [ENCUMBRANCE.] "Encumbrance" means a legal 311.28 claim against real or personal property that is payable upon the 311.29 sale of that property. 311.30 Sec. 8. Minnesota Statutes 1998, section 256J.08, is 311.31 amended by adding a subdivision to read: 311.32 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of need" 311.33 means the appropriate standard used to determine MFIP benefit 311.34 payments for the MFIP unit and applies to: 311.35 (1) the transitional standard, sections 256J.08, 311.36 subdivision 85, and 256J.24, subdivision 5; 312.1 (2) the shared household standard, section 256J.24, 312.2 subdivision 9; and 312.3 (3) the interstate transition standard, section 256J.43. 312.4 Sec. 9. Minnesota Statutes 1998, section 256J.08, 312.5 subdivision 65, is amended to read: 312.6 Subd. 65. [PARTICIPANT.] "Participant" means a person who 312.7 is currently receiving cash assistanceandor the food portion 312.8 available throughMFIP-SMFIP as funded by TANF and the food 312.9 stamp program. A person who fails to withdraw or access 312.10 electronically any portion of the person's cash and food 312.11 assistance payment by the end of the payment month, who makes a 312.12 written request for closure before the first of a payment month 312.13 and repays cash and food assistance electronically issued for 312.14 that payment month within that payment month, or who returns any 312.15 uncashed assistance check and food coupons and withdraws from 312.16 the program is not a participant. A person who withdraws a cash 312.17 or food assistance payment by electronic transfer or receives 312.18 and cashesa cashan MFIP assistance check or food coupons and 312.19 is subsequently determined to be ineligible for assistance for 312.20 that period of time is a participant, regardless whether that 312.21 assistance is repaid. The term "participant" includes the 312.22 caregiver relative and the minor child whose needs are included 312.23 in the assistance payment. A person in an assistance unit who 312.24 does not receive a cash and food assistance payment because the 312.25 person has been suspended fromMFIP-S or because the person's312.26need falls below the $10 minimum payment levelMFIP is a 312.27 participant. 312.28 Sec. 10. Minnesota Statutes 1998, section 256J.08, 312.29 subdivision 82, is amended to read: 312.30 Subd. 82. [SANCTION.] "Sanction" means the reduction of a 312.31 family's assistance payment by a specified percentage of 312.32 theapplicable transitionalMFIP standard of need because: a 312.33 nonexempt participant fails to comply with the requirements of 312.34 sections 256J.52 to 256J.55; a parental caregiver fails without 312.35 good cause to cooperate with the child support enforcement 312.36 requirements; or a participant fails to comply with the 313.1 insurance, tort liability, or other requirements of this chapter. 313.2 Sec. 11. Minnesota Statutes 1998, section 256J.08, 313.3 subdivision 83, is amended to read: 313.4 Subd. 83. [SIGNIFICANT CHANGE.] "Significant change" means 313.5 a decline in gross income of36 percentthe amount of the 313.6 disregard as defined in subdivision 24 or more from the income 313.7 used to determine the grant for the current month. 313.8 Sec. 12. Minnesota Statutes 1998, section 256J.08, 313.9 subdivision 86a, is amended to read: 313.10 Subd. 86a. [UNRELATED MEMBER.] "Unrelated member" means an 313.11 individual in the household who does not meet the definition of 313.12 an eligible caregiver, but does not include an individual who313.13provides child care to a child in the assistance unit. 313.14 Sec. 13. Minnesota Statutes 1998, section 256J.11, 313.15 subdivision 2, is amended to read: 313.16 Subd. 2. [NONCITIZENS; FOOD PORTION.](a) For the period313.17September 1, 1997, to October 31, 1997, noncitizens who do not313.18meet one of the exemptions in section 412 of the Personal313.19Responsibility and Work Opportunity Reconciliation Act of 1996,313.20but were residing in this state as of July 1, 1997, are eligible313.21for the 6/10 of the average value of food stamps for the same313.22family size and composition until MFIP-S is operative in the313.23noncitizen's county of financial responsibility and thereafter,313.24the 6/10 of the food portion of MFIP-S. However, federal food313.25stamp dollars cannot be used to fund the food portion of MFIP-S313.26benefits for an individual under this subdivision.313.27(b) For the period November 1, 1997, to June 30, 1999,313.28noncitizens who do not meet one of the exemptions in section 412313.29of the Personal Responsibility and Work Opportunity313.30Reconciliation Act of 1996, and are receiving cash assistance313.31under the AFDC, family general assistance, MFIP or MFIP-S313.32programs are eligible for the average value of food stamps for313.33the same family size and composition until MFIP-S is operative313.34in the noncitizen's county of financial responsibility and313.35thereafter, the food portion of MFIP-S. However, federal food313.36stamp dollars cannot be used to fund the food portion of MFIP-S314.1benefits for an individual under this subdivisionState dollars 314.2 shall fund the food portion of a noncitizen's MFIP benefits when 314.3 federal food stamp dollars cannot be used to fund those 314.4 benefits. The assistance provided under this subdivision, which 314.5 is designated as a supplement to replace lost benefits under the 314.6 federal food stamp program, must be disregarded as income in all 314.7 programs that do not count food stamps as income where the 314.8 commissioner has the authority to make the income disregard 314.9 determination for the program. 314.10(c) The commissioner shall submit a state plan to the314.11secretary of agriculture to allow the commissioner to purchase314.12federal Food Stamp Program benefits in an amount equal to the314.13MFIP-S food portion for each legal noncitizen receiving MFIP-S314.14assistance who is ineligible to participate in the federal Food314.15Stamp Program solely due to the provisions of section 402 or 403314.16of Public Law Number 104-193, as authorized by Title VII of the314.171997 Emergency Supplemental Appropriations Act, Public Law314.18Number 105-18. The commissioner shall enter into a contract as314.19necessary with the secretary to use the existing federal Food314.20Stamp Program benefits delivery system for the purposes of314.21administering the food portion of MFIP-S under this subdivision.314.22 Sec. 14. Minnesota Statutes 1998, section 256J.11, 314.23 subdivision 3, is amended to read: 314.24 Subd. 3. [BENEFITS FUNDED WITH STATE MONEY.] Legal adult 314.25 noncitizens who have resided in the country for four years or 314.26 more as a lawful permanent resident, whose benefits are funded 314.27 entirely with state money, and who are under 70 years of age, 314.28 must, as a condition of eligibility: 314.29 (1) be enrolled in a literacy class, English as a second 314.30 language class, or a citizen class; 314.31 (2) be applying for admission to a literacy class, English 314.32 as a second language class, and is on a waiting list; 314.33 (3) be in the process of applying for a waiver from the 314.34 Immigration and Naturalization Service of the English language 314.35 or civics requirements of the citizenship test; 314.36 (4) have submitted an application for citizenship to the 315.1 Immigration and Naturalization Service and is waiting for a 315.2 testing date or a subsequent swearing in ceremony; or 315.3 (5) have been denied citizenship due to a failure to pass 315.4 the test after two attempts or because of an inability to 315.5 understand the rights and responsibilities of becoming a United 315.6 States citizen, as documented by the Immigration and 315.7 Naturalization Service or the county. 315.8 If the county social service agency determines that a legal 315.9 noncitizen subject to the requirements of this subdivision will 315.10 require more than one year of English language training, then 315.11 the requirements of clause (1) or (2) shall be imposed after the 315.12 legal noncitizen has resided in the country for three years. 315.13 Individuals who reside in a facility licensed under chapter 315.14 144A, 144D, 245A, or 256I are exempt from the requirements of 315.15 this subdivision. 315.16 Sec. 15. Minnesota Statutes 1998, section 256J.12, 315.17 subdivision 1a, is amended to read: 315.18 Subd. 1a. [30-DAY RESIDENCY REQUIREMENT.] An assistance 315.19 unit is considered to have established residency in this state 315.20 only when a child or caregiver has resided in this state for at 315.21 least 30 consecutive days with the intention of making the 315.22 person's home here and not for any temporary purpose. The birth 315.23 of a child in Minnesota to a member of the assistance unit does 315.24 not automatically establish the residency in this state under 315.25 this subdivision of the other members of the assistance unit. 315.26 Time spent in a shelter for battered women shall count toward 315.27 satisfying the 30-day residency requirement. 315.28 Sec. 16. Minnesota Statutes 1998, section 256J.12, 315.29 subdivision 2, is amended to read: 315.30 Subd. 2. [EXCEPTIONS.] (a) A county shall waive the 30-day 315.31 residency requirement where unusual hardship would result from 315.32 denial of assistance. 315.33 (b) For purposes of this section, unusual hardship means an 315.34 assistance unit: 315.35 (1) is without alternative shelter; or 315.36 (2) is without available resources for food. 316.1 (c) For purposes of this subdivision, the following 316.2 definitions apply (1) "metropolitan statistical area" is as 316.3 defined by the U.S. Census Bureau; (2) "alternative shelter" 316.4 includes any shelter that is located within the metropolitan 316.5 statistical area containing the county and for which the family 316.6 is eligible, provided the assistance unit does not have to 316.7 travel more than 20 miles to reach the shelter and has access to 316.8 transportation to the shelter. Clause (2) does not apply to 316.9 counties in the Minneapolis-St. Paul metropolitan statistical 316.10 area. 316.11 (d) Applicants are considered to meet the residency 316.12 requirement under subdivision 1a if they once resided in 316.13 Minnesota and: 316.14 (1) joined the United States armed services, returned to 316.15 Minnesota within 30 days of leaving the armed services, and 316.16 intend to remain in Minnesota; or 316.17 (2) left to attend school in another state, paid 316.18 nonresident tuition or Minnesota tuition rates under a 316.19 reciprocity agreement, and returned to Minnesota within 30 days 316.20 of graduation with the intent to remain in Minnesota. 316.21 (e) The 30-day residence requirement is met when: 316.22 (1) a minor child or a minor caregiver moves from another 316.23 state to the residence of a relative caregiver; and 316.24(2) the minor caregiver applies for and receives family316.25cash assistance;316.26(3) the relative caregiver chooses not to be part of the316.27MFIP-S assistance unit; and316.28(4) the relative caregiver has resided in Minnesota for at316.29least 30 days prior to the date the assistance unit applies for316.30cash assistance.316.31(f) Ineligible mandatory unit members who have resided in316.32Minnesota for 12 months immediately before the unit's date of316.33application establish the other assistance unit members'316.34eligibility for the MFIP-S transitional standard.316.35 (2) the relative caregiver has resided in Minnesota for at 316.36 least 30 consecutive days and: 317.1 (i) the minor caregiver applies for and receives MFIP; or 317.2 (ii) the relative caregiver applies for assistance for the 317.3 minor child but does not choose to be a member of the MFIP 317.4 assistance unit. 317.5 Sec. 17. Minnesota Statutes 1998, section 256J.14, is 317.6 amended to read: 317.7 256J.14 [ELIGIBILITY FOR PARENTING OR PREGNANT MINORS.] 317.8 (a) The definitions in this paragraph only apply to this 317.9 subdivision. 317.10 (1) "Household of a parent, legal guardian, or other adult 317.11 relative" means the place of residence of: 317.12 (i) a natural or adoptive parent; 317.13 (ii) a legal guardian according to appointment or 317.14 acceptance under section 260.242, 525.615, or 525.6165, and 317.15 related laws; 317.16 (iii) a caregiver as defined in section 256J.08, 317.17 subdivision 11; or 317.18 (iv) an appropriate adult relative designated by a county 317.19 agency. 317.20 (2) "Adult-supervised supportive living arrangement" means 317.21 a private family setting which assumes responsibility for the 317.22 care and control of the minor parent and minor child, or other 317.23 living arrangement, not including a public institution, licensed 317.24 by the commissioner of human services which ensures that the 317.25 minor parent receives adult supervision and supportive services, 317.26 such as counseling, guidance, independent living skills 317.27 training, or supervision. 317.28 (b) A minor parent and the minor child who is in the care 317.29 of the minor parent must reside in the household of a parent, 317.30 legal guardian, other adult relative, or in an adult-supervised 317.31 supportive living arrangement in order to receiveMFIP-SMFIP 317.32 unless: 317.33 (1) the minor parent has no living parent, other adult 317.34 relative, or legal guardian whose whereabouts is known; 317.35 (2) no living parent, other adult relative, or legal 317.36 guardian of the minor parent allows the minor parent to live in 318.1 the parent's, other adult relative's, or legal guardian's home; 318.2 (3) the minor parent lived apart from the minor parent's 318.3 own parent or legal guardian for a period of at least one year 318.4 before either the birth of the minor child or the minor parent's 318.5 application forMFIP-SMFIP; 318.6 (4) the physical or emotional health or safety of the minor 318.7 parent or minor child would be jeopardized if the minor parent 318.8 and the minor child resided in the same residence with the minor 318.9 parent's parent, other adult relative, or legal guardian; or 318.10 (5) an adult supervised supportive living arrangement is 318.11 not available for the minor parent and child in the county in 318.12 which the minor parent and child currently reside. If an adult 318.13 supervised supportive living arrangement becomes available 318.14 within the county, the minor parent and child must reside in 318.15 that arrangement. 318.16 (c) Minor applicants must be informed orally and in writing 318.17 about the eligibility requirements and their rights and 318.18 obligations under theMFIP-SMFIP program. The county must 318.19 advise the minor of the possible exemptions and specifically ask 318.20 whether one or more of these exemptions is applicable. If the 318.21 minor alleges one or more of these exemptions, then the county 318.22 must assist the minor in obtaining the necessary verifications 318.23 to determine whether or not these exemptions apply. 318.24 (d) If the county worker has reason to suspect that the 318.25 physical or emotional health or safety of the minor parent or 318.26 minor child would be jeopardized if they resided with the minor 318.27 parent's parent, other adult relative, or legal guardian, then 318.28 the county worker must make a referral to child protective 318.29 services to determine if paragraph (b), clause (4), applies. A 318.30 new determination by the county worker is not necessary if one 318.31 has been made within the last six months, unless there has been 318.32 a significant change in circumstances which justifies a new 318.33 referral and determination. 318.34 (e) If a minor parent is not living with a parent, legal 318.35 guardian, or other adult relative due to paragraph (b), clause 318.36 (1), (2), or (4), the minor parent must reside, when possible, 319.1 in a living arrangement that meets the standards of paragraph 319.2 (a), clause (2). 319.3 (f)When a minor parent and minor child live with a parent,319.4other adult relative, legal guardian, or in an adult-supervised319.5supportiveRegardless of living arrangement,MFIP-SMFIP must be 319.6 paid, when possible, in the form of a protective payment on 319.7 behalf of the minor parent and minor child according to section 319.8 256J.39, subdivisions 2 to 4. 319.9 Sec. 18. Minnesota Statutes 1998, section 256J.20, 319.10 subdivision 3, is amended to read: 319.11 Subd. 3. [OTHER PROPERTY LIMITATIONS.] To be eligible for 319.12MFIP-SMFIP, the equity value of all nonexcluded real and 319.13 personal property of the assistance unit must not exceed $2,000 319.14 for applicants and $5,000 for ongoing participants. The value 319.15 of assets in clauses (1) to (20) must be excluded when 319.16 determining the equity value of real and personal property: 319.17 (1) a licensed vehicle up to a loan value of less than or 319.18 equal to $7,500. The county agency shall apply any excess loan 319.19 value as if it were equity value to the asset limit described in 319.20 this section. If the assistance unit owns more than one 319.21 licensed vehicle, the county agency shall determine the vehicle 319.22 with the highest loan value and count only the loan value over 319.23 $7,500, excluding: (i) the value of one vehicle per physically 319.24 disabled person when the vehicle is needed to transport the 319.25 disabled unit member; this exclusion does not apply to mentally 319.26 disabled people; (ii) the value of special equipment for a 319.27 handicapped member of the assistance unit; and (iii) any vehicle 319.28 used for long-distance travel, other than daily commuting, for 319.29 the employment of a unit member. 319.30 The county agency shall count the loan value of all other 319.31 vehicles and apply this amount as if it were equity value to the 319.32 asset limit described in this section.The value of special319.33equipment for a handicapped member of the assistance unit is319.34excluded.To establish the loan value of vehicles, a county 319.35 agency must use the N.A.D.A. Official Used Car Guide, Midwest 319.36 Edition, for newer model cars. When a vehicle is not listed in 320.1 the guidebook, or when the applicant or participant disputes the 320.2 loan value listed in the guidebook as unreasonable given the 320.3 condition of the particular vehicle, the county agency may 320.4 require the applicant or participant document the loan value by 320.5 securing a written statement from a motor vehicle dealer 320.6 licensed under section 168.27, stating the amount that the 320.7 dealer would pay to purchase the vehicle. The county agency 320.8 shall reimburse the applicant or participant for the cost of a 320.9 written statement that documents a lower loan value; 320.10 (2) the value of life insurance policies for members of the 320.11 assistance unit; 320.12 (3) one burial plot per member of an assistance unit; 320.13 (4) the value of personal property needed to produce earned 320.14 income, including tools, implements, farm animals, inventory, 320.15 business loans, business checking and savings accounts used at 320.16 least annually and used exclusively for the operation of a 320.17 self-employment business, and any motor vehicles if at least 50 320.18 percent of the vehicle's use is to produce income and if the 320.19 vehicles are essential for the self-employment business; 320.20 (5) the value of personal property not otherwise specified 320.21 which is commonly used by household members in day-to-day living 320.22 such as clothing, necessary household furniture, equipment, and 320.23 other basic maintenance items essential for daily living; 320.24 (6) the value of real and personal property owned by a 320.25 recipient of Supplemental Security Income or Minnesota 320.26 supplemental aid; 320.27 (7) the value of corrective payments, but only for the 320.28 month in which the payment is received and for the following 320.29 month; 320.30 (8) a mobile home or other vehicle used by an applicant or 320.31 participant as the applicant's or participant's home; 320.32 (9) money in a separate escrow account that is needed to 320.33 pay real estate taxes or insurance and that is used for this 320.34 purpose; 320.35 (10) money held in escrow to cover employee FICA, employee 320.36 tax withholding, sales tax withholding, employee worker 321.1 compensation, business insurance, property rental, property 321.2 taxes, and other costs that are paid at least annually, but less 321.3 often than monthly; 321.4 (11) monthly assistance, emergency assistance, and 321.5 diversionary payments for the current month's needs; 321.6 (12) the value of school loans, grants, or scholarships for 321.7 the period they are intended to cover; 321.8 (13) payments listed in section 256J.21, subdivision 2, 321.9 clause (9), which are held in escrow for a period not to exceed 321.10 three months to replace or repair personal or real property; 321.11 (14) income received in a budget month through the end of 321.12 the payment month; 321.13 (15) savings from earned income of a minor child or a minor 321.14 parent that are set aside in a separate account designated 321.15 specifically for future education or employment costs; 321.16 (16) the federal earned income credit, Minnesota working 321.17 family credit, state and federal income tax refunds, state 321.18 homeowners and renters credits under chapter 290A, property tax 321.19 rebatesunder Laws 1997, chapter 231, article 1, section 16,and 321.20 other federal or state tax rebates in the month received and the 321.21 following month; 321.22 (17) payments excluded under federal law as long as those 321.23 payments are held in a separate account from any nonexcluded 321.24 funds; 321.25 (18) money received by a participant of the corps to career 321.26 program under section 84.0887, subdivision 2, paragraph (b), as 321.27 a postservice benefit under the federal Americorps Act; 321.28 (19) the assets of children ineligible to receiveMFIP-S321.29 MFIP benefits because foster care or adoption assistance 321.30 payments are made on their behalf; and 321.31 (20) the assets of persons whose income is excluded under 321.32 section 256J.21, subdivision 2, clause (43). 321.33 Sec. 19. Minnesota Statutes 1998, section 256J.21, 321.34 subdivision 2, is amended to read: 321.35 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 321.36 excluded in determining a family's available income: 322.1 (1) payments for basic care, difficulty of care, and 322.2 clothing allowances received for providing family foster care to 322.3 children or adults under Minnesota Rules, parts 9545.0010 to 322.4 9545.0260 and 9555.5050 to 9555.6265, and payments received and 322.5 used for care and maintenance of a third-party beneficiary who 322.6 is not a household member; 322.7 (2) reimbursements for employment training received through 322.8 the Job Training Partnership Act, United States Code, title 29, 322.9 chapter 19, sections 1501 to 1792b; 322.10 (3) reimbursement for out-of-pocket expenses incurred while 322.11 performing volunteer services, jury duty,oremployment, or 322.12 informal carpooling arrangements directly related to employment; 322.13 (4) all educational assistance, except the county agency 322.14 must count graduate student teaching assistantships, 322.15 fellowships, and other similar paid work as earned income and, 322.16 after allowing deductions for any unmet and necessary 322.17 educational expenses, shall count scholarships or grants awarded 322.18 to graduate students that do not require teaching or research as 322.19 unearned income; 322.20 (5) loans, regardless of purpose, from public or private 322.21 lending institutions, governmental lending institutions, or 322.22 governmental agencies; 322.23 (6) loans from private individuals, regardless of purpose, 322.24 provided an applicant or participant documents that the lender 322.25 expects repayment; 322.26 (7)(i) state income tax refunds; and 322.27 (ii) federal income tax refunds; 322.28 (8)(i) federal earned income credits; 322.29 (ii) Minnesota working family credits; 322.30 (iii) state homeowners and renters credits under chapter 322.31 290A; and 322.32 (iv)property tax rebates under Laws 1997, chapter 231,322.33article 1, section 16; and322.34(v) otherfederal or state tax rebates; 322.35 (9) funds received for reimbursement, replacement, or 322.36 rebate of personal or real property when these payments are made 323.1 by public agencies, awarded by a court, solicited through public 323.2 appeal, or made as a grant by a federal agency, state or local 323.3 government, or disaster assistance organizations, subsequent to 323.4 a presidential declaration of disaster; 323.5 (10) the portion of an insurance settlement that is used to 323.6 pay medical, funeral, and burial expenses, or to repair or 323.7 replace insured property; 323.8 (11) reimbursements for medical expenses that cannot be 323.9 paid by medical assistance; 323.10 (12) payments by a vocational rehabilitation program 323.11 administered by the state under chapter 268A, except those 323.12 payments that are for current living expenses; 323.13 (13) in-kind income, including any payments directly made 323.14 by a third party to a provider of goods and services; 323.15 (14) assistance payments to correct underpayments, but only 323.16 for the month in which the payment is received; 323.17 (15) emergency assistance payments; 323.18 (16) funeral and cemetery payments as provided by section 323.19 256.935; 323.20 (17) nonrecurring cash gifts of $30 or less, not exceeding 323.21 $30 per participant in a calendar month; 323.22 (18) any form of energy assistance payment made through 323.23 Public Law Number 97-35, Low-Income Home Energy Assistance Act 323.24 of 1981, payments made directly to energy providers by other 323.25 public and private agencies, and any form of credit or rebate 323.26 payment issued by energy providers; 323.27 (19) Supplemental Security Income, including retroactive 323.28 payments; 323.29 (20) Minnesota supplemental aid, including retroactive 323.30 payments; 323.31 (21) proceeds from the sale of real or personal property; 323.32 (22) adoption assistance payments under section 259.67; 323.33 (23) state-funded family subsidy program payments made 323.34 under section 252.32 to help families care for children with 323.35 mental retardation or related conditions; 323.36 (24) interest payments and dividends from property that is 324.1 not excluded from and that does not exceed the asset limit; 324.2 (25) rent rebates; 324.3 (26) income earned by a minor caregiveror, minor child 324.4 through age 6, or a minor child who is at least a half-time 324.5 student in an approved elementary or secondary education 324.6 program; 324.7 (27) income earned by a caregiver under age 20 who is at 324.8 least a half-time student in an approved elementary or secondary 324.9 education program; 324.10 (28)MFIP-SMFIP child care payments under section 119B.05; 324.11 (29) all other payments made throughMFIP-SMFIP to support 324.12 a caregiver's pursuit of greater self-support; 324.13 (30) income a participant receives related to shared living 324.14 expenses; 324.15 (31) reverse mortgages; 324.16 (32) benefits provided by the Child Nutrition Act of 1966, 324.17 United States Code, title 42, chapter 13A, sections 1771 to 324.18 1790; 324.19 (33) benefits provided by the women, infants, and children 324.20 (WIC) nutrition program, United States Code, title 42, chapter 324.21 13A, section 1786; 324.22 (34) benefits from the National School Lunch Act, United 324.23 States Code, title 42, chapter 13, sections 1751 to 1769e; 324.24 (35) relocation assistance for displaced persons under the 324.25 Uniform Relocation Assistance and Real Property Acquisition 324.26 Policies Act of 1970, United States Code, title 42, chapter 61, 324.27 subchapter II, section 4636, or the National Housing Act, United 324.28 States Code, title 12, chapter 13, sections 1701 to 1750jj; 324.29 (36) benefits from the Trade Act of 1974, United States 324.30 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 324.31 (37) war reparations payments to Japanese Americans and 324.32 Aleuts under United States Code, title 50, sections 1989 to 324.33 1989d; 324.34 (38) payments to veterans or their dependents as a result 324.35 of legal settlements regarding Agent Orange or other chemical 324.36 exposure under Public Law Number 101-239, section 10405, 325.1 paragraph (a)(2)(E); 325.2 (39) income that is otherwise specifically excluded from 325.3the MFIP-S programMFIP consideration in federal law, state law, 325.4 or federal regulation; 325.5 (40) security and utility deposit refunds; 325.6 (41) American Indian tribal land settlements excluded under 325.7 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 325.8 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 325.9 reservations and payments to members of the White Earth Band, 325.10 under United States Code, title 25, chapter 9, section 331, and 325.11 chapter 16, section 1407; 325.12 (42) all income of the minor parent'sparentparents and 325.13stepparentstepparents when determining the grant for the minor 325.14 parent in households that include a minor parent living witha325.15parentparents orstepparentstepparents onMFIP-SMFIP with 325.16 other children; and 325.17 (43) income of the minor parent'sparentparents and 325.18stepparentstepparents equal to 200 percent of the federal 325.19 poverty guideline for a family size not including the minor 325.20 parent and the minor parent's child in households that include a 325.21 minor parent living witha parentparents orstepparent325.22 stepparents not onMFIP-SMFIP when determining the grant for 325.23 the minor parent. The remainder of income is deemed as 325.24 specified in section 256J.37, subdivision 1b; 325.25 (44) payments made to children eligible for relative 325.26 custody assistance under section 257.85; 325.27 (45) vendor payments for goods and services made on behalf 325.28 of a client unless the client has the option of receiving the 325.29 payment in cash; and 325.30 (46) the principal portion of a contract for deed payment. 325.31 Sec. 20. Minnesota Statutes 1998, section 256J.21, 325.32 subdivision 3, is amended to read: 325.33 Subd. 3. [INITIAL INCOME TEST.] The county agency shall 325.34 determine initial eligibility by considering all earned and 325.35 unearned income that is not excluded under subdivision 2. To be 325.36 eligible forMFIP-SMFIP, the assistance unit's countable income 326.1 minus the disregards in paragraphs (a) and (b) must be below the 326.2 transitional standard of assistance according to section 256J.24 326.3 for that size assistance unit. 326.4 (a) The initial eligibility determination must disregard 326.5 the following items: 326.6 (1) the employment disregard is 18 percent of the gross 326.7 earned income whether or not the member is working full time or 326.8 part time; 326.9 (2) dependent care costs must be deducted from gross earned 326.10 income for the actual amount paid for dependent care up to a 326.11 maximum of $200 per month for each child less than two years of 326.12 age, and $175 per month for each child two years of age and 326.13 older under this chapter and chapter 119B; 326.14 (3) all payments made according to a court order for 326.15 spousal support or the support of children not living in the 326.16 assistance unit's household shall be disregarded from the income 326.17 of the person with the legal obligation to pay support, provided 326.18 that, if there has been a change in the financial circumstances 326.19 of the person with the legal obligation to pay support since the 326.20 support order was entered, the person with the legal obligation 326.21 to pay support has petitioned for a modification of the support 326.22 order; and 326.23 (4) an allocation for the unmet need of an ineligible 326.24 spouse or an ineligible child under the age of 21 for whom the 326.25 caregiver is financially responsible and who lives with the 326.26 caregiver according to section 256J.36. 326.27 (b) Notwithstanding paragraph (a), when determining initial 326.28 eligibility for applicant units when at least one member has 326.29 receivedAFDC, family general assistance, MFIP, MFIP-R,work 326.30 first,orMFIP-SMFIP in this state within four months of the 326.31 most recent application forMFIP-SMFIP, apply theemployment326.32 disregard as defined in section 256J.08, subdivision 24, for all 326.33 unit membersis 36 percent of the gross earned income. 326.34 After initial eligibility is established, the assistance 326.35 payment calculation is based on the monthly income test. 326.36 Sec. 21. Minnesota Statutes 1998, section 256J.21, 327.1 subdivision 4, is amended to read: 327.2 Subd. 4. [MONTHLY INCOME TEST AND DETERMINATION OF 327.3 ASSISTANCE PAYMENT.] The county agency shall determine ongoing 327.4 eligibility and the assistance payment amount according to the 327.5 monthly income test. To be eligible forMFIP-SMFIP, the result 327.6 of the computations in paragraphs (a) to (e) must be at least $1. 327.7 (a) Applya 36 percentan income disregard as defined in 327.8 section 256J.08, subdivision 24, to gross earnings and subtract 327.9 this amount from the family wage level. If the difference is 327.10 equal to or greater than thetransitionalMFIP standard of need, 327.11 the assistance payment is equal to thetransitionalMFIP 327.12 standard of need. If the difference is less than 327.13 thetransitionalMFIP standard of need, the assistance payment 327.14 is equal to the difference. The employment disregard in this 327.15 paragraph must be deducted every month there is earned income. 327.16 (b) All payments made according to a court order for 327.17 spousal support or the support of children not living in the 327.18 assistance unit's household must be disregarded from the income 327.19 of the person with the legal obligation to pay support, provided 327.20 that, if there has been a change in the financial circumstances 327.21 of the person with the legal obligation to pay support since the 327.22 support order was entered, the person with the legal obligation 327.23 to pay support has petitioned for a modification of the court 327.24 order. 327.25 (c) An allocation for the unmet need of an ineligible 327.26 spouse or an ineligible child under the age of 21 for whom the 327.27 caregiver is financially responsible and who lives with the 327.28 caregiver must be made according to section 256J.36. 327.29 (d) Subtract unearned income dollar for dollar from 327.30 thetransitionalMFIP standard of need to determine the 327.31 assistance payment amount. 327.32 (e) When income is both earned and unearned, the amount of 327.33 the assistance payment must be determined by first treating 327.34 gross earned income as specified in paragraph (a). After 327.35 determining the amount of the assistance payment under paragraph 327.36 (a), unearned income must be subtracted from that amount dollar 328.1 for dollar to determine the assistance payment amount. 328.2 (f) When the monthly income is greater than the 328.3transitional or family wage levelMFIP standard of need after 328.4applicabledeductions and the income will only exceed the 328.5 standard for one month, the county agency must suspend the 328.6 assistance payment for the payment month. 328.7 Sec. 22. Minnesota Statutes 1998, section 256J.24, 328.8 subdivision 2, is amended to read: 328.9 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 328.10 for minor caregivers and their children who must be in a 328.11 separate assistance unit from the other persons in the 328.12 household, when the following individuals live together, they 328.13 must be included in the assistance unit: 328.14 (1) a minor child, including a pregnant minor; 328.15 (2) the minor child's minor siblings, minor half-siblings, 328.16 and minor step-siblings; 328.17 (3) the minor child's natural parents, adoptive parents, 328.18 and stepparents; and 328.19 (4) the spouse of a pregnant woman. 328.20 Sec. 23. Minnesota Statutes 1998, section 256J.24, 328.21 subdivision 3, is amended to read: 328.22 Subd. 3. [INDIVIDUALS WHO MUST BE EXCLUDED FROM AN 328.23 ASSISTANCE UNIT.] (a) The following individuals who are part of 328.24 the assistance unit determined under subdivision 2 are 328.25 ineligible to receiveMFIP-SMFIP: 328.26 (1) individuals receiving Supplemental Security Income or 328.27 Minnesota supplemental aid; 328.28 (2)individuals living at home while performing328.29court-imposed, unpaid community service work due to a criminal328.30conviction;328.31(3)individuals disqualified from the food stamp program or 328.32MFIP-SMFIP, until the disqualification ends; 328.33(4)(3) children on whose behalf federal, state or local 328.34 foster care payments are made, except as provided in sections 328.35 256J.13, subdivision 2, and 256J.74, subdivision 2; and 328.36(5)(4) children receiving ongoing monthly adoption 329.1 assistance payments under section 259.67. 329.2 (b) The exclusion of a person under this subdivision does 329.3 not alter the mandatory assistance unit composition. 329.4 Sec. 24. Minnesota Statutes 1998, section 256J.24, 329.5 subdivision 7, is amended to read: 329.6 Subd. 7. [FAMILY WAGE LEVEL STANDARD.] The family wage 329.7 level standard is 110 percent of the transitional standard under 329.8 subdivision 5 and is the standard used when there is earned 329.9 income in the assistance unit. As specified in section 256J.21, 329.10 earned income is subtracted from the family wage level to 329.11 determine the amount of the assistance payment. Not including 329.12 the family wage level standard, assistance payments may not 329.13 exceed theshared household standard or the transitionalMFIP 329.14 standard of need for the assistance unit, whichever is less. 329.15 Sec. 25. Minnesota Statutes 1998, section 256J.24, 329.16 subdivision 8, is amended to read: 329.17 Subd. 8. [ASSISTANCE PAID TO ELIGIBLE ASSISTANCE UNITS.] 329.18 Except for assistance units with nonparental caregivers, 329.19 payments for shelter up to the amount of the cash portion 329.20 ofMFIP-SMFIP benefits for which the assistance unit is 329.21 eligible shall be vendor paid for as many months as the 329.22 assistance unit is eligible or six months, whichever comes 329.23 first. The residual amount of the grant after vendor payment, 329.24 if any, must be paid to theMFIP-SMFIP caregiver. 329.25 Sec. 26. Minnesota Statutes 1998, section 256J.24, 329.26 subdivision 9, is amended to read: 329.27 Subd. 9. [SHARED HOUSEHOLD STANDARD;MFIP-SMFIP.] (a) 329.28 Except as prohibited in paragraph (b), the county agency must 329.29 use the shared household standard when the household includes 329.30 one or more unrelated members, as that term is defined in 329.31 section 256J.08, subdivision 86a. The county agency must use 329.32 the shared household standard, unless a member of the assistance 329.33 unit is a victim of domestic violence and has an approved safety 329.34 plan, regardless of the number of unrelated members in the 329.35 household. 329.36 (b) The county agency must not use the shared household 330.1 standard when all unrelated members are one of the following: 330.2 (1) a recipient of public assistance benefits, including 330.3 food stamps, Supplemental Security Income, adoption assistance, 330.4 relative custody assistance, or foster care payments; 330.5 (2) a roomer or boarder, or a person to whom the assistance 330.6 unit is paying room or board; 330.7 (3) a minor child under the age of 18; 330.8 (4) a minor caregiver living with the minor caregiver's 330.9 parents or in an approved supervised living arrangement;or330.10 (5) a caregiver who is not the parent of the minor child in 330.11 the assistance unit; or 330.12 (6) an individual who provides child care to a child in the 330.13 MFIP assistance unit. 330.14 (c) The shared household standard must be discontinued if 330.15 it is not approved by the United States Department of 330.16 Agriculture under theMFIP-SMFIP waiver. 330.17 Sec. 27. Minnesota Statutes 1998, section 256J.24, is 330.18 amended by adding a subdivision to read: 330.19 Subd. 10. [MFIP EXIT LEVEL.] In state fiscal years 2000 330.20 and 2001, the commissioner shall adjust the MFIP earned income 330.21 disregard to ensure that participants do not lose eligibility 330.22 for MFIP until their income reaches at least 120 percent of the 330.23 federal poverty guidelines in effect in October of each fiscal 330.24 year. Adjustments to the disregard shall be based on a 330.25 household size of three and shall be implemented at the same 330.26 time as the October food stamp cost-of-living adjustment is 330.27 reflected in the food portion of MFIP transitional standard as 330.28 required under subdivision 5a. 330.29 Sec. 28. Minnesota Statutes 1998, section 256J.26, 330.30 subdivision 1, is amended to read: 330.31 Subdivision 1. [PERSON CONVICTED OF DRUG OFFENSES.] (a) 330.32 Applicants or participants who have been convicted of a drug 330.33 offense committed after July 1, 1997, may, if otherwise 330.34 eligible, receiveAFDC or MFIP-SMFIP benefits subject to the 330.35 following conditions: 330.36 (1) Benefits for the entire assistance unit must be paid in 331.1 vendor form for shelter and utilities during any time the 331.2 applicant is part of the assistance unit. 331.3 (2) The convicted applicant or participant shall be subject 331.4 to random drug testing as a condition of continued eligibility 331.5 and following any positive test for an illegal controlled 331.6 substance is subject to the following sanctions: 331.7 (i) for failing a drug test the first time, the 331.8 participant's grant shall be reduced by ten percent of the 331.9MFIP-S transitionalMFIP standard of need,the shared household331.10standard, or the interstate transitional standard, whichever is331.11applicableprior to making vendor payments for shelter and 331.12 utility costs; or 331.13 (ii) for failing a drug test two or more times, the 331.14 residual amount of the participant's grant after making vendor 331.15 payments for shelter and utility costs, if any, must be reduced 331.16 by an amount equal to 30 percent of theMFIP-S transitional331.17standard, the shared household standard, or the interstate331.18transitional standard, whichever is applicableMFIP standard of 331.19 need. 331.20 (3) A participant who fails an initial drug test and is 331.21 under a sanction due to other MFIP program requirements is 331.22 subject to the sanction in clause (2)(ii). 331.23 (b) Applicants requesting only food stamps or participants 331.24 receiving only food stamps, who have been convicted of a drug 331.25 offense that occurred after July 1, 1997, may, if otherwise 331.26 eligible, receive food stamps if the convicted applicant or 331.27 participant is subject to random drug testing as a condition of 331.28 continued eligibility. Following a positive test for an illegal 331.29 controlled substance, the applicant is subject to the following 331.30 sanctions: 331.31 (1) for failing a drug test the first time, food stamps 331.32 shall be reduced by ten percent of the applicable food stamp 331.33 allotment; and 331.34 (2) for failing a drug test two or more times, food stamps 331.35 shall be reduced by an amount equal to 30 percent of the 331.36 applicable food stamp allotment. 332.1 (c) For the purposes of this subdivision, "drug offense" 332.2 meansa convictionan offense that occurred after July 1, 1997, 332.3 of sections 152.021 to 152.025, 152.0261, or 152.096. Drug 332.4 offense also means a conviction in another jurisdiction of the 332.5 possession, use, or distribution of a controlled substance, or 332.6 conspiracy to commit any of these offenses, if the offense 332.7 occurred after July 1, 1997, and the conviction is a felony 332.8 offense in that jurisdiction, or in the case of New Jersey, a 332.9 high misdemeanor. 332.10 Sec. 29. Minnesota Statutes 1998, section 256J.30, 332.11 subdivision 2, is amended to read: 332.12 Subd. 2. [REQUIREMENT TO APPLY FOR OTHER BENEFITS.] An 332.13 applicant or participant must apply for, accept if eligible, and 332.14 follow through with appealing any denials of eligibility for 332.15 benefits from other programs for which the applicant or 332.16 participant is potentially eligible and which would, if 332.17 received, offset assistance payments. An applicant's or 332.18 participant's failure to complete application for these benefits 332.19 without good cause results in denial or termination of 332.20 assistance. Good cause for failure to apply for these benefits 332.21 is allowed when circumstances beyond the control of the 332.22 applicant or participant prevent the applicant or participant 332.23 from making an application. 332.24 Sec. 30. Minnesota Statutes 1998, section 256J.30, 332.25 subdivision 7, is amended to read: 332.26 Subd. 7. [DUE DATE OFMFIP-SMFIP HOUSEHOLD REPORT FORM.] 332.27 AnMFIP-SMFIP household report form must be received by the 332.28 county agency by the eighth calendar day of the month following 332.29 the reporting period covered by the form. When the eighth 332.30 calendar day of the month falls on a weekend or holiday, 332.31 theMFIP-SMFIP household report form must be received by the 332.32 county agency the first working day that follows the eighth 332.33 calendar day.The county agency must send a notice of332.34termination because of a late or incomplete MFIP-S household332.35report form.332.36 Sec. 31. Minnesota Statutes 1998, section 256J.30, 333.1 subdivision 8, is amended to read: 333.2 Subd. 8. [LATEMFIP-SMFIP HOUSEHOLD REPORT FORMS.] 333.3 Paragraphs (a) to (d) apply to the reporting requirements in 333.4 subdivision 7. 333.5 (a) Whena caregiver submitsthe county agency receives an 333.6 incompleteMFIP-SMFIP household report formbefore the last333.7working day of the month on which a ten-day notice of333.8termination can be issued, the county agency must immediately 333.9 return the incomplete formon or before the ten-day notice333.10deadline or any previously sent ten-day notice of termination is333.11invalidand clearly state what the caregiver must do for the 333.12 form to be complete. 333.13 (b)When a complete MFIP-S household report form is not333.14received by a county agency before the last ten days of the333.15month in which the form is due, the county agency must sendThe 333.16 automated eligibility system must send a notice of proposed 333.17 termination of assistance to the assistance unit if a complete 333.18 MFIP household report form is not received by a county agency. 333.19 The automated notice must be mailed to the caregiver by 333.20 approximately the 16th of the month. When a caregiver submits 333.21 an incomplete form on or after the date a notice of proposed 333.22 termination has been sent, the termination is valid unless the 333.23 caregiver submits a complete form before the end of the month. 333.24 (c) An assistance unit required to submit anMFIP-SMFIP 333.25 household report form is considered to have continued its 333.26 application for assistance if a completeMFIP-SMFIP household 333.27 report form is received within a calendar month after the month 333.28 in whichassistance was receivedthe form was due and assistance 333.29 shall be paid for the period beginning with the first day ofthe333.30month in which the report was duethat calendar month. 333.31 (d) A county agency must allow good cause exemptions from 333.32 the reporting requirements under subdivisions 5 and 6 when any 333.33 of the following factors cause a caregiver to fail to provide 333.34 the county agency with a completedMFIP-SMFIP household report 333.35 form before the end of the month in which the form is due: 333.36 (1) an employer delays completion of employment 334.1 verification; 334.2 (2) a county agency does not help a caregiver complete the 334.3MFIP-SMFIP household report form when the caregiver asks for 334.4 help; 334.5 (3) a caregiver does not receive anMFIP-SMFIP household 334.6 report form due to mistake on the part of the department or the 334.7 county agency or due to a reported change in address; 334.8 (4) a caregiver is ill, or physically or mentally 334.9 incapacitated; or 334.10 (5) some other circumstance occurs that a caregiver could 334.11 not avoid with reasonable care which prevents the caregiver from 334.12 providing a completedMFIP-SMFIP household report form before 334.13 the end of the month in which the form is due. 334.14 Sec. 32. Minnesota Statutes 1998, section 256J.30, 334.15 subdivision 9, is amended to read: 334.16 Subd. 9. [CHANGES THAT MUST BE REPORTED.] A caregiver must 334.17 report the changes or anticipated changes specified in clauses 334.18 (1) to (16) within ten days of the date they occur,within ten334.19days of the date the caregiver learns that the change will334.20occur,at the time of the periodic recertification of 334.21 eligibility under section 256J.32, subdivision 6, or within 334.22 eight calendar days of a reporting period as in subdivision 5 or 334.23 6, whichever occurs first. A caregiver must report other 334.24 changes at the time of the periodic recertification of 334.25 eligibility under section 256J.32, subdivision 6, or at the end 334.26 of a reporting period under subdivision 5 or 6, as applicable. 334.27 A caregiver must make these reports in writing to the county 334.28 agency. When a county agency could have reduced or terminated 334.29 assistance for one or more payment months if a delay in 334.30 reporting a change specified under clauses (1) to (16) had not 334.31 occurred, the county agency must determine whether a timely 334.32 notice under section 256J.31, subdivision 4, could have been 334.33 issued on the day that the change occurred. When a timely 334.34 notice could have been issued, each month's overpayment 334.35 subsequent to that notice must be considered a client error 334.36 overpayment under section 256J.38. Calculation of overpayments 335.1 for late reporting under clause (17) is specified in section 335.2 256J.09, subdivision 9. Changes in circumstances which must be 335.3 reported within ten days must also be reported on theMFIP-S335.4 MFIP household report form for the reporting period in which 335.5 those changes occurred. Within ten days, a caregiver must 335.6 report: 335.7 (1) a change in initial employment; 335.8 (2) a change in initial receipt of unearned income; 335.9 (3) a recurring change in unearned income; 335.10 (4) a nonrecurring change of unearned income that exceeds 335.11 $30; 335.12 (5) the receipt of a lump sum; 335.13 (6) an increase in assets that may cause the assistance 335.14 unit to exceed asset limits; 335.15 (7) a change in the physical or mental status of an 335.16 incapacitated member of the assistance unit if the physical or 335.17 mental status is the basis of exemption from anMFIP-S work and335.18trainingMFIP employment services program; 335.19 (8) a change in employment status; 335.20 (9)a change in household composition, including births,335.21returns to and departures from the home of assistance unit335.22members and financially responsible persons, or a change in the335.23custody of a minor childinformation affecting an exception 335.24 under section 256J.24, subdivision 9; 335.25 (10) a change in health insurance coverage; 335.26 (11) the marriage or divorce of an assistance unit member; 335.27 (12) the death of a parent, minor child, or financially 335.28 responsible person; 335.29 (13) a change in address or living quarters of the 335.30 assistance unit; 335.31 (14) the sale, purchase, or other transfer of property; 335.32 (15) a change in school attendance of a custodial parent or 335.33 an employed child;and335.34 (16) filing a lawsuit, a workers' compensation claim, or a 335.35 monetary claim against a third party; and 335.36 (17) a change in household composition, including births, 336.1 returns to and departures from the home of assistance unit 336.2 members and financially responsible persons, or a change in the 336.3 custody of a minor child. 336.4 Sec. 33. Minnesota Statutes 1998, section 256J.31, 336.5 subdivision 5, is amended to read: 336.6 Subd. 5. [MAILING OF NOTICE.] The notice of adverse action 336.7 shall be issued according to paragraphs (a) to(c)(d). 336.8 (a) Acounty agency shall mail anotice of adverse action 336.9 must be mailed at least ten days before the effective date of 336.10 the adverse action, except as provided in paragraphs (b)and (c)336.11 to (d). 336.12 (b)A county agency must mail a notice of adverse action at336.13least five days before the effective date of the adverse action336.14when the county agency has factual information that requires an336.15action to reduce, suspend, or terminate assistance based on336.16probable fraud.336.17(c) A county agency shall mailA notice of adverse action 336.18before or on the effective date of the adverse actionmust be 336.19 mailed no later than four working days before the end of the 336.20 month when the county agency: 336.21 (1)receives the caregiver's signed monthly MFIP-S336.22household report form that includes information that requires336.23payment reduction, suspension, or termination;336.24(2)is informed of the death ofa participantthe only 336.25 caregiver orthepayee in an assistance unit; 336.26(3)(2) receives a signed statement from the caregiver that 336.27 assistance is no longer wanted; 336.28(4) receives a signed statement from the caregiver that336.29provides information that requires the termination or reduction336.30of assistance(3) has factual information to reduce, suspend, or 336.31 terminate assistance based on the failure to timely report 336.32 changes; 336.33(5) verifies that a member of the assistance unit is absent336.34from the home and does not meet temporary absence provisions in336.35section 256J.13;336.36(6)(4) verifies that a member of the assistance unit has 337.1 entered a regional treatment center or a licensed residential 337.2 facility for medical or psychological treatment or 337.3 rehabilitation; 337.4(7)(5) verifies that a member of an assistance unit has 337.5 been removed from the home as a result of a judicial 337.6 determination or placed in foster care, and the provisions of 337.7 section 256J.13, subdivision 2, paragraph (c), clause (2), do 337.8 not apply; 337.9(8) verifies that a member of an assistance unit has been337.10approved to receive assistance by another state;or 337.11(9)(6) cannot locate a caregiver. 337.12 (c) A notice of adverse action must be mailed for a payment 337.13 month when the caregiver makes a written request for closure 337.14 before the first of that payment month. 337.15 (d) A notice of adverse action must be mailed before the 337.16 effective date of the adverse action when the county agency 337.17 receives the caregiver's signed and completed MFIP household 337.18 report form or recertification form that includes information 337.19 that requires payment reduction, suspension, or termination. 337.20 Sec. 34. Minnesota Statutes 1998, section 256J.31, 337.21 subdivision 12, is amended to read: 337.22 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 337.23 participant who is not in vendor payment status may discontinue 337.24 receipt of the cash assistance portion ofMFIP-SMFIP assistance 337.25 grant and retain eligibility for child care assistance under 337.26 section 119B.05 and for medical assistance under sections 337.27 256B.055, subdivision 3a, and 256B.0635. For the months a 337.28 participant chooses to discontinue the receipt of the cash 337.29 portion of the MFIP grant, the assistance unit accrues months of 337.30 eligibility to be applied toward eligibility for child care 337.31 under section 119B.05 and for medical assistance under sections 337.32 256B.055, subdivision 3a, and 256B.0635. 337.33 Sec. 35. Minnesota Statutes 1998, section 256J.32, 337.34 subdivision 4, is amended to read: 337.35 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 337.36 verify the following at application: 338.1 (1) identity of adults; 338.2 (2) presence of the minor child in the home, if 338.3 questionable; 338.4 (3) relationship of a minor child to caregivers in the 338.5 assistance unit; 338.6 (4) age, if necessary to determineMFIP-SMFIP eligibility; 338.7 (5) immigration status; 338.8 (6) social security number according to the requirements of 338.9 section 256J.30, subdivision 12; 338.10 (7) income; 338.11 (8) self-employment expenses used as a deduction; 338.12 (9) source and purpose of deposits and withdrawals from 338.13 business accounts; 338.14 (10) spousal support and child support payments made to 338.15 persons outside the household; 338.16 (11) real property; 338.17 (12) vehicles; 338.18 (13) checking and savings accounts; 338.19 (14) savings certificates, savings bonds, stocks, and 338.20 individual retirement accounts; 338.21 (15) pregnancy, if related to eligibility; 338.22 (16) inconsistent information, if related to eligibility; 338.23 (17) medical insurance; 338.24 (18)anticipated graduation date of an 18-year-old;338.25(19)burial accounts; 338.26(20)(19) school attendance, if related to eligibility; 338.27(21)(20) residence; 338.28(22)(21) a claim of domestic violence if used as a basis 338.29 for a deferral or exemption from the 60-month time limit in 338.30 section 256J.42 or employment and training services requirements 338.31 in section 256J.56;and338.32(23)(22) disability if used as an exemption from 338.33 employment and training services requirements under section 338.34 256J.56; and 338.35 (23) information needed to establish an exception under 338.36 section 256J.24, subdivision 9. 339.1 Sec. 36. Minnesota Statutes 1998, section 256J.32, 339.2 subdivision 6, is amended to read: 339.3 Subd. 6. [RECERTIFICATION.] The county agency shall 339.4 recertify eligibility in an annual face-to-face interview with 339.5 the participant and verify the following: 339.6 (1) presence of the minor child in the home, if 339.7 questionable; 339.8 (2) income, unless excluded, including self-employment 339.9 expenses used as a deduction or deposits or withdrawals from 339.10 business accounts; 339.11 (3) assets when the value is within $200 of the asset 339.12 limit;and339.13 (4) information to establish an exception under section 339.14 256J.24, subdivision 9, if questionable; and 339.15 (5) inconsistent information, if related to eligibility. 339.16 Sec. 37. Minnesota Statutes 1998, section 256J.33, is 339.17 amended to read: 339.18 256J.33 [PROSPECTIVE AND RETROSPECTIVE DETERMINATION OF 339.19MFIP-SMFIP ELIGIBILITY.] 339.20 Subdivision 1. [DETERMINATION OF ELIGIBILITY.] A county 339.21 agency must determineMFIP-SMFIP eligibility prospectively for 339.22 a payment month based on retrospectively assessing income and 339.23 the county agency's best estimate of the circumstances that will 339.24 exist in the payment month. 339.25 Except as described in section 256J.34, subdivision 1, when 339.26 prospective eligibility exists, a county agency must calculate 339.27 the amount of the assistance payment using retrospective 339.28 budgeting. To determineMFIP-SMFIP eligibility and the 339.29 assistance payment amount, a county agency must apply countable 339.30 income, described in section 256J.37, subdivisions 3 to 10, 339.31 received by members of an assistance unit or by other persons 339.32 whose income is counted for the assistance unit, described under 339.33 sections 256J.21 and 256J.37, subdivisions 1 to 2. 339.34 This income must be applied to thetransitionalMFIP 339.35 standard, shared household standard,of need or family 339.36 wagestandardlevel subject to this section and sections 256J.34 340.1 to 256J.36. Income received in a calendar month and not 340.2 otherwise excluded under section 256J.21, subdivision 2, must be 340.3 applied to the needs of an assistance unit. 340.4 Subd. 2. [PROSPECTIVE ELIGIBILITY.] A county agency must 340.5 determine whether the eligibility requirements that pertain to 340.6 an assistance unit, including those in sections 256J.11 to 340.7 256J.15 and 256J.20, will be met prospectively for the payment 340.8 month. Except for the provisions in section 256J.34, 340.9 subdivision 1, the income test will be applied retrospectively. 340.10 Subd. 3. [RETROSPECTIVE ELIGIBILITY.] After the first two 340.11 months ofMFIP-SMFIP eligibility, a county agency must continue 340.12 to determine whether an assistance unit is prospectively 340.13 eligible for the payment month by looking at all factors other 340.14 than income and then determine whether the assistance unit is 340.15 retrospectively income eligible by applying the monthly income 340.16 test to the income from the budget month. When the monthly 340.17 income test is not satisfied, the assistance payment must be 340.18 suspended when ineligibility exists for one month or ended when 340.19 ineligibility exists for more than one month. 340.20 Subd. 4. [MONTHLY INCOME TEST.] A county agency must apply 340.21 the monthly income test retrospectively for each month ofMFIP-S340.22 MFIP eligibility. An assistance unit is not eligible when the 340.23 countable income equals or exceeds thetransitionalMFIP 340.24 standard, the shared household standard,of need or the family 340.25 wage level for the assistance unit. The income applied against 340.26 the monthly income test must include: 340.27 (1) gross earned income from employment, prior to mandatory 340.28 payroll deductions, voluntary payroll deductions, wage 340.29 authorizations, and after the disregards in section 256J.21, 340.30 subdivision 4, and the allocations in section 256J.36, unless 340.31 the employment income is specifically excluded under section 340.32 256J.21, subdivision 2; 340.33 (2) gross earned income from self-employment less 340.34 deductions for self-employment expenses in section 256J.37, 340.35 subdivision 5, but prior to any reductions for personal or 340.36 business state and federal income taxes, personal FICA, personal 341.1 health and life insurance, and after the disregards in section 341.2 256J.21, subdivision 4, and the allocations in section 256J.36; 341.3 (3) unearned income after deductions for allowable expenses 341.4 in section 256J.37, subdivision 9, and allocations in section 341.5 256J.36, unless the income has been specifically excluded in 341.6 section 256J.21, subdivision 2; 341.7 (4) gross earned income from employment as determined under 341.8 clause (1) which is received by a member of an assistance unit 341.9 who is a minor child or minor caregiver and less than a 341.10 half-time student; 341.11 (5) child support and spousal support received or 341.12 anticipated to be received by an assistance unit; 341.13 (6) the income of a parent when that parent is not included 341.14 in the assistance unit; 341.15 (7) the income of an eligible relative and spouse who seek 341.16 to be included in the assistance unit; and 341.17 (8) the unearned income of a minor child included in the 341.18 assistance unit. 341.19 Subd. 5. [WHEN TO TERMINATE ASSISTANCE.] When an 341.20 assistance unit is ineligible forMFIP-SMFIP assistance for two 341.21 consecutive months, the county agency must terminateMFIP-SMFIP 341.22 assistance. 341.23 Sec. 38. Minnesota Statutes 1998, section 256J.34, 341.24 subdivision 1, is amended to read: 341.25 Subdivision 1. [PROSPECTIVE BUDGETING.] A county agency 341.26 must use prospective budgeting to calculate the assistance 341.27 payment amount for the first two months for an applicant who has 341.28 not received assistance in this state for at least one payment 341.29 month preceding the first month of payment under a current 341.30 application. Notwithstanding subdivision 3, paragraph (a), 341.31 clause (2), a county agency must use prospective budgeting for 341.32 the first two months for a person who applies to be added to an 341.33 assistance unit. Prospective budgeting is not subject to 341.34 overpayments or underpayments unless fraud is determined under 341.35 section 256.98. 341.36 (a) The county agency must apply the income received or 342.1 anticipated in the first month ofMFIP-SMFIP eligibility 342.2 against the need of the first month. The county agency must 342.3 apply the income received or anticipated in the second month 342.4 against the need of the second month. 342.5 (b) When the assistance payment for any part of the first 342.6 two months is based on anticipated income, the county agency 342.7 must base the initial assistance payment amount on the 342.8 information available at the time the initial assistance payment 342.9 is made. 342.10 (c) The county agency must determine the assistance payment 342.11 amount for the first two months ofMFIP-SMFIP eligibility by 342.12 budgeting both recurring and nonrecurring income for those two 342.13 months. 342.14 (d) The county agency must budget the child support income 342.15 received or anticipated to be received by an assistance unit to 342.16 determine the assistance payment amount from the month of 342.17 application through the date in whichMFIP-SMFIP eligibility is 342.18 determined and assistance is authorized. Child support income 342.19 which has been budgeted to determine the assistance payment in 342.20 the initial two months is considered nonrecurring income. An 342.21 assistance unit must forward any payment of child support to the 342.22 child support enforcement unit of the county agency following 342.23 the date in which assistance is authorized. 342.24 Sec. 39. Minnesota Statutes 1998, section 256J.34, 342.25 subdivision 3, is amended to read: 342.26 Subd. 3. [ADDITIONAL USES OF RETROSPECTIVE BUDGETING.] 342.27 Notwithstanding subdivision 1, the county agency must use 342.28 retrospective budgeting to calculate the monthly assistance 342.29 payment amount for the first two months under paragraphs (a) and 342.30 (b). 342.31 (a) The county agency must use retrospective budgeting to 342.32 determine the amount of the assistance payment in the first two 342.33 months ofMFIP-SMFIP eligibility: 342.34 (1) when an assistance unit applies for assistance for the 342.35 same month for which assistance has been interrupted, the 342.36 interruption in eligibility is less than one payment month, the 343.1 assistance payment for the preceding month was issued in this 343.2 state, and the assistance payment for the immediately preceding 343.3 month was determined retrospectively; or 343.4 (2) when a person applies in order to be added to an 343.5 assistance unit, that assistance unit has received assistance in 343.6 this state for at least the two preceding months, and that 343.7 person has been living with and has been financially responsible 343.8 for one or more members of that assistance unit for at least the 343.9 two preceding months. 343.10 (b) Except as provided in clauses (1) to (4), the county 343.11 agency must use retrospective budgeting and apply income 343.12 received in the budget month by an assistance unit and by a 343.13 financially responsible household member who is not included in 343.14 the assistance unit against theappropriate transitional or343.15family wage levelMFIP standard of need or family wage level to 343.16 determine the assistance payment to be issued for the payment 343.17 month. 343.18 (1) When a source of income ends prior to the third payment 343.19 month, that income is not considered in calculating the 343.20 assistance payment for that month. When a source of income ends 343.21 prior to the fourth payment month, that income is not considered 343.22 when determining the assistance payment for that month. 343.23 (2) When a member of an assistance unit or a financially 343.24 responsible household member leaves the household of the 343.25 assistance unit, the income of that departed household member is 343.26 not budgeted retrospectively for any full payment month in which 343.27 that household member does not live with that household and is 343.28 not included in the assistance unit. 343.29 (3) When an individual is removed from an assistance unit 343.30 because the individual is no longer a minor child, the income of 343.31 that individual is not budgeted retrospectively for payment 343.32 months in which that individual is not a member of the 343.33 assistance unit, except that income of an ineligible child in 343.34 the household must continue to be budgeted retrospectively 343.35 against the child's needs when the parent or parents of that 343.36 child request allocation of their income against any unmet needs 344.1 of that ineligible child. 344.2 (4) When a person ceases to have financial responsibility 344.3 for one or more members of an assistance unit, the income of 344.4 that person is not budgeted retrospectively for the payment 344.5 months which follow the month in which financial responsibility 344.6 ends. 344.7 Sec. 40. Minnesota Statutes 1998, section 256J.34, 344.8 subdivision 4, is amended to read: 344.9 Subd. 4. [SIGNIFICANT CHANGE IN GROSS INCOME.] The county 344.10 agency must recalculate the assistance payment when an 344.11 assistance unit experiences a significant change, as defined in 344.12 section 256J.08, resulting in a reduction in the gross income 344.13 received in the payment month from the gross income received in 344.14 the budget month. The county agency must issue a supplemental 344.15 assistance payment based on the county agency's best estimate of 344.16 the assistance unit's income and circumstances for the payment 344.17 month.Budget adjustmentsSupplemental assistance payments that 344.18 result from significant changes are limited to two in a 12-month 344.19 period regardless of the reason for the change.Budget344.20adjustmentsNotwithstanding any other statute or rule of law, 344.21 supplementary assistance payments shall not be made when the 344.22 significant change in income is the result of receipt of a lump 344.23 sum, receipt of an extra paycheck, business fluctuation in 344.24 self-employment income, or an assistance unit member's 344.25 participation in a strike or other labor action. Supplementary 344.26 assistance payments due to a significant change in the amount of 344.27 direct support received must not be made after the date the 344.28 assistance unit is required to forward support to the child 344.29 support enforcement unit under subdivision 1, paragraph (d). 344.30 Sec. 41. Minnesota Statutes 1998, section 256J.35, is 344.31 amended to read: 344.32 256J.35 [AMOUNT OF ASSISTANCE PAYMENT.] 344.33 Except as provided in paragraphs (a) to(d)(c), the amount 344.34 of an assistance payment is equal to the difference between the 344.35transitionalMFIP standard, shared household standard,of need 344.36 or the Minnesota family wage level in section 256J.24, whichever345.1is less,and countable income. 345.2 (a) WhenMFIP-SMFIP eligibility exists for the month of 345.3 application, the amount of the assistance payment for the month 345.4 of application must be prorated from the date of application or 345.5 the date all other eligibility factors are met for that 345.6 applicant, whichever is later. This provision applies when an 345.7 applicant loses at least one day ofMFIP-SMFIP eligibility. 345.8 (b)MFIP-SMFIP overpayments to an assistance unit must be 345.9 recouped according to section 256J.38, subdivision 4. 345.10 (c) An initial assistance payment must not be made to an 345.11 applicant who is not eligible on the date payment is made. 345.12(d) An individual whose needs have been otherwise provided345.13for in another state, in whole or in part by county, state, or345.14federal dollars during a month, is ineligible to receive MFIP-S345.15for the month.345.16 Sec. 42. Minnesota Statutes 1998, section 256J.36, is 345.17 amended to read: 345.18 256J.36 [ALLOCATION FOR UNMET NEED OF OTHER HOUSEHOLD 345.19 MEMBERS.] 345.20 Except as prohibited in paragraphs (a) and (b), an 345.21 allocation of income is allowed from the caregiver's income to 345.22 meet the unmet need of an ineligible spouse or an ineligible 345.23 child under the age of 21 for whom the caregiver is financially 345.24 responsible who also lives with the caregiver. That allocation 345.25 is allowed in an amount up to the difference between theMFIP-S345.26transitionalMFIP standard of need for the assistance unit when 345.27 that ineligible person is included in the assistance unit and 345.28 theMFIP-S family allowanceMFIP standard of need for the 345.29 assistance unit when the ineligible person is not included in 345.30 the assistance unit. These allocations must be deducted from 345.31 the caregiver's counted earnings and from unearned income 345.32 subject to paragraphs (a) and (b). 345.33 (a) Income of a minor child in the assistance unit must not 345.34 be allocated to meet the need of an ineligible person, including 345.35 the child's parent, even when that parent is the payee of the 345.36 child's income. 346.1 (b) Income of a caregiver must not be allocated to meet the 346.2 needs of a disqualified person. 346.3 Sec. 43. Minnesota Statutes 1998, section 256J.37, 346.4 subdivision 1, is amended to read: 346.5 Subdivision 1. [DEEMED INCOME FROM INELIGIBLE HOUSEHOLD 346.6 MEMBERS.] Unless otherwise provided under subdivision 1a or 1b, 346.7 the income of ineligible household members must be deemed after 346.8 allowing the following disregards: 346.9 (1) the first 18 percent of the ineligible family member's 346.10 gross earned income; 346.11 (2) amounts the ineligible person actually paid to 346.12 individuals not living in the same household but whom the 346.13 ineligible person claims or could claim as dependents for 346.14 determining federal personal income tax liability; 346.15 (3) all payments made by the ineligible person according to 346.16 a court order for spousal support or the support of children not 346.17 living in the assistance unit's household, provided that, if 346.18 there has been a change in the financial circumstances of the 346.19 ineligible person since the support order was entered, the 346.20 ineligible person has petitioned for a modification of the 346.21 support order; and 346.22 (4) an amount for the needs of the ineligible person and 346.23 other persons who live in the household but are not included in 346.24 the assistance unit and are or could be claimed by an ineligible 346.25 person as dependents for determining federal personal income tax 346.26 liability. This amount is equal to the difference between the 346.27MFIP-S transitionalMFIP standard of need when the ineligible 346.28 person is included in the assistance unit and theMFIP-S346.29transitionalMFIP standard of need when the ineligible person is 346.30 not included in the assistance unit. 346.31 Sec. 44. Minnesota Statutes 1998, section 256J.37, 346.32 subdivision 1a, is amended to read: 346.33 Subd. 1a. [DEEMED INCOME FROM DISQUALIFIED MEMBERS.] The 346.34 income of disqualified members must be deemed after allowing the 346.35 following disregards: 346.36 (1) the first 18 percent of the disqualified member's gross 347.1 earned income; 347.2 (2) amounts the disqualified member actually paid to 347.3 individuals not living in the same household but whom the 347.4 disqualified member claims or could claim as dependents for 347.5 determining federal personal income tax liability; 347.6 (3) all payments made by the disqualified member according 347.7 to a court order for spousal support or the support of children 347.8 not living in the assistance unit's household, provided that, if 347.9 there has been a change in the financial circumstances of the 347.10 disqualified member's legal obligation to pay support since the 347.11 support order was entered, the disqualified member has 347.12 petitioned for a modification of the support order; and 347.13 (4) an amount for the needs of other persons who live in 347.14 the household but are not included in the assistance unit and 347.15 are or could be claimed by the disqualified member as dependents 347.16 for determining federal personal income tax liability. This 347.17 amount is equal to the difference between theMFIP-S347.18transitionalMFIP standard of need when the ineligible person is 347.19 included in the assistance unit and theMFIP-S transitionalMFIP 347.20 standard of need when the ineligible person is not included in 347.21 the assistance unit. An amount shall not be allowed for the 347.22 needs of a disqualified member. 347.23 Sec. 45. Minnesota Statutes 1998, section 256J.37, 347.24 subdivision 2, is amended to read: 347.25 Subd. 2. [DEEMED INCOME AND ASSETS OF SPONSOR OF 347.26 NONCITIZENS.]If a noncitizen applies for or receives MFIP-S,347.27the county must deem the income and assets of the noncitizen's347.28sponsor and the sponsor's spouse who have signed an affidavit of347.29support for the noncitizen as specified in Public Law Number347.30104-193, title IV, sections 421 and 422, the Personal347.31Responsibility and Work Opportunity Reconciliation Act of 1996.347.32The income of a sponsor and the sponsor's spouse is considered347.33unearned income of the noncitizen. The assets of a sponsor and347.34the sponsor's spouse are considered available assets of the347.35noncitizen.(a) If a noncitizen applies for or receives MFIP, 347.36 the county must deem the income and assets of the noncitizen's 348.1 sponsor and the sponsor's spouse as provided in this paragraph 348.2 and paragraph (b) or (c), whichever is applicable. The deemed 348.3 income of a sponsor and the sponsor's spouse is considered 348.4 unearned income of the noncitizen. The deemed assets of a 348.5 sponsor and the sponsor's spouse are considered available assets 348.6 of the noncitizen. 348.7 (b) The income and assets of a sponsor who signed an 348.8 affidavit of support under title IV, sections 421, 422, and 423, 348.9 of Public Law Number 104-193, the Personal Responsibility and 348.10 Work Opportunity Reconciliation Act of 1996, and the income and 348.11 assets of the sponsor's spouse, must be deemed to the noncitizen 348.12 to the extent required by those sections of Public Law Number 348.13 104-193. 348.14 (c) The income and assets of a sponsor and the sponsor's 348.15 spouse to whom the provisions of paragraph (b) do not apply must 348.16 be deemed to the noncitizen to the full extent allowed under 348.17 title V, section 5505, of Public Law Number 105-33, the Balanced 348.18 Budget Act of 1997. 348.19 Sec. 46. Minnesota Statutes 1998, section 256J.37, 348.20 subdivision 9, is amended to read: 348.21 Subd. 9. [UNEARNED INCOME.](a)The county agency must 348.22 apply unearned income to thetransitionalapplicable MFIP 348.23 standard. When determining the amount of unearned income, the 348.24 county agency must deduct the costs necessary to secure payments 348.25 of unearned income. These costs include legal fees, medical 348.26 fees, and mandatory deductions such as federal and state income 348.27 taxes. 348.28(b) Effective July 1, 1999, the county agency shall count348.29$100 of the value of public and assisted rental subsidies348.30provided through the Department of Housing and Urban Development348.31(HUD) as unearned income. The full amount of the subsidy must348.32be counted as unearned income when the subsidy is less than $100.348.33 Sec. 47. Minnesota Statutes 1998, section 256J.37, 348.34 subdivision 10, is amended to read: 348.35 Subd. 10. [TREATMENT OF LUMP SUMS.] (a) The county agency 348.36 must treat lump-sum payments as earned or unearned income. If 349.1 the lump-sum payment is included in the category of income 349.2 identified in subdivision 9, it must be treated as unearned 349.3 income. A lump sum is counted as income in the month received 349.4 and budgeted either prospectively or retrospectively depending 349.5 on the budget cycle at the time of receipt. When an individual 349.6 receives a lump-sum payment, that lump sum must be combined with 349.7 all other earned and unearned income received in the same budget 349.8 month, and it must be applied according to paragraphs (a) to 349.9 (c). A lump sum may not be carried over into subsequent months. 349.10 Any funds that remain in the third month after the month of 349.11 receipt are counted in the asset limit. 349.12 (b) For a lump sum received by an applicant during the 349.13 first two months, prospective budgeting is used to determine the 349.14 payment and the lump sum must be combined with other earned or 349.15 unearned income received and budgeted in that prospective month. 349.16 (c) For a lump sum received by a participant after the 349.17 first two months ofMFIP-SMFIP eligibility, the lump sum must 349.18 be combined with other income received in that budget month, and 349.19 the combined amount must be applied retrospectively against the 349.20 applicable payment month. 349.21 (d) When a lump sum, combined with other income under 349.22 paragraphs (b) and (c), is less than thetransitionalMFIP 349.23 standard of need for theapplicableappropriate payment month, 349.24 the assistance payment must be reduced according to the amount 349.25 of the countable income. When the countable income is greater 349.26 than thetransitionalMFIP standardor the family wage349.27standardor family wage level, the assistance payment must be 349.28 suspended for the payment month. 349.29 Sec. 48. Minnesota Statutes 1998, section 256J.38, 349.30 subdivision 4, is amended to read: 349.31 Subd. 4. [RECOUPING OVERPAYMENTS FROM PARTICIPANTS.] A 349.32 participant may voluntarily repay, in part or in full, an 349.33 overpayment even if assistance is reduced under this 349.34 subdivision, until the total amount of the overpayment is 349.35 repaid. When an overpayment occurs due to fraud, the county 349.36 agency must recover ten percent of thetransitionalapplicable 350.1 standard or the amount of the monthly assistance payment, 350.2 whichever is less. When a nonfraud overpayment occurs, the 350.3 county agency must recover three percent of thetransitional350.4 MFIP standard of need or the amount of the monthly assistance 350.5 payment, whichever is less. 350.6 Sec. 49. Minnesota Statutes 1998, section 256J.42, 350.7 subdivision 1, is amended to read: 350.8 Subdivision 1. [TIME LIMIT.] (a) Except for the exemptions 350.9 in this sectionand in section 256J.11, subdivision 2, an 350.10 assistance unit in which any adult caregiver has received 60 350.11 months of cash assistance funded in whole or in part by the TANF 350.12 block grant in this or any other state or United States 350.13 territory,MFIP-Sor from a tribal TANF program, MFIP, AFDC, or 350.14 family general assistance, funded in whole or in part by state 350.15 appropriations, is ineligible to receiveMFIP-SMFIP. Any cash 350.16 assistance funded with TANF dollars in this or any other state 350.17 or United States territory, or from a tribal TANF program, or 350.18MFIP-SMFIP assistance funded in whole or in part by state 350.19 appropriations, that was received by the unit on or after the 350.20 date TANF was implemented, including any assistance received in 350.21 states or United States territories of prior residence, counts 350.22 toward the 60-month limitation. The 60-month limit applies to a 350.23 minor who is the head of a household or who is married to the 350.24 head of a household except under subdivision 5. The 60-month 350.25 time period does not need to be consecutive months for this 350.26 provision to apply. 350.27 (b) The months before July 1998 in which individuals 350.28receivereceived assistance as part of the field trials as an 350.29 MFIP, MFIP-R, or MFIP or MFIP-R comparison group familyunder350.30sections 256.031 to 256.0361 or sections 256.047 to 256.048are 350.31 not included in the 60-month time limit. 350.32 Sec. 50. Minnesota Statutes 1998, section 256J.42, 350.33 subdivision 5, is amended to read: 350.34 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 350.35 assistance received by an assistance unit does not count toward 350.36 the 60-month limit on assistance during a month in which the 351.1 caregiver is in the category in section 256J.56, paragraph (a), 351.2 clause (1).The exemption applies for the period of time the351.3caregiver belongs to one of the categories specified in this351.4subdivision.351.5 (b) From July 1, 1997, until the dateMFIP-SMFIP is 351.6 operative in the caregiver's county of financial responsibility, 351.7 any cash assistance received by a caregiver who is complying 351.8 with sections 256.73, subdivision 5a, and 256.736, if 351.9 applicable, does not count toward the 60-month limit on 351.10 assistance. Thereafter, any cash assistance received by a minor 351.11 caregiver who is complying with the requirements of sections 351.12 256J.14 and 256J.54, if applicable, does not count towards the 351.13 60-month limit on assistance. 351.14 (c) Any diversionary assistance or emergency assistance 351.15 received does not count toward the 60-month limit. 351.16 (d) Any cash assistance received by an 18- or 19-year-old 351.17 caregiver who is complying with the requirements of section 351.18 256J.54 does not count toward the 60-month limit. 351.19 Sec. 51. Minnesota Statutes 1998, section 256J.42, is 351.20 amended by adding a subdivision to read: 351.21 Subd. 6. [FAMILIES WITH INCAPACITATED MEMBERS.] Any cash 351.22 assistance received by a caregiver does not count toward the 351.23 60-month limit on assistance during a month in which a caregiver 351.24 qualifies for an exemption from MFIP-S work requirements because 351.25 the caregiver: 351.26 (1) is suffering from a professionally certified permanent 351.27 injury or incapacity which is expected to continue for more than 351.28 30 days and which prevents the person from obtaining or 351.29 retaining employment; or 351.30 (2) is required to care for another member in the household 351.31 who has a professionally certified illness or incapacity that is 351.32 expected to last for more than 30 days and the caregiver's 351.33 presence replaces other specialized care arrangements. 351.34 Sec. 52. Minnesota Statutes 1998, section 256J.43, is 351.35 amended to read: 351.36 256J.43 [INTERSTATEPAYMENTTRANSITIONAL STANDARDS.] 352.1 Subdivision 1. [PAYMENT.] (a) Effective July 1, 1997, the 352.2 amount of assistance paid to an eligible unit in which all 352.3 members have resided in this state for fewer than 12 consecutive 352.4 calendar months immediately preceding the date of application 352.5 shall be the lesser of either the interstate transitional 352.6 standard that would have been received by the assistance unit 352.7 from the state of immediate prior residence, or the amount 352.8 calculated in accordance withAFDC or MFIP-SMFIP standards. 352.9 The lesser payment must continue until the assistance unit meets 352.10 the 12-month requirement. An assistance unit that has not 352.11 resided in Minnesota for 12 months from the date of application 352.12 is not exempt from the interstatepaymenttransitional standards 352.13 provisions solely because a child is born in Minnesota to a 352.14 member of the assistance unit. Payment must be calculated by 352.15 applying thisstate'sMFIP's budgeting policies, and the unit's 352.16 net income must be deducted from the payment standard in the 352.17 other state or the MFIP transitional or shared household 352.18 standard in this state, whichever is lower. Payment shall be 352.19 made in vendor form for shelter and utilities, up to the limit 352.20 of the grant amount, and residual amounts, if any, shall be paid 352.21 directly to the assistance unit. 352.22 (b) During the first 12 months an assistance unit resides 352.23 in this state, the number of months that a unit is eligible to 352.24 receiveAFDC or MFIP-SMFIP benefits is limited to the number of 352.25 months the assistance unit would have been eligible to receive 352.26 similar benefits in the state of immediate prior residence. 352.27 (c) This policy applies whether or not the assistance unit 352.28 received similar benefits while residing in the state of 352.29 previous residence. 352.30 (d) When an assistance unit moves to this state from 352.31 another state where the assistance unit has exhausted that 352.32 state's time limit for receiving benefits under that state's 352.33 TANF program, the unit will not be eligible to receive anyAFDC352.34or MFIP-SMFIP benefits in this state for 12 months from the 352.35 date the assistance unit moves here. 352.36 (e) For the purposes of this section, "state of immediate 353.1 prior residence" means: 353.2 (1) the state in which the applicant declares the applicant 353.3 spent the most time in the 30 days prior to moving to this 353.4 state; or 353.5 (2) the state in which an applicant who is a migrant worker 353.6 maintains a home. 353.7 (f) The commissioner shall annually verify and update all 353.8 other states' payment standards as they are to be in effect in 353.9 July of each year. 353.10 (g) Applicants must provide verification of their state of 353.11 immediate prior residence, in the form of tax statements, a 353.12 driver's license, automobile registration, rent receipts, or 353.13 other forms of verification approved by the commissioner. 353.14 (h) Migrant workers, as defined in section 256J.08, and 353.15 their immediate families are exempt from this section, provided 353.16 the migrant worker provides verification that the migrant family 353.17 worked in this state within the last 12 months and earned at 353.18 least $1,000 in gross wages during the time the migrant worker 353.19 worked in this state. 353.20 Subd. 2. [TEMPORARY ABSENCE FROM MINNESOTA.] (a) For an 353.21 assistance unit that has met the requirements of section 353.22 256J.12, the number of months that the assistance unit receives 353.23 benefits under the interstatepaymenttransitional standards in 353.24 this section is not affected by an absence from Minnesota for 353.25 fewer than 30 consecutive days. 353.26 (b) For an assistance unit that has met the requirements of 353.27 section 256J.12, the number of months that the assistance unit 353.28 receives benefits under the interstatepaymenttransitional 353.29 standards in this section is not affected by an absence from 353.30 Minnesota for more than 30 consecutive days but fewer than 90 353.31 consecutive days, provided the assistance unit continues to 353.32 maintain a residence in Minnesota during the period of absence. 353.33 Subd. 3. [EXCEPTIONS TO THE INTERSTATE PAYMENT POLICY.] 353.34 Applicants who lived in another state in the 12 months prior to 353.35 applying for assistance are exempt from the interstate payment 353.36 policy for the months that a member of the unit: 354.1 (1) served in the United States armed services, provided 354.2 the person returned to Minnesota within 30 days of leaving the 354.3 armed forces, and intends to remain in Minnesota; 354.4 (2) attended school in another state, paid nonresident 354.5 tuition or Minnesota tuition rates under a reciprocity 354.6 agreement, provided the person left Minnesota specifically to 354.7 attend school and returned to Minnesota within 30 days of 354.8 graduation with the intent to remain in Minnesota; or 354.9 (3) meets the following criteria: 354.10 (i) a minor child or a minor caregiver moves from another 354.11 state to the residence of a relative caregiver; 354.12 (ii) the minor caregiver applies for and receives family 354.13 cash assistance; 354.14 (iii) the relative caregiver chooses not to be part of the 354.15MFIP-SMFIP assistance unit; and 354.16 (iv) the relative caregiver has resided in Minnesota for at 354.17 least 12 months from the date the assistance unit applies for 354.18 cash assistance. 354.19 Subd. 4. [INELIGIBLE MANDATORY UNIT MEMBERS.] Ineligible 354.20 mandatory unit members who have resided in Minnesota for 12 354.21 months immediately before the unit's date of application 354.22 establish the other assistance unit members' eligibility for the 354.23MFIP-SMFIP transitional standard, shared household or family 354.24 wage level, whichever is applicable. 354.25 Sec. 53. Minnesota Statutes 1998, section 256J.45, 354.26 subdivision 1, is amended to read: 354.27 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 354.28 county agency must provide eachMFIP-SMFIP caregiver who is not 354.29 exempt under section 256J.56, paragraph (a), clause (6) or (8), 354.30 with a face-to-face orientation.The caregiver must attend the354.31orientation.The county agency must informthe caregiver354.32 caregivers who are not exempt under section 256J.56, paragraph 354.33 (a), clause (6) or (8), that failure to attend the orientation 354.34 is considered an occurrence of noncompliance with program 354.35 requirements, and will result in the imposition of a sanction 354.36 under section 256J.46. If the client complies with the 355.1 orientation requirement prior to the first day of the month in 355.2 which the grant reduction is proposed to occur, the orientation 355.3 sanction shall be lifted. 355.4 Sec. 54. Minnesota Statutes 1998, section 256J.46, 355.5 subdivision 1, is amended to read: 355.6 Subdivision 1. [SANCTIONS FOR PARTICIPANTS NOT COMPLYING 355.7 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 355.8 good cause to comply with the requirements of this chapter, and 355.9 who is not subject to a sanction under subdivision 2, shall be 355.10 subject to a sanction as provided in this subdivision. 355.11 A sanction under this subdivision becomes effective the 355.12 month following the month in which a required notice is given. 355.13 A sanction must not be imposed when a participant comes into 355.14 compliance with the requirements for orientation under section 355.15 256J.45 or third-party liability for medical services under 355.16 section 256J.30, subdivision 10, prior to the effective date of 355.17 the sanction. A sanction must not be imposed when a participant 355.18 comes into compliance with the requirements for employment and 355.19 training services under sections 256J.49 to 256J.72 ten days 355.20 prior to the effective date of the sanction. For purposes of 355.21 this subdivision, each month that a participant fails to comply 355.22 with a requirement of this chapter shall be considered a 355.23 separate occurrence of noncompliance. A participant who has had 355.24 one or more sanctions imposed must remain in compliance with the 355.25 provisions of this chapter for six months in order for a 355.26 subsequent occurrence of noncompliance to be considered a first 355.27 occurrence. 355.28 (b) Sanctions for noncompliance shall be imposed as follows: 355.29 (1) For the first occurrence of noncompliance by a 355.30 participant in a single-parent household or by one participant 355.31 in a two-parent household, the assistance unit's grant shall be 355.32 reduced by ten percent of theMFIP-S transitionalMFIP standard,355.33the shared household standard, or the interstate transitional355.34standardof need for an assistance unit of the same size,355.35whichever is applicable,with the residual grant paid to the 355.36 participant. The reduction in the grant amount must be in 356.1 effect for a minimum of one month and shall be removed in the 356.2 month following the month that the participant returns to 356.3 compliance. 356.4 (2) For a second or subsequent occurrence of noncompliance, 356.5 or when both participants in a two-parent household are out of 356.6 compliance at the same time, the assistance unit's shelter costs 356.7 shall be vendor paid up to the amount of the cash portion of the 356.8MFIP-SMFIP grant for which the participant's assistance unit is 356.9 eligible. At county option, the assistance unit's utilities may 356.10 also be vendor paid up to the amount of the cash portion of the 356.11MFIP-SMFIP grant remaining after vendor payment of the 356.12 assistance unit's shelter costs. The residual amount of the 356.13 grant after vendor payment, if any, must be reduced by an amount 356.14 equal to 30 percent of theMFIP-S transitionalMFIP standard,356.15the shared household standard, or the interstate transitional356.16standardof need for an assistance unit of the same size,356.17whichever is applicable,before the residual grant is paid to 356.18 the assistance unit. The reduction in the grant amount must be 356.19 in effect for a minimum of one month and shall be removed in the 356.20 month following the month that a participant in a one-parent 356.21 household returns to compliance. In a two-parent household, the 356.22 grant reduction must be in effect for a minimum of one month and 356.23 shall be removed in the month following the month both 356.24 participants return to compliance. The vendor payment of 356.25 shelter costs and, if applicable, utilities shall be removed six 356.26 months after the month in which the participant or participants 356.27 return to compliance. 356.28 (c) No later than during the second month that a sanction 356.29 under paragraph (b), clause (2), is in effect due to 356.30 noncompliance with employment services, the participant's case 356.31 file must be reviewed to determine if: 356.32 (i) the continued noncompliance can be explained and 356.33 mitigated by providing a needed preemployment activity, as 356.34 defined in section 256J.49, subdivision 13, clause (16); 356.35 (ii) the participant qualifies for a good cause exception 356.36 under section 256J.57; or 357.1 (iii) the participant qualifies for an exemption under 357.2 section 256J.56. 357.3 If the lack of an identified activity can explain the 357.4 noncompliance, the county must work with the participant to 357.5 provide the identified activity, and the county must restore the 357.6 participant's grant amount to the full amount for which the 357.7 assistance unit is eligible. The grant must be restored 357.8 retroactively to the first day of the month in which the 357.9 participant was found to lack preemployment activities or to 357.10 qualify for an exemption or good cause exception. 357.11 If the participant is found to qualify for a good cause 357.12 exception or an exemption, the county must restore the 357.13 participant's grant to the full amount for which the assistance 357.14 unit is eligible. 357.15 Sec. 55. Minnesota Statutes 1998, section 256J.46, 357.16 subdivision 2, is amended to read: 357.17 Subd. 2. [SANCTIONS FOR REFUSAL TO COOPERATE WITH SUPPORT 357.18 REQUIREMENTS.] The grant of anMFIP-SMFIP caregiver who refuses 357.19 to cooperate, as determined by the child support enforcement 357.20 agency, with support requirements under section 256.741, shall 357.21 be subject to sanction as specified in this subdivision. The 357.22 assistance unit's grant must be reduced by 25 percent of the 357.23 applicabletransitionalMFIP standard of need. The residual 357.24 amount of the grant, if any, must be paid to the caregiver. A 357.25 sanction under this subdivision becomes effective the first 357.26 month following the month in which a required notice is given. 357.27 A sanction must not be imposed when a caregiver comes into 357.28 compliance with the requirements under section 256.741 prior to 357.29 the effective date of the sanction. The sanction shall be 357.30 removed in the month following the month that the caregiver 357.31 cooperates with the support requirements. Each month that 357.32 anMFIP-SMFIP caregiver fails to comply with the requirements 357.33 of section 256.741 must be considered a separate occurrence of 357.34 noncompliance. AnMFIP-SMFIP caregiver who has had one or more 357.35 sanctions imposed must remain in compliance with the 357.36 requirements of section 256.741 for six months in order for a 358.1 subsequent sanction to be considered a first occurrence. 358.2 Sec. 56. Minnesota Statutes 1998, section 256J.46, 358.3 subdivision 2a, is amended to read: 358.4 Subd. 2a. [DUAL SANCTIONS.] (a) Notwithstanding the 358.5 provisions of subdivisions 1 and 2, for a participant subject to 358.6 a sanction for refusal to comply with child support requirements 358.7 under subdivision 2 and subject to a concurrent sanction for 358.8 refusal to cooperate with other program requirements under 358.9 subdivision 1, sanctions shall be imposed in the manner 358.10 prescribed in this subdivision. 358.11 A participant who has had one or more sanctions imposed 358.12 under this subdivision must remain in compliance with the 358.13 provisions of this chapter for six months in order for a 358.14 subsequent occurrence of noncompliance to be considered a first 358.15 occurrence. Any vendor payment of shelter costs or utilities 358.16 under this subdivision must remain in effect for six months 358.17 after the month in which the participant is no longer subject to 358.18 sanction under subdivision 1. 358.19 (b) If the participant was subject to sanction for: 358.20 (i) noncompliance under subdivision 1 before being subject 358.21 to sanction for noncooperation under subdivision 2; or 358.22 (ii) noncooperation under subdivision 2 before being 358.23 subject to sanction for noncompliance under subdivision 1; 358.24 the participant shall be sanctioned as provided in subdivision 358.25 1, paragraph (b), clause (2), and the requirement that the 358.26 county conduct a review as specified in subdivision 1, paragraph 358.27 (c), remains in effect. 358.28 (c) A participant who first becomes subject to sanction 358.29 under both subdivisions 1 and 2 in the same month is subject to 358.30 sanction as follows: 358.31 (i) in the first month of noncompliance and noncooperation, 358.32 the participant's grant must be reduced by 25 percent of the 358.33 applicabletransitionalMFIP standard of need, with any residual 358.34 amount paid to the participant; 358.35 (ii) in the second and subsequent months of noncompliance 358.36 and noncooperation, the participant shall be sanctioned as 359.1 provided in subdivision 1, paragraph (b), clause (2). 359.2 The requirement that the county conduct a review as 359.3 specified in subdivision 1, paragraph (c), remains in effect. 359.4 (d) A participant remains subject to sanction under 359.5 subdivision 2 if the participant: 359.6 (i) returns to compliance and is no longer subject to 359.7 sanction under subdivision 1; or 359.8 (ii) has the sanction under subdivision 1, paragraph (b), 359.9 removed upon completion of the review under subdivision 1, 359.10 paragraph (c). 359.11 A participant remains subject to sanction under subdivision 359.12 1, paragraph (b), if the participant cooperates and is no longer 359.13 subject to sanction under subdivision 2. 359.14 Sec. 57. Minnesota Statutes 1998, section 256J.47, 359.15 subdivision 4, is amended to read: 359.16 Subd. 4. [INELIGIBILITY FORMFIP-SMFIP; EMERGENCY 359.17 ASSISTANCE; AND EMERGENCY GENERAL ASSISTANCE.] Upon receipt of 359.18 diversionary assistance, the family is ineligible forMFIP-S359.19 MFIP, emergency assistance, and emergency general assistance for 359.20 a period of time. To determine the period of ineligibility, the 359.21 county shall use the following formula: regardless of household 359.22 changes, the county agency must calculate the number of days of 359.23 ineligibility by dividing the diversionary assistance issued by 359.24 thetransitionalMFIP standard of need a family of the same size 359.25 and composition would have received underMFIP-S, or if359.26applicable the interstate transitional standard,MFIP multiplied 359.27 by 30, truncating the result. The ineligibility period begins 359.28 the date the diversionary assistance is issued. 359.29 Sec. 58. Minnesota Statutes 1998, section 256J.48, 359.30 subdivision 2, is amended to read: 359.31 Subd. 2. [ELIGIBILITY.] Notwithstanding other eligibility 359.32 provisions of this chapter, any family without resources 359.33 immediately available to meet emergency needs identified in 359.34 subdivision 3 shall be eligible for an emergency grant under the 359.35 following conditions: 359.36 (1) a family member has resided in this state for at least 360.1 30 days; 360.2 (2) the family is without resources immediately available 360.3 to meet emergency needs; 360.4 (3) assistance is necessary to avoid destitution or provide 360.5 emergency shelter arrangements; 360.6 (4) the family's destitution or need for shelter or 360.7 utilities did not arise because the assistance unit is under 360.8 sanction, the caregiver is disqualified, or the child or 360.9 relative caregiver refused without good cause under section 360.10 256J.57 to accept employment or training for employment in this 360.11 state or another state; and 360.12 (5) at least one child or pregnant woman in the emergency 360.13 assistance unit meetsMFIP-SMFIP citizenship requirements in 360.14 section 256J.11. 360.15 Sec. 59. Minnesota Statutes 1998, section 256J.48, 360.16 subdivision 3, is amended to read: 360.17 Subd. 3. [EMERGENCY NEEDS.] Emergency needs are limited to 360.18 the following: 360.19 (a) [RENT.] A county agency may deny assistance to prevent 360.20 eviction from rented or leased shelter of an otherwise eligible 360.21 applicant when the county agency determines that an applicant's 360.22 anticipated income will not cover continued payment for shelter, 360.23 subject to conditions in clauses (1) to (3): 360.24 (1) a county agency must not deny assistance when an 360.25 applicant can document that the applicant is unable to locate 360.26 habitable shelter, unless the county agency can document that 360.27 one or more habitable shelters are available in the community 360.28 that will result in at least a 20 percent reduction in monthly 360.29 expense for shelter and that this shelter will be cost-effective 360.30 for the applicant; 360.31 (2) when no alternative shelter can be identified by either 360.32 the applicant or the county agency, the county agency shall not 360.33 deny assistance because anticipated income will not cover rental 360.34 obligation; and 360.35 (3) when cost-effective alternative shelter is identified, 360.36 the county agency shall issue assistance for moving expenses as 361.1 provided in paragraph (e). 361.2 (b) [DEFINITIONS.] For purposes of paragraph (a), the 361.3 following definitions apply (1) "metropolitan statistical area" 361.4 is as defined by the United States Census Bureau; (2) 361.5 "alternative shelter" includes any shelter that is located 361.6 within the metropolitan statistical area containing the county 361.7 and for which the applicant is eligible, provided the applicant 361.8 does not have to travel more than 20 miles to reach the shelter 361.9 and has access to transportation to the shelter. Clause (2) 361.10 does not apply to counties in the Minneapolis-St. Paul 361.11 metropolitan statistical area. 361.12 (c) [MORTGAGE AND CONTRACT FOR DEED ARREARAGES.] A county 361.13 agency shall issue assistance for mortgage or contract for deed 361.14 arrearages on behalf of an otherwise eligible applicant 361.15 according to clauses (1) to (4): 361.16 (1) assistance for arrearages must be issued only when a 361.17 home is owned, occupied, and maintained by the applicant; 361.18 (2) assistance for arrearages must be issued only when no 361.19 subsequent foreclosure action is expected within the 12 months 361.20 following the issuance; 361.21 (3) assistance for arrearages must be issued only when an 361.22 applicant has been refused refinancing through a bank or other 361.23 lending institution and the amount payable, when combined with 361.24 any payments made by the applicant, will be accepted by the 361.25 creditor as full payment of the arrearage; 361.26 (4) costs paid by a family which are counted toward the 361.27 payment requirements in this clause are: principal and interest 361.28 payments on mortgages or contracts for deed, balloon payments, 361.29 homeowner's insurance payments, manufactured home lot rental 361.30 payments, and tax or special assessment payments related to the 361.31 homestead. Costs which are not counted include closing costs 361.32 related to the sale or purchase of real property. 361.33 To be eligible for assistance for costs specified in clause 361.34 (4) which are outstanding at the time of foreclosure, an 361.35 applicant must have paid at least 40 percent of the family's 361.36 gross income toward these costs in the month of application and 362.1 the 11-month period immediately preceding the month of 362.2 application. 362.3 When an applicant is eligible under clause (4), a county 362.4 agency shall issue assistance up to a maximum of four times the 362.5MFIP-S transitionalMFIP standard of need for a comparable 362.6 assistance unit. 362.7 (d) [DAMAGE OR UTILITY DEPOSITS.] A county agency shall 362.8 issue assistance for damage or utility deposits when necessary 362.9 to alleviate the emergency. The county may require that 362.10 assistance paid in the form of a damage deposit, less any amount 362.11 retained by the landlord to remedy a tenant's default in payment 362.12 of rent or other funds due to the landlord under a rental 362.13 agreement, or to restore the premises to the condition at the 362.14 commencement of the tenancy, ordinary wear and tear excepted, be 362.15 returned to the county when the individual vacates the premises 362.16 or be paid to the recipient's new landlord as a vendor payment. 362.17 The county may require that assistance paid in the form of a 362.18 utility deposit less any amount retained to satisfy outstanding 362.19 utility costs be returned to the county when the person vacates 362.20 the premises, or be paid for the person's new housing unit as a 362.21 vendor payment. The vendor payment of returned funds shall not 362.22 be considered a new use of emergency assistance. 362.23 (e) [MOVING EXPENSES.] A county agency shall issue 362.24 assistance for expenses incurred when a family must move to a 362.25 different shelter according to clauses (1) to (4): 362.26 (1) moving expenses include the cost to transport personal 362.27 property belonging to a family, the cost for utility connection, 362.28 and the cost for securing different shelter; 362.29 (2) moving expenses must be paid only when the county 362.30 agency determines that a move is cost-effective; 362.31 (3) moving expenses must be paid at the request of an 362.32 applicant, but only when destitution or threatened destitution 362.33 exists; and 362.34 (4) moving expenses must be paid when a county agency 362.35 denies assistance to prevent an eviction because the county 362.36 agency has determined that an applicant's anticipated income 363.1 will not cover continued shelter obligation in paragraph (a). 363.2 (f) [HOME REPAIRS.] A county agency shall pay for repairs 363.3 to the roof, foundation, wiring, heating system, chimney, and 363.4 water and sewer system of a home that is owned and lived in by 363.5 an applicant. 363.6 The applicant shall document, and the county agency shall 363.7 verify the need for and method of repair. 363.8 The payment must be cost-effective in relation to the 363.9 overall condition of the home and in relation to the cost and 363.10 availability of alternative housing. 363.11 (g) [UTILITY COSTS.] Assistance for utility costs must be 363.12 made when an otherwise eligible family has had a termination or 363.13 is threatened with a termination of municipal water and sewer 363.14 service, electric, gas or heating fuel service, refuse removal 363.15 service, or lacks wood when that is the heating source, subject 363.16 to the conditions in clauses (1) and (2): 363.17 (1) a county agency must not issue assistance unless the 363.18 county agency receives confirmation from the utility provider 363.19 that assistance combined with payment by the applicant will 363.20 continue or restore the utility; and 363.21 (2) a county agency shall not issue assistance for utility 363.22 costs unless a family paid at least eight percent of the 363.23 family's gross income toward utility costs due during the 363.24 preceding 12 months. 363.25 Clauses (1) and (2) must not be construed to prevent the 363.26 issuance of assistance when a county agency must take immediate 363.27 and temporary action necessary to protect the life or health of 363.28 a child. 363.29 (h) [SPECIAL DIETS.] Effective January 1, 1998, a county 363.30 shall pay for special diets or dietary items forMFIP-SMFIP 363.31 participants. Persons receiving emergency assistance funds for 363.32 special diets or dietary items are also eligible to receive 363.33 emergency assistance for shelter and utility emergencies, if 363.34 otherwise eligible. The need for special diets or dietary items 363.35 must be prescribed by a licensed physician. Costs for special 363.36 diets shall be determined as percentages of the allotment for a 364.1 one-person household under the Thrifty Food Plan as defined by 364.2 the United States Department of Agriculture. The types of diets 364.3 and the percentages of the Thrifty Food Plan that are covered 364.4 are as follows: 364.5 (1) high protein diet, at least 80 grams daily, 25 percent 364.6 of Thrifty Food Plan; 364.7 (2) controlled protein diet, 40 to 60 grams and requires 364.8 special products, 100 percent of Thrifty Food Plan; 364.9 (3) controlled protein diet, less than 40 grams and 364.10 requires special products, 125 percent of Thrifty Food Plan; 364.11 (4) low cholesterol diet, 25 percent of Thrifty Food Plan; 364.12 (5) high residue diet, 20 percent of Thrifty Food Plan; 364.13 (6) pregnancy and lactation diet, 35 percent of Thrifty 364.14 Food Plan; 364.15 (7) gluten-free diet, 25 percent of Thrifty Food Plan; 364.16 (8) lactose-free diet, 25 percent of Thrifty Food Plan; 364.17 (9) antidumping diet, 15 percent of Thrifty Food Plan; 364.18 (10) hypoglycemic diet, 15 percent of Thrifty Food Plan; or 364.19 (11) ketogenic diet, 25 percent of Thrifty Food Plan. 364.20 Sec. 60. Minnesota Statutes 1998, section 256J.50, 364.21 subdivision 1, is amended to read: 364.22 Subdivision 1. [EMPLOYMENT AND TRAINING SERVICES COMPONENT 364.23 OFMFIP-SMFIP.] (a) By January 1, 1998, each county must 364.24 develop and implement an employment and training services 364.25 component ofMFIP-SMFIP which is designed to put participants 364.26 on the most direct path to unsubsidized employment. 364.27 Participation in these services is mandatory for allMFIP-SMFIP 364.28 caregivers, unless the caregiver is exempt under section 256J.56. 364.29 (b)A county may provide employment and training services364.30to MFIP-S caregivers who are exempt from the employment and364.31training services component but volunteer for the services.A 364.32 county must provide employment and training services under 364.33 sections 256J.515 to 256J.74 within 30 days after the 364.34 caregiver's participation becomes mandatory under subdivision 5. 364.35 Sec. 61. Minnesota Statutes 1998, section 256J.515, is 364.36 amended to read: 365.1 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 365.2 During the first meeting with participants, job counselors 365.3 must ensure that an overview of employment and training services 365.4 is provided that: 365.5 (1) stresses the necessity and opportunity of immediate 365.6 employment; 365.7 (2) outlines the job search resources offered; 365.8 (3) outlines education or training opportunities available; 365.9 (4) describes the range of work activities, including 365.10 activities under section 256J.49, subdivision 13, clause (18), 365.11 that are allowable underMFIP-SMFIP to meet the individual 365.12 needs of participants; 365.13 (5) explains the requirements to comply with an employment 365.14 plan; 365.15 (6) explains the consequences for failing to comply; and 365.16 (7) explains the services that are available to support job 365.17 search and work and education. 365.18 Failure to attend the overview of employment and training 365.19 services without good cause results in the imposition of a 365.20 sanction under section 256J.46. 365.21 Sec. 62. Minnesota Statutes 1998, section 256J.52, 365.22 subdivision 1, is amended to read: 365.23 Subdivision 1. [APPLICATION LIMITED TO CERTAIN 365.24 PARTICIPANTS.] This section applies to participants receiving 365.25MFIP-SMFIP assistance who are not exempt under section 256J.56, 365.26 and to caregivers who volunteer for employment and training 365.27 servicesunder section 256J.50. 365.28 Sec. 63. Minnesota Statutes 1998, section 256J.52, 365.29 subdivision 4, is amended to read: 365.30 Subd. 4. [SECONDARY ASSESSMENT.] (a) The job counselor 365.31 must conduct a secondary assessment for those participants who: 365.32 (1) in the judgment of the job counselor, have barriers to 365.33 obtaining employment that will not be overcome with a job search 365.34 support plan under subdivision 3; 365.35 (2) have completed eight weeks of job search under 365.36 subdivision 3 without obtaining suitable employment; 366.1 (3) have not received a secondary assessment, are working 366.2 at least 20 hours per week, and the participant, job counselor, 366.3 or county agency requests a secondary assessment; or 366.4 (4) have an existing job search plan or employment plan 366.5 developed for another program or are already involved in 366.6 training or education activities under section 256J.55, 366.7 subdivision 5. 366.8 (b) In the secondary assessment the job counselor must 366.9 evaluate the participant's skills and prior work experience, 366.10 family circumstances, interests and abilities, need for 366.11 preemployment activities, supportive or educational services, 366.12 and the extent of any barriers to employment. Failure to 366.13 complete a secondary assessment shall result in the imposition 366.14 of a sanction as specified in sections 256J.46 and 256J.57. The 366.15 job counselor must use the information gathered through the 366.16 secondary assessment to develop an employment plan under 366.17 subdivision 5. 366.18 (c) In the secondary assessment the job counselor may 366.19 require the participant to complete a professional medical 366.20 substance abuse or psychological assessment as a component of 366.21 the secondary assessment when the job counselor has a reasonable 366.22 belief, based on objective evidence, that a participant's 366.23 ability to obtain and retain suitable employment is impaired by 366.24 a medical condition. The job counselor must ensure that 366.25 appropriate services are available to participants to 366.26 accommodate any disabilities identified by an assessment. Data 366.27 gathered as part of a professional assessment shall be 366.28 classified and disclosed in accordance with the data practices 366.29 provisions specified in section 13.46. 366.30 (d) The provider shall make available to participants 366.31 information regarding additional vendors or resources which 366.32 provide employment and training services that may be available 366.33 to the participant under a plan developed under this section. 366.34 The information must include a brief summary of services 366.35 provided and related performance indicators. Performance 366.36 indicators must include, but are not limited to, the average 367.1 time to complete program offerings, placement rates, entry and 367.2 average wages, and retention rates. To be included in the 367.3 information given to participants, a vendor or resource must 367.4 provide counties with relevant information in the format 367.5 required by the county. 367.6 Sec. 64. Minnesota Statutes 1998, section 256J.52, is 367.7 amended by adding a subdivision to read: 367.8 Subd. 5a. [BASIC EDUCATION ACTIVITIES IN 367.9 PLAN.] Participants with low skills in reading or mathematics 367.10 who are proficient only at or below an eighth-grade level must 367.11 be allowed to include basic education activities or an English 367.12 as a second language program in a job search support plan or an 367.13 employment plan, whichever is applicable. 367.14 Sec. 65. Minnesota Statutes 1998, section 256J.52, 367.15 subdivision 8, is amended to read: 367.16 Subd. 8. [ADMINISTRATIVE SUPPORT FOR POSTEMPLOYMENT 367.17 EDUCATION AND TRAINING.] After a caregiver receivingMFIP-SMFIP 367.18 has been employed for six consecutive months, during which time 367.19 the caregiver works on average more than 20 hours per week, or 367.20 if the job counselor determines that the caregiver is not likely 367.21 to exit MFIP within 12 months because the caregiver's current 367.22 employment offers limited opportunities for advancement, the 367.23 caregiver's job counselor shall inform the caregiver that the 367.24 caregiver may request a secondary assessment described in 367.25 subdivision 4 and shallprovide information about: 367.26 (1) explore, investigate, and examine potential training 367.27 options, which may be through the caregiver's current employer, 367.28 the Minnesota job skills partnership, other employers, technical 367.29 colleges or other educational institutions, nonprofit 367.30 organizations, county services, state agencies, or any other 367.31 resource available that will enhance the caregiver's skills and 367.32 improve the potential for increase earnings; 367.33 (2) present part-time education and training options 367.34 available to the caregiver that are consistent with the 367.35 caregiver's interests and career path;and367.36(2)(3) provide information about child care and 368.1 transportation resources available to support postemployment 368.2 education and training; and 368.3 (4) ensure that the caregiver is apprised of the training 368.4 options and is allowed to pursue ongoing training needed to 368.5 achieve self-sufficiency. 368.6 Sec. 66. [256J.535] [SUPPORTING PARENTS MAKING 368.7 SATISFACTORY PROGRESS IN EDUCATION AND TRAINING.] 368.8 For each semester or quarter, whichever is applicable, that 368.9 a participant is enrolled in a post-secondary education or 368.10 training program and is maintaining a 2.5 grade point average, 368.11 on a 4.0 scale, the number of months the participant maintained 368.12 a 2.5 grade point average shall be added prospectively to the 368.13 total number of months the participant has remaining on 368.14 assistance. The participant must provide verification of the 368.15 2.5 grade point average to the county agency after each 368.16 applicable semester or quarter. A participant may take 368.17 advantage of this section for no more than a total of 36 months. 368.18 Sec. 67. Minnesota Statutes 1998, section 256J.55, 368.19 subdivision 4, is amended to read: 368.20 Subd. 4. [CHOICE OF PROVIDER.]A participantMFIP 368.21 caregivers must be able to choose from at least two employment 368.22 and training service providers, unless the county has 368.23 demonstrated to the commissioner that the provision of multiple 368.24 employment and training service providers would result in 368.25 financial hardship for the county, or the county is utilizing a 368.26 workforce center as specified in section 256J.50, subdivision 368.27 8. Both parents in a two-parent family must choose the same 368.28 employment and training service provider unless a special need, 368.29 such as bilingual services, is identified but not available 368.30 through one service provider. 368.31 Sec. 68. Minnesota Statutes 1998, section 256J.56, is 368.32 amended to read: 368.33 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 368.34 EXEMPTIONS.] 368.35 (a) AnMFIP-SMFIP caregiver is exempt from the 368.36 requirements of sections 256J.52 to 256J.55 if the caregiver 369.1 belongs to any of the following groups: 369.2 (1) individuals who are age 60 or older; 369.3 (2) individuals who are suffering from a professionally 369.4 certified permanent or temporary illness, injury, or incapacity 369.5 which is expected to continue for more than 30 days and which 369.6 prevents the person from obtaining or retaining employment. 369.7 Persons in this category with a temporary illness, injury, or 369.8 incapacity must be reevaluated at least quarterly; 369.9 (3) caregivers whose presence in the home is required 369.10 because of the professionally certified illness or incapacity of 369.11 another member in the assistance unit, a relative in the 369.12 household, or a foster child in the household; 369.13 (4) women who are pregnant, if the pregnancy has resulted 369.14 in a professionally certified incapacity that prevents the woman 369.15 from obtaining or retaining employment; 369.16 (5) caregivers of a child under the age of one year who 369.17 personally provide full-time care for the child. This exemption 369.18 may be used for only 12 months in a lifetime. In two-parent 369.19 households, only one parent or other relative may qualify for 369.20 this exemption; 369.21 (6) individuals who are single parents, or one parent in a 369.22 two-parent family, employed at least 35 hours per week; 369.23 (7) individuals experiencing a personal or family crisis 369.24 that makes them incapable of participating in the program, as 369.25 determined by the county agency. If the participant does not 369.26 agree with the county agency's determination, the participant 369.27 may seek professional certification, as defined in section 369.28 256J.08, that the participant is incapable of participating in 369.29 the program. 369.30 Persons in this exemption category must be reevaluated 369.31 every 60 days; or 369.32 (8) second parents in two-parent families employed for 20 369.33 or more hours per week, provided the first parent is employed at 369.34 least 35 hours per week. 369.35 A caregiver who is exempt under clause (5) must enroll in 369.36 and attend an early childhood and family education class, a 370.1 parenting class, or some similar activity, if available, during 370.2 the period of time the caregiver is exempt under this section. 370.3 Notwithstanding section 256J.46, failure to attend the required 370.4 activity shall not result in the imposition of a sanction. 370.5 (b) The county agency must provide employment and training 370.6 services toMFIP-SMFIP caregivers who are exempt under this 370.7 section, but who volunteer to participate. Exempt volunteers 370.8 may request approval for any work activity under section 370.9 256J.49, subdivision 13. The hourly participation requirements 370.10 for nonexempt caregivers under section 256J.50, subdivision 5, 370.11 do not apply to exempt caregivers who volunteer to participate. 370.12 Sec. 69. Minnesota Statutes 1998, section 256J.57, 370.13 subdivision 1, is amended to read: 370.14 Subdivision 1. [GOOD CAUSE FOR FAILURE TO COMPLY.] The 370.15 county agency shall not impose the sanction under section 370.16 256J.46 if it determines that the participant has good cause for 370.17 failing to comply with the requirements of sections 256J.52 to 370.18 256J.55. Good cause exists when: 370.19 (1) appropriate child care is not available; 370.20 (2) the job does not meet the definition of suitable 370.21 employment; 370.22 (3) the participant is ill or injured; 370.23 (4) a member of the assistance unit, a relative in the 370.24 household, or a foster child in the household is ill and needs 370.25 care by the participant that prevents the participant from 370.26 complying with the job search support plan or employment plan; 370.27 (5) the parental caregiver is unable to secure necessary 370.28 transportation; 370.29 (6) the parental caregiver is in an emergency situation 370.30 that prevents compliance with the job search support plan or 370.31 employment plan; 370.32 (7) the schedule of compliance with the job search support 370.33 plan or employment plan conflicts with judicial proceedings; 370.34 (8) a mandatory MFIP meeting is scheduled during a time 370.35 that conflicts with a judicial proceeding or a meeting related 370.36 to a juvenile court matter, or a participant's work schedule; 371.1 (9) the parental caregiver is already participating in 371.2 acceptable work activities; 371.3(9)(10) the employment plan requires an educational 371.4 program for a caregiver under age 20, but the educational 371.5 program is not available; 371.6(10)(11) activities identified in the job search support 371.7 plan or employment plan are not available; 371.8(11)(12) the parental caregiver is willing to accept 371.9 suitable employment, but suitable employment is not available; 371.10 or 371.11(12)(13) the parental caregiver documents other verifiable 371.12 impediments to compliance with the job search support plan or 371.13 employment plan beyond the parental caregiver's control. 371.14 The job counselor shall work with the participant to 371.15 reschedule mandatory meetings for individuals who fall under 371.16 clauses (1), (3), (4), (5), (6), (7), and (8). 371.17 Sec. 70. [256J.58] [SUPPORTING WORKING FAMILIES.] 371.18 Subdivision 1. [WORK REQUIRED.] To reward and support 371.19 caregivers who are earning income and working the number of 371.20 hours required under section 256J.50, subdivision 5, months in 371.21 which the caregiver has reported weekly hours of employment 371.22 equal to or greater than the work requirement will not count 371.23 toward the 60-month lifetime limit on assistance. 371.24 Subd. 2. [MONTHS COUNTED.] Count each month of MFIP cash 371.25 benefits received in this state for purposes of the 60-month 371.26 lifetime limit, except as follows: 371.27 (1) do not count a month in which a single-parent caregiver 371.28 who does not have a child under six years of age has earnings 371.29 that average 30 hours or more per week; 371.30 (2) do not count a month in which the caregivers in a 371.31 two-parent family have earnings that average 55 hours or more 371.32 per week; and 371.33 (3) do not count a month in which a single-parent caregiver 371.34 who has a child under six years of age has earnings that average 371.35 20 hours or more per week. 371.36 Sec. 71. Minnesota Statutes 1998, section 256J.62, 372.1 subdivision 1, is amended to read: 372.2 Subdivision 1. [ALLOCATION.] Money appropriated forMFIP-S372.3 MFIP employment and training services must be allocated to 372.4 counties and eligible tribal providers as specified in this 372.5 section. 372.6 Sec. 72. Minnesota Statutes 1998, section 256J.62, is 372.7 amended by adding a subdivision to read: 372.8 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 372.9 state fiscal year 2000, and for all subsequent years, money 372.10 shall be allocated to counties and eligible tribal providers 372.11 based on their average number of MFIP cases as a proportion of 372.12 the statewide total number of MFIP cases: 372.13 (1) the average number of cases must be based upon counts 372.14 of MFIP or tribal TANF cases as of March 31, June 30, September 372.15 30, and December 31 of the previous calendar year, less the 372.16 number of child only cases and cases where all the caregivers 372.17 are age 60 or over. Two-parent cases, with the exception of 372.18 those with a caregiver age 60 or over, will be multiplied by a 372.19 factor of two; 372.20 (2) the MFIP or tribal TANF case count for each eligible 372.21 tribal provider shall be based upon the number of MFIP or tribal 372.22 TANF cases who are enrolled in, or are eligible for enrollment 372.23 in their reservation; and the case must be an active MFIP case; 372.24 and the case members must reside within the tribal program's 372.25 service delivery area; 372.26 (3) MFIP or tribal TANF cases counted for determining 372.27 allocations to tribal providers shall be removed from the case 372.28 counts of the respective counties where they reside to prevent 372.29 duplicate counts; 372.30 (4) prior to allocating funds to counties and tribal 372.31 providers, $1,000,000 shall be set aside to allow the 372.32 commissioner to use these set-aside funds to provide funding to 372.33 county or tribal providers who experience an unforeseen influx 372.34 of participants or other emergent situations beyond their 372.35 control; and 372.36 (5) the commissioner shall use a portion of the funds in 373.1 clause (4) to offset a reduction in funds allocated to any 373.2 county between state fiscal year 1999 and state fiscal year 2000 373.3 that results from the adjustment in clause (3). The funding 373.4 provided under this clause must reduce by half the reduction for 373.5 state fiscal year 2000 that any county would otherwise 373.6 experience in the absence of this clause. 373.7 Any funds specified in this clause that remain unspent by March 373.8 31 of each year shall be reallocated out to county and tribal 373.9 providers using the funding formula detailed in clauses (1) to 373.10 (5). 373.11 Sec. 73. Minnesota Statutes 1998, section 256J.62, 373.12 subdivision 6, is amended to read: 373.13 Subd. 6. [BILINGUAL EMPLOYMENT AND TRAINING SERVICES TO 373.14 REFUGEES.] Funds appropriated to cover the costs of bilingual 373.15 employment and training services to refugees shall be allocated 373.16 to county agencies as follows: 373.17 (1) for state fiscal year 1998, the allocation shall be 373.18 based on the county's proportion of the total statewide number 373.19 of AFDC refugee cases in the previous fiscal year. Counties 373.20 with less than one percent of the statewide number of AFDC, 373.21 MFIP-R, or MFIP refugee cases shall not receive an allocation of 373.22 bilingual employment and training services funds; and 373.23 (2) for each subsequent fiscal year, the allocation shall 373.24 be based on the county's proportion of the total statewide 373.25 number ofMFIP-SMFIP refugee cases in the previous fiscal year. 373.26 Counties with less than one percent of the statewide number of 373.27MFIP-SMFIP refugee cases shall not receive an allocation of 373.28 bilingual employment and training services funds. 373.29 Sec. 74. Minnesota Statutes 1998, section 256J.62, 373.30 subdivision 7, is amended to read: 373.31 Subd. 7. [WORK LITERACY LANGUAGE PROGRAMS.] Funds 373.32 appropriated to cover the costs of work literacy language 373.33 programs to non-English-speaking recipients shall be allocated 373.34 to county agencies as follows: 373.35 (1) for state fiscal year 1998, the allocation shall be 373.36 based on the county's proportion of the total statewide number 374.1 of AFDC or MFIP cases in the previous fiscal year where the lack 374.2 of English is a barrier to employment. Counties with less than 374.3 two percent of the statewide number of AFDC or MFIP cases where 374.4 the lack of English is a barrier to employment shall not receive 374.5 an allocation of the work literacy language program funds; and 374.6 (2) for each subsequent fiscal year, the allocation shall 374.7 be based on the county's proportion of the total statewide 374.8 number ofMFIP-SMFIP cases in the previous fiscal year where 374.9 the lack of English is a barrier to employment. Counties with 374.10 less than two percent of the statewide number ofMFIP-SMFIP 374.11 cases where the lack of English is a barrier to employment shall 374.12 not receive an allocation of the work literacy language program 374.13 funds. 374.14 Sec. 75. Minnesota Statutes 1998, section 256J.62, 374.15 subdivision 8, is amended to read: 374.16 Subd. 8. [REALLOCATION.] The commissioner of human 374.17 services shall review county agency expenditures ofMFIP-SMFIP 374.18 employment and training services funds at the end of the third 374.19 quarter of the first year of the biennium and each quarter after 374.20 that and may reallocate unencumbered or unexpended money 374.21 appropriated under this section to those county agencies that 374.22 can demonstrate a need for additional money. 374.23 Sec. 76. Minnesota Statutes 1998, section 256J.62, 374.24 subdivision 9, is amended to read: 374.25 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 374.26 request of the caregiver, the county may continue to provide 374.27 case management, counseling or other support services to a 374.28 participant following the participant's achievement of the 374.29 employment goal, for up to six months following termination of 374.30 the participant's eligibility forMFIP-SMFIP. 374.31 A county may expend funds for a specific employment and 374.32 training service for the duration of that service to a 374.33 participant if the funds are obligated or expended prior to the 374.34 participant losingMFIP-SMFIP eligibility. 374.35 Sec. 77. Minnesota Statutes 1998, section 256J.67, 374.36 subdivision 4, is amended to read: 375.1 Subd. 4. [EMPLOYMENT PLAN.] (a) The caretaker's employment 375.2 plan must include the length of time needed in the work 375.3 experience program, the need to continue job-seeking activities 375.4 while participating in work experience, and the caregiver's 375.5 employment goals. 375.6 (b) After each six months of a caregiver's participation in 375.7 a work experience job placement, and at the conclusion of each 375.8 work experience assignment under this section, the county agency 375.9 shall reassess and revise, as appropriate, the caregiver's 375.10 employment plan. 375.11 (c) A caregiver may claim good cause under section 256J.57, 375.12 subdivision 1, for failure to cooperate with a work experience 375.13 job placement. 375.14 (d) The county agency shall limit the maximum number of 375.15 hours any participant may work under this section to the amount 375.16 of thetransitionalMFIP standard of need divided by the federal 375.17 or applicable state minimum wage, whichever is higher. After a 375.18 participant has been assigned to a position for nine months, the 375.19 participant may not continue in that assignment unless the 375.20 maximum number of hours a participant works is no greater than 375.21 the amount of thetransitionalMFIP standard of need divided by 375.22 the rate of pay for individuals employed in the same or similar 375.23 occupations by the same employer at the same site. This limit 375.24 does not apply if it would prevent a participant from counting 375.25 toward the federal work participation rate. 375.26 Sec. 78. Minnesota Statutes 1998, section 256J.74, 375.27 subdivision 2, is amended to read: 375.28 Subd. 2. [CONCURRENT ELIGIBILITY, LIMITATIONS.] (a) An 375.29 individual whose needs have been otherwise provided for in 375.30 another state, in whole or in part by county, state, or federal 375.31 dollars during a month, is ineligible to receive MFIP for the 375.32 month. 375.33 (b) A county agency must not count an applicant or 375.34 participant as a member of more than one assistance unit in this 375.35 state in a given payment month, except as provided in clauses 375.36 (1) and (2). 376.1 (1) A participant who is a member of an assistance unitin376.2this stateis eligible to be included in a second assistance 376.3 unit thefirst fullmonth after the month the participant joins 376.4 the second unit. 376.5 (2) An applicant whose needs are met through federal, 376.6 state, or local foster carethat is reimbursed under title IV-E376.7of the Social Security Actpayments for the first part of an 376.8 application month is eligible to receive assistance for the 376.9 remaining part of the month in which the applicant returns 376.10 home.Title IV-EFoster care paymentsand adoption assistance376.11paymentsmust be considered prorated payments rather than a 376.12 duplication ofMFIP-SMFIP need. 376.13 Sec. 79. [256J.751] [COUNTY PERFORMANCE MANAGEMENT.] 376.14 (a) The commissioner shall report quarterly to all counties 376.15 each county's performance on the following measures: 376.16 (1) percent of MFIP caseload working in paid employment; 376.17 (2) percent of MFIP caseload receiving only the food 376.18 portion of assistance; 376.19 (3) number of MFIP cases that have left assistance; 376.20 (4) federal participation requirements as specified in 376.21 title 1 of Public Law Number 104-193; and 376.22 (5) median placement wage rate. 376.23 (b) By January 1, 2000, the commissioner shall, in 376.24 consultation with counties, develop measures for county 376.25 performance in addition to those in paragraph (a). In 376.26 developing these measures, the commissioner must consider: 376.27 (1) a measure for MFIP cases that leave assistance due to 376.28 employment; 376.29 (2) job retention after participants leave MFIP; and 376.30 (3) participant's earnings at a follow-up point after the 376.31 participant has left MFIP. 376.32 (c) If sanctions occur for failure to meet the performance 376.33 standards specified in title 1 of Public Law Number 104-193 of 376.34 the Personal Responsibility and Work Opportunity Act of 1996, 376.35 the state shall pay 88 percent of the sanction. The remaining 376.36 12 percent of the sanction will be paid by the counties. The 377.1 county portion of the sanction will be distributed across all 377.2 counties in proportion to each county's percentage of the MFIP 377.3 average monthly caseload during the period for which the 377.4 sanction was applied. 377.5 (d) If a county fails to meet the performance standards 377.6 specified in title 1 of Public Law Number 104-193 of the 377.7 Personal Responsibility and Work Opportunity Act of 1996 for any 377.8 year, the commissioner shall work with counties to organize a 377.9 joint state-county technical assistance team to work with the 377.10 county. The commissioner shall coordinate any technical 377.11 assistance with other departments and agencies including the 377.12 departments of economic security and children, families, and 377.13 learning as necessary to achieve the purpose of this paragraph. 377.14 Sec. 80. Minnesota Statutes 1998, section 256J.76, 377.15 subdivision 1, is amended to read: 377.16 Subdivision 1. [ADMINISTRATIVE FUNCTIONS.] Beginning July 377.17 1, 1997, counties will receive federal funds from the TANF block 377.18 grant for use in supporting eligibility, fraud control, and 377.19 other related administrative functions. The federal funds 377.20 available for distribution, as determined by the commissioner, 377.21 must be an amount equal to federal administrative aid 377.22 distributed for fiscal year 1996 under titles IV-A and IV-F of 377.23 the Social Security Act in effect prior to October 1, 1996. 377.24 This amount must include the amount paid for local 377.25 collaboratives under sections 245.4932 and 256F.13, but must not 377.26 include administrative aid associated with child care under 377.27 section 119B.05, with emergency assistance intensive family 377.28 preservation services under section 256.8711, with 377.29 administrative activities as part of the employment and training 377.30 services under section 256.736, or with fraud prevention 377.31 investigation activities under section 256.983. Before July 15, 377.32 1999, a county may ask for a review of the commissioner's 377.33 determination when the county believes fiscal year 1996 377.34 information was inaccurate or incomplete. By August 15, 1999, 377.35 the commissioner must adjust that county's base when the 377.36 commissioner has determined that inaccurate or incomplete 378.1 information was used to develop that base. The commissioner 378.2 shall adjust the county's 1999 allocation amount to reflect the 378.3 base change. 378.4 Sec. 81. Minnesota Statutes 1998, section 256J.76, 378.5 subdivision 2, is amended to read: 378.6 Subd. 2. [ALLOCATION OF COUNTY FUNDS.] (a) The 378.7 commissioner shall determine and allocate the funds available to 378.8 each county, on a calendar year basis, proportional to the 378.9 amount paid to each county for fiscal year 1996, excluding the 378.10 amount paid for local collaboratives under sections 245.4932 and 378.11 256F.13. For the period beginning July 1, 1997, and ending 378.12 December 31, 1998, each county shall receive 150 percent of its 378.13 base year allocation. 378.14 (b) Beginning January 1, 2000, the commissioner shall 378.15 allocate funds made available under this section on a calendar 378.16 year basis to each county first, in amounts equal to each 378.17 county's guaranteed floor as described in clause (1), second, to 378.18 provide an allocation of up to $2,000 to each county as provided 378.19 for in clause (2), and third, any remaining funds shall be 378.20 allocated in proportion to the sum of each county's average 378.21 monthly MFIP cases plus ten percent of each county's average 378.22 monthly MFIP recipients with budgeted earnings as determined by 378.23 the most recent calendar year data available. 378.24 (1) Each county's guaranteed floor shall be calculated as 378.25 follows: 378.26 (i) 90 percent of that county's allocation in the preceding 378.27 calendar year; or 378.28 (ii) when the amount of funds available is less than the 378.29 guaranteed floor, each county's allocation shall be equal to the 378.30 previous calendar year allocation reduced by the same percentage 378.31 that the statewide allocation was reduced. 378.32 (2) Each county shall be allocated up to $2,000. If, after 378.33 application of the guaranteed floor, funds are insufficient to 378.34 provide $2,000 per county, each county's allocation under this 378.35 clause shall be an equal share of remaining funds available. 378.36 Sec. 82. Minnesota Statutes 1998, section 256J.76, 379.1 subdivision 4, is amended to read: 379.2 Subd. 4. [REPORTING REQUIREMENT AND REIMBURSEMENT.] The 379.3 commissioner shall specify requirements for reporting according 379.4 to section 256.01, subdivision 2, paragraph (17). Each county 379.5 shall be reimbursed at a rate of 50 percent of eligible 379.6 expenditures up to the limit of its allocation. The 379.7 commissioner shall regularly review each county's eligible 379.8 expenditures compared to its allocation. The commissioner may 379.9 reallocate funds at any time, from counties which have not or 379.10 will not have expended their allocations, to counties that have 379.11 eligible expenditures in excess of their allocation. 379.12 Sec. 83. [STUDY OF EXTENSIONS TO 60-MONTH LIMIT.] 379.13 By January 15, 2000, the commissioner of human services 379.14 shall submit to the legislature recommendations regarding how to 379.15 implement any extension of assistance to MFIP families that 379.16 includes an adult caregiver who has received 60 months of cash 379.17 assistance funded in whole or in part by the TANF block grant. 379.18 Sec. 84. [UNIVERSITY OF MINNESOTA MFIP PILOT PROJECT.] 379.19 Notwithstanding Minnesota Statutes, section 256J.53, 379.20 subdivision 1, job counselors may approve employment plans that 379.21 include the University of Minnesota student parent MFIP 379.22 program. Plans must support participation in the program and 379.23 require participants to accept the job guaranteed by the 379.24 University of Minnesota, or a comparably paid job, at the end of 379.25 the second year of education. 379.26 Sec. 85. [REVIEW OF MINNESOTA SUPPLEMENTAL AID SPECIAL 379.27 DIET ALLOWANCE; REPORT.] 379.28 The commissioner of human services shall review the 379.29 Minnesota supplemental aid special diet allowance under 379.30 Minnesota Statutes, section 256D.44, subdivision 5, and provide 379.31 a report to the appropriate senate and house committee chairs by 379.32 December 1, 1999, which contains updated special diet allowance 379.33 rates. 379.34 Sec. 86. [REPEALER.] 379.35 Minnesota Statutes 1998, sections 256D.051, subdivisions 6 379.36 and 19; 256D.053, subdivision 4; 256J.03; 256J.30, subdivision 380.1 6; and 256J.62, subdivisions 2, 3, and 5; and Laws 1997, chapter 380.2 85, article 1, section 63, are repealed. 380.3 ARTICLE 7 380.4 CHILD SUPPORT 380.5 Section 1. Minnesota Statutes 1998, section 256.87, 380.6 subdivision 1a, is amended to read: 380.7 Subd. 1a. [CONTINUING SUPPORT CONTRIBUTIONS.] In addition 380.8 to granting the county or state agency a money judgment, the 380.9 court may, upon a motion or order to show cause, order 380.10 continuing support contributions by a parent found able to 380.11 reimburse the county or state agency. The order shall be 380.12 effective for the period of time during which the recipient 380.13 receives public assistance from any county or state agency and 380.14 thereafter. The order shall require support according to 380.15 chapter 518 and include the names and social security numbers of 380.16 the father, mother, and the child or children. An order for 380.17 continuing contributions is reinstated without further hearing 380.18 upon notice to the parent by any county or state agency that 380.19 public assistance, as defined in section 256.741, is again being 380.20 provided for the child of the parent. The notice shall be in 380.21 writing and shall indicate that the parent may request a hearing 380.22 for modification of the amount of support or maintenance. 380.23 Sec. 2. Minnesota Statutes 1998, section 257.66, 380.24 subdivision 3, is amended to read: 380.25 Subd. 3. [JUDGMENT; ORDER.] The judgment or order shall 380.26 contain provisions concerning the duty of support, the custody 380.27 of the child, the name of the child, the social security number 380.28 of the mother, father, and child, if known at the time of 380.29 adjudication, visitation privileges with the child, the 380.30 furnishing of bond or other security for the payment of the 380.31 judgment, or any other matter in the best interest of the 380.32 child. Custody and visitation and all subsequent motions 380.33 related to them shall proceed and be determined under section 380.34 257.541. The remaining matters and all subsequent motions 380.35 related to them shall proceed and be determined in accordance 380.36 with chapter 518. The judgment or order may direct the 381.1 appropriate party to pay all or a proportion of the reasonable 381.2 expenses of the mother's pregnancy and confinement, including 381.3 the mother's lost wages due to medical necessity, after 381.4 consideration of the relevant facts, including the relative 381.5 financial means of the parents; the earning ability of each 381.6 parent; and any health insurance policies held by either parent, 381.7 or by a spouse or parent of the parent, which would provide 381.8 benefits for the expenses incurred by the mother during her 381.9 pregnancy and confinement. Pregnancy and confinement expenses 381.10 and genetic testing costs, submitted by the public authority, 381.11 are admissible as evidence without third-party foundation 381.12 testimony and constitute prima facie evidence of the amounts 381.13 incurred for those services or for the genetic testing. 381.14 Remedies available for the collection and enforcement of child 381.15 support apply to confinement costs and are considered additional 381.16 child support. 381.17 Sec. 3. Minnesota Statutes 1998, section 257.75, 381.18 subdivision 2, is amended to read: 381.19 Subd. 2. [REVOCATION OF RECOGNITION.] A recognition may be 381.20 revoked in a writing signed by the mother or father before a 381.21 notary public and filed with the state registrar of vital 381.22 statistics within the earlier of3060 days after the 381.23 recognition is executed or the date of an administrative or 381.24 judicial hearing relating to the child in which the revoking 381.25 party is a party to the related action. A joinder in a 381.26 recognition may be revoked in a writing signed by the man who 381.27 executed the joinder and filed with the state registrar of vital 381.28 statistics within3060 days after the joinder is executed. 381.29 Upon receipt of a revocation of the recognition of parentage or 381.30 joinder in a recognition, the state registrar of vital 381.31 statistics shall forward a copy of the revocation to the 381.32 nonrevoking parent, or, in the case of a joinder in a 381.33 recognition, to the mother and father who executed the 381.34 recognition. 381.35 Sec. 4. Minnesota Statutes 1998, section 518.10, is 381.36 amended to read: 382.1 518.10 [REQUISITES OF PETITION.] 382.2 The petition for dissolution of marriage or legal 382.3 separation shall state and allege: 382.4 (a) the name, address, and, in circumstances in which child 382.5 support or spousal maintenance will be addressed, social 382.6 security number of the petitioner and any prior or other name 382.7 used by the petitioner; 382.8 (b) the name and, if known, the address and, in 382.9 circumstances in which child support or spousal maintenance will 382.10 be addressed, social security number of the respondent and any 382.11 prior or other name used by the respondent and known to the 382.12 petitioner; 382.13 (c) the place and date of the marriage of the parties; 382.14 (d) in the case of a petition for dissolution, that either 382.15 the petitioner or the respondent or both: 382.16 (1) has resided in this state for not less than 180 days 382.17 immediately preceding the commencement of the proceeding, or 382.18 (2) has been a member of the armed services and has been 382.19 stationed in this state for not less than 180 days immediately 382.20 preceding the commencement of the proceeding, or 382.21 (3) has been a domiciliary of this state for not less than 382.22 180 days immediately preceding the commencement of the 382.23 proceeding; 382.24 (e) the name at the time of the petition and any prior or 382.25 other name, social security number, age, and date of birth of 382.26 each living minor or dependent child of the parties born before 382.27 the marriage or born or adopted during the marriage and a 382.28 reference to, and the expected date of birth of, a child of the 382.29 parties conceived during the marriage but not born; 382.30 (f) whether or not a separate proceeding for dissolution, 382.31 legal separation, or custody is pending in a court in this state 382.32 or elsewhere; 382.33 (g) in the case of a petition for dissolution, that there 382.34 has been an irretrievable breakdown of the marriage 382.35 relationship; 382.36 (h) in the case of a petition for legal separation, that 383.1 there is a need for a decree of legal separation; 383.2 (i) any temporary or permanent maintenance, child support, 383.3 child custody, disposition of property, attorneys' fees, costs 383.4 and disbursements applied for without setting forth the amounts; 383.5 and 383.6 (j) whether an order for protection under chapter 518B or a 383.7 similar law of another state that governs the parties or a party 383.8 and a minor child of the parties is in effect and, if so, the 383.9 district court or similar jurisdiction in which it was entered. 383.10 The petition shall be verified by the petitioner or 383.11 petitioners, and its allegations established by competent 383.12 evidence. 383.13 Sec. 5. Minnesota Statutes 1998, section 518.551, is 383.14 amended by adding a subdivision to read: 383.15 Subd. 15. [LICENSE SUSPENSION.] (a) Upon motion of an 383.16 obligee or the public authority, which has been properly served 383.17 on the obligor by first class mail at the last known address or 383.18 in person, and if at a hearing, the court finds that (1) the 383.19 obligor is in arrears in court-ordered child support or 383.20 maintenance payments, or both, in an amount equal to or greater 383.21 than three times the obligor's total monthly support and 383.22 maintenance payments and is not in compliance with a written 383.23 payment agreement regarding both current support and arrearages, 383.24 or (2) has failed, after receiving notice, to comply with a 383.25 subpoena relating to a paternity or child support proceeding, 383.26 the court may direct the commissioner of natural resources to 383.27 suspend or bar receipt of the obligor's recreational license or 383.28 licenses. 383.29 (b) For purposes of this subdivision, a recreational 383.30 license includes all licenses, permits, and stamps issued 383.31 centrally by the commissioner of natural resources under 383.32 sections 97B.301, 97B.401, 97B.501, 97B.515, 97B.601, 97B.715, 383.33 97B.721, 97B.801, 97C.301, and 97C.305. 383.34 (c) An obligor whose recreational license or licenses have 383.35 been suspended or barred may provide proof to the court that the 383.36 obligor is in compliance with all written payment agreements 384.1 regarding both current support and arrearages. Within 15 days 384.2 of receipt of that proof, the court shall notify the 384.3 commissioner of natural resources that the obligor's 384.4 recreational license or licenses should no longer be suspended 384.5 nor should receipt be barred. 384.6 Sec. 6. Minnesota Statutes 1998, section 518.5853, is 384.7 amended by adding a subdivision to read: 384.8 Subd. 11. [COLLECTIONS UNIT RECOUPMENT ACCOUNT.] The 384.9 commissioner of human services may establish a revolving account 384.10 to cover funds issued in error due to insufficient funds or 384.11 other reasons. Appropriations for this purpose and all 384.12 recoupments against payments from the account shall be deposited 384.13 in the collections unit's recoupment account and are 384.14 appropriated to the commissioner. Any unexpended balance in the 384.15 account does not cancel, but is available until expended. 384.16 Sec. 7. [CHILD SUPPORT ARREARAGE FORGIVENESS REPORT.] 384.17 The commissioner of human services shall examine the 384.18 feasibility of forgiving child support arrears in a fair and 384.19 consistent manner and shall develop child support arrearage 384.20 forgiveness policies to be used throughout the state. Also, the 384.21 commissioner shall explore the possibility of forwarding a 384.22 portion of, or the entire amount of, the current child support 384.23 payment to the custodial parent in order to bridge the child 384.24 support with the family. The information must be in a report to 384.25 the chairs of the appropriate senate and house committees and 384.26 their members by December 1, 1999. 384.27 ARTICLE 8 384.28 CHILD PROTECTION AND 384.29 RELATED MAXIMIZATION OF FEDERAL FUNDS 384.30 Section 1. Minnesota Statutes 1998, section 144.1761, 384.31 subdivision 1, is amended to read: 384.32 Subdivision 1. [REQUEST.] (a) Whenever an adopted person 384.33 requests the state registrar to disclose the information on the 384.34 adopted person's original birth certificate, the state registrar 384.35 shall act in accordance with the provisions of section 259.89. 384.36 (b) The state registrar shall provide a copy of an adopted 385.1 person's original birth certificate to an authorized 385.2 representative of a federally recognized American Indian tribe 385.3 for the sole purpose of determining the adopted person's 385.4 eligibility for enrollment or membership. Information contained 385.5 on the birth certificate may not be used to provide the adopted 385.6 person information about the person's birth parents except as 385.7 provided in this section or section 259.83. 385.8 Sec. 2. Minnesota Statutes 1998, section 245A.30, is 385.9 amended to read: 385.10 245A.30 [LICENSING PROHIBITION FOR CERTAIN JUVENILE 385.11 FACILITIES.] 385.12 The commissioner may not: 385.13 (1) issue any license under Minnesota Rules, parts 385.14 9545.0905 to 9545.1125, for the residential placement of 385.15 juveniles at a facility if the facility accepts juveniles who 385.16 reside outside of Minnesota without an agreement with the entity 385.17 placing the juvenile at the facility that obligates the entity 385.18 to pay the educational and medical expenses of the juvenile; or 385.19 (2) renew a license under Minnesota Rules, parts 9545.0905 385.20 to 9545.1125, for the residential placement of juveniles if the 385.21 facility accepts juveniles who reside outside of Minnesota 385.22 without an agreement with the entity placing the juvenile at the 385.23 facility that obligates the entity to pay the educational and 385.24 medical expenses of the juvenile. 385.25 (Effective Date: Section 2 (245A.30) is effective July 1, 385.26 2000.) 385.27 Sec. 3. [254A.175] [CHEMICAL DEPENDENCY TREATMENT MODELS 385.28 FOR FAMILIES WITH POTENTIAL CHILD PROTECTION PROBLEMS.] 385.29 The commissioner shall explore and experiment with 385.30 different chemical dependency service models for parents with 385.31 children who are found to be in need of chemical dependency 385.32 treatment pursuant to an assessment under section 626.556, 385.33 subdivision 10, or a case plan under section 257.071 or 260.191, 385.34 subdivision 1e. The commissioner shall tailor services to 385.35 better serve this high-risk population, which may include 385.36 long-term treatment that allows the children to stay with the 386.1 parent at the treatment facility. 386.2 Sec. 4. Minnesota Statutes 1998, section 254B.04, 386.3 subdivision 1, is amended to read: 386.4 Subdivision 1. [ELIGIBILITY.] (a) Persons eligible for 386.5 benefits under Code of Federal Regulations, title 25, part 20, 386.6 persons eligible for medical assistance benefits under sections 386.7 256B.055, 256B.056, and 256B.057, subdivisions 1, 2, 5, and 6, 386.8 or who meet the income standards of section 256B.056, 386.9 subdivision 4, and persons eligible for general assistance 386.10 medical care under section 256D.03, subdivision 3, are entitled 386.11 to chemical dependency fund services. State money appropriated 386.12 for this paragraph must be placed in a separate account 386.13 established for this purpose. 386.14 Persons with dependent children who are determined to be in 386.15 need of chemical dependency treatment pursuant to an assessment 386.16 under section 626.556, subdivision 10, or a case plan under 386.17 section 257.071 or 260.191, subdivision 1e, shall be assisted by 386.18 the local agency to access needed treatment services. Treatment 386.19 services must be appropriate for the individual or family, which 386.20 may include long-term care treatment or treatment in a facility 386.21 that allows the dependent children to stay in the treatment 386.22 facility. The county shall pay for out-of-home placement costs, 386.23 if applicable. 386.24 (b) A person not entitled to services under paragraph (a), 386.25 but with family income that is less than 60 percent of the state 386.26 median income for a family of like size and composition, shall 386.27 be eligible to receive chemical dependency fund services within 386.28 the limit of funds available after persons entitled to services 386.29 under paragraph (a) have been served. If notified by the state 386.30 agency of limited funds, a county must give preferential 386.31 treatment to persons with dependent children who are in need of 386.32 chemical dependency treatment pursuant to an assessment under 386.33 section 626.556, subdivision 10, or a case plan under section 386.34 257.071 or 260.191, subdivision 1e. A county may spend money 386.35 from its own sources to serve persons under this paragraph. 386.36 State money appropriated for this paragraph must be placed in a 387.1 separate account established for this purpose. 387.2 (c) Persons whose income is between 60 percent and 115 387.3 percent of the state median income shall be eligible for 387.4 chemical dependency services on a sliding fee basis, within the 387.5 limit of funds available, after persons entitled to services 387.6 under paragraph (a) and persons eligible for services under 387.7 paragraph (b) have been served. Persons eligible under this 387.8 paragraph must contribute to the cost of services according to 387.9 the sliding fee scale established under subdivision 3. A county 387.10 may spend money from its own sources to provide services to 387.11 persons under this paragraph. State money appropriated for this 387.12 paragraph must be placed in a separate account established for 387.13 this purpose. 387.14 Sec. 5. Minnesota Statutes 1998, section 256.01, 387.15 subdivision 2, is amended to read: 387.16 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 387.17 section 241.021, subdivision 2, the commissioner of human 387.18 services shall: 387.19 (1) Administer and supervise all forms of public assistance 387.20 provided for by state law and other welfare activities or 387.21 services as are vested in the commissioner. Administration and 387.22 supervision of human services activities or services includes, 387.23 but is not limited to, assuring timely and accurate distribution 387.24 of benefits, completeness of service, and quality program 387.25 management. In addition to administering and supervising human 387.26 services activities vested by law in the department, the 387.27 commissioner shall have the authority to: 387.28 (a) require county agency participation in training and 387.29 technical assistance programs to promote compliance with 387.30 statutes, rules, federal laws, regulations, and policies 387.31 governing human services; 387.32 (b) monitor, on an ongoing basis, the performance of county 387.33 agencies in the operation and administration of human services, 387.34 enforce compliance with statutes, rules, federal laws, 387.35 regulations, and policies governing welfare services and promote 387.36 excellence of administration and program operation; 388.1 (c) develop a quality control program or other monitoring 388.2 program to review county performance and accuracy of benefit 388.3 determinations; 388.4 (d) require county agencies to make an adjustment to the 388.5 public assistance benefits issued to any individual consistent 388.6 with federal law and regulation and state law and rule and to 388.7 issue or recover benefits as appropriate; 388.8 (e) delay or deny payment of all or part of the state and 388.9 federal share of benefits and administrative reimbursement 388.10 according to the procedures set forth in section 256.017; 388.11 (f) make contracts with and grants to public and private 388.12 agencies and organizations, both profit and nonprofit, and 388.13 individuals, using appropriated funds; and 388.14 (g) enter into contractual agreements with federally 388.15 recognized Indian tribes with a reservation in Minnesota to the 388.16 extent necessary for the tribe to operate a federally approved 388.17 family assistance program or any other program under the 388.18 supervision of the commissioner. The commissioner shall consult 388.19 with the affected county or counties in the contractual 388.20 agreement negotiations, if the county or counties wish to be 388.21 included, in order to avoid the duplication of county and tribal 388.22 assistance program services. The commissioner may establish 388.23 necessary accounts for the purposes of receiving and disbursing 388.24 funds as necessary for the operation of the programs. 388.25 (2) Inform county agencies, on a timely basis, of changes 388.26 in statute, rule, federal law, regulation, and policy necessary 388.27 to county agency administration of the programs. 388.28 (3) Administer and supervise all child welfare activities; 388.29 promote the enforcement of laws protecting handicapped, 388.30 dependent, neglected and delinquent children, and children born 388.31 to mothers who were not married to the children's fathers at the 388.32 times of the conception nor at the births of the children; 388.33 license and supervise child-caring and child-placing agencies 388.34 and institutions; supervise the care of children in boarding and 388.35 foster homes or in private institutions; and generally perform 388.36 all functions relating to the field of child welfare now vested 389.1 in the state board of control. 389.2 (4) Administer and supervise all noninstitutional service 389.3 to handicapped persons, including those who are visually 389.4 impaired, hearing impaired, or physically impaired or otherwise 389.5 handicapped. The commissioner may provide and contract for the 389.6 care and treatment of qualified indigent children in facilities 389.7 other than those located and available at state hospitals when 389.8 it is not feasible to provide the service in state hospitals. 389.9 (5) Assist and actively cooperate with other departments, 389.10 agencies and institutions, local, state, and federal, by 389.11 performing services in conformity with the purposes of Laws 389.12 1939, chapter 431. 389.13 (6) Act as the agent of and cooperate with the federal 389.14 government in matters of mutual concern relative to and in 389.15 conformity with the provisions of Laws 1939, chapter 431, 389.16 including the administration of any federal funds granted to the 389.17 state to aid in the performance of any functions of the 389.18 commissioner as specified in Laws 1939, chapter 431, and 389.19 including the promulgation of rules making uniformly available 389.20 medical care benefits to all recipients of public assistance, at 389.21 such times as the federal government increases its participation 389.22 in assistance expenditures for medical care to recipients of 389.23 public assistance, the cost thereof to be borne in the same 389.24 proportion as are grants of aid to said recipients. 389.25 (7) Establish and maintain any administrative units 389.26 reasonably necessary for the performance of administrative 389.27 functions common to all divisions of the department. 389.28 (8) Act as designated guardian of both the estate and the 389.29 person of all the wards of the state of Minnesota, whether by 389.30 operation of law or by an order of court, without any further 389.31 act or proceeding whatever, except as to persons committed as 389.32 mentally retarded. For children under the guardianship of the 389.33 commissioner whose interests would be best served by adoptive 389.34 placement, the commissioner may contract with a licensed 389.35 child-placing agency to provide adoption services. A contract 389.36 with a licensed child-placing agency must be designed to 390.1 supplement existing county efforts and may not replace existing 390.2 county programs, unless the replacement is agreed to by the 390.3 county board and the appropriate exclusive bargaining 390.4 representative or the commissioner has evidence that child 390.5 placements of the county continue to be substantially below that 390.6 of other counties. Funds encumbered and obligated under an 390.7 agreement for a specific child shall remain available until the 390.8 terms of the agreement are fulfilled or the agreement is 390.9 terminated. 390.10 (9) Act as coordinating referral and informational center 390.11 on requests for service for newly arrived immigrants coming to 390.12 Minnesota. 390.13 (10) The specific enumeration of powers and duties as 390.14 hereinabove set forth shall in no way be construed to be a 390.15 limitation upon the general transfer of powers herein contained. 390.16 (11) Establish county, regional, or statewide schedules of 390.17 maximum fees and charges which may be paid by county agencies 390.18 for medical, dental, surgical, hospital, nursing and nursing 390.19 home care and medicine and medical supplies under all programs 390.20 of medical care provided by the state and for congregate living 390.21 care under the income maintenance programs. 390.22 (12) Have the authority to conduct and administer 390.23 experimental projects to test methods and procedures of 390.24 administering assistance and services to recipients or potential 390.25 recipients of public welfare. To carry out such experimental 390.26 projects, it is further provided that the commissioner of human 390.27 services is authorized to waive the enforcement of existing 390.28 specific statutory program requirements, rules, and standards in 390.29 one or more counties. The order establishing the waiver shall 390.30 provide alternative methods and procedures of administration, 390.31 shall not be in conflict with the basic purposes, coverage, or 390.32 benefits provided by law, and in no event shall the duration of 390.33 a project exceed four years. It is further provided that no 390.34 order establishing an experimental project as authorized by the 390.35 provisions of this section shall become effective until the 390.36 following conditions have been met: 391.1 (a) The secretary of health, education, and welfare of the 391.2 United States has agreed, for the same project, to waive state 391.3 plan requirements relative to statewide uniformity. 391.4 (b) A comprehensive plan, including estimated project 391.5 costs, shall be approved by the legislative advisory commission 391.6 and filed with the commissioner of administration. 391.7 (13) According to federal requirements, establish 391.8 procedures to be followed by local welfare boards in creating 391.9 citizen advisory committees, including procedures for selection 391.10 of committee members. 391.11 (14) Allocate federal fiscal disallowances or sanctions 391.12 which are based on quality control error rates for the aid to 391.13 families with dependent children, Minnesota family investment 391.14 program-statewide, medical assistance, or food stamp program in 391.15 the following manner: 391.16 (a) One-half of the total amount of the disallowance shall 391.17 be borne by the county boards responsible for administering the 391.18 programs. For the medical assistance, MFIP-S, and AFDC 391.19 programs, disallowances shall be shared by each county board in 391.20 the same proportion as that county's expenditures for the 391.21 sanctioned program are to the total of all counties' 391.22 expenditures for the AFDC, MFIP-S, and medical assistance 391.23 programs. For the food stamp program, sanctions shall be shared 391.24 by each county board, with 50 percent of the sanction being 391.25 distributed to each county in the same proportion as that 391.26 county's administrative costs for food stamps are to the total 391.27 of all food stamp administrative costs for all counties, and 50 391.28 percent of the sanctions being distributed to each county in the 391.29 same proportion as that county's value of food stamp benefits 391.30 issued are to the total of all benefits issued for all 391.31 counties. Each county shall pay its share of the disallowance 391.32 to the state of Minnesota. When a county fails to pay the 391.33 amount due hereunder, the commissioner may deduct the amount 391.34 from reimbursement otherwise due the county, or the attorney 391.35 general, upon the request of the commissioner, may institute 391.36 civil action to recover the amount due. 392.1 (b) Notwithstanding the provisions of paragraph (a), if the 392.2 disallowance results from knowing noncompliance by one or more 392.3 counties with a specific program instruction, and that knowing 392.4 noncompliance is a matter of official county board record, the 392.5 commissioner may require payment or recover from the county or 392.6 counties, in the manner prescribed in paragraph (a), an amount 392.7 equal to the portion of the total disallowance which resulted 392.8 from the noncompliance, and may distribute the balance of the 392.9 disallowance according to paragraph (a). 392.10 (15) Develop and implement special projects that maximize 392.11 reimbursements and result in the recovery of money to the 392.12 state. For the purpose of recovering state money, the 392.13 commissioner may enter into contracts with third parties. Any 392.14 recoveries that result from projects or contracts entered into 392.15 under this paragraph shall be deposited in the state treasury 392.16 and credited to a special account until the balance in the 392.17 account reaches $1,000,000. When the balance in the account 392.18 exceeds $1,000,000, the excess shall be transferred and credited 392.19 to the general fund. All money in the account is appropriated 392.20 to the commissioner for the purposes of this paragraph. 392.21 (16) Have the authority to make direct payments to 392.22 facilities providing shelter to women and their children 392.23 according to section 256D.05, subdivision 3. Upon the written 392.24 request of a shelter facility that has been denied payments 392.25 under section 256D.05, subdivision 3, the commissioner shall 392.26 review all relevant evidence and make a determination within 30 392.27 days of the request for review regarding issuance of direct 392.28 payments to the shelter facility. Failure to act within 30 days 392.29 shall be considered a determination not to issue direct payments. 392.30 (17) Have the authority to establish and enforce the 392.31 following county reporting requirements: 392.32 (a) The commissioner shall establish fiscal and statistical 392.33 reporting requirements necessary to account for the expenditure 392.34 of funds allocated to counties for human services programs. 392.35 When establishing financial and statistical reporting 392.36 requirements, the commissioner shall evaluate all reports, in 393.1 consultation with the counties, to determine if the reports can 393.2 be simplified or the number of reports can be reduced. 393.3 (b) The county board shall submit monthly or quarterly 393.4 reports to the department as required by the commissioner. 393.5 Monthly reports are due no later than 15 working days after the 393.6 end of the month. Quarterly reports are due no later than 30 393.7 calendar days after the end of the quarter, unless the 393.8 commissioner determines that the deadline must be shortened to 393.9 20 calendar days to avoid jeopardizing compliance with federal 393.10 deadlines or risking a loss of federal funding. Only reports 393.11 that are complete, legible, and in the required format shall be 393.12 accepted by the commissioner. 393.13 (c) If the required reports are not received by the 393.14 deadlines established in clause (b), the commissioner may delay 393.15 payments and withhold funds from the county board until the next 393.16 reporting period. When the report is needed to account for the 393.17 use of federal funds and the late report results in a reduction 393.18 in federal funding, the commissioner shall withhold from the 393.19 county boards with late reports an amount equal to the reduction 393.20 in federal funding until full federal funding is received. 393.21 (d) A county board that submits reports that are late, 393.22 illegible, incomplete, or not in the required format for two out 393.23 of three consecutive reporting periods is considered 393.24 noncompliant. When a county board is found to be noncompliant, 393.25 the commissioner shall notify the county board of the reason the 393.26 county board is considered noncompliant and request that the 393.27 county board develop a corrective action plan stating how the 393.28 county board plans to correct the problem. The corrective 393.29 action plan must be submitted to the commissioner within 45 days 393.30 after the date the county board received notice of noncompliance. 393.31 (e) The final deadline for fiscal reports or amendments to 393.32 fiscal reports is one year after the date the report was 393.33 originally due. If the commissioner does not receive a report 393.34 by the final deadline, the county board forfeits the funding 393.35 associated with the report for that reporting period and the 393.36 county board must repay any funds associated with the report 394.1 received for that reporting period. 394.2 (f) The commissioner may not delay payments, withhold 394.3 funds, or require repayment under paragraph (c) or (e) if the 394.4 county demonstrates that the commissioner failed to provide 394.5 appropriate forms, guidelines, and technical assistance to 394.6 enable the county to comply with the requirements. If the 394.7 county board disagrees with an action taken by the commissioner 394.8 under paragraph (c) or (e), the county board may appeal the 394.9 action according to sections 14.57 to 14.69. 394.10 (g) Counties subject to withholding of funds under 394.11 paragraph (c) or forfeiture or repayment of funds under 394.12 paragraph (e) shall not reduce or withhold benefits or services 394.13 to clients to cover costs incurred due to actions taken by the 394.14 commissioner under paragraph (c) or (e). 394.15 (18) Allocate federal fiscal disallowances or sanctions for 394.16 audit exceptions when federal fiscal disallowances or sanctions 394.17 are based on a statewide random sample for the foster care 394.18 program under title IV-E of the Social Security Act, United 394.19 States Code, title 42, in direct proportion to each county's 394.20 title IV-E foster care maintenance claim for that period. 394.21 (19) Be responsible for ensuring the detection, prevention, 394.22 investigation, and resolution of fraudulent activities or 394.23 behavior by applicants, recipients, and other participants in 394.24 the human services programs administered by the department. 394.25 (20) Require county agencies to identify overpayments, 394.26 establish claims, and utilize all available and cost-beneficial 394.27 methodologies to collect and recover these overpayments in the 394.28 human services programs administered by the department. 394.29 (21) Have the authority to administer a drug rebate program 394.30 for drugs purchased pursuant to the senior citizen drug program 394.31 established under section 256.955 after the beneficiary's 394.32 satisfaction of any deductible established in the program. The 394.33 commissioner shall require a rebate agreement from all 394.34 manufacturers of covered drugs as defined in section 256B.0625, 394.35 subdivision 13. For each drug, the amount of the rebate shall 394.36 be equal to the basic rebate as defined for purposes of the 395.1 federal rebate program in United States Code, title 42, section 395.2 1396r-8(c)(1). This basic rebate shall be applied to 395.3 single-source and multiple-source drugs. The manufacturers must 395.4 provide full payment within 30 days of receipt of the state 395.5 invoice for the rebate within the terms and conditions used for 395.6 the federal rebate program established pursuant to section 1927 395.7 of title XIX of the Social Security Act. The manufacturers must 395.8 provide the commissioner with any information necessary to 395.9 verify the rebate determined per drug. The rebate program shall 395.10 utilize the terms and conditions used for the federal rebate 395.11 program established pursuant to section 1927 of title XIX of the 395.12 Social Security Act. 395.13 Sec. 6. Minnesota Statutes 1998, section 256B.0625, is 395.14 amended by adding a subdivision to read: 395.15 Subd. 41. [RESIDENTIAL SERVICES FOR CHILDREN WITH SEVERE 395.16 EMOTIONAL DISTURBANCE.] Medical assistance covers rehabilitative 395.17 services in accordance with section 256B.0945 that are provided 395.18 by a county through a residential facility, for children who 395.19 have been diagnosed with severe emotional disturbance and have 395.20 been determined to require the level of care provided in a 395.21 residential facility. 395.22 (Effective Date: Section 6 (256B.0625, adding subdivision 395.23 41) is effective July 1, 2000.) 395.24 Sec. 7. Minnesota Statutes 1998, section 256B.094, 395.25 subdivision 3, is amended to read: 395.26 Subd. 3. [COORDINATION AND PROVISION OF SERVICES.] (a) In 395.27 a county or reservation where a prepaid medical assistance 395.28 provider has contracted under section 256B.031 or 256B.69 to 395.29 provide mental health services, the case management provider 395.30 shall coordinate with the prepaid provider to ensure that all 395.31 necessary mental health services required under the contract are 395.32 provided to recipients of case management services. 395.33 (b) When the case management provider determines that a 395.34 prepaid provider is not providing mental health services as 395.35 required under the contract, the case management provider shall 395.36 assist the recipient to appeal the prepaid provider's denial 396.1 pursuant to section 256.045, and may make other arrangements for 396.2 provision of the covered services. 396.3 (c) The case management provider may bill the provider of 396.4 prepaid health care services for any mental health services 396.5 provided to a recipient of case management services which the 396.6 county or tribal social services arranges for or provides and 396.7 which are included in the prepaid provider's contract, and which 396.8 were determined to be medically necessary as a result of an 396.9 appeal pursuant to section 256.045. The prepaid provider must 396.10 reimburse the mental health provider, at the prepaid provider's 396.11 standard rate for that service, for any services delivered under 396.12 this subdivision. 396.13 (d) If the county or tribal social services has not 396.14 obtained prior authorization for this service, or an appeal 396.15 results in a determination that the services were not medically 396.16 necessary, the county or tribal social services may not seek 396.17 reimbursement from the prepaid provider. 396.18 Sec. 8. Minnesota Statutes 1998, section 256B.094, 396.19 subdivision 5, is amended to read: 396.20 Subd. 5. [CASE MANAGER.] To provide case management 396.21 services, a case manager must be employed or contracted by and 396.22 authorized by the case management provider to provide case 396.23 management services and meet all requirements under section 396.24 256F.10. 396.25 Sec. 9. Minnesota Statutes 1998, section 256B.094, 396.26 subdivision 6, is amended to read: 396.27 Subd. 6. [MEDICAL ASSISTANCE REIMBURSEMENT OF CASE 396.28 MANAGEMENT SERVICES.] (a) Medical assistance reimbursement for 396.29 services under this section shall be made on a monthly basis. 396.30 Payment is based on face-to-face or telephone contacts between 396.31 the case manager and the client, client's family, primary 396.32 caregiver, legal representative, or other relevant person 396.33 identified as necessary to the development or implementation of 396.34 the goals of the individual service plan regarding the status of 396.35 the client, the individual service plan, or the goals for the 396.36 client. These contacts must meet the minimum standards in 397.1 clauses (1) and (2): 397.2 (1) there must be a face-to-face contact at least once a 397.3 month except as provided in clause (2); and 397.4 (2) for a client placed outside of the county of financial 397.5 responsibility in an excluded time facility under section 397.6 256G.02, subdivision 6, or through the Interstate Compact on the 397.7 Placement of Children, section 257.40, and the placement in 397.8 either case is more than 60 miles beyond the county or 397.9 reservation boundaries, there must be at least one contact per 397.10 month and not more than two consecutive months without a 397.11 face-to-face contact. 397.12 (b) Except as provided in paragraph (c), the payment rate 397.13 is established using time study data on activities of provider 397.14 service staff and reports required under sections 245.482, 397.15 256.01, subdivision 2, paragraph (17), and 256E.08, subdivision 397.16 8. 397.17 (c) For tribes, payment may be in accordance with section 397.18 256B.0625 for child welfare targeted case management provided by 397.19 Indian health services and facilities operated by a tribe or 397.20 tribal organization. 397.21 (d) Payment for case management provided by vendors 397.22 contracted by the county or by tribal social services shall be 397.23 based on a monthly rate negotiated by the host county or tribal 397.24 social services. The negotiated rate must not exceed the rate 397.25 charged by the vendor for the same service to other payers. If 397.26 the service is provided by a team of contracted vendors, the 397.27 county or tribal social services may negotiate a team rate with 397.28 a vendor who is a member of the team. The team shall determine 397.29 how to distribute the rate among its members. No reimbursement 397.30 received by contracted vendors shall be returned to the county 397.31 or tribal social services, except to reimburse the county or 397.32 tribal social services for advance funding provided by the 397.33 county or tribal social services to the vendor. 397.34 (e) If the service is provided by a team that includes 397.35 contracted vendors and county or tribal social services staff, 397.36 the costs for county or tribal social services staff 398.1 participation in the team shall be included in the rate for 398.2 county or tribal social services-provided services. In this 398.3 case, the contracted vendor and the county or tribal social 398.4 services may each receive separate payment for services provided 398.5 by each entity in the same month. In order to prevent 398.6 duplication of services, each entity must document, in the 398.7 recipient's file, the need for team case management and a 398.8 description of the roles and services of the team members. 398.9 Separate payment rates may be established for different 398.10 groups of providers to maximize reimbursement as determined by 398.11 the commissioner. The payment rate will be reviewed annually 398.12 and revised periodically to be consistent with the most recent 398.13 time study and other data. Payment for services will be made 398.14 upon submission of a valid claim and verification of proper 398.15 documentation described in subdivision 7. Federal 398.16 administrative revenue earned through the time study or other 398.17 method of reimbursement under paragraph (c) shall be distributed 398.18 according to earnings, to counties, reservations, or groups of 398.19 counties or reservations which have the same payment rate under 398.20 this subdivision, and to the group of counties or reservations 398.21 which are not certified providers under section 256F.10. The 398.22 commissioner shall modify the requirements set out in Minnesota 398.23 Rules, parts 9550.0300 to 9550.0370, as necessary to accomplish 398.24 this. 398.25 Sec. 10. [256B.0945] [RESIDENTIAL SERVICES FOR CHILDREN 398.26 WITH SEVERE EMOTIONAL DISTURBANCE.] 398.27 Subdivision 1. [PROVIDER QUALIFICATIONS.] Counties must 398.28 arrange to provide residential services for children with severe 398.29 emotional disturbance according to section 245.4882 and this 398.30 section. Services must be provided by a facility that is 398.31 licensed according to section 245.4882 and administrative rules 398.32 promulgated thereunder, and under contract with the county. 398.33 Facilities providing services under subdivision 2, paragraph(a), 398.34 must be accredited as a psychiatric facility by the Joint 398.35 Commission on Accreditation of Healthcare Organizations, the 398.36 Commission on Accreditation of Rehabilitation Facilities, or the 399.1 Council on Accreditation. Accreditation is not required for 399.2 facilities providing services under subdivision 2, paragraph (b). 399.3 Subd. 2. [COVERED SERVICES.] All services must be included 399.4 in a child's individualized treatment or collaborative family 399.5 service plan as defined in chapter 245. 399.6 (a) For facilities that are institutions for mental 399.7 diseases according to statute and regulation or are not 399.8 institutions for mental diseases but choose to provide services 399.9 under this paragraph, medical assistance covers the full 399.10 contract rate, including room and board if the services meet the 399.11 requirements of Code of Federal Regulations, title 42, section 399.12 440.160. 399.13 (b) For facilities that are not institutions for mental 399.14 diseases according to federal statute and regulation and are not 399.15 providing services under paragraph (a), medical assistance 399.16 covers mental health related services that are required to be 399.17 provided by a residential facility under section 245.4882 and 399.18 administrative rules promulgated thereunder, except for room and 399.19 board. 399.20 Subd. 3. [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 399.21 PAYMENTS.] Notwithstanding section 256B.041, county payments for 399.22 the cost of residential services provided under this section 399.23 shall not be made to the state treasurer. 399.24 Subd. 4. [PAYMENT RATES.] (a) Notwithstanding sections 399.25 256.025, subdivision 2; 256B.19; and 256B.041, payments to 399.26 counties for residential services provided by a residential 399.27 facility shall only be made of federal earnings for services 399.28 provided under this section, and the nonfederal share of costs 399.29 for services provided under this section shall be paid by the 399.30 county from sources other than federal funds or funds used to 399.31 match other federal funds. Total annual payments for federal 399.32 earnings shall not exceed the federal medical assistance 399.33 percentage matching rate multiplied by the total county 399.34 expenditures for services provided under section 245.4882 for 399.35 either (1) the calendar year 1999 or (2) the average annual 399.36 expenditures for the calendar years 1995 to 1999, whichever is 400.1 greater. Payment to counties for services provided according to 400.2 subdivision 2, paragraph (a), shall be the federal share of the 400.3 contract rate. Payment to counties for services provided 400.4 according to subdivision 2, paragraph (b), shall be a proportion 400.5 of the per day contract rate that relates to rehabilitative 400.6 mental health services and shall not include payment for costs 400.7 or services that are billed to the IV-E program as room and 400.8 board. 400.9 (b) The commissioner shall set aside a portion of the 400.10 federal funds earned under this section to cover the state costs 400.11 of two staff positions and support costs necessary in 400.12 administering this section. Any unexpended funds from the 400.13 set-aside shall be distributed to the counties in proportion to 400.14 their earnings under this section. 400.15 Subd. 5. [QUALITY MEASURES.] Counties must collect and 400.16 report to the commissioner information on outcomes for services 400.17 provided under this section using standardized tools that 400.18 measure functioning, living stability, and parent and child 400.19 satisfaction consistent with the goals of sections 245.4876, 400.20 subdivision 1, and 256F.01. The commissioner shall designate 400.21 standardized tools to be used and shall collect and analyze 400.22 individualized outcome data on a statewide basis and report to 400.23 the legislature by December 1, 2003. The commissioner shall 400.24 provide standardized tools that measure child and adolescent 400.25 functional assessment for intake and discharge, child behavior, 400.26 residential living environment and placement stability, and 400.27 satisfaction for youth and family members. 400.28 Subd. 6. [FEDERAL EARNINGS.] Use of new federal funding 400.29 earned from services provided under this section is limited to: 400.30 (1) increasing prevention and early intervention and 400.31 supportive services to meet the mental health and child welfare 400.32 needs of the children and families in the system of care; 400.33 (2) replacing reductions in federal IV-E reimbursement 400.34 resulting from new medical assistance coverage; and 400.35 (3) paying the nonfederal share of additional provider 400.36 costs due to accreditation and new program standards necessary 401.1 for Medicaid reimbursement. 401.2 For purposes of this section, early intervention and supportive 401.3 services include alternative responses to child maltreatment 401.4 reports under chapter 626 and services outlined in sections 401.5 245.4875, subdivision 2, children's mental health, and 256F.05, 401.6 subdivision 8, family preservation services. 401.7 Subd. 7. [MAINTENANCE OF EFFORT.] (a) Counties that 401.8 receive payment under this section must maintain a level of 401.9 expenditures such that each year's county expenditures for early 401.10 intervention and supportive services is at least equal to that 401.11 county's average expenditures for those services for calendar 401.12 years 1998 and 1999. For purposes of this section, "county 401.13 expenditures" are the total expenditures for those services 401.14 minus the state and federal revenues specifically designated for 401.15 these services. 401.16 (b) The commissioner may waive the requirements in 401.17 paragraph (a) if any of the conditions specified in section 401.18 256F.13, subdivision 1, paragraph (a), clause (4), items (i) to 401.19 (iv), are met. 401.20 Subd. 8. [REPORTS.] The commissioner shall review county 401.21 expenditures annually using reports required under sections 401.22 245.482; 256.01, subdivision 2, clause (17); and 256E.08, 401.23 subdivision 8, to ensure that counties meet their obligation 401.24 under subdivision 7, and that the base level of expenditures for 401.25 mental health and child welfare early intervention and family 401.26 support services and children's mental health residential 401.27 treatment is continued from sources other than federal funds 401.28 earned under this section. 401.29 Subd. 9. [SANCTIONS.] The commissioner may suspend, 401.30 reduce, or terminate the federal reimbursement to a county that 401.31 does not meet one or all of the requirements of this section. 401.32 Subd. 10. [RECOMMENDATIONS.] The commissioner shall 401.33 provide recommendations to the legislature by January 15, 2000, 401.34 regarding any amendments to this section that may be necessary 401.35 or advisable prior to implementation. 401.36 (Effective Date: Section 10 (256B.0945) is effective July 402.1 1, 2000.) 402.2 Sec. 11. Minnesota Statutes 1998, section 256F.03, 402.3 subdivision 5, is amended to read: 402.4 Subd. 5. [FAMILY-BASED SERVICES.] "Family-based services" 402.5 means one or more of the services described in paragraphs (a) 402.6 to(f)(e) provided to families primarily in their own home for 402.7 a limited time. 402.8 (a) [CRISIS SERVICES.] "Crisis services" means 402.9 professional services provided within 24 hours of referral to 402.10 alleviate a family crisis and to offer an alternative to placing 402.11 a child outside the family home. The services are intensive and 402.12 time limited. The service may offer transition to other 402.13 appropriate community-based services. 402.14 (b) [COUNSELING SERVICES.] "Counseling services" means 402.15 professional family counseling provided to alleviate individual 402.16 and family dysfunction; provide an alternative to placing a 402.17 child outside the family home; or permit a child to return 402.18 home. The duration, frequency, and intensity of the service is 402.19 determined in the individual or family service plan. 402.20 (c) [LIFE MANAGEMENT SKILLS SERVICES.] "Life management 402.21 skills services" means paraprofessional services that teach 402.22 family members skills in such areas as parenting, budgeting, 402.23 home management, and communication. The goal is to strengthen 402.24 family skills as an alternative to placing a child outside the 402.25 family home or to permit a child to return home. A social 402.26 worker shall coordinate these services within the family case 402.27 plan. 402.28 (d)[CASE COORDINATION SERVICES.] "Case coordination402.29services" means professional services provided to an individual,402.30family, or caretaker as an alternative to placing a child402.31outside the family home, to permit a child to return home, or to402.32stabilize the long-term or permanent placement of a child.402.33Coordinated services are provided directly, are arranged, or are402.34monitored to meet the needs of a child and family. The402.35duration, frequency, and intensity of services is determined in402.36the individual or family service plan.403.1(e)[MENTAL HEALTH SERVICES.] "Mental health services" 403.2 means the professional services defined in section 245.4871, 403.3 subdivision 31. 403.4(f)(e) [EARLY INTERVENTION SERVICES.] "Early intervention 403.5 services" means family-based intervention services designed to 403.6 help at-risk families avoid crisis situations. 403.7 Sec. 12. Minnesota Statutes 1998, section 256F.05, 403.8 subdivision 8, is amended to read: 403.9 Subd. 8. [USES OF FAMILY PRESERVATION FUND GRANTS.] (a) A 403.10 county which has not demonstrated that year that its family 403.11 preservation core services are developed as provided in 403.12 subdivision 1a, must use its family preservation fund grant 403.13 exclusively for family preservation services defined in section 403.14 256F.03, subdivision 5, paragraphs (a), (b), (c), and(e)(d). 403.15 (b) A county which has demonstrated that year that its 403.16 family preservation core services are developed becomes eligible 403.17 either to continue using its family preservation fund grant as 403.18 provided in paragraph (a), or to exercise the expanded service 403.19 option under paragraph (c). 403.20 (c) The expanded service option permits an eligible county 403.21 to use its family preservation fund grant for child welfare 403.22 preventive services. For purposes of this section, child 403.23 welfare preventive services are those services directed toward a 403.24 specific child or family that further the goals of section 403.25 256F.01 and include assessments, family preservation services, 403.26 service coordination, community-based treatment, crisis nursery 403.27 services when the parents retain custody and there is no 403.28 voluntary placement agreement with a child-placing agency, 403.29 respite care except when it is provided under a medical 403.30 assistance waiver, home-based services, and other related 403.31 services. For purposes of this section, child welfare 403.32 preventive services shall not include shelter care or other 403.33 placement services under the authority of the court or public 403.34 agency to address an emergency. To exercise this option, an 403.35 eligible county must notify the commissioner in writing of its 403.36 intention to do sono later than 30 days into the quarter during404.1which it intends to beginor select this option in its county 404.2 plan, as provided in section 256F.04, subdivision 2. Effective 404.3 with the first day ofthat quarterthe grant period in which 404.4 this option is selected, the county must maintain its base level 404.5 of expenditures for child welfare preventive services and use 404.6 the family preservation fund to expand them. The base level of 404.7 expenditures for a county shall be that established under 404.8 section 256F.10, subdivision 7. For counties which have no such 404.9 base established, a comparable base shall be established with 404.10 the base year being the calendar year ending at least two 404.11 calendar quarters before the first calendar quarter in which the 404.12 county exercises its expanded service option. The commissioner 404.13 shall, at the request of the counties, reduce, suspend, or 404.14 eliminate either or both of a county's obligations to continue 404.15 the base level of expenditures and to expand child welfare 404.16 preventive services under extraordinary circumstances. 404.17 (d) Notwithstanding paragraph (a), a county that is 404.18 participating in the child protection assessments or 404.19 investigations community collaboration pilot program under 404.20 section 626.5560, or in the concurrent permanency planning pilot 404.21 program under section 257.0711, may use its family preservation 404.22 fund grant for those programs. 404.23 Sec. 13. Minnesota Statutes 1998, section 256F.10, 404.24 subdivision 1, is amended to read: 404.25 Subdivision 1. [ELIGIBILITY.] Persons under 21 years of 404.26 age who are eligible to receive medical assistance are eligible 404.27 for child welfare targeted case management services under 404.28 section 256B.094 and this section if they have received an 404.29 assessment and have been determined by the local county or 404.30 tribal social services agency to be: 404.31 (1) at risk of placement or in placement as described in 404.32 section 257.071, subdivision 1; 404.33 (2) at risk of maltreatment or experiencing maltreatment as 404.34 defined in section 626.556, subdivision 10e; or 404.35 (3) in need of protection or services as defined in section 404.36 260.015, subdivision 2a. 405.1 Sec. 14. Minnesota Statutes 1998, section 256F.10, 405.2 subdivision 4, is amended to read: 405.3 Subd. 4. [PROVIDER QUALIFICATIONS AND CERTIFICATION 405.4 STANDARDS.] The commissioner must certify each provider before 405.5 enrolling it as a child welfare targeted case management 405.6 provider of services under section 256B.094 and this section. 405.7 The certification process shall examine the provider's ability 405.8 to meet the qualification requirements and certification 405.9 standards in this subdivision and other federal and state 405.10 requirements of this service. A certified child welfare 405.11 targeted case management provider is an enrolled medical 405.12 assistance provider who is determined by the commissioner to 405.13 have all of the following: 405.14 (1) the legal authority to provide public welfare under 405.15 sections 393.01, subdivision 7, and 393.07 or a federally 405.16 recognized Indian tribe; 405.17 (2) the demonstrated capacity and experience to provide the 405.18 components of case management to coordinate and link community 405.19 resources needed by the eligible population; 405.20 (3) administrative capacity and experience in serving the 405.21 target population for whom it will provide services and in 405.22 ensuring quality of services under state and federal 405.23 requirements; 405.24 (4) the legal authority to provide complete investigative 405.25 and protective services under section 626.556, subdivision 10, 405.26 and child welfare and foster care services under section 393.07, 405.27 subdivisions 1 and 2, or a federally recognized Indian tribe; 405.28 (5) a financial management system that provides accurate 405.29 documentation of services and costs under state and federal 405.30 requirements; and 405.31 (6) the capacity to document and maintain individual case 405.32 records under state and federal requirements. 405.33 Sec. 15. Minnesota Statutes 1998, section 256F.10, 405.34 subdivision 6, is amended to read: 405.35 Subd. 6. [DISTRIBUTION OF NEW FEDERAL REVENUE.] (a) Except 405.36 for portion set aside in paragraph (b), the federal funds earned 406.1 under this section and section 256B.094 bycountiesproviders 406.2 shall be paid to eachcountyprovider based on its earnings, and 406.3 must be used by eachcountyprovider to expand preventive child 406.4 welfare services. 406.5 If a county or tribal social services agency chooses to be a 406.6 provider of child welfare targeted case management and if that 406.7 county or tribal social services agency also joins a local 406.8 children's mental health collaborative as authorized by the 1993 406.9 legislature, then the federal reimbursement received by the 406.10 county or tribal social services agency for providing child 406.11 welfare targeted case management services to children served by 406.12 the local collaborative shall be transferred by the county or 406.13 tribal social services agency to the integrated fund. The 406.14 federal reimbursement transferred to the integrated fund by the 406.15 county or tribal social services agency must not be used for 406.16 residential care other than respite care described under 406.17 subdivision 7, paragraph (d). 406.18 (b) The commissioner shall set aside a portion of the 406.19 federal funds earned under this section to repay the special 406.20 revenue maximization account under section 256.01, subdivision 406.21 2, clause (15). The repayment is limited to: 406.22 (1) the costs of developing and implementing this section 406.23 and sections 256.8711 and 256B.094; 406.24 (2) programming the information systems; and 406.25 (3) the lost federal revenue for the central office claim 406.26 directly caused by the implementation of these sections. 406.27 Any unexpended funds from the set aside under this 406.28 paragraph shall be distributed tocountiesproviders according 406.29 to paragraph (a). 406.30 Sec. 16. Minnesota Statutes 1998, section 256F.10, 406.31 subdivision 7, is amended to read: 406.32 Subd. 7. [EXPANSION OF SERVICES AND BASE LEVEL OF 406.33 EXPENDITURES.] (a) Counties and tribal social services must 406.34 continue the base level of expenditures for preventive child 406.35 welfare services from either or both of any state, county, or 406.36 federal funding source, which, in the absence of federal funds 407.1 earned under this section, would have been available for these 407.2 services. The commissioner shall review the county or tribal 407.3 social services expenditures annually using reports required 407.4 under sections 245.482, 256.01, subdivision 2, paragraph 17, and 407.5 256E.08, subdivision 8, to ensure that the base level of 407.6 expenditures for preventive child welfare services is continued 407.7 from sources other than the federal funds earned under this 407.8 section. 407.9 (b) The commissioner may reduce, suspend, or eliminate 407.10 either or both of a county's or tribal social services' 407.11 obligations to continue the base level of expenditures and to 407.12 expand child welfare preventive services if the commissioner 407.13 determines that one or more of the following conditions apply to 407.14 that county or reservation: 407.15 (1) imposition of levy limits that significantly reduce 407.16 available social service funds; 407.17 (2) reduction in the net tax capacity of the taxable 407.18 property within a county or reservation that significantly 407.19 reduces available social service funds; 407.20 (3) reduction in the number of children under age 19 in the 407.21 county or reservation by 25 percent when compared with the 407.22 number in the base year using the most recent data provided by 407.23 the state demographer's office; or 407.24 (4) termination of the federal revenue earned under this 407.25 section. 407.26 (c) The commissioner may suspend for one year either or 407.27 both of a county's or tribal social services' obligations to 407.28 continue the base level of expenditures and to expand child 407.29 welfare preventive services if the commissioner determines that 407.30 in the previous year one or more of the following conditions 407.31 applied to that county or reservation: 407.32 (1) the total number of children in placement under 407.33 sections 257.071 and 393.07, subdivisions 1 and 2, has been 407.34 reduced by 50 percent from the total number in the base year; or 407.35 (2) the average number of children in placement under 407.36 sections 257.071 and 393.07, subdivisions 1 and 2, on the last 408.1 day of each month is equal to or less than one child per 1,000 408.2 children in the county or reservation. 408.3 (d) For the purposes of this section, child welfare 408.4 preventive services are those services directed toward a 408.5 specific child or family that further the goals of section 408.6 256F.01 and include assessments, family preservation services, 408.7 service coordination, community-based treatment, crisis nursery 408.8 services when the parents retain custody and there is no 408.9 voluntary placement agreement with a child-placing agency, 408.10 respite care except when it is provided under a medical 408.11 assistance waiver, home-based services, and other related 408.12 services. For the purposes of this section, child welfare 408.13 preventive services shall not include shelter care placements 408.14 under the authority of the court or public agency to address an 408.15 emergency, residential services except for respite care, child 408.16 care for the purposes of employment and training, adult 408.17 services, services other than child welfare targeted case 408.18 management when they are provided under medical assistance, 408.19 placement services, or activities not directed toward a specific 408.20 child or family. Respite care must be planned, routine care to 408.21 support the continuing residence of the child with its family or 408.22 long-term primary caretaker and must not be provided to address 408.23 an emergency. 408.24 (e) For the counties and tribal social services beginning 408.25 to claim federal reimbursement for services under this section 408.26 and section 256B.094, the base year is the calendar year ending 408.27 at least two calendar quarters before the first calendar quarter 408.28 in which thecountyprovider begins claiming reimbursement. For 408.29 the purposes of this section, the base level of expenditures is 408.30 the level of county or tribal social services expenditures in 408.31 the base year for eligible child welfare preventive services 408.32 described in this subdivision. 408.33 Sec. 17. Minnesota Statutes 1998, section 256F.10, 408.34 subdivision 8, is amended to read: 408.35 Subd. 8. [PROVIDER RESPONSIBILITIES.] (a) Notwithstanding 408.36 section 256B.19, subdivision 1, for the purposes of child 409.1 welfare targeted case management under section 256B.094 and this 409.2 section, the nonfederal share of costs shall be provided by the 409.3 provider of child welfare targeted case management from sources 409.4 other than federal funds or funds used to match other federal 409.5 funds, except when allowed by federal law or agreement. 409.6 (b) Provider expenditures eligible for federal 409.7 reimbursement under this section must not be made from federal 409.8 funds or funds used to match other federal funds, except when 409.9 allowed by federal law or agreement. 409.10 (c) The commissioner may suspend, reduce, or terminate the 409.11 federal reimbursement to a provider that does not meet the 409.12 reporting or other requirements of section 256B.094 and this 409.13 section. The county or reservation is responsible for any 409.14 federal disallowances. The county or reservation may share this 409.15 responsibility with its contracted vendors. 409.16 Sec. 18. Minnesota Statutes 1998, section 256F.10, 409.17 subdivision 9, is amended to read: 409.18 Subd. 9. [PAYMENTS.] Notwithstanding section 256.025, 409.19 subdivision 2, payments to certified providers for child welfare 409.20 targeted case management expenditures under section 256B.094 and 409.21 this section shall only be made of federal earnings from 409.22 services provided under section 256B.094 and this 409.23 section. Payments to contracted vendors shall include both the 409.24 federal earnings and the nonfederal share. 409.25 Sec. 19. Minnesota Statutes 1998, section 256F.10, 409.26 subdivision 10, is amended to read: 409.27 Subd. 10. [CENTRALIZED DISBURSEMENT OF MEDICAL ASSISTANCE 409.28 PAYMENTS.] Notwithstanding section 256B.041,countyprovider 409.29 payments for the cost of child welfare targeted case management 409.30 services shall not be made to the state treasurer. For the 409.31 purposes of child welfare targeted case management services 409.32 under section 256B.094 and this section, the centralized 409.33 disbursement of payments to providers under section 256B.041 409.34 consists only of federal earnings from services provided under 409.35 section 256B.094 and this section. 409.36 Sec. 20. Minnesota Statutes 1998, section 257.071, 410.1 subdivision 1, is amended to read: 410.2 Subdivision 1. [PLACEMENT; PLAN.] (a) A case plan shall be 410.3 prepared within 30 days after any child is placed in a 410.4 residential facility by court order or by the voluntary release 410.5 of the child by the parent or parents. 410.6 For purposes of this section, a residential facility means 410.7 any group home, family foster home or other publicly supported 410.8 out-of-home residential facility, including any out-of-home 410.9 residential facility under contract with the state, county or 410.10 other political subdivision, or any agency thereof, to provide 410.11 those services or foster care as defined in section 260.015, 410.12 subdivision 7. 410.13 (b) When a child is in placement, the responsible local 410.14 social services agency shall make diligent efforts to identify, 410.15 locate, and, where appropriate, offer services to both parents 410.16 of the child. If a noncustodial or nonadjudicated parent is 410.17 willing and capable of providing for the day-to-day care of the 410.18 child, the local social services agency may seek authority from 410.19 the custodial parent or the court to have that parent assume 410.20 day-to-day care of the child. If a parent is not an adjudicated 410.21 parent, the local social services agency shall require the 410.22 nonadjudicated parent to cooperate with paternity establishment 410.23 procedures as part of the case plan. 410.24 (c) If, after assessment, the local social services agency 410.25 determines that the child cannot be in the day-to-day care of 410.26 either parent, the agency shall prepare a case plan addressing 410.27 the conditions that each parent must mitigate before the child 410.28 could be in that parent's day-to-day care. 410.29 (d) If, after the provision of services following a case 410.30 plan under this section and ordered by the juvenile court, the 410.31 child cannot return to the care of the parent from whom the 410.32 child was removed or who had legal custody at the time the child 410.33 was placed in foster care, the agency may petition on behalf of 410.34 a noncustodial parent to establish legal custody with that 410.35 parent under section 260.191, subdivision 3b. If paternity has 410.36 not already been established, it may be established in the same 411.1 proceeding in the manner provided for under this chapter. 411.2 The responsible social services agency may be relieved of 411.3 the requirement to locate and offer services to both parents by 411.4 the juvenile court upon a finding of good cause after the filing 411.5 of a petition under section 260.131. 411.6 (e) For the purposes of this section, a case plan means a 411.7 written document which is ordered by the court or which is 411.8 prepared by the socialserviceservices agency responsible for 411.9 the residential facility placement and is signed by the parent 411.10 or parents, or other custodian, of the child, the child's legal 411.11 guardian, the socialserviceservices agency responsible for the 411.12 residential facility placement, and, if possible, the child. 411.13 The document shall be explained to all persons involved in its 411.14 implementation, including the child who has signed the document, 411.15 and shall set forth: 411.16 (1) the specific reasons for the placement of the child in 411.17 a residential facility, including a description of the problems 411.18 or conditions in the home of the parent or parents which 411.19 necessitated removal of the child from home; 411.20 (2) the specific actions to be taken by the parent or 411.21 parents of the child to eliminate or correct the problems or 411.22 conditions identified in clause (1), and the time period during 411.23 which the actions are to be taken; 411.24 (3) the financial responsibilities and obligations, if any, 411.25 of the parents for the support of the child during the period 411.26 the child is in the residential facility; 411.27 (4) the visitation rights and obligations of the parent or 411.28 parents or other relatives as defined in section 260.181, if 411.29 such visitation is consistent with the best interest of the 411.30 child, during the period the child is in the residential 411.31 facility; 411.32 (5) the social and other supportive services to be provided 411.33 to the parent or parents of the child, the child, and the 411.34 residential facility during the period the child is in the 411.35 residential facility; 411.36 (6) the date on which the child is expected to be returned 412.1 to and safely maintained in the home of the parent or parents or 412.2 placed for adoption or otherwise permanently removed from the 412.3 care of the parent by court order; 412.4 (7) the nature of the effort to be made by the social 412.5serviceservices agency responsible for the placement to reunite 412.6 the family;and412.7 (8) notice to the parent or parents: 412.8 (i) that placement of the child in foster care may result 412.9 in termination of parental rights but only after notice and a 412.10 hearing as provided in chapter 260.; and 412.11 (ii) in cases where the agency has determined that both 412.12 reasonable efforts to reunify the child with the parents, and 412.13 reasonable efforts to place the child in a permanent home away 412.14 from the parent that may become legally permanent are 412.15 appropriate, notice of: 412.16 (A) time limits on the length of placement and of 412.17 reunification services; 412.18 (B) the nature of the services available to the parent; 412.19 (C) the consequences to the parent and the child if the 412.20 parent fails or is unable to use services to correct the 412.21 circumstances that led to the child's placement; 412.22 (D) the first consideration for relative placement; and 412.23 (E) the benefit to the child in getting the child out of 412.24 residential care as soon as possible, preferably by returning 412.25 the child home, but if that is not possible, through a permanent 412.26 legal placement of the child away from the parent; 412.27 (9) a permanency hearing under section 260.191, subdivision 412.28 3b, or a termination of parental rights hearing under sections 412.29 260.221 to 260.245, where the agency asks the court to find that 412.30 the child should be permanently placed away from the parent and 412.31 includes documentation of the steps taken by the responsible 412.32 social services agency to find an adoptive family or other 412.33 permanent legal placement for the child, to place the child with 412.34 an adoptive family, a fit and willing relative through an award 412.35 of permanent legal and physical custody, or in another planned 412.36 and permanent legal placement. The documentation must include 413.1 child specific recruitment efforts; and 413.2 (10) if the court has issued an order terminating the 413.3 rights of both parents of the child or of the only known, living 413.4 parent of the child, documentation of steps to finalize the 413.5 adoption or legal guardianship of the child. 413.6 (f) The parent or parents and the child each shall have the 413.7 right to legal counsel in the preparation of the case plan and 413.8 shall be informed of the right at the time of placement of the 413.9 child. The child shall also have the right to a guardian ad 413.10 litem. If unable to employ counsel from their own resources, 413.11 the court shall appoint counsel upon the request of the parent 413.12 or parents or the child or the child's legal guardian. The 413.13 parent or parents may also receive assistance from any person or 413.14 socialserviceservices agency in preparation of the case plan. 413.15 After the plan has been agreed upon by the parties 413.16 involved, the foster parents shall be fully informed of the 413.17 provisions of the case plan and shall be provided a copy of the 413.18 plan. 413.19 (g) When an agency accepts a child for placement, the 413.20 agency shall determine whether the child has had a physical 413.21 examination by or under the direction of a licensed physician 413.22 within the 12 months immediately preceding the date when the 413.23 child came into the agency's care. If there is documentation 413.24 that the child has had such an examination within the last 12 413.25 months, the agency is responsible for seeing that the child has 413.26 another physical examination within one year of the documented 413.27 examination and annually in subsequent years. If the agency 413.28 determines that the child has not had a physical examination 413.29 within the 12 months immediately preceding placement, the agency 413.30 shall ensure that the child has the examination within 30 days 413.31 of coming into the agency's care and once a year in subsequent 413.32 years. 413.33 Sec. 21. Minnesota Statutes 1998, section 257.071, 413.34 subdivision 1a, is amended to read: 413.35 Subd. 1a. [PLACEMENT DECISIONS BASED ON BEST INTEREST OF 413.36 THE CHILD.] (a) The policy of the state of Minnesota is to 414.1 ensure that the child's best interests are met by requiring an 414.2 individualized determination of the needs of the child and of 414.3 how the selected placement will serve the needs of the child 414.4 being placed. The authorized child-placing agency shall place a 414.5 child, released by court order or by voluntary release by the 414.6 parent or parents, in a family foster home selected by 414.7 considering placement with relatives and important friends 414.8 consistent with section 260.181, subdivision 3. 414.9 (b) Among the factors the agency shall consider in 414.10 determining the needs of the child are those specified under 414.11 section 260.181, subdivision 3, paragraph (b). 414.12 (c) Placement of a child cannot be delayed or denied based 414.13 on race, color, or national origin of the foster parent or the 414.14 child.Whenever possible,Siblings should be placed together 414.15 for foster care and adoption at the earliest possible time 414.16 unless it is determined not to be in the best interests of a 414.17 sibling or unless it is not possible after appropriate efforts 414.18 by the responsible social services agency. 414.19 Sec. 22. Minnesota Statutes 1998, section 257.071, 414.20 subdivision 1c, is amended to read: 414.21 Subd. 1c. [NOTICE BEFORE VOLUNTARY PLACEMENT.] The local 414.22 socialserviceservices agency shall inform a parent considering 414.23 voluntary placement of a child who is not developmentally 414.24 disabled or emotionally handicapped of the following: 414.25 (1) the parent and the child each has a right to separate 414.26 legal counsel before signing a voluntary placement agreement, 414.27 but not to counsel appointed at public expense; 414.28 (2) the parent is not required to agree to the voluntary 414.29 placement, and a parent who enters a voluntary placement 414.30 agreement may at any time request that the agency return the 414.31 child. If the parent so requests, the child must be returned 414.32 within 24 hours of the receipt of the request; 414.33 (3) evidence gathered during the time the child is 414.34 voluntarily placed may be used at a later time as the basis for 414.35 a petition alleging that the child is in need of protection or 414.36 services or as the basis for a petition seeking termination of 415.1 parental rights or other permanent placement of the child away 415.2 from the parent; 415.3 (4) if the local socialserviceservices agency files a 415.4 petition alleging that the child is in need of protection or 415.5 services or a petition seeking the termination of parental 415.6 rights or other permanent placement of the child away from the 415.7 parent, the parent would have the right to appointment of 415.8 separate legal counsel and the child would have a right to the 415.9 appointment of counsel and a guardian ad litem as provided by 415.10 law, and that counsel will be appointed at public expense if 415.11 they are unable to afford counsel; and 415.12 (5) the timelines and procedures for review of voluntary 415.13 placements under subdivision 3, and the effect the time spent in 415.14 voluntary placement on the scheduling of a permanent placement 415.15 determination hearing under section 260.191, subdivision 3b. 415.16 Sec. 23. Minnesota Statutes 1998, section 257.071, 415.17 subdivision 1d, is amended to read: 415.18 Subd. 1d. [RELATIVE SEARCH; NATURE.] (a) As soon as 415.19 possible, but in any event within six months after a child is 415.20 initially placed in a residential facility, the local social 415.21 services agency shall identify any relatives of the child and 415.22 notify them of the need for a foster care home for the child and 415.23 of the possibility of the need for a permanent out-of-home 415.24 placement of the child. Relatives should also be notified that 415.25 a decision not to be a placement resource at the beginning of 415.26 the case may affect the relative being considered for placement 415.27 of the child with that relative later. The relatives must be 415.28 notified that they must keep the local social services agency 415.29 informed of their current address in order to receive notice 415.30 that a permanent placement is being sought for the child. A 415.31 relative who fails to provide a current address to the local 415.32 social services agency forfeits the right to notice of the 415.33 possibility of permanent placement. If the child's parent 415.34 refuses to give the responsible social services agency 415.35 information sufficient to identify relatives of the child, the 415.36 agency shall determine whether the parent's refusal is in the 416.1 child's best interests. If the agency determines the parent's 416.2 refusal is not in the child's best interests, the agency shall 416.3 file a petition under section 260.131, and shall ask the 416.4 juvenile court to order the parent to provide the necessary 416.5 information. 416.6 (b) Unless relieved of this duty by the court because the 416.7 child is placed with an appropriate relative who wishes to 416.8 provide a permanent home for the child or the child is placed 416.9 with a foster home that has committed to being the permanent 416.10 legal placement for the child and the responsible social 416.11 services agency approves of that foster home for permanent 416.12 placement of the child, when the agency determines that it is 416.13 necessary to prepare for the permanent placement determination 416.14 hearing, or in anticipation of filing a termination of parental 416.15 rights petition, the agency shall send notice to the relatives, 416.16 any adult with whom the child is currently residing, any adult 416.17 with whom the child has resided for one year or longer in the 416.18 past, and any adults who have maintained a relationship or 416.19 exercised visitation with the child as identified in the agency 416.20 case plan. The notice must state that a permanent home is 416.21 sought for the child and that the individuals receiving the 416.22 notice may indicate to the agency their interest in providing a 416.23 permanent home. The notice must state that within 30 days of 416.24 receipt of the notice an individual receiving the notice must 416.25 indicate to the agency the individual's interest in providing a 416.26 permanent home for the child or that the individual may lose the 416.27 opportunity to be considered for a permanent placement. This 416.28 notice need not be sent if the child is placed with an 416.29 appropriate relative who wishes to provide a permanent home for 416.30 the child. 416.31 Sec. 24. Minnesota Statutes 1998, section 257.071, 416.32 subdivision 1e, is amended to read: 416.33 Subd. 1e. [CHANGE IN PLACEMENT.] If a child is removed 416.34 from a permanent placement disposition authorized under section 416.35 260.191, subdivision 3b, within one year after the placement was 416.36 made: 417.1 (1) the child must be returned to the residential facility 417.2 where the child was placed immediately preceding the permanent 417.3 placement; or 417.4 (2) the court shall hold a hearing within ten days after 417.5 the child istaken into custodyremoved from the permanent 417.6 placement to determine where the child is to be placed. A 417.7 guardian ad litem must be appointed for the child for this 417.8 hearing. 417.9 Sec. 25. Minnesota Statutes 1998, section 257.071, 417.10 subdivision 3, is amended to read: 417.11 Subd. 3. [REVIEW OF VOLUNTARY PLACEMENTS.] Except as 417.12 provided in subdivision 4, if the child has been placed in a 417.13 residential facility pursuant to a voluntary release by the 417.14 parent or parents, and is not returned home within 90 days after 417.15 initial placement in the residential facility, the social 417.16serviceservices agency responsible for the placement shall: 417.17 (1) return the child to the home of the parent or parents; 417.18 or 417.19 (2) file a petition according to section 260.131, 417.20 subdivision 1, which may: 417.21 (i) ask the court to review the placement and approve it 417.22 for up toextend the placement foran additional 90 days.; 417.23 (ii) ask the court to order continued out-of-home placement 417.24 according to sections 260.172 and 260.191; or 417.25 (iii) ask the court to terminate parental rights under 417.26 section 260.221. 417.27 The case plan must be updated when a petition is filed and 417.28 must include a specific plan for permanency, which may include a 417.29 time line for returning the child home or a plan for permanent 417.30 placement of the child away from the parent, or both. 417.31 If the court approvesthe extensioncontinued out-of-home 417.32 placement for up to 90 more days, at the end of the 417.33secondcourt-approved 90-day period, the child must be returned 417.34 to the parent's home, unless a petition is. If the child is not 417.35 returned home, the responsible social services agency must 417.36 proceed on the petition filedfor aalleging the child in need 418.1 of protection or services or the petition for termination of 418.2 parental rights. The court must find a statutory basis to order 418.3 the placement of the child under section 260.172; 260.191; or 418.4 260.241. 418.5 Sec. 26. Minnesota Statutes 1998, section 257.071, 418.6 subdivision 4, is amended to read: 418.7 Subd. 4. [REVIEW OF DEVELOPMENTALLY DISABLED AND 418.8 EMOTIONALLY HANDICAPPED CHILD PLACEMENTS.] If a developmentally 418.9 disabled child, as that term is defined in United States Code, 418.10 title 42, section 6001 (7), as amended through December 31, 418.11 1979, or a child diagnosed with an emotional handicap as defined 418.12 in section 252.27, subdivision 1a, has been placed in a 418.13 residential facility pursuant to a voluntary release by the 418.14 child's parent or parents because of the child's handicapping 418.15 conditions or need for long-term residential treatment or 418.16 supervision, the socialserviceservices agency responsible for 418.17 the placement shall bring a petition for review of the child's 418.18 foster care status, pursuant to section 260.131,subdivision 1a,418.19rather than aafter the child has been in placement for six 418.20 months. If a child is in placement due solely to the child's 418.21 handicapping condition and custody of the child is not 418.22 transferred to the responsible social services agency under 418.23 section 260.191, subdivision 1, paragraph (a), clause (2), no 418.24 petitionasis required by section 260.191, subdivision 3b,418.25after the child has been in foster care for six months or, in418.26the case of a child with an emotional handicap, after the child418.27has been in a residential facility for six months. Whenever a 418.28 petition for review is brought pursuant to this subdivision, a 418.29 guardian ad litem shall be appointed for the child. 418.30 Sec. 27. Minnesota Statutes 1998, section 257.85, 418.31 subdivision 2, is amended to read: 418.32 Subd. 2. [SCOPE.] The provisions of this section apply to 418.33 those situations in which the legal and physical custody of a 418.34 child is established with a relative or important friend with 418.35 whom the child has resided or had significant contact according 418.36 to section 260.191, subdivision 3b, by a court order issued on 419.1 or after July 1, 1997. 419.2 Sec. 28. Minnesota Statutes 1998, section 257.85, 419.3 subdivision 3, is amended to read: 419.4 Subd. 3. [DEFINITIONS.] For purposes of this section, the 419.5 terms defined in this subdivision have the meanings given them. 419.6 (a) "AFDC orMFIP standard" means themonthly standard of419.7need used to calculate assistance under the AFDC program, the419.8 transitional standard used to calculate assistance under the 419.9 MFIP-S program, or, ifneither of those is applicablepermanent 419.10 legal and physical custody of the child is given to a relative 419.11 custodian residing outside of Minnesota, the analogous 419.12 transitional standard or standard of need used to calculate 419.13 assistance under theMFIP or MFIP-R programsTANF program of the 419.14 state where the relative custodian lives. 419.15 (b) "Local agency" means the local socialserviceservices 419.16 agency with legal custody of a child prior to the transfer of 419.17 permanent legal and physical custodyto a relative. 419.18 (c) "Permanent legal and physical custody" means permanent 419.19 legal and physical custody ordered by a Minnesota juvenile court 419.20 under section 260.191, subdivision 3b. 419.21 (d) "Relative" means an individual, other than a parent, 419.22 who is related to a child by blood, marriage, or adoption. 419.23 (e) "Relative custodian" means arelative of a child for419.24whom the relativeperson who has permanent legal and physical 419.25 custody of a child. When siblings, including half-siblings and 419.26 step siblings, are placed together inthepermanent legal and 419.27 physical custodyof a relative of one of the siblings, the 419.28 person receiving permanent legal and physical custody of the 419.29 siblings is considered a relative custodian of all of the 419.30 siblings for purposes of this section. 419.31 (f) "Relative custody assistance agreement" means an 419.32 agreement entered into between a local agency andthe relative419.33ofachildperson who has been or will be awarded permanent 419.34 legal and physical custody ofthea child. 419.35 (g) "Relative custody assistance payment" means a monthly 419.36 cash grant made to a relative custodian pursuant to a relative 420.1 custody assistance agreement and in an amount calculated under 420.2 subdivision 7. 420.3 (h) "Remains in the physical custody of the relative 420.4 custodian" means that the relative custodian is providing 420.5 day-to-day care for the child and that the child lives with the 420.6 relative custodian; absence from the relative custodian's home 420.7 for a period of more than 120 days raises a presumption that the 420.8 child no longer remains in the physical custody of the relative 420.9 custodian. 420.10 Sec. 29. Minnesota Statutes 1998, section 257.85, 420.11 subdivision 4, is amended to read: 420.12 Subd. 4. [DUTIES OF LOCAL AGENCY.] (a) When a local agency 420.13 seeks a court order under section 260.191, subdivision 3b, to 420.14 establish permanent legal and physical custody of a child with a 420.15 relative or important friend with whom the child has resided or 420.16 had significant contact, or if such an order is issued by the 420.17 court, the local agency shall perform the duties in this 420.18 subdivision. 420.19 (b) As soon as possible after the local agency determines 420.20 that it will seek to establish permanent legal and physical 420.21 custody of the childwith a relativeor, if the agency did not 420.22 seek to establish custody, as soon as possible after the 420.23 issuance of the court order establishing custody, the local 420.24 agency shall inform the relative custodian about the relative 420.25 custody assistance program, including eligibility criteria and 420.26 payment levels. Anytime prior to, but not later than seven days 420.27 after, the date the court issues the order establishing 420.28 permanent legal and physical custody of the childwith a420.29relative, the local agency shall determine whether the 420.30 eligibility criteria in subdivision 6 are met to allow the 420.31 relative custodian to receive relative custody assistance. Not 420.32 later than seven days after determining whether the eligibility 420.33 criteria are met, the local agency shall inform the relative 420.34 custodian of its determination and of the process for appealing 420.35 that determination under subdivision 9. 420.36 (c) If the local agency determines that the relative 421.1 custodian is eligible to receive relative custody assistance, 421.2 the local agency shall prepare the relative custody assistance 421.3 agreement and ensure that it meets the criteria of subdivision 6. 421.4 (d) The local agency shall make monthly payments to the 421.5 relative custodian as set forth in the relative custody 421.6 assistance agreement. On a quarterly basis and on a form to be 421.7 provided by the commissioner, the local agency shall make claims 421.8 for reimbursement from the commissioner for relative custody 421.9 assistance payments made. 421.10 (e) For a relative custody assistance agreement that is in 421.11 place for longer than one year, and as long as the agreement 421.12 remains in effect, the local agency shall send an annual 421.13 affidavit form to the relative custodian of the eligible child 421.14 within the month before the anniversary date of the agreement. 421.15 The local agency shall monitor whether the annual affidavit is 421.16 returned by the relative custodian within 30 days following the 421.17 anniversary date of the agreement. The local agency shall 421.18 review the affidavit and any other information in its possession 421.19 to ensure continuing eligibility for relative custody assistance 421.20 and that the amount of payment made according to the agreement 421.21 is correct. 421.22 (f) When the local agency determines that a relative 421.23 custody assistance agreement should be terminated or modified, 421.24 it shall provide notice of the proposed termination or 421.25 modification to the relative custodian at least ten days before 421.26 the proposed action along with information about the process for 421.27 appealing the proposed action. 421.28 Sec. 30. Minnesota Statutes 1998, section 257.85, 421.29 subdivision 5, is amended to read: 421.30 Subd. 5. [RELATIVE CUSTODY ASSISTANCE AGREEMENT.] (a) A 421.31 relative custody assistance agreement will not be effective, 421.32 unless it is signed by the local agency and the relative 421.33 custodian no later than 30 days after the date of the order 421.34 establishing permanent legal and physical custodywith the421.35relative, except that a local agency may enter into a relative 421.36 custody assistance agreement with a relative custodian more than 422.1 30 days after the date of the order if it certifies that the 422.2 delay in entering the agreement was through no fault of the 422.3 relative custodian. There must be a separate agreement for each 422.4 child for whom the relative custodian is receiving relative 422.5 custody assistance. 422.6 (b) Regardless of when the relative custody assistance 422.7 agreement is signed by the local agency and relative custodian, 422.8 the effective date of the agreement shall be the date of the 422.9 order establishing permanent legal and physical custody. 422.10 (c) If MFIP-S is not the applicable program for a child at 422.11 the time that a relative custody assistance agreement is entered 422.12 on behalf of the child, when MFIP-S becomes the applicable 422.13 program, if the relative custodian had been receiving custody 422.14 assistance payments calculated based upon a different program, 422.15 the amount of relative custody assistance payment under 422.16 subdivision 7 shall be recalculated under the MFIP-S program. 422.17 (d) The relative custody assistance agreement shall be in a 422.18 form specified by the commissioner and shall include provisions 422.19 relating to the following: 422.20 (1) the responsibilities of all parties to the agreement; 422.21 (2) the payment terms, including the financial 422.22 circumstances of the relative custodian, the needs of the child, 422.23 the amount and calculation of the relative custody assistance 422.24 payments, and that the amount of the payments shall be 422.25 reevaluated annually; 422.26 (3) the effective date of the agreement, which shall also 422.27 be the anniversary date for the purpose of submitting the annual 422.28 affidavit under subdivision 8; 422.29 (4) that failure to submit the affidavit as required by 422.30 subdivision 8 will be grounds for terminating the agreement; 422.31 (5) the agreement's expected duration, which shall not 422.32 extend beyond the child's eighteenth birthday; 422.33 (6) any specific known circumstances that could cause the 422.34 agreement or payments to be modified, reduced, or terminated and 422.35 the relative custodian's appeal rights under subdivision 9; 422.36 (7) that the relative custodian must notify the local 423.1 agency within 30 days of any of the following: 423.2 (i) a change in the child's status; 423.3 (ii) a change in the relationship between the relative 423.4 custodian and the child; 423.5 (iii) a change in composition or level of income of the 423.6 relative custodian's family; 423.7 (iv) a change in eligibility or receipt of benefits under 423.8AFDC,MFIP-S,or other assistance program; and 423.9 (v) any other change that could affect eligibility for or 423.10 amount of relative custody assistance; 423.11 (8) that failure to provide notice of a change as required 423.12 by clause (7) will be grounds for terminating the agreement; 423.13 (9) that the amount of relative custody assistance is 423.14 subject to the availability of state funds to reimburse the 423.15 local agency making the payments; 423.16 (10) that the relative custodian may choose to temporarily 423.17 stop receiving payments under the agreement at any time by 423.18 providing 30 days' notice to the local agency and may choose to 423.19 begin receiving payments again by providing the same notice but 423.20 any payments the relative custodian chooses not to receive are 423.21 forfeit; and 423.22 (11) that the local agency will continue to be responsible 423.23 for making relative custody assistance payments under the 423.24 agreement regardless of the relative custodian's place of 423.25 residence. 423.26 Sec. 31. Minnesota Statutes 1998, section 257.85, 423.27 subdivision 6, is amended to read: 423.28 Subd. 6. [ELIGIBILITY CRITERIA.] A local agency shall 423.29 enter into a relative custody assistance agreement under 423.30 subdivision 5 if it certifies that the following criteria are 423.31 met: 423.32 (1) the juvenile court has determined or is expected to 423.33 determine that the child, under the former or current custody of 423.34 the local agency, cannot return to the home of the child's 423.35 parents; 423.36 (2) the court, upon determining that it is in the child's 424.1 best interests, has issued or is expected to issue an order 424.2 transferring permanent legal and physical custody of the child 424.3to the relative; and 424.4 (3) the child either: 424.5 (i) is a member of a sibling group to be placed together; 424.6 or 424.7 (ii) has a physical, mental, emotional, or behavioral 424.8 disability that will require financial support. 424.9 When the local agency bases its certification that the 424.10 criteria in clause (1) or (2) are met upon the expectation that 424.11 the juvenile court will take a certain action, the relative 424.12 custody assistance agreement does not become effective until and 424.13 unless the court acts as expected. 424.14 Sec. 32. Minnesota Statutes 1998, section 257.85, 424.15 subdivision 7, is amended to read: 424.16 Subd. 7. [AMOUNT OF RELATIVE CUSTODY ASSISTANCE PAYMENTS.] 424.17 (a) The amount of a monthly relative custody assistance payment 424.18 shall be determined according to the provisions of this 424.19 paragraph. 424.20 (1) The total maximum assistance rate is equal to the base 424.21 assistance rate plus, if applicable, the supplemental assistance 424.22 rate. 424.23 (i) The base assistance rate is equal to the maximum amount 424.24 that could be received as basic maintenance for a child of the 424.25 same age under the adoption assistance program. 424.26 (ii) The local agency shall determine whether the child has 424.27 physical, mental, emotional, or behavioral disabilities that 424.28 require care, supervision, or structure beyond that ordinarily 424.29 provided in a family setting to children of the same age such 424.30 that the child would be eligible for supplemental maintenance 424.31 payments under the adoption assistance program if an adoption 424.32 assistance agreement were entered on the child's behalf. If the 424.33 local agency determines that the child has such a disability, 424.34 the supplemental assistance rate shall be the maximum amount of 424.35 monthly supplemental maintenance payment that could be received 424.36 on behalf of a child of the same age, disabilities, and 425.1 circumstances under the adoption assistance program. 425.2 (2) The net maximum assistance rate is equal to the total 425.3 maximum assistance rate from clause (1) less the following 425.4 offsets: 425.5 (i) if the child is or will be part of an assistance unit 425.6 receiving anAFDC,MFIP-S, or other MFIPgrant or a grant from a 425.7 similar program of another state, the portion of theAFDC or425.8 MFIP standard relating to the child as calculated under 425.9 paragraph (b), clause (2); 425.10 (ii) Supplemental Security Income payments received by or 425.11 on behalf of the child; 425.12 (iii) veteran's benefits received by or on behalf of the 425.13 child; and 425.14 (iv) any other income of the child, including child support 425.15 payments made on behalf of the child. 425.16 (3) The relative custody assistance payment to be made to 425.17 the relative custodian shall be a percentage of the net maximum 425.18 assistance rate calculated in clause (2) based upon the gross 425.19 income of the relative custodian's family, including the child 425.20 for whom the relative custodian has permanent legal and physical 425.21 custody. In no case shall the amount of the relative custody 425.22 assistance payment exceed that which the child could qualify for 425.23 under the adoption assistance program if an adoption assistance 425.24 agreement were entered on the child's behalf. The relative 425.25 custody assistance payment shall be calculated as follows: 425.26 (i) if the relative custodian's gross family income is less 425.27 than or equal to 200 percent of federal poverty guidelines, the 425.28 relative custody assistance payment shall be the full amount of 425.29 the net maximum assistance rate; 425.30 (ii) if the relative custodian's gross family income is 425.31 greater than 200 percent and less than or equal to 225 percent 425.32 of federal poverty guidelines, the relative custody assistance 425.33 payment shall be 80 percent of the net maximum assistance rate; 425.34 (iii) if the relative custodian's gross family income is 425.35 greater than 225 percent and less than or equal to 250 percent 425.36 of federal poverty guidelines, the relative custody assistance 426.1 payment shall be 60 percent of the net maximum assistance rate; 426.2 (iv) if the relative custodian's gross family income is 426.3 greater than 250 percent and less than or equal to 275 percent 426.4 of federal poverty guidelines, the relative custody assistance 426.5 payment shall be 40 percent of the net maximum assistance rate; 426.6 (v) if the relative custodian's gross family income is 426.7 greater than 275 percent and less than or equal to 300 percent 426.8 of federal poverty guidelines, the relative custody assistance 426.9 payment shall be 20 percent of the net maximum assistance rate; 426.10 or 426.11 (vi) if the relative custodian's gross family income is 426.12 greater than 300 percent of federal poverty guidelines, no 426.13 relative custody assistance payment shall be made. 426.14 (b)This paragraph specifies the provisions pertaining to426.15the relationship between relative custody assistance and AFDC,426.16MFIP-S, or other MFIP programsThe following provisions cover 426.17 the relationship between relative custody assistance and 426.18 assistance programs: 426.19 (1) The relative custodian of a child for whom the relative 426.20 custodian is receiving relative custody assistance is expected 426.21 to seek whatever assistance is available for the child 426.22 throughthe AFDC,MFIP-S,orother MFIP, if the relative 426.23 custodian resides in a state other than Minnesota, similar 426.24 programs of that state. If a relative custodian fails to apply 426.25 for assistance throughAFDC,MFIP-S,or otherMFIPprogram for 426.26 which the child is eligible, the child's portion of theAFDC or426.27 MFIP standard will be calculated as if application had been made 426.28 and assistance received;. 426.29 (2) The portion of theAFDC orMFIP standard relating to 426.30 each child for whom relative custody assistance is being 426.31 received shall be calculated as follows: 426.32 (i) determine the totalAFDC orMFIP standard for the 426.33 assistance unit; 426.34 (ii) determine the amount that theAFDC orMFIP standard 426.35 would have been if the assistance unit had not included the 426.36 children for whom relative custody assistance is being received; 427.1 (iii) subtract the amount determined in item (ii) from the 427.2 amount determined in item (i); and 427.3 (iv) divide the result in item (iii) by the number of 427.4 children for whom relative custody assistance is being received 427.5 that are part of the assistance unit; or. 427.6 (3) If a child for whom relative custody assistance is 427.7 being received is not eligible for assistance throughthe AFDC,427.8 MFIP-S,orother MFIPsimilar programs of another state, the 427.9 portion ofAFDC orMFIP standard relating to that child shall be 427.10 equal to zero. 427.11 Sec. 33. Minnesota Statutes 1998, section 257.85, 427.12 subdivision 9, is amended to read: 427.13 Subd. 9. [RIGHT OF APPEAL.] A relative custodian who 427.14 enters or seeks to enter into a relative custody assistance 427.15 agreement with a local agency has the right to appeal to the 427.16 commissioner according to section 256.045 when the local agency 427.17 establishes, denies, terminates, or modifies the agreement. 427.18 Upon appeal, the commissioner may review only: 427.19 (1) whether the local agency has met the legal requirements 427.20 imposed by this chapter for establishing, denying, terminating, 427.21 or modifying the agreement; 427.22 (2) whether the amount of the relative custody assistance 427.23 payment was correctly calculated under the method in subdivision 427.24 7; 427.25 (3) whether the local agency paid for correct time periods 427.26 under the relative custody assistance agreement; 427.27 (4) whether the child remains in the physical custody of 427.28 the relative custodian; 427.29 (5) whether the local agency correctlycalculatedmodified 427.30 the amount of the supplemental assistance rate based on a change 427.31 in the child's physical, mental, emotional, or behavioral needs, 427.32 or based on the relative custodian's failure todocumentprovide 427.33 documentation, after the local agency has requested such 427.34 documentation, that thecontinuing need for the supplemental427.35assistance rate after the local agency has requested such427.36documentationchild continues to have physical, mental, 428.1 emotional, or behavioral needs that support the current amount 428.2 of relative custody assistance; and 428.3 (6) whether the local agency correctlycalculatedmodified 428.4 or terminated the amount of relative custody assistance based on 428.5 a change in the gross income of the relative custodian's family 428.6 or based on the relative custodian's failure to provide 428.7 documentation of the gross income of the relative custodian's 428.8 family after the local agency has requested such documentation. 428.9 Sec. 34. Minnesota Statutes 1998, section 257.85, 428.10 subdivision 11, is amended to read: 428.11 Subd. 11. [FINANCIAL CONSIDERATIONS.] (a) Payment of 428.12 relative custody assistance under a relative custody assistance 428.13 agreement is subject to the availability of state funds and 428.14 payments may be reduced or suspended on order of the 428.15 commissioner if insufficient funds are available. 428.16 (b) Upon receipt from a local agency of a claim for 428.17 reimbursement, the commissioner shall reimburse the local agency 428.18 in an amount equal to 100 percent of the relative custody 428.19 assistance payments provided to relative custodians. The local 428.20 agency may not seek and the commissioner shall not provide 428.21 reimbursement for the administrative costs associated with 428.22 performing the duties described in subdivision 4. 428.23 (c) For the purposes of determining eligibility or payment 428.24 amounts underthe AFDC,MFIP-S,and other MFIP programs,428.25 relative custody assistance payments shall beconsidered428.26 excluded in determining the family's available income. 428.27 Sec. 35. Minnesota Statutes 1998, section 259.67, 428.28 subdivision 6, is amended to read: 428.29 Subd. 6. [RIGHT OF APPEAL.] (a) The adoptive parents have 428.30 the right to appeal to the commissioner pursuant to section 428.31 256.045, when the commissioner denies, discontinues, or modifies 428.32 the agreement. 428.33 (b) Adoptive parents who believe that their adopted child 428.34 was incorrectly denied adoption assistance, or who did not seek 428.35 adoption assistance on the child's behalf because of being 428.36 provided with inaccurate or insufficient information about the 429.1 child or the adoption assistance program, may request a hearing 429.2 under section 256.045. Notwithstanding subdivision 2, the 429.3 purpose of the hearing shall be to determine whether, under 429.4 standards established by the federal Department of Health and 429.5 Human Services, the circumstances surrounding the child's 429.6 adoption warrant making an adoption assistance agreement on 429.7 behalf of the child after the final decree of adoption has been 429.8 issued. The commissioner shall enter into an adoption 429.9 assistance agreement on the child's behalf if it is determined 429.10 that: (1) at the time of the adoption and at the time the 429.11 request for a hearing was submitted the child was eligible for 429.12 adoption assistance under United States Code, title 42, chapter 429.13 7, subchapter IV, part E, sections 670 to 679a, at the time of 429.14 the adoptionand at the time the request for a hearing was429.15submitted but, because of extenuating circumstances, did not429.16receiveor for state funded adoption assistance under 429.17 subdivision 4; and (2) an adoption assistance agreement was not 429.18 entered into on behalf of the child before the final decree of 429.19 adoption because of extenuating circumstances as the term is 429.20 used in the standards established by the federal Department of 429.21 Health and Human Services. An adoption assistance agreement 429.22 made under this paragraph shall be effective the date the 429.23 request for a hearing was received by the commissioner or the 429.24 local agency. 429.25 Sec. 36. Minnesota Statutes 1998, section 259.67, 429.26 subdivision 7, is amended to read: 429.27 Subd. 7. [REIMBURSEMENT OF COSTS.] (a) Subject to rules of 429.28 the commissioner, and the provisions of this subdivision 429.29 aMinnesota-licensedchild-placing agency licensed in Minnesota 429.30 or any other state, or local social services agency shall 429.31 receive a reimbursement from the commissioner equal to 100 429.32 percent of the reasonable and appropriate cost of providing 429.33 adoption services for a child certified as eligible for adoption 429.34 assistance under subdivision 4. Such assistance may include 429.35 adoptive family recruitment, counseling, and special training 429.36 when needed. AMinnesota-licensedchild-placing agency licensed 430.1 in Minnesota or any other state shall receive reimbursement for 430.2 adoption services it purchases for or directly provides to an 430.3 eligible child. A local social services agency shall receive 430.4 such reimbursement only for adoption services it purchases for 430.5 an eligible child. 430.6 (b) AMinnesota-licensedchild-placing agency licensed in 430.7 Minnesota or any other state or local social services agency 430.8 seeking reimbursement under this subdivision shall enter into a 430.9 reimbursement agreement with the commissioner before providing 430.10 adoption services for which reimbursement is sought. No 430.11 reimbursement under this subdivision shall be made to an agency 430.12 for services provided prior to entering a reimbursement 430.13 agreement. Separate reimbursement agreements shall be made for 430.14 each child and separate records shall be kept on each child for 430.15 whom a reimbursement agreement is made. Funds encumbered and 430.16 obligated under such an agreement for the child remain available 430.17 until the terms of the agreement are fulfilled or the agreement 430.18 is terminated. 430.19 (c) When a local social services agency uses a purchase of 430.20 service agreement to provide services reimbursable under a 430.21 reimbursement agreement, the commissioner may make reimbursement 430.22 payments directly to the agency providing the service if direct 430.23 reimbursement is specified by the purchase of service agreement, 430.24 and if the request for reimbursement is submitted by the local 430.25 social services agency along with a verification that the 430.26 service was provided. 430.27 Sec. 37. Minnesota Statutes 1998, section 259.73, is 430.28 amended to read: 430.29 259.73 [REIMBURSEMENT OF NONRECURRING ADOPTION EXPENSES.] 430.30 The commissioner of human services shall provide 430.31 reimbursement of up to $2,000 to the adoptive parent or parents 430.32 for costs incurred in adopting a child with special needs. The 430.33 commissioner shall determine the child's eligibility for 430.34 adoption expense reimbursement under title IV-E of the Social 430.35 Security Act, United States Code, title 42, sections 670 to 430.36 676. To be reimbursed, costs must be reasonable, necessary, and 431.1 directly related to the legal adoption of the child. 431.2 Sec. 38. Minnesota Statutes 1998, section 259.85, 431.3 subdivision 2, is amended to read: 431.4 Subd. 2. [ELIGIBILITY CRITERIA.] A child may be certified 431.5 by the local socialserviceservices agency as eligible for a 431.6 postadoption service grant after a final decree of adoptionand431.7before the child's 18th birthdayif: 431.8(a)(1) the child was a ward of the commissioner or a 431.9 Minnesota licensed child-placing agency before adoption; 431.10(b)(2) the child had special needs at the time of adoption. 431.11 For the purposes of this section, "special needs" means a child 431.12 who had a physical, mental, emotional, or behavioral disability 431.13 at the time of an adoption or has a preadoption background to 431.14 which the current development of such disabilities can be 431.15 attributed;and431.16(c)(3) the adoptive parents have exhausted all other 431.17 available resources. Available resources include public income 431.18 support programs, medical assistance, health insurance coverage, 431.19 services available through community resources, and any other 431.20 private or public benefits or resources available to the family 431.21 or to the child to meet the child's special needs; and 431.22 (4) the child is under 18 years of age or, if the child is 431.23 under 22 years of age and remains dependent on the adoptive 431.24 parent or parents for care and financial support and is enrolled 431.25 in a secondary education program as a full-time student. 431.26 Sec. 39. Minnesota Statutes 1998, section 259.85, 431.27 subdivision 3, is amended to read: 431.28 Subd. 3. [CERTIFICATION STATEMENT.] The local social 431.29serviceservices agency shall certify a child's eligibility for 431.30 a postadoption service grant in writing to the commissioner. 431.31 The certification statement shall include: 431.32 (1) a description and history of the special needs upon 431.33 which eligibility is based;and431.34 (2) separate certification for each of the eligibility 431.35 criteria under subdivision 2, that the criteria is met; and 431.36 (3) applicable supporting documentation including: 432.1 (i) the child's individual service plan; 432.2 (ii) medical, psychological, or special education 432.3 evaluations; 432.4 (iii) documentation that all other resources have been 432.5 exhausted; and 432.6 (iv) an estimate of the costs necessary to meet the special 432.7 needs of the child. 432.8 Sec. 40. Minnesota Statutes 1998, section 259.85, 432.9 subdivision 5, is amended to read: 432.10 Subd. 5. [GRANT PAYMENTS.] The amount of the postadoption 432.11 service grant payment shall be based on the special needs of the 432.12 child and the determination that other resources to meet those 432.13 special needs are not available. The amount of any grant 432.14 payments shall be based on the severity of the child's 432.15 disability and the effect of the disability on the family and 432.16 must not exceed $10,000 annually. Adoptive parents are eligible 432.17 for grant payments until their child's 18th birthday, or if the 432.18 child is under 22 years of age and remains dependent on the 432.19 adoptive parent or parents for care and financial support and is 432.20 enrolled in a secondary education program as a full-time student. 432.21 Permissible expenses that may be paid from grants shall be 432.22 limited to: 432.23 (1) medical expenses not covered by the family's health 432.24 insurance or medical assistance; 432.25 (2) therapeutic expenses, including individual and family 432.26 therapy; and 432.27 (3) nonmedical services, items, or equipment required to 432.28 meet the special needs of the child. 432.29 The grants under this section shall not be used for 432.30 maintenance for out-of-home placement of the child in substitute 432.31 care. 432.32 Sec. 41. Minnesota Statutes 1998, section 259.89, is 432.33 amended by adding a subdivision to read: 432.34 Subd. 6. [DETERMINATION OF ELIGIBILITY FOR ENROLLMENT OR 432.35 MEMBERSHIP IN A FEDERALLY RECOGNIZED AMERICAN INDIAN TRIBE.] The 432.36 state registrar shall provide a copy of an adopted person's 433.1 original birth certificate to an authorized representative of a 433.2 federally recognized American Indian tribe for the sole purpose 433.3 of determining the adopted person's eligibility for enrollment 433.4 or membership in the tribe. 433.5 Sec. 42. Minnesota Statutes 1998, section 260.011, 433.6 subdivision 2, is amended to read: 433.7 Subd. 2. (a) The paramount consideration in all 433.8 proceedings concerning a child alleged or found to be in need of 433.9 protection or services is the health, safety, and best interests 433.10 of the child. In proceedings involving an American Indian 433.11 child, as defined in section 257.351, subdivision 6, the best 433.12 interests of the child must be determined consistent with 433.13 sections 257.35 to 257.3579 and the Indian Child Welfare Act, 433.14 United States Code, title 25, sections 1901 to 1923. The 433.15 purpose of the laws relating to juvenile courts is to secure for 433.16 each child alleged or adjudicated in need of protection or 433.17 services and under the jurisdiction of the court, the care and 433.18 guidance, preferably in the child's own home, as will best serve 433.19 the spiritual, emotional, mental, and physical welfare of the 433.20 child; to provide judicial procedures which protect the welfare 433.21 of the child; to preserve and strengthen the child's family ties 433.22 whenever possible and in the child's best interests, removing 433.23 the child from the custody of parents only when the child's 433.24 welfare or safety cannot be adequately safeguarded without 433.25 removal; and, when removal from the child's own family is 433.26 necessary and in the child's best interests, to secure for the 433.27 child custody, care and discipline as nearly as possible 433.28 equivalent to that which should have been given by the parents. 433.29 (b) The purpose of the laws relating to termination of 433.30 parental rights is to ensure that: 433.31 (1) when required and appropriate, reasonable efforts have 433.32 been made by the socialserviceservices agency to reunite the 433.33 child with the child's parents in aplacementhome that is safe 433.34 and permanent; and 433.35 (2) if placement with the parents is not reasonably 433.36 foreseeable, to secure for the child a safe and permanent 434.1 placement, preferably with adoptive parents or a fit and willing 434.2 relative through transfer of permanent legal and physical 434.3 custody to that relative. 434.4 Nothing in this section requires reasonable efforts to be 434.5 made in circumstances where the court has determined that the 434.6 child has been subjected to egregious harm or the parental 434.7 rights of the parent to a sibling have been involuntarily 434.8 terminated. 434.9 The paramount consideration in all proceedings for the 434.10 termination of parental rights is the best interests of the 434.11 child. In proceedings involving an American Indian child, as 434.12 defined in section 257.351, subdivision 6, the best interests of 434.13 the child must be determined consistent with the Indian Child 434.14 Welfare Act of 1978, United States Code, title 25, section 1901, 434.15 et seq. 434.16 (c) The purpose of the laws relating to children alleged or 434.17 adjudicated to be delinquent is to promote the public safety and 434.18 reduce juvenile delinquency by maintaining the integrity of the 434.19 substantive law prohibiting certain behavior and by developing 434.20 individual responsibility for lawful behavior. This purpose 434.21 should be pursued through means that are fair and just, that 434.22 recognize the unique characteristics and needs of children, and 434.23 that give children access to opportunities for personal and 434.24 social growth. 434.25 (d) The laws relating to juvenile courts shall be liberally 434.26 construed to carry out these purposes. 434.27 Sec. 43. Minnesota Statutes 1998, section 260.012, is 434.28 amended to read: 434.29 260.012 [DUTY TO ENSURE PLACEMENT PREVENTION AND FAMILY 434.30 REUNIFICATION; REASONABLE EFFORTS.] 434.31 (a)IfOnce a child alleged to be in need of protection or 434.32 services is under the court's jurisdiction, the court shall 434.33 ensure that reasonable efforts including culturally appropriate 434.34 services by the socialserviceservices agency are made to 434.35 prevent placement or to eliminate the need for removal and to 434.36 reunite the child with the child's family at the earliest 435.1 possible time, consistent with the best interests, safety, and 435.2 protection of the child.The court may, upon motion and435.3hearing, order the cessation of reasonable efforts if the court435.4finds that provision of services or further services for the435.5purpose of rehabilitation and reunification is futile and435.6therefore unreasonable under the circumstances.In determining 435.7 reasonable efforts to be made with respect to a child and in 435.8 making those reasonable efforts, the child's health and safety 435.9 must be of paramount concern. Reasonable efforts for 435.10 rehabilitation and reunification are not requiredifupon a 435.11 determination by the courtdeterminesthat: 435.12 (1) a termination of parental rights petition has been 435.13 filed stating a prima facie case that: 435.14 (i) the parent has subjectedthea child to egregious harm 435.15 as defined in section 260.015, subdivision 29, or; 435.16 (ii) the parental rights of the parent toa siblinganother 435.17 child have been terminated involuntarily; or 435.18 (iii) the child is an abandoned infant under section 435.19 260.221, subdivision 1a, paragraph (a), clause (2); 435.20 (2) the county attorney has filed a determination not to 435.21 proceed with a termination of parental rights petition on these 435.22 grounds was made under section 260.221, subdivision 1b, 435.23 paragraph (b), and a permanency hearing is held within 30 days 435.24 of the determination.; or 435.25 (3) a termination of parental rights petition or other 435.26 petition according to section 260.191, subdivision 3b, has been 435.27 filed alleging a prima facie case that the provision of services 435.28 or further services for the purpose of reunification is futile 435.29 and therefore unreasonable under the circumstances. 435.30 In the case of an Indian child, in proceedings under 435.31 sections 260.172, 260.191, and 260.221 the juvenile court must 435.32 make findings and conclusions consistent with the Indian Child 435.33 Welfare Act of 1978, United States Code, title 25, section 1901 435.34 et seq., as to the provision of active efforts. If a child is 435.35 under the court's delinquency jurisdiction, it shall be the duty 435.36 of the court to ensure that reasonable efforts are made to 436.1 reunite the child with the child's family at the earliest 436.2 possible time, consistent with the best interests of the child 436.3 and the safety of the public. 436.4 (b) "Reasonable efforts" means the exercise of due 436.5 diligence by the responsible socialserviceservices agency to 436.6 use appropriate and available services to meet the needs of the 436.7 child and the child's family in order to prevent removal of the 436.8 child from the child's family; or upon removal, services to 436.9 eliminate the need for removal and reunite the family. 436.10 (1) Services may include those listed under section 436.11 256F.07, subdivision 3, and other appropriate services available 436.12 in the community. 436.13 (2) At each stage of the proceedings where the court is 436.14 required to review the appropriateness of the responsible social 436.15 services agency's reasonable efforts, the socialservice436.16 services agency has the burden of demonstrating that it has made 436.17 reasonable efforts, or that provision of services or further 436.18 services for the purpose of rehabilitation and reunification is 436.19 futile and therefore unreasonable under the circumstances.or 436.20 that reasonable efforts aimed at reunification are not required 436.21 under this section. The agency may meet this burden by stating 436.22 facts in a sworn petition filed under section 260.131, or by 436.23 filing an affidavit summarizing the agency's reasonable efforts 436.24 or facts the agency believes demonstrate there is no need for 436.25 reasonable efforts to reunify the parent and child. 436.26 (3) No reasonable efforts for reunification are required 436.27 when the court makes a determination under paragraph (a) unless, 436.28 after a hearing according to section 260.155, the court finds 436.29 there is not clear and convincing evidence of the facts upon 436.30 which the court based its prima facie determination. In this 436.31 case, the court may proceed under section 260.235. 436.32 Reunification of a surviving child with a parent is not required 436.33 if the parent has been convicted of: 436.34(1)(i) a violation of, or an attempt or conspiracy to 436.35 commit a violation of, sections 609.185 to 609.20; 609.222, 436.36 subdivision 2; or 609.223 in regard to another child of the 437.1 parent; 437.2(2)(ii) a violation of section 609.222, subdivision 2; or 437.3 609.223, in regard to the surviving child; or 437.4(3)(iii) a violation of, or an attempt or conspiracy to 437.5 commit a violation of, United States Code, title 18, section 437.6 1111(a) or 1112(a), in regard to another child of the parent. 437.7 (c) The juvenile court, in proceedings under sections 437.8 260.172, 260.191, and 260.221 shall make findings and 437.9 conclusions as to the provision of reasonable efforts. When 437.10 determining whether reasonable efforts have been made, the court 437.11 shall consider whether services to the child and family were: 437.12 (1) relevant to the safety and protection of the child; 437.13 (2) adequate to meet the needs of the child and family; 437.14 (3) culturally appropriate; 437.15 (4) available and accessible; 437.16 (5) consistent and timely; and 437.17 (6) realistic under the circumstances. 437.18 In the alternative, the court may determine that provision 437.19 of services or further services for the purpose of 437.20 rehabilitation is futile and therefore unreasonable under the 437.21 circumstances or that reasonable efforts are not required as 437.22 provided in paragraph (a). 437.23 (d) This section does not prevent out-of-home placement for 437.24 treatment of a child with a mental disability when the child's 437.25 diagnostic assessment or individual treatment plan indicates 437.26 that appropriate and necessary treatment cannot be effectively 437.27 provided outside of a residential or inpatient treatment program. 437.28 (e) If continuation of reasonable efforts described in 437.29 paragraph (b) is determined by the court to be inconsistent with 437.30 thepermanencypermanent plan for the child, or upon a 437.31 determination under paragraph (a), reasonable efforts must be 437.32 made to place the child in a timely manner in accordance with 437.33 thepermanencypermanent plan ordered by the court and to 437.34 complete whatever steps are necessary to finalize thepermanency437.35 permanent plan for the child. 437.36 (f) Reasonable efforts to place a child for adoption or in 438.1 another permanent placement may be made concurrently with 438.2 reasonable efforts as described in paragraphs (a) and (b). When 438.3 the responsible social services agency decides to concurrently 438.4 make reasonable efforts for both reunification and permanent 438.5 placement away from the parent under paragraphs (a) and (b), the 438.6 agency shall disclose its decision and both plans for concurrent 438.7 reasonable efforts to all parties and the court. When the 438.8 agency discloses its decision to proceed on both plans for 438.9 reunification and permanent placement away from the parent, the 438.10 court's review of the agency's reasonable efforts shall include 438.11 the agency's efforts under paragraphs (a) and (b). 438.12 Sec. 44. Minnesota Statutes 1998, section 260.015, 438.13 subdivision 2a, is amended to read: 438.14 Subd. 2a. [CHILD IN NEED OF PROTECTION OR SERVICES.] 438.15 "Child in need of protection or services" means a child who is 438.16 in need of protection or services because the child: 438.17 (1) is abandoned or without parent, guardian, or custodian; 438.18 (2)(i) has been a victim of physical or sexual abuse, (ii) 438.19 resides with or has resided with a victim of domestic child 438.20 abuse as defined in subdivision 24, (iii) resides with or would 438.21 reside with a perpetrator of domestic child abuse or child abuse 438.22 as defined in subdivision 28, or (iv) is a victim of emotional 438.23 maltreatment as defined in subdivision 5a; 438.24 (3) is without necessary food, clothing, shelter, 438.25 education, or other required care for the child's physical or 438.26 mental health or morals because the child's parent, guardian, or 438.27 custodian is unable or unwilling to provide that care; 438.28 (4) is without the special care made necessary by a 438.29 physical, mental, or emotional condition because the child's 438.30 parent, guardian, or custodian is unable or unwilling to provide 438.31 that care, including a child in voluntary placement according to 438.32 release of the parent under section 257.071, subdivision 4; 438.33 (5) is medically neglected, which includes, but is not 438.34 limited to, the withholding of medically indicated treatment 438.35 from a disabled infant with a life-threatening condition. The 438.36 term "withholding of medically indicated treatment" means the 439.1 failure to respond to the infant's life-threatening conditions 439.2 by providing treatment, including appropriate nutrition, 439.3 hydration, and medication which, in the treating physician's or 439.4 physicians' reasonable medical judgment, will be most likely to 439.5 be effective in ameliorating or correcting all conditions, 439.6 except that the term does not include the failure to provide 439.7 treatment other than appropriate nutrition, hydration, or 439.8 medication to an infant when, in the treating physician's or 439.9 physicians' reasonable medical judgment: 439.10 (i) the infant is chronically and irreversibly comatose; 439.11 (ii) the provision of the treatment would merely prolong 439.12 dying, not be effective in ameliorating or correcting all of the 439.13 infant's life-threatening conditions, or otherwise be futile in 439.14 terms of the survival of the infant; or 439.15 (iii) the provision of the treatment would be virtually 439.16 futile in terms of the survival of the infant and the treatment 439.17 itself under the circumstances would be inhumane; 439.18 (6) is one whose parent, guardian, or other custodian for 439.19 good cause desires to be relieved of the child's care and 439.20 custody, including a child in placement according to voluntary 439.21 release by the parent under section 257.071, subdivision 3; 439.22 (7) has been placed for adoption or care in violation of 439.23 law; 439.24 (8) is without proper parental care because of the 439.25 emotional, mental, or physical disability, or state of 439.26 immaturity of the child's parent, guardian, or other custodian; 439.27 (9) is one whose behavior, condition, or environment is 439.28 such as to be injurious or dangerous to the child or others. An 439.29 injurious or dangerous environment may include, but is not 439.30 limited to, the exposure of a child to criminal activity in the 439.31 child's home; 439.32 (10) is experiencing growth delays, which may be referred 439.33 to as failure to thrive, that have been diagnosed by a physician 439.34 and are due to parental neglect; 439.35 (11) has engaged in prostitution as defined in section 439.36 609.321, subdivision 9; 440.1 (12) has committed a delinquent act or a juvenile petty 440.2 offense before becoming ten years old; 440.3 (13) is a runaway; 440.4 (14) is an habitual truant; 440.5 (15) has been found incompetent to proceed or has been 440.6 found not guilty by reason of mental illness or mental 440.7 deficiency in connection with a delinquency proceeding, a 440.8 certification under section 260.125, an extended jurisdiction 440.9 juvenile prosecution, or a proceeding involving a juvenile petty 440.10 offense; 440.11 (16)is one whose custodial parent's parental rights to440.12another child have been involuntarily terminated within the past440.13five years; or440.14(17)has been found by the court to have committed domestic 440.15 abuse perpetrated by a minor under Laws 1997, chapter 239, 440.16 article 10, sections 2 to 26, has been ordered excluded from the 440.17 child's parent's home by an order for protection/minor 440.18 respondent, and the parent or guardian is either unwilling or 440.19 unable to provide an alternative safe living arrangement for the 440.20 child. 440.21 Sec. 45. Minnesota Statutes 1998, section 260.015, 440.22 subdivision 13, is amended to read: 440.23 Subd. 13. [RELATIVE.] "Relative" means a parent, 440.24 stepparent, grandparent, brother, sister, uncle, or aunt of the 440.25 minor. This relationship may be by blood or marriage. For an 440.26 Indian child, relative includes members of the extended family 440.27 as defined by the law or custom of the Indian child's tribe or, 440.28 in the absence of laws or custom, nieces, nephews, or first or 440.29 second cousins, as provided in the Indian Child Welfare Act of 440.30 1978, United States Code, title 25, section 1903. For purposes 440.31 ofdispositions, relative has the meaning given in section440.32260.181, subdivision 3.child in need of protection or services 440.33 proceedings, termination of parental rights proceedings, and 440.34 permanency proceedings under section 260.191, subdivision 3b, 440.35 relative means a person related to the child by blood, marriage, 440.36 or adoption, or an individual who is an important friend with 441.1 whom the child has resided or had significant contact. 441.2 Sec. 46. Minnesota Statutes 1998, section 260.015, 441.3 subdivision 29, is amended to read: 441.4 Subd. 29. [EGREGIOUS HARM.] "Egregious harm" means the 441.5 infliction of bodily harm to a child or neglect of a child which 441.6 demonstrates a grossly inadequate ability to provide minimally 441.7 adequate parental care. The egregious harm need not have 441.8 occurred in the state or in the county where a termination of 441.9 parental rights action is otherwise properly venued. Egregious 441.10 harm includes, but is not limited to: 441.11 (1) conduct towards a child that constitutes a violation of 441.12 sections 609.185 to 609.21, 609.222, subdivision 2, 609.223, or 441.13 any other similar law of any other state; 441.14 (2) the infliction of "substantial bodily harm" to a child, 441.15 as defined in section 609.02, subdivision 7a; 441.16 (3) conduct towards a child that constitutes felony 441.17 malicious punishment of a child under section 609.377; 441.18 (4) conduct towards a child that constitutes felony 441.19 unreasonable restraint of a child under section 609.255, 441.20 subdivision 3; 441.21 (5) conduct towards a child that constitutes felony neglect 441.22 or endangerment of a child under section 609.378; 441.23 (6) conduct towards a child that constitutes assault under 441.24 section 609.221, 609.222, or 609.223; 441.25 (7) conduct towards a child that constitutes solicitation, 441.26 inducement, or promotion of, or receiving profit derived from 441.27 prostitution under section 609.322; 441.28 (8) conduct toward a child that constitutes murder or 441.29 voluntary manslaughter as defined by United States Code, title 441.30 18, section 1111(a) or 1112(a);or441.31 (9) conduct toward a child that constitutes aiding or 441.32 abetting, attempting, conspiring, or soliciting to commit a 441.33 murder or voluntary manslaughter that constitutes a violation of 441.34 United States Code, title 18, section 1111(a) or 1112(a); or 441.35 (10) conduct toward a child that constitutes criminal 441.36 sexual conduct under sections 609.342 to 609.345. 442.1 Sec. 47. Minnesota Statutes 1998, section 260.131, 442.2 subdivision 1a, is amended to read: 442.3 Subd. 1a. [REVIEW OF FOSTER CARE STATUS.] The social 442.4serviceservices agency responsible for the placement of a child 442.5 in a residential facility, as defined in section 257.071, 442.6 subdivision 1, pursuant to a voluntary release by the child's 442.7 parent or parents may bring a petition in juvenile court to 442.8 review the foster care status of the child in the manner 442.9 provided in this section. The responsible social services 442.10 agency shall file either a petition alleging the child to be in 442.11 need of protection or services or a petition to terminate 442.12 parental rights. 442.13 (a) In the case of a child in voluntary placement according 442.14 to section 257.071, subdivision 3, the petition shall be filed 442.15 within 90 days of the date of the voluntary placement agreement 442.16 and shall state the reasons why the child is in placement, the 442.17 progress on the case plan required under section 257.071, 442.18 subdivision 1, and the statutory basis for the petition under 442.19 section 260.015, subdivision 2a, or 260.221. 442.20 (1) In the case of a petition filed under this paragraph, 442.21 if all parties agree and the court finds it is in the best 442.22 interests of the child, the court may find the petition states a 442.23 prima facie case that: 442.24 (i) the child's needs are being met; 442.25 (ii) the placement of the child in foster care is in the 442.26 best interests of the child; and 442.27 (iii) the child will be returned home in the next six 442.28 months. 442.29 (2) If the court makes findings under paragraph (1), the 442.30 court shall approve the voluntary arrangement and continue the 442.31 matter for up to six more months to ensure the child returns to 442.32 the parents' home. The responsible social services agency shall: 442.33 (i) report to the court when the child returns home and the 442.34 progress made by the parent on the case plan required under 442.35 section 257.071, in which case the court shall dismiss 442.36 jurisdiction; 443.1 (ii) report to the court that the child has not returned 443.2 home, in which case the matter shall be returned to the court 443.3 for further proceedings under section 260.155; or 443.4 (iii) if any party does not agree to continue the matter 443.5 under paragraph (1) and this paragraph, the matter shall proceed 443.6 under section 260.155. 443.7 (b) In the case of a child in voluntary placement according 443.8 to section 257.071, subdivision 4, the petition shall be filed 443.9 within six months of the date of the voluntary placement 443.10 agreement and shall state the date of the voluntary placement 443.11 agreement, the nature of the child's developmental delay or 443.12 emotional handicap, the plan for the ongoing care of the child, 443.13 the parents' participation in the plan, and the statutory basis 443.14 for the petition. 443.15 (1) In the case of petitions filed under this paragraph, 443.16 the court may find, based on the contents of the sworn petition, 443.17 and the agreement of all parties, including the child, where 443.18 appropriate, that the voluntary arrangement is in the best 443.19 interests of the child, approve the voluntary arrangement, and 443.20 dismiss the matter from further jurisdiction. The court shall 443.21 give notice to the responsible social services agency that the 443.22 matter must be returned to the court for further review if the 443.23 child remains in placement after 12 months. 443.24 (2) If any party, including the child, disagrees with the 443.25 voluntary arrangement, the court shall proceed under section 443.26 260.155. 443.27 Sec. 48. Minnesota Statutes 1998, section 260.133, 443.28 subdivision 1, is amended to read: 443.29 Subdivision 1. [PETITION.] The local welfare agency may 443.30 bring an emergency petition on behalf of minor family or 443.31 household members seeking relief from acts of domestic child 443.32 abuse. The petition shall be brought according to section 443.33 260.131 and shall allege the existence of or immediate and 443.34 present danger of domestic child abuse, and shall be accompanied443.35by an affidavit made under oath stating the specific facts and443.36circumstances from which relief is sought. The court has 444.1 jurisdiction over the parties to a domestic child abuse matter 444.2 notwithstanding that there is a parent in the child's household 444.3 who is willing to enforce the court's order and accept services 444.4 on behalf of the family. 444.5 Sec. 49. Minnesota Statutes 1998, section 260.133, 444.6 subdivision 2, is amended to read: 444.7 Subd. 2. [TEMPORARY ORDER.] (a) If it appears from the 444.8 notarized petitionor by sworn affidavitthat there are 444.9 reasonable grounds to believe the child is in immediate and 444.10 present danger of domestic child abuse, the court may grant an 444.11 ex parte temporary order for protection, pending afull444.12 hearing according to section 260.135, which shall be held not 444.13 later than 14 days after service of the ex parte order on the 444.14 respondent. The court may grant relief as it deems proper, 444.15 including an order: 444.16 (1) restraining any party from committing acts of domestic 444.17 child abuse; or 444.18 (2) excluding the alleged abusing party from the dwelling 444.19 which the family or household members share or from the 444.20 residence of the child. 444.21However,(b) No order excluding the alleged abusing party 444.22 from the dwelling may be issued unless the court finds that: 444.23 (1) the order is in the best interests of the child or 444.24 children remaining in the dwelling; and 444.25 (2) a parent remainingadult family orin the child's 444.26 householdmemberis able to care adequately for the child or 444.27 children in the absence of the excluded party and to seek 444.28 appropriate assistance in enforcing the provisions of the order. 444.29 Before the temporary order is issued, the local welfare 444.30 agency shall advise the court and the other parties who are 444.31 present that appropriate social services will be provided to the 444.32 family or household members during the effective period of the 444.33 order. The petition shall identify the parent remaining in the 444.34 child's household as appropriate to provide care for the child 444.35 and enforce the court's orders. 444.36 An ex parte temporary order for protection shall be 445.1 effective for a fixed period not to exceed 14 days.Within five445.2days of the issuance of the temporary order, the petitioner445.3shall file a petition with the court pursuant to section445.4260.131, alleging that the child is in need of protection or445.5services and the court shall give docket priority to the445.6petition.445.7 The court may renew the temporary order for protection one 445.8 time for a fixed period not to exceed 14 daysif a petition445.9alleging that the child is in need of protection or services has445.10been filed with the court andif the court determines, upon 445.11 informal review of the case file, that the renewal is 445.12 appropriate. If the court determines that the petition states a 445.13 prima facie case exists for reasonable grounds to believe that 445.14 the child is in immediate danger of domestic child abuse or 445.15 child abuse without the court's order, then at the hearing under 445.16 section 260.135, the court may continue its order issued under 445.17 this subdivision pending trial under section 260.155. 445.18 Sec. 50. Minnesota Statutes 1998, section 260.135, is 445.19 amended by adding a subdivision to read: 445.20 Subd. 1a. After a petition has been filed alleging a child 445.21 to be in need of protection or services and unless the persons 445.22 named in clauses (1) to (4) voluntarily appear or are summoned 445.23 according to subdivision 1, the court shall issue a notice to: 445.24 (1) an adjudicated or presumed father of the child; 445.25 (2) an alleged father of the child; 445.26 (3) a noncustodial mother; and 445.27 (4) a grandparent with the right to participate under 445.28 section 260.155, subdivision 1a. 445.29 Sec. 51. Minnesota Statutes 1998, section 260.172, 445.30 subdivision 1, is amended to read: 445.31 Subdivision 1. [HEARING AND RELEASE REQUIREMENTS.] (a) If 445.32 a child was taken into custody under section 260.165, 445.33 subdivision 1, clause (a) or (c)(2), the court shall hold a 445.34 hearing within 72 hours of the time the child was taken into 445.35 custody, excluding Saturdays, Sundays, and holidays, to 445.36 determine whether the child should continue in custody. 446.1 (b) In all other cases, the court shall hold a detention 446.2 hearing: 446.3 (1) within 36 hours of the time the child was taken into 446.4 custody, excluding Saturdays, Sundays, and holidays, if the 446.5 child is being held at a juvenile secure detention facility or 446.6 shelter care facility; or 446.7 (2) within 24 hours of the time the child was taken into 446.8 custody, excluding Saturdays, Sundays, and holidays, if the 446.9 child is being held at an adult jail or municipal lockup. 446.10 (c) Unless there is reason to believe that the child would 446.11 endanger self or others, not return for a court hearing, run 446.12 away from the child's parent, guardian, or custodian or 446.13 otherwise not remain in the care or control of the person to 446.14 whose lawful custody the child is released, or that the child's 446.15 health or welfare would be immediately endangered, the child 446.16 shall be released to the custody of a parent, guardian, 446.17 custodian, or other suitable person, subject to reasonable 446.18 conditions of release including, but not limited to, a 446.19 requirement that the child undergo a chemical use assessment as 446.20 provided in section 260.151, subdivision 1. In determining 446.21 whether the child's health or welfare would be immediately 446.22 endangered, the court shall consider whether the child would 446.23 reside with a perpetrator of domestic child abuse. In a 446.24 proceeding regarding a child in need of protection or services, 446.25 the court, before determining whether a child should continue in 446.26 custody, shall also make a determination, consistent with 446.27 section 260.012 as to whether reasonable efforts, or in the case 446.28 of an Indian child, active efforts, according to the Indian 446.29 Child Welfare Act of 1978, United States Code, title 25, section 446.30 1912(d), were made to prevent placement or to reunite the child 446.31 with the child's family, or that reasonable efforts were not 446.32 possible. The court shall also determine whether there are 446.33 available services that would prevent the need for further 446.34 detention. 446.35 If the court finds the social services agency's preventive 446.36 or reunification efforts have not been reasonable but further 447.1 preventive or reunification efforts could not permit the child 447.2 to safely remain at home, the court may nevertheless authorize 447.3 or continue the removal of the child. 447.4The court may determine(d) At the detention hearing, or at 447.5 any time prior to an adjudicatory hearing, that reasonable447.6efforts are not required because the facts, if proved, will447.7demonstrate that the parent has subjected the child to egregious447.8harm as defined in section 260.015, subdivision 29, or the447.9parental rights of the parent to a sibling of the child have447.10been terminated involuntarily.and upon notice and request of 447.11 the county attorney, the court shall make the following 447.12 determinations: 447.13 (1) whether a termination of parental rights petition has 447.14 been filed stating a prima facie case that: 447.15 (i) the parent has subjected a child to egregious harm as 447.16 defined in section 260.015, subdivision 29; 447.17 (ii) the parental rights of the parent to another child 447.18 have been involuntarily terminated; or 447.19 (iii) the child is an abandoned infant under section 447.20 260.221, subdivision 1a, paragraph (a), clause (2); 447.21 (2) that the county attorney has determined not to proceed 447.22 with a termination of parental rights petition under section 447.23 260.221, subdivision 1b; or 447.24 (3) whether a termination of parental rights petition or 447.25 other petition according to section 260.191, subdivision 3b, has 447.26 been filed alleging a prima facie case that the provision of 447.27 services or further services for the purpose of rehabilitation 447.28 and reunification is futile and therefore unreasonable under the 447.29 circumstances. 447.30 If the court determines that the county attorney is not 447.31 proceeding with a termination of parental rights petition under 447.32 section 260.221, subdivision 1b, but is proceeding with a 447.33 petition under section 260.191, subdivision 3b, the court shall 447.34 schedule a permanency hearing within 30 days. If the county 447.35 attorney has filed a petition under section 260.221, subdivision 447.36 1b, the court shall schedule a trial under section 260.155 448.1 within 90 days of the filing of the petition. 448.2 (e) If the court determines the child should be ordered 448.3 into out-of-home placement and the child's parent refuses to 448.4 give information to the responsible social services agency 448.5 regarding the child's father or relatives of the child, the 448.6 court may order the parent to disclose the names, addresses, 448.7 telephone numbers, and other identifying information to the 448.8 local social services agency for the purpose of complying with 448.9 the requirements of sections 257.071, 257.072, and 260.135. 448.10 Sec. 52. Minnesota Statutes 1998, section 260.172, is 448.11 amended by adding a subdivision to read: 448.12 Subd. 5. [CASE PLAN.] (a) A case plan required under 448.13 section 257.071 shall be filed with the court within 30 days of 448.14 the filing of a petition alleging the child to be in need of 448.15 protection or services under section 260.131. 448.16 (b) Upon the filing of the case plan, the court may approve 448.17 the case plan based on the allegations contained in the 448.18 petition. A parent may agree to comply with the terms of the 448.19 case plan filed with the court. 448.20 (c) Upon notice and motion by a parent who agrees to comply 448.21 with the terms of a case plan, the court may modify the case and 448.22 order the responsible social services agency to provide other or 448.23 additional services for reunification, if reunification efforts 448.24 are required, and the court determines the agency's case plan 448.25 inadequate under section 260.012. 448.26 (d) Unless the parent agrees to comply with the terms of 448.27 the case plan, the court may not order a parent to comply with 448.28 the provisions of the case plan until the court makes a 448.29 determination under section 260.191, subdivision 1. 448.30 Sec. 53. Minnesota Statutes 1998, section 260.191, 448.31 subdivision 1, is amended to read: 448.32 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 448.33 the child is in need of protection or services or neglected and 448.34 in foster care, it shall enter an order making any of the 448.35 following dispositions of the case: 448.36 (1) place the child under the protective supervision of the 449.1 local social services agency or child-placing agency in the 449.2child's ownhome of a parent of the child under conditions 449.3 prescribed by the court directed to the correction of the 449.4 child's need for protection or services;, or: 449.5 (i) the court may order the child into the home of a parent 449.6 who does not otherwise have legal custody of the child, however, 449.7 an order under this section does not confer legal custody on 449.8 that parent; 449.9 (ii) if the court orders the child into the home of a 449.10 father who is not adjudicated, he must cooperate with paternity 449.11 establishment proceedings regarding the child in the appropriate 449.12 jurisdiction as one of the conditions prescribed by the court 449.13 for the child to continue in his home; 449.14 (iii) the court may order the child into the home of a 449.15 noncustodial parent with conditions and may also order both the 449.16 noncustodial and the custodial parent to comply with the 449.17 requirements of a case plan under subdivision 1a; 449.18 (2) transfer legal custody to one of the following: 449.19 (i) a child-placing agency; or 449.20 (ii) the local social services agency. 449.21 In placing a child whose custody has been transferred under 449.22 this paragraph, the agencies shall follow theorder of449.23preference stated inrequirements of section 260.181, 449.24 subdivision 3; 449.25 (3) if the child is in need of special treatment and care 449.26 for reasons of physical or mental health, the court may order 449.27 the child's parent, guardian, or custodian to provide it. If 449.28 the parent, guardian, or custodian fails or is unable to provide 449.29 this treatment or care, the court may order it provided. The 449.30 court shall not transfer legal custody of the child for the 449.31 purpose of obtaining special treatment or care solely because 449.32 the parent is unable to provide the treatment or care. If the 449.33 court's order for mental health treatment is based on a 449.34 diagnosis made by a treatment professional, the court may order 449.35 that the diagnosing professional not provide the treatment to 449.36 the child if it finds that such an order is in the child's best 450.1 interests; or 450.2 (4) if the court believes that the child has sufficient 450.3 maturity and judgment and that it is in the best interests of 450.4 the child, the court may order a child 16 years old or older to 450.5 be allowed to live independently, either alone or with others as 450.6 approved by the court under supervision the court considers 450.7 appropriate, if the county board, after consultation with the 450.8 court, has specifically authorized this dispositional 450.9 alternative for a child. 450.10 (b) If the child was adjudicated in need of protection or 450.11 services because the child is a runaway or habitual truant, the 450.12 court may order any of the following dispositions in addition to 450.13 or as alternatives to the dispositions authorized under 450.14 paragraph (a): 450.15 (1) counsel the child or the child's parents, guardian, or 450.16 custodian; 450.17 (2) place the child under the supervision of a probation 450.18 officer or other suitable person in the child's own home under 450.19 conditions prescribed by the court, including reasonable rules 450.20 for the child's conduct and the conduct of the parents, 450.21 guardian, or custodian, designed for the physical, mental, and 450.22 moral well-being and behavior of the child; or with the consent 450.23 of the commissioner of corrections, place the child in a group 450.24 foster care facility which is under the commissioner's 450.25 management and supervision; 450.26 (3) subject to the court's supervision, transfer legal 450.27 custody of the child to one of the following: 450.28 (i) a reputable person of good moral character. No person 450.29 may receive custody of two or more unrelated children unless 450.30 licensed to operate a residential program under sections 245A.01 450.31 to 245A.16; or 450.32 (ii) a county probation officer for placement in a group 450.33 foster home established under the direction of the juvenile 450.34 court and licensed pursuant to section 241.021; 450.35 (4) require the child to pay a fine of up to $100. The 450.36 court shall order payment of the fine in a manner that will not 451.1 impose undue financial hardship upon the child; 451.2 (5) require the child to participate in a community service 451.3 project; 451.4 (6) order the child to undergo a chemical dependency 451.5 evaluation and, if warranted by the evaluation, order 451.6 participation by the child in a drug awareness program or an 451.7 inpatient or outpatient chemical dependency treatment program; 451.8 (7) if the court believes that it is in the best interests 451.9 of the child and of public safety that the child's driver's 451.10 license or instruction permit be canceled, the court may order 451.11 the commissioner of public safety to cancel the child's license 451.12 or permit for any period up to the child's 18th birthday. If 451.13 the child does not have a driver's license or permit, the court 451.14 may order a denial of driving privileges for any period up to 451.15 the child's 18th birthday. The court shall forward an order 451.16 issued under this clause to the commissioner, who shall cancel 451.17 the license or permit or deny driving privileges without a 451.18 hearing for the period specified by the court. At any time 451.19 before the expiration of the period of cancellation or denial, 451.20 the court may, for good cause, order the commissioner of public 451.21 safety to allow the child to apply for a license or permit, and 451.22 the commissioner shall so authorize; 451.23 (8) order that the child's parent or legal guardian deliver 451.24 the child to school at the beginning of each school day for a 451.25 period of time specified by the court; or 451.26 (9) require the child to perform any other activities or 451.27 participate in any other treatment programs deemed appropriate 451.28 by the court. 451.29 To the extent practicable, the court shall enter a 451.30 disposition order the same day it makes a finding that a child 451.31 is in need of protection or services or neglected and in foster 451.32 care, but in no event more than 15 days after the finding unless 451.33 the court finds that the best interests of the child will be 451.34 served by granting a delay. If the child was under eight years 451.35 of age at the time the petition was filed, the disposition order 451.36 must be entered within ten days of the finding and the court may 452.1 not grant a delay unless good cause is shown and the court finds 452.2 the best interests of the child will be served by the delay. 452.3 (c) If a child who is 14 years of age or older is 452.4 adjudicated in need of protection or services because the child 452.5 is a habitual truant and truancy procedures involving the child 452.6 were previously dealt with by a school attendance review board 452.7 or county attorney mediation program under section 260A.06 or 452.8 260A.07, the court shall order a cancellation or denial of 452.9 driving privileges under paragraph (b), clause (7), for any 452.10 period up to the child's 18th birthday. 452.11 (d) In the case of a child adjudicated in need of 452.12 protection or services because the child has committed domestic 452.13 abuse and been ordered excluded from the child's parent's home, 452.14 the court shall dismiss jurisdiction if the court, at any time, 452.15 finds the parent is able or willing to provide an alternative 452.16 safe living arrangement for the child, as defined in Laws 1997, 452.17 chapter 239, article 10, section 2. 452.18 Sec. 54. Minnesota Statutes 1998, section 260.191, 452.19 subdivision 1a, is amended to read: 452.20 Subd. 1a. [WRITTEN FINDINGS.] Any order for a disposition 452.21 authorized under this section shall contain written findings of 452.22 fact to support the disposition and case plan ordered, and shall 452.23 also set forth in writing the following information: 452.24 (a) Why the best interests and safety of the child are 452.25 served by the disposition and case plan ordered; 452.26 (b) What alternative dispositions or services under the 452.27 case plan were considered by the court and why such dispositions 452.28 or services were not appropriate in the instant case; 452.29 (c) How the court's disposition complies with the 452.30 requirements of section 260.181, subdivision 3; and 452.31 (d) Whether reasonable efforts consistent with section 452.32 260.012 were made to prevent or eliminate the necessity of the 452.33 child's removal and to reunify the family after removal. The 452.34 court's findings must include a brief description of what 452.35 preventive and reunification efforts were made and why further 452.36 efforts could not have prevented or eliminated the necessity of 453.1 removal or that reasonable efforts were not required under 453.2 section 260.012 or 260.172, subdivision 1. 453.3 If the court finds that the social services agency's 453.4 preventive or reunification efforts have not been reasonable but 453.5 that further preventive or reunification efforts could not 453.6 permit the child to safely remain at home, the court may 453.7 nevertheless authorize or continue the removal of the child. 453.8 Sec. 55. Minnesota Statutes 1998, section 260.191, 453.9 subdivision 1b, is amended to read: 453.10 Subd. 1b. [DOMESTIC CHILD ABUSE.] (a) If the court finds 453.11 that the child is a victim of domestic child abuse, as defined 453.12 in section 260.015, subdivision 24, it may order any of the 453.13 following dispositions of the case in addition to or as 453.14 alternatives to the dispositions authorized under subdivision 1: 453.15 (1) restrain any party from committing acts of domestic 453.16 child abuse; 453.17 (2) exclude the abusing party from the dwelling which the 453.18 family or household members share or from the residence of the 453.19 child; 453.20 (3) on the same basis as is provided in chapter 518, 453.21 establish temporary visitation with regard to minor children of 453.22 the adult family or household members; 453.23 (4) on the same basis as is provided in chapter 518, 453.24 establish temporary support or maintenance for a period of 30 453.25 days for minor children or a spouse; 453.26 (5) provide counseling or other social services for the 453.27 family or household members; or 453.28 (6) order the abusing party to participate in treatment or 453.29 counseling services. 453.30 (b) Any relief granted by the order for protection shall be 453.31 for a fixed period not to exceed one year. 453.32 However, no order excluding the abusing party from the 453.33 dwelling may be issued unless the court finds that: 453.34 (1) the order is in the best interests of the child or 453.35 children remaining in the dwelling; 453.36 (2) a remaining adult family or household member is able to 454.1 care adequately for the child or children in the absence of the 454.2 excluded party; and 454.3 (3) the local welfare agency has developed a plan to 454.4 provide appropriate social services to the remaining family or 454.5 household members. 454.6 (c) Upon a finding that the remaining parent is able to 454.7 care adequately for the child and enforce an order excluding the 454.8 abusing party from the home and that the provision of supportive 454.9 services by the responsible social services agency is no longer 454.10 necessary, the responsible social services agency may be 454.11 dismissed as a party to the proceedings. Any orders entered 454.12 regarding the abusing party remain in full force and effect and 454.13 may be renewed by the remaining parent as necessary for the 454.14 continued protection of the child for specified periods of time, 454.15 not to exceed one year. 454.16 Sec. 56. Minnesota Statutes 1998, section 260.191, 454.17 subdivision 3b, is amended to read: 454.18 Subd. 3b. [REVIEW OF COURT ORDERED PLACEMENTS; PERMANENT 454.19 PLACEMENT DETERMINATION.] (a) Except for cases where the child 454.20 is in placement due solely to the child's status as 454.21 developmentally delayed under United States Code, title 42, 454.22 section 6001(7), or emotionally handicapped under section 252.27 454.23 and where custody has not been transferred to the responsible 454.24 social services agency, the court shall conduct a hearing to 454.25 determine the permanent status of a child not later than 12 454.26 months after the child is placed out of the home of the parent, 454.27 except that if the child was under eight years of age at the 454.28 time the petition was filed, the hearing must be conducted no 454.29 later than six months after the child is placed out of the home 454.30 of the parent. 454.31 For purposes of this subdivision, the date of the child's 454.32 placement out of the home of the parent is the earlier of the 454.33 first court-ordered placement or 60 days after the date on which 454.34 the child has been voluntarily placed out of the home. 454.35 For purposes of this subdivision, 12 months is calculated 454.36 as follows: 455.1 (1) during the pendency of a petition alleging that a child 455.2 is in need of protection or services, all time periods when a 455.3 child is placed out of the home of the parent are cumulated; 455.4 (2) if a child has been placed out of the home of the 455.5 parent within the previous five yearsin connection with one or455.6more prior petitions for a child in need of protection or455.7services, the lengths of all prior time periods when the child 455.8 was placed out of the home within the previous five yearsand455.9under the current petition,are cumulated. If a child under 455.10 this clause has been out of the home for 12 months or more, the 455.11 court, if it is in the best interests of the child and for 455.12 compelling reasons, may extend the total time the child may 455.13 continue out of the home under the current petition up to an 455.14 additional six months before making a permanency determination. 455.15 (b) Unless the responsible social services agency 455.16 recommends return of the child to the custodial parent or 455.17 parents, not later thanten30 days prior to this hearing, the 455.18 responsible socialserviceservices agency shall file pleadings 455.19 in juvenile court to establish the basis for the juvenile court 455.20 to order permanent placementdeterminationof the child 455.21 according to paragraph (d). Notice of the hearing and copies of 455.22 the pleadings must be provided pursuant to section 260.141. If 455.23 a termination of parental rights petition is filed before the 455.24 date required for the permanency planning determination and 455.25 there is a trial under section 260.155 scheduled on that 455.26 petition within 90 days of the filing of the petition, no 455.27 hearing need be conducted under this subdivision. 455.28 (c) At the conclusion of the hearing, the court shall 455.29determine whetherorder the childis to bereturned home or, if455.30not, whatorder a permanent placementis consistent within the 455.31 child's best interests. The "best interests of the child" means 455.32 all relevant factors to be considered and evaluated. 455.33(c)(d) At a hearing under this subdivision, if the child 455.34 was under eight years of age at the time the petition was filed 455.35 alleging the child in need of protection or services, the court 455.36 shall review the progress of the case and the case plan, 456.1 including the provision of services. The court may order the 456.2 local socialserviceservices agency to show cause why it should 456.3 not file a termination of parental rights petition. Cause may 456.4 include, but is not limited to, the following conditions: 456.5 (1) the parents or guardians have maintained regular 456.6 contact with the child, the parents are complying with the 456.7 court-ordered case plan, and the child would benefit from 456.8 continuing this relationship; 456.9 (2) grounds for termination under section 260.221 do not 456.10 exist; or 456.11 (3) the permanent plan for the child is transfer of 456.12 permanent legal and physical custody to a relative. When the 456.13 permanent plan for the child is transfer of permanent legal and 456.14 physical custody to a relative, a petition supporting the plan 456.15 shall be filed in juvenile court within 30 days of the hearing 456.16 required under this subdivision and a hearing on the petition 456.17 held within 30 days of the filing of the pleadings. 456.18(d)(e) If the child is not returned to the home, the court 456.19 must order one of the following dispositionsavailable for456.20permanent placement determination are: 456.21 (1) permanent legal and physical custody to a relative in 456.22 the best interests of the child. In transferring permanent 456.23 legal and physical custody to a relative, the juvenile court 456.24 shall follow the standards and procedures applicable under 456.25 chapter 257 or 518. An order establishing permanent legal or 456.26 physical custody under this subdivision must be filed with the 456.27 family court. A transfer of legal and physical custody includes 456.28 responsibility for the protection, education, care, and control 456.29 of the child and decision making on behalf of the child. The 456.30 socialserviceservices agency may petition on behalf of the 456.31 proposed custodian; 456.32 (2) termination of parental rightsand adoption; unless the 456.33 socialserviceservices agencyshall filehas already filed a 456.34 petition for termination of parental rights under section 456.35 260.231, the court may order such a petition filed and all the 456.36 requirements of sections 260.221 to 260.245 remain applicable. 457.1 An adoption completed subsequent to a determination under this 457.2 subdivision may include an agreement for communication or 457.3 contact under section 259.58; or 457.4 (3) long-term foster care; transfer of legal custody and 457.5 adoption are preferred permanency options for a child who cannot 457.6 return home. The court may order a child into long-term foster 457.7 care only if it finds that neither an award of legal and 457.8 physical custody to a relative, nor termination of parental 457.9 rights nor adoption is in the child's best interests. Further, 457.10 the court may only order long-term foster care for the child 457.11 under this section if it finds the following: 457.12 (i) the child has reached age 12 and reasonable efforts by 457.13 the responsible socialserviceservices agency have failed to 457.14 locate an adoptive family for the child; or 457.15 (ii) the child is a sibling of a child described in clause 457.16 (i) and the siblings have a significant positive relationship 457.17 and are ordered into the same long-term foster care home; or 457.18 (4) foster care for a specified period of time may be 457.19 ordered only if: 457.20 (i) the sole basis for an adjudication thatathe child is 457.21 in need of protection or services isthat the child is a457.22runaway, is an habitual truant, or committed a delinquent act457.23before age tenthe child's behavior; and 457.24 (ii) the court finds that foster care for a specified 457.25 period of time is in the best interests of the child. 457.26 (e) In ordering a permanent placement of a child, the court 457.27 must be governed by the best interests of the child, including a 457.28 review of the relationship between the child and relatives and 457.29 the child and other important persons with whom the child has 457.30 resided or had significant contact. 457.31 (f) Once a permanent placement determination has been made 457.32 and permanent placement has been established, further court 457.33 reviews and dispositional hearings are only necessary if the 457.34 placement is made under paragraph (d), clause (4), review is 457.35 otherwise required by federal law, an adoption has not yet been 457.36 finalized, or there is a disruption of the permanent or 458.1 long-term placement. 458.2 (g) An order under this subdivision must include the 458.3 following detailed findings: 458.4 (1) how the child's best interests are served by the order; 458.5 (2) the nature and extent of the responsible socialservice458.6 services agency's reasonable efforts, or, in the case of an 458.7 Indian child, active efforts, to reunify the child with the 458.8 parent or parents; 458.9 (3) the parent's or parents' efforts and ability to use 458.10 services to correct the conditions which led to the out-of-home 458.11 placement; and 458.12 (4) whether the conditions which led to the out-of-home 458.13 placement have been corrected so that the child can return home;458.14and458.15(5) if the child cannot be returned home, whether there is458.16a substantial probability of the child being able to return home458.17in the next six months. 458.18 (h) An order for permanent legal and physical custody of a 458.19 child may be modified under sections 518.18 and 518.185. The 458.20 socialserviceservices agency is a party to the proceeding and 458.21 must receive notice. An order for long-term foster care is 458.22 reviewable upon motion and a showing by the parent of a 458.23 substantial change in the parent's circumstances such that the 458.24 parent could provide appropriate care for the child and that 458.25 removal of the child from the child's permanent placement and 458.26 the return to the parent's care would be in the best interest of 458.27 the child. 458.28 (i) The court shall issue an order required under this 458.29 section within 15 days of the close of the proceedings. The 458.30 court may extend issuing the order an additional 15 days when 458.31 necessary in the interests of justice and the best interests of 458.32 the child. 458.33 Sec. 57. Minnesota Statutes 1998, section 260.192, is 458.34 amended to read: 458.35 260.192 [DISPOSITIONS; VOLUNTARY FOSTER CARE PLACEMENTS.] 458.36 Unless the court disposes of the petition under section 459.1 260.131, subdivision 1a, upon a petition for review of the 459.2 foster care status of a child, the court may: 459.3 (a)In the case of a petition required to be filed under459.4section 257.071, subdivision 3, find that the child's needs are459.5being met, that the child's placement in foster care is in the459.6best interests of the child, and that the child will be returned459.7home in the next six months, in which case the court shall459.8approve the voluntary arrangement and continue the matter for459.9six months to assure the child returns to the parent's home.459.10(b) In the case of a petition required to be filed under459.11section 257.071, subdivision 4, find that the child's needs are459.12being met and that the child's placement in foster care is in459.13the best interests of the child, in which case the court shall459.14approve the voluntary arrangement. The court shall order the459.15social service agency responsible for the placement to bring a459.16petition under section 260.131, subdivision 1 or 1a, as459.17appropriate, within 12 months.459.18(c)Find that the child's needs are not being met, in which 459.19 case the court shall order the socialserviceservices agency or 459.20 the parents to take whatever action is necessary and feasible to 459.21 meet the child's needs, including, when appropriate, the 459.22 provision by the socialserviceservices agency of services to 459.23 the parents which would enable the child to live at home, and 459.24 order a disposition under section 260.191. 459.25(d)(b) Find that the child has been abandoned by parents 459.26 financially or emotionally, or that the developmentally disabled 459.27 child does not require out-of-home care because of the 459.28 handicapping condition, in which case the court shall order the 459.29 socialserviceservices agency to file an appropriate petition 459.30 pursuant to sections 260.131, subdivision 1, or 260.231. 459.31 Nothing in this section shall be construed to prohibit 459.32 bringing a petition pursuant to section 260.131, subdivision 1 459.33 or 2, sooner than required by court order pursuant to this 459.34 section. 459.35 Sec. 58. Minnesota Statutes 1998, section 260.221, 459.36 subdivision 1, is amended to read: 460.1 Subdivision 1. [VOLUNTARY AND INVOLUNTARY.] The juvenile 460.2 court may upon petition, terminate all rights of a parent to a 460.3 child: 460.4 (a) with the written consent of a parent who for good cause 460.5 desires to terminate parental rights; or 460.6 (b) if it finds that one or more of the following 460.7 conditions exist: 460.8 (1) that the parent has abandoned the child; 460.9 (2) that the parent has substantially, continuously, or 460.10 repeatedly refused or neglected to comply with the duties 460.11 imposed upon that parent by the parent and child relationship, 460.12 including but not limited to providing the child with necessary 460.13 food, clothing, shelter, education, and other care and control 460.14 necessary for the child's physical, mental, or emotional health 460.15 and development, if the parent is physically and financially 460.16 able, and either reasonable efforts by the socialservice460.17 services agency have failed to correct the conditions that 460.18 formed the basis of the petition or reasonable efforts would be 460.19 futile and therefore unreasonable; 460.20 (3) that a parent has been ordered to contribute to the 460.21 support of the child or financially aid in the child's birth and 460.22 has continuously failed to do so without good cause. This 460.23 clause shall not be construed to state a grounds for termination 460.24 of parental rights of a noncustodial parent if that parent has 460.25 not been ordered to or cannot financially contribute to the 460.26 support of the child or aid in the child's birth; 460.27 (4) that a parent is palpably unfit to be a party to the 460.28 parent and child relationship because of a consistent pattern of 460.29 specific conduct before the child or of specific conditions 460.30 directly relating to the parent and child relationship either of 460.31 which are determined by the court to be of a duration or nature 460.32 that renders the parent unable, for the reasonably foreseeable 460.33 future, to care appropriately for the ongoing physical, mental, 460.34 or emotional needs of the child. It is presumed that a parent 460.35 is palpably unfit to be a party to the parent and child 460.36 relationship upon a showing that:461.1(i) the child was adjudicated in need of protection or461.2services due to circumstances described in section 260.015,461.3subdivision 2a, clause (1), (2), (3), (5), or (8); and461.4(ii)the parent's parental rights to one or more other 461.5 children were involuntarily terminatedunder clause (1), (2),461.6(4), or (7), or under clause (5) if the child was initially461.7determined to be in need of protection or services due to461.8circumstances described in section 260.015, subdivision 2a,461.9clause (1), (2), (3), (5), or (8); 461.10 (5) that followingupon a determination of neglect or461.11dependency, or of a child's need for protection or servicesthe 461.12 child's placement out of the home, reasonable efforts, under the 461.13 direction of the court, have failed to correct the conditions 461.14 leading to thedeterminationchild's placement. It is presumed 461.15 that reasonable efforts under this clause have failed upon a 461.16 showing that: 461.17 (i) a child has resided out of the parental home under 461.18 court order for a cumulative period ofmore than one year within461.19a five-year period following an adjudication of dependency,461.20neglect, need for protection or services under section 260.015,461.21subdivision 2a, clause (1), (2), (3), (6), (8), or (9), or461.22neglected and in foster care, and an order for disposition under461.23section 260.191, including adoption of the case plan required by461.24section 257.071;12 months within the preceding 22 months. In 461.25 the case of a child under age eight at the time the petition was 461.26 filed alleging the child to be in need of protection or 461.27 services, the presumption arises when the child has resided out 461.28 of the parental home under court order for six months unless the 461.29 parent has maintained regular contact with the child and the 461.30 parent is complying with the case plan; 461.31 (ii) the court has approved a case plan required under 461.32 section 257.071 and filed with the court under section 260.172; 461.33 (iii) conditions leading to thedetermination461.34willout-of-home placement have notbebeen correctedwithin461.35the reasonably foreseeable future. It is presumed that 461.36 conditions leading to a child's out-of-home placementwillhave 462.1 notbebeen correctedin the reasonably foreseeable futureupon 462.2 a showing that the parent or parents have not substantially 462.3 complied with the court's orders and a reasonable case plan, and462.4the conditions which led to the out-of-home placement have not462.5been corrected; and 462.6(iii)(iv) reasonable efforts have been made by the social 462.7serviceservices agency to rehabilitate the parent and reunite 462.8 the family. 462.9 This clause does not prohibit the termination of parental 462.10 rights prior to one year, or in the case of a child under age 462.11 eight, within six months after a child has been placed out of 462.12 the home. 462.13 It is also presumed that reasonable efforts have failed 462.14 under this clause upon a showing that: 462.15(i)(A) the parent has been diagnosed as chemically 462.16 dependent by a professional certified to make the diagnosis; 462.17(ii)(B) the parent has been required by a case plan to 462.18 participate in a chemical dependency treatment program; 462.19(iii)(C) the treatment programs offered to the parent were 462.20 culturally, linguistically, and clinically appropriate; 462.21(iv)(D) the parent has either failed two or more times to 462.22 successfully complete a treatment program or has refused at two 462.23 or more separate meetings with a caseworker to participate in a 462.24 treatment program; and 462.25(v)(E) the parent continues to abuse chemicals. 462.26Provided, that this presumption applies only to parents required462.27by a case plan to participate in a chemical dependency treatment462.28program on or after July 1, 1990;462.29 (6) that a child has experienced egregious harm in the 462.30 parent's care which is of a nature, duration, or chronicity that 462.31 indicates a lack of regard for the child's well-being, such that 462.32 a reasonable person would believe it contrary to the best 462.33 interest of the child or of any child to be in the parent's 462.34 care; 462.35 (7) that in the case of a child born to a mother who was 462.36 not married to the child's father when the child was conceived 463.1 nor when the child was born the person is not entitled to notice 463.2 of an adoption hearing under section 259.49 and the person has 463.3 not registered with the fathers' adoption registry under section 463.4 259.52; 463.5 (8) that the child is neglected and in foster care; or 463.6 (9) that the parent has been convicted of a crime listed in 463.7 section 260.012, paragraph (b), clauses (1) to (3). 463.8 In an action involving an American Indian child, sections 463.9 257.35 to 257.3579 and the Indian Child Welfare Act, United 463.10 States Code, title 25, sections 1901 to 1923, control to the 463.11 extent that the provisions of this section are inconsistent with 463.12 those laws. 463.13 Sec. 59. Minnesota Statutes 1998, section 260.221, 463.14 subdivision 1a, is amended to read: 463.15 Subd. 1a. [EVIDENCE OF ABANDONMENT.] For purposes of 463.16 subdivision 1, paragraph (b), clause (1): 463.17 (a) Abandonment is presumed when: 463.18 (1) the parent has had no contact with the child on a 463.19 regular basis and not demonstrated consistent interest in the 463.20 child's well-being for six months and the socialservice463.21 services agency has made reasonable efforts to facilitate 463.22 contact, unless the parent establishes that an extreme financial 463.23 or physical hardship or treatment for mental disability or 463.24 chemical dependency or other good cause prevented the parent 463.25 from making contact with the child. This presumption does not 463.26 apply to children whose custody has been determined under 463.27 chapter 257 or 518; or 463.28 (2) the child is an infant under two years of age and has 463.29 been deserted by the parent under circumstances that show an 463.30 intent not to return to care for the child. 463.31 The court is not prohibited from finding abandonment in the 463.32 absence of the presumptions in clauses (1) and (2). 463.33 (b) The following are prima facie evidence of abandonment 463.34 whereadoption proceedings are pending andthere has been a 463.35 showing that the person was not entitled to notice of an 463.36 adoption proceeding under section 259.49: 464.1 (1) failure to register with the fathers' adoption registry 464.2 under section 259.52; or 464.3 (2) if the person registered with the fathers' adoption 464.4 registry under section 259.52: 464.5 (i) filing a denial of paternity within 30 days of receipt 464.6 of notice under section 259.52, subdivision 8; 464.7 (ii) failing to timely file an intent to claim parental 464.8 rights with entry of appearance form within 30 days of receipt 464.9 of notice under section 259.52, subdivision 10; or 464.10 (iii) timely filing an intent to claim parental rights with 464.11 entry of appearance form within 30 days of receipt of notice 464.12 under section 259.52, subdivision 10, but failing to initiate a 464.13 paternity action within 30 days of receiving the fathers' 464.14 adoption registry notice where there has been no showing of good 464.15 cause for the delay. 464.16 Sec. 60. Minnesota Statutes 1998, section 260.221, 464.17 subdivision 1b, is amended to read: 464.18 Subd. 1b. [REQUIRED TERMINATION OF PARENTAL RIGHTS.] (a) 464.19 The county attorney shall file a termination of parental rights 464.20 petition within 30 days of the responsible social services 464.21 agency determining that achild's placement in out-of-home care464.22if thechild has been subjected to egregious harm as defined in 464.23 section 260.015, subdivision 29, is determined to be the sibling 464.24 of another child of the parent who was subjected to egregious 464.25 harm, or is an abandoned infant as defined in subdivision 1a, 464.26 paragraph (a), clause (2). The local social services agency 464.27 shall concurrently identify, recruit, process, and approve an 464.28 adoptive family for the child. If a termination of parental 464.29 rights petition has been filed by another party, the local 464.30 social services agency shall be joined as a party to the 464.31 petition. If criminal charges have been filed against a parent 464.32 arising out of the conduct alleged to constitute egregious harm, 464.33 the county attorney shall determine which matter should proceed 464.34 to trial first, consistent with the best interests of the child 464.35 and subject to the defendant's right to a speedy trial. 464.36 (b) This requirement does not apply if the county attorney 465.1 determines and files with the courtits determination that: 465.2 (1) a petition for transfer of permanent legal and physical 465.3 custody to a relativeis in the best interests of the child or465.4there isunder section 260.191, subdivision 3b, including a 465.5 determination that the transfer is in the best interests of the 465.6 child; or 465.7 (2) a petition alleging the child, and where appropriate, 465.8 the child's siblings, to be in need of protection or services 465.9 accompanied by a case plan prepared by the responsible social 465.10 services agency documenting a compelling reasondocumented by465.11the local social services agency thatwhy filingthea 465.12 termination of parental rights petition would not be in the best 465.13 interests of the child. 465.14 Sec. 61. Minnesota Statutes 1998, section 260.221, 465.15 subdivision 1c, is amended to read: 465.16 Subd. 1c. [CURRENT FOSTER CARE CHILDREN.] Except for cases 465.17 where the child is in placement due solely to the child's status 465.18 as developmentally delayed under United States Code, title 42, 465.19 section 6001(7), or emotionally handicapped under section 465.20 252.27, and where custody has not been transferred to the 465.21 responsible social services agency, the county attorney shall 465.22 file a termination of parental rights petition orothera 465.23 petition to support another permanent placement proceeding under 465.24 section 260.191, subdivision 3b, for all childrendetermined to465.25be in need of protection or serviceswho are placed in 465.26 out-of-home care for reasons other than care or treatment of the 465.27 child's disability, and who are in out-of-home placement on 465.28 April 21, 1998, and have been in out-of-home care for 15 of the 465.29 most recent 22 months. This requirement does not apply if there 465.30 is a compelling reason documented in a case plan filed with the 465.31 court for determining that filing a termination of parental 465.32 rights petition or other permanency petition would not be in the 465.33 best interests of the child or if the responsible social 465.34 services agency has not provided reasonable efforts necessary 465.35 for the safe return of the child, if reasonable efforts are 465.36 required. 466.1 Sec. 62. Minnesota Statutes 1998, section 260.221, 466.2 subdivision 3, is amended to read: 466.3 Subd. 3. [WHEN PRIOR FINDING REQUIRED.] For purposes of 466.4 subdivision 1, clause (b), no prior judicial finding of 466.5dependency, neglect,need for protection or services, or 466.6 neglected and in foster care is required, except as provided in 466.7 subdivision 1, clause (b), item (5). 466.8 Sec. 63. Minnesota Statutes 1998, section 260.221, 466.9 subdivision 5, is amended to read: 466.10 Subd. 5. [FINDINGS REGARDING REASONABLE EFFORTS.] In any 466.11 proceeding under this section, the court shall make specific 466.12 findings: 466.13 (1) regarding the nature and extent of efforts made by the 466.14 socialserviceservices agency to rehabilitate the parent and 466.15 reunite the family; or 466.16 (2)that provision of services or further services for the466.17purpose of rehabilitation and reunification is futile and466.18therefore unreasonable under the circumstances; or466.19(3)that reasonable efforts at reunification are not 466.20 required as provided under section 260.012. 466.21 Sec. 64. [626.5551] [ALTERNATIVE RESPONSE PROGRAMS FOR 466.22 CHILD PROTECTION ASSESSMENTS OR INVESTIGATIONS.] 466.23 Subdivision 1. [PROGRAMS AUTHORIZED.] (a) A county may 466.24 establish a program that uses alternative responses to reports 466.25 of child maltreatment under section 626.556, as provided in this 466.26 section. 466.27 (b) Alternative responses may include a family assessment 466.28 and services approach under which the local welfare agency 466.29 assesses the risk of abuse and neglect and the service needs of 466.30 the family and arranges for appropriate services, diversions, 466.31 referral for services, or other response identified in the plan 466.32 under subdivision 4. 466.33 (c) This section may not be used for reports of 466.34 maltreatment in facilities required to be licensed under 466.35 sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 466.36 chapter 245B, or in a school as defined in sections 120A.05, 467.1 subdivisions 9, 11, and 13; and 124D.10, or in a nonlicensed 467.2 personal care provider association as defined in sections 467.3 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 467.4 Subd. 2. [USE OF ALTERNATIVE RESPONSE OR 467.5 INVESTIGATION.] (a) Upon receipt of a report under section 467.6 626.556, the local welfare agency in a county that has 467.7 established an alternative response program under this section 467.8 shall determine whether to conduct an investigation under 467.9 section 626.556 or to use an alternative response as appropriate 467.10 to prevent or provide a remedy for child maltreatment. 467.11 (b) The local welfare agency may conduct an investigation 467.12 of any report, but shall conduct an investigation of reports 467.13 that, if true, would mean that the child has experienced, or is 467.14 at risk of experiencing, serious physical injury, sexual abuse, 467.15 abandonment, or neglect that substantially endangers the child's 467.16 physical or mental health, including growth delays, which may be 467.17 referred to as failure to thrive, that have been diagnosed by a 467.18 physician and are due to parental neglect, or conduct that would 467.19 be a violation of, or an attempt to commit a violation of: 467.20 (1) section 609.185; 609.19; or 609.195 (murder in the 467.21 first, second, or third degree); 467.22 (2) section 609.20 or 609.205 (manslaughter in the first or 467.23 second degree); 467.24 (3) section 609.221; 609.222; or 609.223 (assault in the 467.25 first, second, or third degree); 467.26 (4) section 609.322 (solicitation, inducement, and 467.27 promotion of prostitution); 467.28 (5) sections 609.342 to 609.3451 (criminal sexual conduct); 467.29 (6) section 609.352 (solicitation of children to engage in 467.30 sexual conduct); 467.31 (7) section 609.377 or 609.378 (malicious punishment or 467.32 neglect or endangerment of a child); or 467.33 (8) section 617.246 (use of minor in sexual performance). 467.34 (c) In addition, in all cases the local welfare agency 467.35 shall notify the appropriate law enforcement agency as provided 467.36 in section 626.556, subdivision 3. 468.1 (d) The local welfare agency shall begin an immediate 468.2 investigation under section 626.556 if at any time when it is 468.3 using an alternative response it determines that an 468.4 investigation is required under paragraph (b) or would otherwise 468.5 be appropriate. The local welfare agency may use an alternative 468.6 response to a report that was initially referred for an 468.7 investigation if the agency determines that a complete 468.8 investigation is not required. In determining that a complete 468.9 investigation is not required, the local welfare agency must 468.10 document the reason for terminating the investigation and 468.11 consult with: 468.12 (1) the local law enforcement agency, if the local law 468.13 enforcement is involved, and notify the county attorney of the 468.14 decision to terminate the investigation; or 468.15 (2) the county attorney, if the local law enforcement is 468.16 not involved. 468.17 Subd. 3. [DOCUMENTATION.] When a case in which an 468.18 alternative response was used is closed, the local welfare 468.19 agency shall document the outcome of the approach, including a 468.20 description of the response and services provided and the 468.21 removal or reduction of risk to the child, if it existed. 468.22 Records maintained under this section must contain the 468.23 documentation and must be retained for at least four years. 468.24 Subd. 4. [PLAN.] The county community social service plan 468.25 required under section 256E.09 must address the extent that the 468.26 county will use the alternative response program authorized 468.27 under this section, based on the availability of new federal 468.28 funding that is earned and other available revenue sources to 468.29 fund the additional cost to the county of using the program. To 468.30 the extent the county uses the program, the county must include 468.31 the program in the community social service plan and in the 468.32 program evaluation under section 256E.10. The plan must address 468.33 alternative responses and services that will be used for the 468.34 program and protocols for determining the appropriate response 468.35 to reports under section 626.556 and address how the protocols 468.36 comply with the guidelines of the commissioner under subdivision 469.1 5. 469.2 Subd. 5. [COMMISSIONER OF HUMAN SERVICES TO DEVELOP 469.3 GUIDELINES.] The commissioner of human services, in consultation 469.4 with county representatives, may develop guidelines defining 469.5 alternative responses and setting out procedures for family 469.6 assessment and service delivery under this section. The 469.7 commissioner may also develop guidelines for counties regarding 469.8 the provisions of section 626.556 that continue to apply when 469.9 using an alternative response under this section. The 469.10 commissioner may also develop forms, best practice guidelines, 469.11 and training to assist counties in implementing alternative 469.12 responses under this section. 469.13 Sec. 65. Minnesota Statutes 1998, section 626.556, 469.14 subdivision 2, is amended to read: 469.15 Subd. 2. [DEFINITIONS.] As used in this section, the 469.16 following terms have the meanings given them unless the specific 469.17 content indicates otherwise: 469.18 (a) "Sexual abuse" means the subjection of a child by a 469.19 person responsible for the child's care, by a person who has a 469.20 significant relationship to the child, as defined in section 469.21 609.341, or by a person in a position of authority, as defined 469.22 in section 609.341, subdivision 10, to any act which constitutes 469.23 a violation of section 609.342 (criminal sexual conduct in the 469.24 first degree), 609.343 (criminal sexual conduct in the second 469.25 degree), 609.344 (criminal sexual conduct in the third 469.26 degree),or609.345 (criminal sexual conduct in the fourth 469.27 degree), or 609.3451 (criminal sexual conduct in the fifth 469.28 degree). Sexual abuse also includes any act which involves a 469.29 minor which constitutes a violation of prostitution offenses 469.30 under sections 609.321 to 609.324 or 617.246. Sexual abuse 469.31 includes threatened sexual abuse. 469.32 (b) "Person responsible for the child's care" means (1) an 469.33 individual functioning within the family unit and having 469.34 responsibilities for the care of the child such as a parent, 469.35 guardian, or other person having similar care responsibilities, 469.36 or (2) an individual functioning outside the family unit and 470.1 having responsibilities for the care of the child such as a 470.2 teacher, school administrator, or other lawful custodian of a 470.3 child having either full-time or short-term care 470.4 responsibilities including, but not limited to, day care, 470.5 babysitting whether paid or unpaid, counseling, teaching, and 470.6 coaching. 470.7 (c) "Neglect" means: 470.8 (1) failure by a person responsible for a child's care to 470.9 supply a child with necessary food, clothing, shelteror, 470.10 health, medical, or other care required for the child's physical 470.11 or mental health when reasonably able to do so,; 470.12 (2) failure to protect a child from conditions or actions 470.13 which imminently and seriously endanger the child's physical or 470.14 mental health when reasonably able to do so, or; 470.15 (3) failure to provide for necessary supervision or child 470.16 care arrangements appropriate for a child after considering 470.17 factors as the child's age, mental ability, physical condition, 470.18 length of absence, or environment, when the child is unable to 470.19 care for the child's own basic needs or safety, or the basic 470.20 needs or safety of another child in their care; 470.21 (4) failureto take steps to ensure that a child is470.22educated in accordance with state law.to ensure that the child 470.23 is educated as defined in sections 120A.22 and 260.155, 470.24 subdivision 9; 470.25 (5) nothing in this section shall be construed to mean that 470.26 a child is neglected solely because the child's parent, 470.27 guardian, or other person responsible for the child's care in 470.28 good faith selects and depends upon spiritual means or prayer 470.29 for treatment or care of disease or remedial care of the child 470.30 in lieu of medical care; except that a parent, guardian, or 470.31 caretaker, or a person mandated to report pursuant to 470.32 subdivision 3, has a duty to report if a lack of medical care 470.33 may cause serious danger to the child's health. This section 470.34 does not impose upon persons, not otherwise legally responsible 470.35 for providing a child with necessary food, clothing, shelter, 470.36 education, or medical care, a duty to provide that care.; 471.1Neglect includes(6) prenatal exposure to a controlled 471.2 substance, as defined in section 253B.02, subdivision 2, used by 471.3 the mother for a nonmedical purpose, as evidenced by withdrawal 471.4 symptoms in the child at birth, results of a toxicology test 471.5 performed on the mother at delivery or the child at birth, or 471.6 medical effects or developmental delays during the child's first 471.7 year of life that medically indicate prenatal exposure to a 471.8 controlled substance.; 471.9Neglect also means(7) "medical neglect" as defined in 471.10 section 260.015, subdivision 2a, clause (5).; 471.11 (8) that the parent or other person responsible for the 471.12 care of the child: 471.13 (i) engages in violent behavior that demonstrates a 471.14 disregard for the well being of the child as indicated by action 471.15 that could reasonably result in serious physical, mental, or 471.16 threatened injury, or emotional damage to the child; 471.17 (ii) engages in repeated domestic assault that would 471.18 constitute a violation of section 609.2242, subdivision 2 or 4; 471.19 (iii) commits domestic assault that would constitute a 471.20 violation of section 609.2242 within sight or sound of the 471.21 child; or 471.22 (iv) if the actions of the abuser subject the child to 471.23 ongoing domestic violence within the home environment that is 471.24 likely to have a detrimental effect on the well being of the 471.25 child; 471.26 (9) chronic and severe use of alcohol or a controlled 471.27 substance by a parent or person responsible for the care of the 471.28 child that adversely affects the child's basic needs and safety; 471.29 or 471.30 (10) emotional harm from a pattern of behavior which 471.31 contributes to impaired emotional functioning of the child which 471.32 may be demonstrated by a substantial and observable effect in 471.33 the child's behavior, emotional response, or cognition that is 471.34 not within the normal range for the child's age and stage of 471.35 development, with due regard to the child's culture. 471.36 (d) "Physical abuse" means any physicalorinjury, mental 472.1 injury, or threatened injury, inflicted by a person responsible 472.2 for the child's care on a child other than by accidental means, 472.3 or any physical or mental injury that cannot reasonably be 472.4 explained by the child's history of injuries, or any aversive472.5and deprivation procedures that have not been authorized under472.6section 245.825. Abuse does not include reasonable and moderate 472.7 physical discipline of a child administered by a parent or legal 472.8 guardian which does not result in an injury. Actions which are 472.9 not reasonable and moderate include, but are not limited to: 472.10 (1) throwing, kicking, burning, biting, or cutting a child; 472.11 (2) striking a child with a closed fist; 472.12 (3) shaking a child under age three; 472.13 (4) striking or other actions which result in any 472.14 nonaccidental injury to a child under 18 months of age; 472.15 (5) unreasonable interference with a child's breathing; 472.16 (6) threatening a child with a weapon, as defined in 472.17 section 609.02, subdivision 6; 472.18 (7) striking a child under age one on the face or head; 472.19 (8) purposely giving a child poison, alcohol, or dangerous, 472.20 harmful, or controlled substances which were not prescribed for 472.21 the child by a practitioner, in order to control or punish the 472.22 child; or other substances that substantially affect the child's 472.23 behavior, motor coordination, or judgment or that results in 472.24 sickness or internal injury, or subjects the child to medical 472.25 procedures that would be unnecessary if the child were not 472.26 exposed to the substances; or 472.27 (9) unreasonable physical confinement or restraint not 472.28 permitted under section 609.379, including but not limited to 472.29 tying, caging, or chaining. 472.30 (e) "Report" means any report received by the local welfare 472.31 agency, police department, or county sheriff pursuant to this 472.32 section. 472.33 (f) "Facility" means a licensed or unlicensed day care 472.34 facility, residential facility, agency, hospital, sanitarium, or 472.35 other facility or institution required to be licensedpursuant472.36tounder sections 144.50 to 144.58, 241.021, or 245A.01 to 473.1 245A.16., or chapter 245B; or a school as defined in sections 473.2 120A.05, subdivisions 9, 11, and 13; and 124D.10; or a 473.3 nonlicensed personal care provider organization as defined in 473.4 sections 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 473.5 (g) "Operator" means an operator or agency as defined in 473.6 section 245A.02. 473.7 (h) "Commissioner" means the commissioner of human services. 473.8 (i) "Assessment" includes authority to interview the child, 473.9 the person or persons responsible for the child's care, the 473.10 alleged perpetrator, and any other person with knowledge of the 473.11 abuse or neglect for the purpose of gathering the facts, 473.12 assessing the risk to the child, and formulating a plan. 473.13 (j) "Practice of social services," for the purposes of 473.14 subdivision 3, includes but is not limited to employee 473.15 assistance counseling and the provision of guardian ad litem and 473.16 visitation expeditor services. 473.17 (k) "Mental injury" means an injury to the psychological 473.18 capacity or emotional stability of a child as evidenced by an 473.19 observable or substantial impairment in the child's ability to 473.20 function within a normal range of performance and behavior with 473.21 due regard to the child's culture or harm to a child's 473.22 psychological or intellectual functioning which now, or in the 473.23 future, is likely to be evidenced by serious mental, behavioral, 473.24 or personality disorder, including severe anxiety, depression, 473.25 withdrawal, severe aggressive behavior, seriously delayed 473.26 development or similarly serious dysfunctional behavior when 473.27 caused by a statement, overt act, omission, condition, or status 473.28 of the child's caretaker. 473.29 (l) "Threatened injury" means a statement, overt act, 473.30 condition, or status that represents a substantial risk of 473.31 physical or sexual abuse or mental injury. 473.32 (m) Persons who conduct assessments or investigations under 473.33 this section shall take into account accepted child-rearing 473.34 practices of the culture in which a child participates, which 473.35 are not injurious to the child's health, welfare, and safety. 473.36 Sec. 66. Minnesota Statutes 1998, section 626.556, 474.1 subdivision 3, is amended to read: 474.2 Subd. 3. [PERSONS MANDATED TO REPORT.] (a) A person who 474.3 knows or has reason to believe a child is being neglected or 474.4 physically or sexually abused, as defined in subdivision 2, or 474.5 has been neglected or physically or sexually abused within the 474.6 preceding three years, shall immediately report the information 474.7 to the local welfare agency, agency responsible for assessing or 474.8 investigating the report, police department, or the county 474.9 sheriff if the person is: 474.10 (1) a professional or professional's delegate who is 474.11 engaged in the practice of the healing arts, social services, 474.12 hospital administration, psychological or psychiatric treatment, 474.13 child care, education, or law enforcement; or 474.14 (2) employed as a member of the clergy and received the 474.15 information while engaged in ministerial duties, provided that a 474.16 member of the clergy is not required by this subdivision to 474.17 report information that is otherwise privileged under section 474.18 595.02, subdivision 1, paragraph (c). 474.19 The police department or the county sheriff, upon receiving 474.20 a report, shall immediately notify the local welfare agency or 474.21 agency responsible for assessing or investigating the report, 474.22 orally and in writing. The local welfare agency, or agency 474.23 responsible for assessing or investigating the report, upon 474.24 receiving a report, shall immediately notify the local police 474.25 department or the county sheriff orally and in writing. The 474.26 county sheriff and the head of every local welfare agency, 474.27 agency responsible for assessing or investigating reports, and 474.28 police department shall each designate a person within their 474.29 agency, department, or office who is responsible for ensuring 474.30 that the notification duties of this paragraph and paragraph (b) 474.31 are carried out. Nothing in this subdivision shall be construed 474.32 to require more than one report from any institution, facility, 474.33 school, or agency. 474.34 (b) Any person may voluntarily report to the local welfare 474.35 agency, agency responsible for assessing or investigating the 474.36 report, police department, or the county sheriff if the person 475.1 knows, has reason to believe, or suspects a child is being or 475.2 has been neglected or subjected to physical or sexual abuse. 475.3 The police department or the county sheriff, upon receiving a 475.4 report, shall immediately notify the local welfare agency or 475.5 agency responsible for assessing or investigating the report, 475.6 orally and in writing. The local welfare agency or agency 475.7 responsible for assessing or investigating the report, upon 475.8 receiving a report, shall immediately notify the local police 475.9 department or the county sheriff orally and in writing. 475.10 (c) A person mandated to report physical or sexual child 475.11 abuse or neglect occurring within a licensed facility shall 475.12 report the information to the agency responsible for licensing 475.13 the facility under sections 144.50 to 144.58; 241.021; 245A.01 475.14 to 245A.16; or 245B, or a school as defined in sections 120A.05, 475.15 subdivisions 9, 11, and 13; 120A.36; and 124D.68, or a 475.16 nonlicensed personal care provider organization as defined in 475.17 sections 256B.04, subdivision 16; and 256B.0625, subdivision 19. 475.18 A health or corrections agency receiving a report may request 475.19 the local welfare agency to provide assistance pursuant to 475.20 subdivisions 10, 10a, and 10b. 475.21 (d) Any person mandated to report shall receive a summary 475.22 of the disposition of any report made by that 475.23 reporter, including whether the case has been opened for child 475.24 protection or other services, or if a referral has been made to 475.25 a community organization, unless release would be detrimental to 475.26 the best interests of the child. Any person who is not mandated 475.27 to report shall, upon request to the local welfare agency, 475.28 receive a concise summary of the disposition of any report made 475.29 by that reporter, unless release would be detrimental to the 475.30 best interests of the child. 475.31 (e) For purposes of this subdivision, "immediately" means 475.32 as soon as possible but in no event longer than 24 hours. 475.33 Sec. 67. Minnesota Statutes 1998, section 626.556, is 475.34 amended by adding a subdivision to read: 475.35 Subd. 3b. [AGENCY RESPONSIBLE FOR ASSESSING OR 475.36 INVESTIGATING REPORTS OF MALTREATMENT.] 476.1 The following agencies are the administrative agencies 476.2 responsible for assessing or investigating reports of alleged 476.3 child maltreatment in facilities made under this section: 476.4 (1) the county local welfare agency is the agency 476.5 responsible for assessing or investigating allegations of 476.6 maltreatment in child foster care, family child care, and 476.7 legally unlicensed child care and in juvenile correctional 476.8 facilities licensed under section 241.021 located in the local 476.9 welfare agency's county; 476.10 (2) the department of human services is the agency 476.11 responsible for assessing or investigating allegations of 476.12 maltreatment in facilities licensed under chapters 245A and 476.13 245B, except for child foster care and family child care; and 476.14 (3) the department of health is the agency responsible for 476.15 assessing or investigating allegations of child maltreatment in 476.16 facilities licensed under sections 144.50 to 144.58, and in 476.17 unlicensed home health care. 476.18 Sec. 68. Minnesota Statutes 1998, section 626.556, 476.19 subdivision 4, is amended to read: 476.20 Subd. 4. [IMMUNITY FROM LIABILITY.] (a) The following 476.21 persons are immune from any civil or criminal liability that 476.22 otherwise might result from their actions, if they are acting in 476.23 good faith: 476.24 (1) any person making a voluntary or mandated report under 476.25 subdivision 3 or under section 626.5561 or assisting in an 476.26 assessment under this section or under section 626.5561; 476.27 (2) any person with responsibility for performing duties 476.28 under this section or supervisor employed by a local welfare 476.29 agencyor, the commissioner of an agency responsible for 476.30 operating or supervising a licensed or unlicensed day care 476.31 facility, residential facility, agency, hospital, sanitarium, or 476.32 other facility or institution required to be licensed under 476.33 sections 144.50 to 144.58; 241.021; 245A.01 to 245A.16; or 245B, 476.34 or a school as defined in sections 120A.05, subdivisions 9, 11, 476.35 and 13; 120A.36; and 124D.68, or a nonlicensed personal care 476.36 provider organization as defined in sections 256B.04, 477.1 subdivision 16; and 256B.0625, subdivision 19a, complying with 477.2 subdivision 10d; and 477.3 (3) any public or private school, facility as defined in 477.4 subdivision 2, or the employee of any public or private school 477.5 or facility who permits access by a local welfare agency or 477.6 local law enforcement agency and assists in an investigation or 477.7 assessment pursuant to subdivision 10 or under section 626.5561. 477.8 (b) A person who is a supervisor or person with 477.9 responsibility for performing duties under this section employed 477.10 by a local welfare agency or the commissioner complying with 477.11 subdivisions 10 and 11 or section 626.5561 or any related rule 477.12 or provision of law is immune from any civil or criminal 477.13 liability that might otherwise result from the person's actions, 477.14 if the person is (1) acting in good faith and exercising due 477.15 care, or (2) acting in good faith and following the information 477.16 collection procedures established under subdivision 10, 477.17 paragraphs (h), (i), and (j). 477.18 (c) This subdivision does not provide immunity to any 477.19 person for failure to make a required report or for committing 477.20 neglect, physical abuse, or sexual abuse of a child. 477.21 (d) If a person who makes a voluntary or mandatory report 477.22 under subdivision 3 prevails in a civil action from which the 477.23 person has been granted immunity under this subdivision, the 477.24 court may award the person attorney fees and costs. 477.25 Sec. 69. Minnesota Statutes 1998, section 626.556, 477.26 subdivision 7, is amended to read: 477.27 Subd. 7. [REPORT.] An oral report shall be made 477.28 immediately by telephone or otherwise. An oral report made by a 477.29 person required under subdivision 3 to report shall be followed 477.30 within 72 hours, exclusive of weekends and holidays, by a report 477.31 in writing to the appropriate police department, the county 477.32 sheriff or local welfare agency, unless the appropriate agency 477.33 has informed the reporter that the oral information does not 477.34 constitute a report under subdivision 10. Any report shall be 477.35 of sufficient content to identify the child, any person believed 477.36 to be responsible for the abuse or neglect of the child if the 478.1 person is known, the nature and extent of the abuse or neglect 478.2 and the name and address of the reporter. If requested, the 478.3 local welfare agency shall inform the reporter within ten days 478.4 after the report is made, either orally or in writing, whether 478.5 the report was accepted for assessment or investigation. 478.6 Written reports received by a police department or the county 478.7 sheriff shall be forwarded immediately to the local welfare 478.8 agency. The police department or the county sheriff may keep 478.9 copies of reports received by them. Copies of written reports 478.10 received by a local welfare department shall be forwarded 478.11 immediately to the local police department or the county sheriff. 478.12 A written copy of a report maintained by personnel of 478.13 agencies, other than welfare or law enforcement agencies, which 478.14 are subject to chapter 13 shall be confidential. An individual 478.15 subject of the report may obtain access to the original report 478.16 as provided by subdivision 11. 478.17 Sec. 70. Minnesota Statutes 1998, section 626.556, 478.18 subdivision 10, is amended to read: 478.19 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 478.20 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 478.21 alleges neglect, physical abuse, or sexual abuse by a parent, 478.22 guardian, or individual functioning within the family unit as a 478.23 person responsible for the child's care, the local welfare 478.24 agency shall immediately conduct an assessment and screening for 478.25 substance abuse and offer protective social services for 478.26 purposes of preventing further abuses, safeguarding and 478.27 enhancing the welfare of the abused or neglected minor, and 478.28 preserving family life whenever possible. If the report alleges 478.29 a violation of a criminal statute involving sexual abuse, 478.30 physical abuse, or neglect or endangerment, under section 478.31 609.378, the local law enforcement agency and local welfare 478.32 agency shall coordinate the planning and execution of their 478.33 respective investigation and assessment efforts to avoid a 478.34 duplication of fact-finding efforts and multiple interviews. 478.35 Each agency shall prepare a separate report of the results of 478.36 its investigation. In cases of alleged child maltreatment 479.1 resulting in death, the local agency may rely on the 479.2 fact-finding efforts of a law enforcement investigation to make 479.3 a determination of whether or not maltreatment occurred. When 479.4 necessary the local welfare agency shall seek authority to 479.5 remove the child from the custody of a parent, guardian, or 479.6 adult with whom the child is living. In performing any of these 479.7 duties, the local welfare agency shall maintain appropriate 479.8 records. 479.9 If the screening for substance abuse indicates abuse of 479.10 alcohol or other drugs, the local welfare agency shall conduct a 479.11 chemical use assessment pursuant to Minnesota Rules, part 479.12 9530.6615. The local welfare agency shall report the 479.13 determination of the chemical use assessment, and the 479.14 recommendations and referrals for alcohol and other drug 479.15 treatment services to the state authority on alcohol and drug 479.16 abuse. 479.17 (b) When a local agency receives a report or otherwise has 479.18 information indicating that a child who is a client, as defined 479.19 in section 245.91, has been the subject of physical abuse, 479.20 sexual abuse, or neglect at an agency, facility, or program as 479.21 defined in section 245.91, it shall, in addition to its other 479.22 duties under this section, immediately inform the ombudsman 479.23 established under sections 245.91 to 245.97. 479.24 (c) Authority of the local welfare agency responsible for 479.25 assessing the child abuse or neglect report and of the local law 479.26 enforcement agency for investigating the alleged abuse or 479.27 neglect includes, but is not limited to, authority to interview, 479.28 without parental consent, the alleged victim and any other 479.29 minors who currently reside with or who have resided with the 479.30 alleged offender. The interview may take place at school or at 479.31 any facility or other place where the alleged victim or other 479.32 minors might be found or the child may be transported to, and 479.33 the interview conducted at, a place appropriate for the 479.34 interview of a child designated by the local welfare agency or 479.35 law enforcement agency. The interview may take place outside 479.36 the presence of the alleged offender or parent, legal custodian, 480.1 guardian, or school official. Except as provided in this 480.2 paragraph, the parent, legal custodian, or guardian shall be 480.3 notified by the responsible local welfare or law enforcement 480.4 agency no later than the conclusion of the investigation or 480.5 assessment that this interview has occurred. Notwithstanding 480.6 rule 49.02 of the Minnesota rules of procedure for juvenile 480.7 courts, the juvenile court may, after hearing on an ex parte 480.8 motion by the local welfare agency, order that, where reasonable 480.9 cause exists, the agency withhold notification of this interview 480.10 from the parent, legal custodian, or guardian. If the interview 480.11 took place or is to take place on school property, the order 480.12 shall specify that school officials may not disclose to the 480.13 parent, legal custodian, or guardian the contents of the 480.14 notification of intent to interview the child on school 480.15 property, as provided under this paragraph, and any other 480.16 related information regarding the interview that may be a part 480.17 of the child's school record. A copy of the order shall be sent 480.18 by the local welfare or law enforcement agency to the 480.19 appropriate school official. 480.20 (d) When the local welfare or local law enforcement agency 480.21 determines that an interview should take place on school 480.22 property, written notification of intent to interview the child 480.23 on school property must be received by school officials prior to 480.24 the interview. The notification shall include the name of the 480.25 child to be interviewed, the purpose of the interview, and a 480.26 reference to the statutory authority to conduct an interview on 480.27 school property. For interviews conducted by the local welfare 480.28 agency, the notification shall be signed by the chair of the 480.29 local social services agency or the chair's designee. The 480.30 notification shall be private data on individuals subject to the 480.31 provisions of this paragraph. School officials may not disclose 480.32 to the parent, legal custodian, or guardian the contents of the 480.33 notification or any other related information regarding the 480.34 interview until notified in writing by the local welfare or law 480.35 enforcement agency that the investigation or assessment has been 480.36 concluded. Until that time, the local welfare or law 481.1 enforcement agency shall be solely responsible for any 481.2 disclosures regarding the nature of the assessment or 481.3 investigation. 481.4 Except where the alleged offender is believed to be a 481.5 school official or employee, the time and place, and manner of 481.6 the interview on school premises shall be within the discretion 481.7 of school officials, but the local welfare or law enforcement 481.8 agency shall have the exclusive authority to determine who may 481.9 attend the interview. The conditions as to time, place, and 481.10 manner of the interview set by the school officials shall be 481.11 reasonable and the interview shall be conducted not more than 24 481.12 hours after the receipt of the notification unless another time 481.13 is considered necessary by agreement between the school 481.14 officials and the local welfare or law enforcement agency. 481.15 Where the school fails to comply with the provisions of this 481.16 paragraph, the juvenile court may order the school to comply. 481.17 Every effort must be made to reduce the disruption of the 481.18 educational program of the child, other students, or school 481.19 staff when an interview is conducted on school premises. 481.20 (e) Where the alleged offender or a person responsible for 481.21 the care of the alleged victim or other minor prevents access to 481.22 the victim or other minor by the local welfare agency, the 481.23 juvenile court may order the parents, legal custodian, or 481.24 guardian to produce the alleged victim or other minor for 481.25 questioning by the local welfare agency or the local law 481.26 enforcement agency outside the presence of the alleged offender 481.27 or any person responsible for the child's care at reasonable 481.28 places and times as specified by court order. 481.29 (f) Before making an order under paragraph (e), the court 481.30 shall issue an order to show cause, either upon its own motion 481.31 or upon a verified petition, specifying the basis for the 481.32 requested interviews and fixing the time and place of the 481.33 hearing. The order to show cause shall be served personally and 481.34 shall be heard in the same manner as provided in other cases in 481.35 the juvenile court. The court shall consider the need for 481.36 appointment of a guardian ad litem to protect the best interests 482.1 of the child. If appointed, the guardian ad litem shall be 482.2 present at the hearing on the order to show cause. 482.3 (g) The commissioner, the ombudsman for mental health and 482.4 mental retardation, the local welfare agencies responsible for 482.5 investigating reports, and the local law enforcement agencies 482.6 have the right to enter facilities as defined in subdivision 2 482.7 and to inspect and copy the facility's records, including 482.8 medical records, as part of the investigation. Notwithstanding 482.9 the provisions of chapter 13, they also have the right to inform 482.10 the facility under investigation that they are conducting an 482.11 investigation, to disclose to the facility the names of the 482.12 individuals under investigation for abusing or neglecting a 482.13 child, and to provide the facility with a copy of the report and 482.14 the investigative findings. 482.15 (h) The local welfare agency shall collect available and 482.16 relevant information to ascertain whether maltreatment occurred 482.17 and whether protective services are needed. Information 482.18 collected includes, when relevant, information with regard to 482.19 the person reporting the alleged maltreatment, including the 482.20 nature of the reporter's relationship to the child and to the 482.21 alleged offender, and the basis of the reporter's knowledge for 482.22 the report; the child allegedly being maltreated; the alleged 482.23 offender; the child's caretaker; and other collateral sources 482.24 having relevant information related to the alleged 482.25 maltreatment. The local welfare agency may make a determination 482.26 of no maltreatment early in an assessment, and close the case 482.27 and retain immunity, if the collected information shows no basis 482.28 for a full assessment or investigation. 482.29 Information relevant to the assessment or investigation 482.30 must be asked for, and may include: 482.31 (1) the child's sex and age, prior reports of maltreatment, 482.32 information relating to developmental functioning, credibility 482.33 of the child's statement, and whether the information provided 482.34 under this clause is consistent with other information collected 482.35 during the course of the assessment or investigation; 482.36 (2) the alleged offender's age, a record check for prior 483.1 reports of maltreatment, and criminal charges and convictions. 483.2 The local welfare agency must provide the alleged offender with 483.3 an opportunity to make a statement. The alleged offender may 483.4 submit supporting documentation relevant to the assessment or 483.5 investigation; 483.6 (3) collateral source information regarding the alleged 483.7 maltreatment and care of the child. Collateral information 483.8 includes, when relevant: (i) a medical examination of the 483.9 child; (ii) prior medical records relating to the alleged 483.10 maltreatment or the care of the child and an interview with the 483.11 treating professionals; and (iii) interviews with the child's 483.12 caretakers, including the child's parent, guardian, foster 483.13 parent, child care provider, teachers, counselors, family 483.14 members, relatives, and other persons who may have knowledge 483.15 regarding the alleged maltreatment and the care of the child; 483.16 and 483.17 (4) information on the existence of domestic abuse and 483.18 violence in the home of the child, and substance abuse. 483.19 Nothing in this paragraph precludes the local welfare 483.20 agency from collecting other relevant information necessary to 483.21 conduct the assessment or investigation. Notwithstanding the 483.22 data's classification in the possession of any other agency, 483.23 data acquired by the local welfare agency during the course of 483.24 the assessment or investigation are private data on individuals 483.25 and must be maintained in accordance with subdivision 11. 483.26 (i) In the initial stages of an assessment or 483.27 investigation, the local welfare agency shall conduct a 483.28 face-to-face observation of the child reported to be maltreated 483.29 and a face-to-face interview of the alleged offender. The 483.30 interview with the alleged offender may be postponed if it would 483.31 jeopardize an active law enforcement investigation. 483.32 (j) The local welfare agency shall use a question and 483.33 answer interviewing format with questioning as nondirective as 483.34 possible to elicit spontaneous responses. The following 483.35 interviewing methods and procedures must be used whenever 483.36 possible when collecting information: 484.1 (1) audio recordings of all interviews with witnesses and 484.2 collateral sources; and 484.3 (2) in cases of alleged sexual abuse, audio-video 484.4 recordings of each interview with the alleged victim and child 484.5 witnesses. 484.6 Sec. 71. Minnesota Statutes 1998, section 626.556, 484.7 subdivision 10b, is amended to read: 484.8 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 484.9 FACILITY.] (a) This section applies to the commissioners of 484.10 human services and health. The commissioner of the agency 484.11 responsible for assessing or investigating the report shall 484.12 immediately investigate if the report alleges that: 484.13 (1) a child who is in the care of a facility as defined in 484.14 subdivision 2 is neglected, physically abused, or sexually 484.15 abused by an individual in that facility, or has been so 484.16 neglected or abused by an individual in that facility within the 484.17 three years preceding the report; or 484.18 (2) a child was neglected, physically abused, or sexually 484.19 abused by an individual in a facility defined in subdivision 2, 484.20 while in the care of that facility within the three years 484.21 preceding the report. 484.22 The commissioner of the agency responsible for assessing or 484.23 investigating the report shall arrange for the transmittal to 484.24 the commissioner of reports received by local agencies and may 484.25 delegate to a local welfare agency the duty to investigate 484.26 reports. In conducting an investigation under this section, the 484.27 commissioner has the powers and duties specified for local 484.28 welfare agencies under this section. The commissioner of the 484.29 agency responsible for assessing or investigating the report or 484.30 local welfare agency may interview any children who are or have 484.31 been in the care of a facility under investigation and their 484.32 parents, guardians, or legal custodians. 484.33 (b) Prior to any interview, the commissioner of the agency 484.34 responsible for assessing or investigating the report or local 484.35 welfare agency shall notify the parent, guardian, or legal 484.36 custodian of a child who will be interviewed in the manner 485.1 provided for in subdivision 10d, paragraph (a). If reasonable 485.2 efforts to reach the parent, guardian, or legal custodian of a 485.3 child in an out-of-home placement have failed, the child may be 485.4 interviewed if there is reason to believe the interview is 485.5 necessary to protect the child or other children in the 485.6 facility. The commissioner of the agency responsible for 485.7 assessing or investigating the report or local agency must 485.8 provide the information required in this subdivision to the 485.9 parent, guardian, or legal custodian of a child interviewed 485.10 without parental notification as soon as possible after the 485.11 interview. When the investigation is completed, any parent, 485.12 guardian, or legal custodian notified under this subdivision 485.13 shall receive the written memorandum provided for in subdivision 485.14 10d, paragraph (c). 485.15 (c) In conducting investigations under this subdivision the 485.16 commissioner or local welfare agency shall obtain access to 485.17 information consistent with subdivision 10, paragraphs (h), (i), 485.18 and (j). 485.19 (d) Except for foster care and family child care, the 485.20 commissioner has the primary responsibility for the 485.21 investigations and notifications required under subdivisions 10d 485.22 and 10f for reports that allege maltreatment related to the care 485.23 provided by or in facilities licensed by the commissioner. The 485.24 commissioner may request assistance from the local 485.25 socialserviceservices agency. 485.26 Sec. 72. Minnesota Statutes 1998, section 626.556, 485.27 subdivision 10d, is amended to read: 485.28 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 485.29 (a) When a report is received that alleges neglect, physical 485.30 abuse, or sexual abuse of a child while in the care of a 485.31facility required to be licensed pursuant to chapter 245A,485.32 licensed or unlicensed day care facility, residential facility, 485.33 agency, hospital, sanitarium, or other facility or institution 485.34 required to be licensed according to sections 144.50 to 144.58; 485.35 241.021; or 245A.01 to 245A.16; or chapter 245B, or a school as 485.36 defined in sections 120A.05, subdivisions 9, 11, and 13; 486.1 120A.36; and 124D.68, or a nonlicensed personal care provider 486.2 organization as defined in section 256B.04, subdivision 16, and 486.3 256B.0625, subdivision 19a, the commissioner of the agency 486.4 responsible for assessing or investigating the report or local 486.5 welfare agency investigating the report shall provide the 486.6 following information to the parent, guardian, or legal 486.7 custodian of a child alleged to have been neglected, physically 486.8 abused, or sexually abused: the name of the facility; the fact 486.9 that a report alleging neglect, physical abuse, or sexual abuse 486.10 of a child in the facility has been received; the nature of the 486.11 alleged neglect, physical abuse, or sexual abuse; that the 486.12 agency is conducting an investigation; any protective or 486.13 corrective measures being taken pending the outcome of the 486.14 investigation; and that a written memorandum will be provided 486.15 when the investigation is completed. 486.16 (b) The commissioner of the agency responsible for 486.17 assessing or investigating the report or local welfare agency 486.18 may also provide the information in paragraph (a) to the parent, 486.19 guardian, or legal custodian of any other child in the facility 486.20 if the investigative agency knows or has reason to believe the 486.21 alleged neglect, physical abuse, or sexual abuse has occurred. 486.22 In determining whether to exercise this authority, the 486.23 commissioner of the agency responsible for assessing or 486.24 investigating the report or local welfare agency shall consider 486.25 the seriousness of the alleged neglect, physical abuse, or 486.26 sexual abuse; the number of children allegedly neglected, 486.27 physically abused, or sexually abused; the number of alleged 486.28 perpetrators; and the length of the investigation. The facility 486.29 shall be notified whenever this discretion is exercised. 486.30 (c) When the commissioner of the agency responsible for 486.31 assessing or investigating the report or local welfare agency 486.32 has completed its investigation, every parent, guardian, or 486.33 legal custodian notified of the investigation by the 486.34 commissioner or local welfare agency shall be provided with the 486.35 following information in a written memorandum: the name of the 486.36 facility investigated; the nature of the alleged neglect, 487.1 physical abuse, or sexual abuse; the investigator's name; a 487.2 summary of the investigation findings; a statement whether 487.3 maltreatment was found; and the protective or corrective 487.4 measures that are being or will be taken. The memorandum shall 487.5 be written in a manner that protects the identity of the 487.6 reporter and the child and shall not contain the name, or to the 487.7 extent possible, reveal the identity of the alleged perpetrator 487.8 or of those interviewed during the investigation. The 487.9 commissioner or local welfare agency shall also provide the 487.10 written memorandum to the parent, guardian, or legal custodian 487.11 of each child in the facility if maltreatment is determined to 487.12 exist. 487.13 Sec. 73. Minnesota Statutes 1998, section 626.556, 487.14 subdivision 10e, is amended to read: 487.15 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 487.16 assessment or investigation it conducts, the local welfare 487.17 agency shall make two determinations: first, whether 487.18 maltreatment has occurred; and second, whether child protective 487.19 services are needed. When maltreatment is determined in an 487.20 investigation involving a facility, the investigating agency 487.21 shall also determine whether the facility or individual was 487.22 responsible for the maltreatment using the mitigating factors in 487.23 paragraph (d). Determinations under this subdivision must be 487.24 made based on a preponderance of the evidence. 487.25 (a) For the purposes of this subdivision, "maltreatment" 487.26 means any of the following acts or omissions committed by a 487.27 person responsible for the child's care: 487.28 (1) physical abuse as defined in subdivision 2, paragraph 487.29 (d); 487.30 (2) neglect as defined in subdivision 2, paragraph (c); 487.31 (3) sexual abuse as defined in subdivision 2, paragraph 487.32 (a); or 487.33 (4) mental injury as defined in subdivision 2, paragraph 487.34 (k). 487.35 (b) For the purposes of this subdivision, a determination 487.36 that child protective services are needed means that the local 488.1 welfare agency has documented conditions during the assessment 488.2 or investigation sufficient to cause a child protection worker, 488.3 as defined in section 626.559, subdivision 1, to conclude that a 488.4 child is at significant risk of maltreatment if protective 488.5 intervention is not provided and that the individuals 488.6 responsible for the child's care have not taken or are not 488.7 likely to take actions to protect the child from maltreatment or 488.8 risk of maltreatment. 488.9 (c) This subdivision does not mean that maltreatment has 488.10 occurred solely because the child's parent, guardian, or other 488.11 person responsible for the child's care in good faith selects 488.12 and depends upon spiritual means or prayer for treatment or care 488.13 of disease or remedial care of the child, in lieu of medical 488.14 care. However, if lack of medical care may result in serious 488.15 danger to the child's health, the local welfare agency may 488.16 ensure that necessary medical services are provided to the child. 488.17 (d) When determining whether the facility or individual is 488.18 the responsible party for determined maltreatment in a facility, 488.19 the investigating agency shall consider at least the following 488.20 mitigating factors: 488.21 (1) whether the actions of the facility or the individual 488.22 caregivers were according to, and followed the terms of, an 488.23 erroneous physician order, prescription, individual care plan, 488.24 or directive; however, this is not a mitigating factor when the 488.25 facility or caregiver was responsible for the issuance of the 488.26 erroneous order, prescription, individual care plan, or 488.27 directive or knew or should have known of the errors and took no 488.28 reasonable measures to correct the defect before administering 488.29 care; 488.30 (2) comparative responsibility between the facility, other 488.31 caregivers, and requirements placed upon an employee, including 488.32 the facility's compliance with related regulatory standards and 488.33 the adequacy of facility policies and procedures, facility 488.34 training, an individual's participation in the training, the 488.35 caregiver's supervision, and facility staffing levels and the 488.36 scope of the individual employee's authority and discretion; and 489.1 (3) whether the facility or individual followed 489.2 professional standards in exercising professional judgment. 489.3(e) The commissioner shall work with the maltreatment of489.4minors advisory committee established under Laws 1997, chapter489.5203, to make recommendations to further specify the kinds of489.6acts or omissions that constitute physical abuse, neglect,489.7sexual abuse, or mental injury. The commissioner shall submit489.8the recommendation and any legislation needed by January 15,489.91999.Individual counties may implement more detailed 489.10 definitions or criteria that indicate which allegations to 489.11 investigate, as long as a county's policies are consistent with 489.12 the definitions in the statutes and rules and are approved by 489.13 the county board. Each local welfare agency shall periodically 489.14 inform mandated reporters under subdivision 3 who work in the 489.15 county of the definitions of maltreatment in the statutes and 489.16 rules and any additional definitions or criteria that have been 489.17 approved by the county board. 489.18 Sec. 74. Minnesota Statutes 1998, section 626.556, 489.19 subdivision 10f, is amended to read: 489.20 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 489.21 days of the conclusion of an assessment, the local welfare 489.22 agency or agency responsible for assessing or investigating the 489.23 report shall notify the parent or guardian of the child, the 489.24 person determined to be maltreating the child, and if 489.25 applicable, the director of the facility, of the determination 489.26 and a summary of the specific reasons for the determination. 489.27 The notice must also include a certification that the 489.28 information collection procedures under subdivision 10, 489.29 paragraphs (h), (i), and (j), were followed and a notice of the 489.30 right of a data subject to obtain access to other private data 489.31 on the subject collected, created, or maintained under this 489.32 section. In addition, the notice shall include the length of 489.33 time that the records will be kept under subdivision 11c. The 489.34 investigating agency shall notify the parent or guardian of the 489.35 child who is the subject of the report, and any person or 489.36 facility determined to have maltreated a child, of their appeal 490.1 rights under this section. 490.2 Sec. 75. Minnesota Statutes 1998, section 626.556, 490.3 subdivision 10j, is amended to read: 490.4 Subd. 10j. [RELEASE OF DATA TO MANDATED REPORTERS.] A 490.5 local socialserviceservices or child protection agency may 490.6 provide relevant private data on individuals obtained under this 490.7 section to mandated reporters who have an ongoing responsibility 490.8 for the health, education, or welfare of a child affected by the 490.9 data, in the best interests of the child.The commissioner490.10shall consult with the maltreatment of minors advisory committee490.11to develop criteria for determining which records may be shared490.12with mandated reporters under this subdivision.Mandated 490.13 reporters with ongoing responsibility for the health, education, 490.14 or welfare of a child affected by the data include the child's 490.15 teachers or other appropriate school personnel, foster parents, 490.16 health care providers, respite care workers, therapists, social 490.17 workers, child care providers, residential care staff, crisis 490.18 nursery staff, probation officers, and court services 490.19 personnel. Under this section, a mandated reporter need not 490.20 have made the report to be considered a person with ongoing 490.21 responsibility for the health, education, or welfare of a child 490.22 affected by the data. 490.23 Sec. 76. Minnesota Statutes 1998, section 626.556, 490.24 subdivision 11, is amended to read: 490.25 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 490.26 (b) and subdivisions 10b, 10d, 10g, and 11b, all records 490.27 concerning individuals maintained by a local welfare agency or 490.28 agency responsible for assessing or investigating the report 490.29 under this section, including any written reports filed under 490.30 subdivision 7, shall be private data on individuals, except 490.31 insofar as copies of reports are required by subdivision 7 to be 490.32 sent to the local police department or the county sheriff. 490.33 Reports maintained by any police department or the county 490.34 sheriff shall be private data on individuals except the reports 490.35 shall be made available to the investigating, petitioning, or 490.36 prosecuting authority, including county medical examiners or 491.1 county coroners. Section 13.82, subdivisions 5, 5a, and 5b, 491.2 apply to law enforcement data other than the reports. The local 491.3 social services agency or agency responsible for assessing or 491.4 investigating the report shall make available to the 491.5 investigating, petitioning, or prosecuting authority, including 491.6 county medical examiners or county coroners or their 491.7 professional delegates, any records which contain information 491.8 relating to a specific incident of neglect or abuse which is 491.9 under investigation, petition, or prosecution and information 491.10 relating to any prior incidents of neglect or abuse involving 491.11 any of the same persons. The records shall be collected and 491.12 maintained in accordance with the provisions of chapter 13. In 491.13 conducting investigations and assessments pursuant to this 491.14 section, the notice required by section 13.04, subdivision 2, 491.15 need not be provided to a minor under the age of ten who is the 491.16 alleged victim of abuse or neglect. An individual subject of a 491.17 record shall have access to the record in accordance with those 491.18 sections, except that the name of the reporter shall be 491.19 confidential while the report is under assessment or 491.20 investigation except as otherwise permitted by this 491.21 subdivision. Any person conducting an investigation or 491.22 assessment under this section who intentionally discloses the 491.23 identity of a reporter prior to the completion of the 491.24 investigation or assessment is guilty of a misdemeanor. After 491.25 the assessment or investigation is completed, the name of the 491.26 reporter shall be confidential. The subject of the report may 491.27 compel disclosure of the name of the reporter only with the 491.28 consent of the reporter or upon a written finding by the court 491.29 that the report was false and that there is evidence that the 491.30 report was made in bad faith. This subdivision does not alter 491.31 disclosure responsibilities or obligations under the rules of 491.32 criminal procedure. 491.33 (b) Upon request of the legislative auditor, data on 491.34 individuals maintained under this section must be released to 491.35 the legislative auditor in order for the auditor to fulfill the 491.36 auditor's duties under section 3.971. The auditor shall 492.1 maintain the data in accordance with chapter 13. 492.2 Sec. 77. Minnesota Statutes 1998, section 626.556, 492.3 subdivision 11b, is amended to read: 492.4 Subd. 11b. [DATA RECEIVED FROM LAW ENFORCEMENT.] Active 492.5 law enforcement investigative data received by a local welfare 492.6 agency or agency responsible for assessing or investigating the 492.7 report under this section are confidential data on individuals. 492.8 When this data become inactive in the law enforcement agency, 492.9 the data are private data on individuals. 492.10 Sec. 78. Minnesota Statutes 1998, section 626.556, 492.11 subdivision 11c, is amended to read: 492.12 Subd. 11c. [WELFARE, COURT SERVICES AGENCY, AND SCHOOL 492.13 RECORDS MAINTAINED.] Notwithstanding sections 138.163 and 492.14 138.17, records maintained or records derived from reports of 492.15 abuse by local welfare agencies, agencies responsible for 492.16 assessing or investigating the report, court services agencies, 492.17 or schools under this section shall be destroyed as provided in 492.18 paragraphs (a) to (d) by the responsible authority. 492.19 (a) If upon assessment or investigation there is no 492.20 determination of maltreatment or the need for child protective 492.21 services, the records must be maintained for a period of four 492.22 years. Records under this paragraph may not be used for 492.23 employment, background checks, or purposes other than to assist 492.24 in future risk and safety assessments. 492.25 (b) All records relating to reports which, upon assessment 492.26 or investigation, indicate either maltreatment or a need for 492.27 child protective services shall be maintained for at least ten 492.28 years after the date of the final entry in the case record. 492.29 (c) All records regarding a report of maltreatment, 492.30 including any notification of intent to interview which was 492.31 received by a school under subdivision 10, paragraph (d), shall 492.32 be destroyed by the school when ordered to do so by the agency 492.33 conducting the assessment or investigation. The agency shall 492.34 order the destruction of the notification when other records 492.35 relating to the report under investigation or assessment are 492.36 destroyed under this subdivision. 493.1 (d) Private or confidential data released to a court 493.2 services agency under subdivision 10h must be destroyed by the 493.3 court services agency when ordered to do so by the local welfare 493.4 agency that released the data. The local welfare agency or 493.5 agency responsible for assessing or investigating the report 493.6 shall order destruction of the data when other records relating 493.7 to the assessment or investigation are destroyed under this 493.8 subdivision. 493.9 Sec. 79. Minnesota Statutes 1998, section 626.558, 493.10 subdivision 1, is amended to read: 493.11 Subdivision 1. [ESTABLISHMENT OF THE TEAM.] A county shall 493.12 establish a multidisciplinary child protection team that may 493.13 include, but not be limited to, the director of the local 493.14 welfare agency or designees, the county attorney or designees, 493.15 the county sheriff or designees, representatives of health and 493.16 education, representatives of mental health or other appropriate 493.17 human service or community-based agencies, and parent groups. 493.18 As used in this section, a "community-based agency" may include, 493.19 but is not limited to, schools, social service agencies, family 493.20 service and mental health collaboratives, early childhood and 493.21 family education programs, Head Start, or other agencies serving 493.22 children and families. A member of the team must be designated 493.23 as the lead person of the team responsible for coordinating its 493.24 activities with battered women's programs and services. 493.25 Sec. 80. [AMEND CHEMICAL DEPENDENCY ASSESSMENT CRITERIA.] 493.26 Subdivision 1. [CHILD PROTECTION.] The commissioner of 493.27 human services shall amend the assessment criteria under 493.28 Minnesota Rules, part 9530.6600, specifically Minnesota Rules, 493.29 part 9530.6615, to include assessment criteria that addresses 493.30 issues related to parents who have open child protection cases 493.31 due, in part, to chemical abuse. In amending this rule part, 493.32 the commissioner shall use the expedited rulemaking process 493.33 under Minnesota Statutes, section 14.389, and assure that 493.34 notification provisions are in accordance with federal law. 493.35 Subd. 2. [PREGNANCY.] The commissioner of human services 493.36 shall amend Minnesota Rules, part 9530.6605, to address 494.1 pregnancy as a risk factor in determining the need for chemical 494.2 dependency treatment. 494.3 Sec. 81. [REHABILITATION SERVICES OPTION FOR ADULTS WITH 494.4 MENTAL ILLNESS OR OTHER CONDITIONS.] 494.5 The commissioner of human services, in consultation with 494.6 the association of Minnesota counties and other stakeholders, 494.7 shall design a proposal to add rehabilitation services to the 494.8 state medical assistance plan for adults with mental illness or 494.9 other debilitating conditions, including, but not limited to, 494.10 chemical dependency. 494.11 Sec. 82. [TARGETED CASE MANAGEMENT FOR VULNERABLE ADULTS.] 494.12 The commissioner of human services, in consultation with 494.13 the association of Minnesota counties and other stakeholders, 494.14 shall design a proposal to provide medical assistance coverage 494.15 for targeted case management service activities for adults 494.16 receiving services through a county or state agency that are in 494.17 need of service coordination, including, but not limited to, 494.18 people age 65 and older; people in need of adult protective 494.19 services; people applying for financial assistance; people who 494.20 have chemical dependency; and other people who require community 494.21 social services under Minnesota Statutes, chapter 256E. 494.22 Sec. 83. [RECOMMENDATIONS TO THE LEGISLATURE.] 494.23 The commissioner of human services shall submit to the 494.24 legislature design and implementation recommendations for the 494.25 proposals required in sections 81 and 82, including draft 494.26 legislation, by January 15, 2000, for implementation by July 1, 494.27 2000. The proposals shall not include requirements for 494.28 maintenance of effort and expanded expenditures concerning 494.29 federal reimbursements earned in these programs. 494.30 Sec. 84. [INSTRUCTION TO REVISOR.] 494.31 The revisor of statutes shall delete the references to 494.32 Minnesota Statutes, section 260.181, and substitute a reference 494.33 to Minnesota Statutes, section 260.015, subdivision 13, in the 494.34 following sections: Minnesota Statutes, sections 245A.035, 494.35 subdivision 1; 257.071, subdivision 1; 260.191, subdivision 1d; 494.36 and 260.191, subdivision 1e. 495.1 Sec. 85. [REPEALER.] 495.2 Minnesota Statutes 1998, section 257.071, subdivisions 8 495.3 and 10, are repealed. 495.4 Sec. 86. [EFFECTIVE DATE.] 495.5 When preparing the conference committee report for adoption 495.6 by the legislature, the revisor shall combine all effective date 495.7 notations in this article into this effective date section. 495.8 ARTICLE 9 495.9 HEALTH OCCUPATIONS 495.10 Section 1. Minnesota Statutes 1998, section 13.99, 495.11 subdivision 38a, is amended to read: 495.12 Subd. 38a. [AMBULANCE SERVICE DATA.] Data required to be 495.13 reported by ambulance services under section144E.17,495.14subdivision 1,144E.123 are classified under that section. 495.15 Sec. 2. Minnesota Statutes 1998, section 13.99, is amended 495.16 by adding a subdivision to read: 495.17 Subd. 39b. [EMT, EMT-I, EMT-P, OR FIRST RESPONDER 495.18 MISCONDUCT.] Reports of emergency medical technician, emergency 495.19 medical technician-intermediate, emergency medical 495.20 technician-paramedic, or first responder misconduct are 495.21 classified under section 144E.305, subdivision 3. 495.22 Sec. 3. Minnesota Statutes 1998, section 144E.001, is 495.23 amended by adding a subdivision to read: 495.24 Subd. 1a. [ADVANCED AIRWAY MANAGEMENT.] "Advanced airway 495.25 management" means insertion of an endotracheal tube or creation 495.26 of a surgical airway. 495.27 Sec. 4. Minnesota Statutes 1998, section 144E.001, is 495.28 amended by adding a subdivision to read: 495.29 Subd. 1b. [ADVANCED LIFE SUPPORT.] "Advanced life support" 495.30 means rendering basic life support and rendering intravenous 495.31 therapy, drug therapy, intubation, and defibrillation as 495.32 outlined in the United States Department of Transportation 495.33 emergency medical technician-paramedic curriculum or its 495.34 equivalent, as approved by the board. 495.35 Sec. 5. Minnesota Statutes 1998, section 144E.001, is 495.36 amended by adding a subdivision to read: 496.1 Subd. 3a. [AMBULANCE SERVICE PERSONNEL.] "Ambulance 496.2 service personnel" means individuals who are authorized by a 496.3 licensed ambulance service to provide emergency care for the 496.4 ambulance service and are: 496.5 (1) EMTs, EMT-Is, or EMT-Ps; 496.6 (2) Minnesota registered nurses who are: (i) EMTs, are 496.7 currently practicing nursing, and have passed a paramedic 496.8 practical skills test, as approved by the board and administered 496.9 by a training program approved by the board; (ii) on the roster 496.10 of an ambulance service on or before January 1, 2000; or (iii) 496.11 after petitioning the board, deemed by the board to have 496.12 training and skills equivalent to an EMT, as determined on a 496.13 case-by-case basis; or 496.14 (3) Minnesota registered physician assistants who are: (i) 496.15 EMTs, are currently practicing as physician assistants, and have 496.16 passed a paramedic practical skills test, as approved by the 496.17 board and administered by a training program approved by the 496.18 board; (ii) on the roster of an ambulance service on or before 496.19 January 1, 2000; or (iii) after petitioning the board, deemed by 496.20 the board to have training and skills equivalent to an EMT, as 496.21 determined on a case-by-case basis. 496.22 Sec. 6. Minnesota Statutes 1998, section 144E.001, is 496.23 amended by adding a subdivision to read: 496.24 Subd. 4a. [BASIC AIRWAY MANAGEMENT.] "Basic airway 496.25 management" means: 496.26 (1) resuscitation by mouth-to-mouth, mouth-to-mask, bag 496.27 valve mask, or oxygen powered ventilators; or 496.28 (2) insertion of an oropharyngeal, nasal pharyngeal, 496.29 esophageal obturator airway, esophageal tracheal airway, or 496.30 esophageal gastric tube airway. 496.31 Sec. 7. Minnesota Statutes 1998, section 144E.001, is 496.32 amended by adding a subdivision to read: 496.33 Subd. 4b. [BASIC LIFE SUPPORT.] "Basic life support" means 496.34 rendering basic-level emergency care, including, but not limited 496.35 to, basic airway management, cardiopulmonary resuscitation, 496.36 controlling shock and bleeding, and splinting fractures, as 497.1 outlined in the United States Department of Transportation 497.2 emergency medical technician-basic curriculum or its equivalent, 497.3 as approved by the board. 497.4 Sec. 8. Minnesota Statutes 1998, section 144E.001, is 497.5 amended by adding a subdivision to read: 497.6 Subd. 5a. [CLINICAL TRAINING SITE.] "Clinical training 497.7 site" means a licensed health care facility. 497.8 Sec. 9. Minnesota Statutes 1998, section 144E.001, is 497.9 amended by adding a subdivision to read: 497.10 Subd. 5b. [DEFIBRILLATOR.] "Defibrillator" means an 497.11 automatic, semiautomatic, or manual device that delivers an 497.12 electric shock at a preset voltage to the myocardium through the 497.13 chest wall and that is used to restore the normal cardiac rhythm 497.14 and rate when the heart has stopped beating or is fibrillating. 497.15 Sec. 10. Minnesota Statutes 1998, section 144E.001, is 497.16 amended by adding a subdivision to read: 497.17 Subd. 5c. [EMERGENCY MEDICAL TECHNICIAN OR EMT.] 497.18 "Emergency medical technician" or "EMT" means a person who has 497.19 successfully completed the United States Department of 497.20 Transportation emergency medical technician-basic course or its 497.21 equivalent, as approved by the board, and has been issued valid 497.22 certification by the board. 497.23 Sec. 11. Minnesota Statutes 1998, section 144E.001, is 497.24 amended by adding a subdivision to read: 497.25 Subd. 5d. [EMERGENCY MEDICAL TECHNICIAN-INTERMEDIATE OR 497.26 EMT-I.] "Emergency medical technician-intermediate" or "EMT-I" 497.27 means a person who has successfully completed the United States 497.28 Department of Transportation emergency medical 497.29 technician-intermediate course or its equivalent, as approved by 497.30 the board, and has been issued valid certification by the board. 497.31 Sec. 12. Minnesota Statutes 1998, section 144E.001, is 497.32 amended by adding a subdivision to read: 497.33 Subd. 5e. [EMERGENCY MEDICAL TECHNICIAN-PARAMEDIC OR 497.34 EMT-P.] "Emergency medical technician-paramedic" or "EMT-P" 497.35 means a person who has successfully completed the United States 497.36 Department of Transportation emergency medical technician 498.1 course-paramedic or its equivalent, as approved by the board, 498.2 and has been issued valid certification by the board. 498.3 Sec. 13. Minnesota Statutes 1998, section 144E.001, is 498.4 amended by adding a subdivision to read: 498.5 Subd. 5f. [EMERGENCY MEDICAL TECHNICIAN INSTRUCTOR.] 498.6 "Emergency medical technician instructor" means a person who has 498.7 been certified by the board to teach an EMT, EMT-I, or EMT-P 498.8 course. 498.9 Sec. 14. Minnesota Statutes 1998, section 144E.001, is 498.10 amended by adding a subdivision to read: 498.11 Subd. 8a. [MEDICAL CONTROL.] "Medical control" means 498.12 direction by a physician or a physician's designee of 498.13 out-of-hospital emergency medical care. 498.14 Sec. 15. Minnesota Statutes 1998, section 144E.001, is 498.15 amended by adding a subdivision to read: 498.16 Subd. 9a. [PART-TIME ADVANCED LIFE SUPPORT.] "Part-time 498.17 advanced life support" means rendering basic life support and 498.18 advanced life support for less than 24 hours of every day. 498.19 Sec. 16. Minnesota Statutes 1998, section 144E.001, is 498.20 amended by adding a subdivision to read: 498.21 Subd. 9b. [PHYSICIAN.] "Physician" means a person licensed 498.22 to practice medicine under chapter 147. 498.23 Sec. 17. Minnesota Statutes 1998, section 144E.001, is 498.24 amended by adding a subdivision to read: 498.25 Subd. 9c. [PHYSICIAN ASSISTANT.] "Physician assistant" 498.26 means a person registered to practice as a physician assistant 498.27 under chapter 147A. 498.28 Sec. 18. Minnesota Statutes 1998, section 144E.001, is 498.29 amended by adding a subdivision to read: 498.30 Subd. 9d. [PREHOSPITAL CARE DATA.] "Prehospital care data" 498.31 means information collected by ambulance service personnel about 498.32 the circumstances related to an emergency response and patient 498.33 care activities provided by the ambulance service personnel in a 498.34 prehospital setting. 498.35 Sec. 19. Minnesota Statutes 1998, section 144E.001, is 498.36 amended by adding a subdivision to read: 499.1 Subd. 11. [PROGRAM MEDICAL DIRECTOR.] "Program medical 499.2 director" means a physician who is responsible for ensuring an 499.3 accurate and thorough presentation of the medical content of an 499.4 emergency care training program; certifying that each student 499.5 has successfully completed the training course; and in 499.6 conjunction with the program coordinator, planning the clinical 499.7 training. 499.8 Sec. 20. Minnesota Statutes 1998, section 144E.001, is 499.9 amended by adding a subdivision to read: 499.10 Subd. 12. [REGISTERED NURSE.] "Registered nurse" means a 499.11 person licensed to practice professional nursing under chapter 499.12 148. 499.13 Sec. 21. Minnesota Statutes 1998, section 144E.001, is 499.14 amended by adding a subdivision to read: 499.15 Subd. 13. [STANDING ORDER.] "Standing order" means a type 499.16 of medical protocol that provides specific, written orders for 499.17 actions, techniques, or drug administration when communication 499.18 has not been established for direct medical control. 499.19 Sec. 22. Minnesota Statutes 1998, section 144E.001, is 499.20 amended by adding a subdivision to read: 499.21 Subd. 14. [TRAINING PROGRAM COORDINATOR.] "Training 499.22 program coordinator" means an individual who serves as the 499.23 administrator of an emergency care training program and who is 499.24 responsible for planning, conducting, and evaluating the 499.25 program; selecting students and certified instructors; 499.26 documenting and maintaining records; developing a curriculum; 499.27 and assisting in the coordination of examination sessions and 499.28 clinical training. 499.29 Sec. 23. Minnesota Statutes 1998, section 144E.10, 499.30 subdivision 1, is amended to read: 499.31 Subdivision 1. [LICENSE REQUIRED.] No natural person, 499.32 partnership, association, corporation, or unit of government may 499.33 operate an ambulance service within this state unless it 499.34 possesses a valid license to do so issued by the board. The 499.35 license shall specify the base of operations, the primary 499.36 service area, and the type or types of ambulance service for 500.1 which the licensee is licensed. The licensee shall obtain a new 500.2 license if it wishes to expand its primary service area, or to 500.3 provide a new type or types of service.The cost of licenses500.4shall be in an amount prescribed by the board pursuant to500.5section 144E.05. Licenses shall expire and be renewed in500.6accordance with rules adopted by the board.500.7 Sec. 24. [144E.101] [AMBULANCE SERVICE REQUIREMENTS.] 500.8 Subdivision 1. [PERSONNEL.] (a) No publicly or privately 500.9 owned ambulance service shall be operated in the state unless 500.10 its ambulance service personnel are certified, appropriate to 500.11 the type of ambulance service being provided, according to 500.12 section 144E.28 or meet the staffing criteria specific to the 500.13 type of ambulance service. 500.14 (b) An ambulance service shall have a medical director as 500.15 provided under section 144E.265. 500.16 Subd. 2. [PATIENT CARE.] When a patient is being 500.17 transported, at least one of the ambulance service personnel 500.18 must be in the patient compartment. If advanced life support 500.19 procedures are required, an EMT-P, a registered nurse qualified 500.20 under section 144E.001, subdivision 3a, clause (2), item (i), or 500.21 a physician assistant qualified under section 144E.001, 500.22 subdivision 3a, clause (3), item (i), shall be in the patient 500.23 compartment. 500.24 Subd. 3. [CONTINUAL SERVICE.] An ambulance service shall 500.25 offer service 24 hours per day every day of the year, unless 500.26 otherwise authorized under subdivisions 8 and 9. 500.27 Subd. 4. [DENIAL OF SERVICE PROHIBITED.] An ambulance 500.28 service shall not deny prehospital care to a person needing 500.29 emergency ambulance service because of inability to pay or 500.30 because of the source of payment for services if the need 500.31 develops within the licensee's primary service area or when 500.32 responding to a mutual aid call. Transport for the patient may 500.33 be limited to the closest appropriate emergency medical facility. 500.34 Subd. 5. [TYPES OF SERVICE.] The board shall regulate the 500.35 following types of ambulance service: 500.36 (1) basic life support; 501.1 (2) advanced life support; 501.2 (3) part-time advanced life support; and 501.3 (4) specialized life support. 501.4 Subd. 6. [BASIC LIFE SUPPORT.] (a) A basic life support 501.5 ambulance shall be staffed by at least two ambulance service 501.6 personnel, at least one of which must be an EMT, who provide a 501.7 level of care so as to ensure that: 501.8 (1) life-threatening situations and potentially serious 501.9 injuries are recognized; 501.10 (2) patients are protected from additional hazards; 501.11 (3) basic treatment to reduce the seriousness of emergency 501.12 situations is administered; and 501.13 (4) patients are transported to an appropriate medical 501.14 facility for treatment. 501.15 (b) A basic life support service shall provide basic airway 501.16 management. 501.17 (c) By January 1, 2001, a basic life support service shall 501.18 provide automatic defibrillation, as provided in section 501.19 144E.103, subdivision 1, paragraph (b). 501.20 (d) A basic life support service licensee's medical 501.21 director may authorize the ambulance service personnel to carry 501.22 and to use medical antishock trousers and to perform intravenous 501.23 infusion if the ambulance service personnel have been properly 501.24 trained. 501.25 Subd. 7. [ADVANCED LIFE SUPPORT.] (a) An advanced life 501.26 support ambulance shall be staffed by at least: 501.27 (1) one EMT and one EMT-P; 501.28 (2) one EMT and one registered nurse who is an EMT, is 501.29 currently practicing nursing, and has passed a paramedic 501.30 practical skills test approved by the board and administered by 501.31 a training program; or 501.32 (3) one EMT and one physician assistant who is an EMT, is 501.33 currently practicing as a physician assistant, and has passed a 501.34 paramedic practical skills test approved by the board and 501.35 administered by a training program. 501.36 (b) An advanced life support service shall provide basic 502.1 life support, as specified under subdivision 6, paragraph (a), 502.2 advanced airway management, manual defibrillation, and 502.3 administration of intravenous fluids and pharmaceuticals. 502.4 (c) In addition to providing advanced life support, an 502.5 advanced life support service may staff additional ambulances to 502.6 provide basic life support according to subdivision 6. When 502.7 routinely staffed and equipped as a basic life support service 502.8 according to subdivision 6 and section 144E.103, subdivision 1, 502.9 the vehicle shall not be marked as advanced life support. 502.10 (d) An ambulance service providing advanced life support 502.11 shall have a written agreement with its medical director to 502.12 ensure medical control for patient care 24 hours a day, seven 502.13 days a week. The terms of the agreement shall include a written 502.14 policy on the administration of medical control for the 502.15 service. The policy shall address the following issues: 502.16 (i) two-way communication for physician direction of 502.17 ambulance service personnel; 502.18 (ii) patient triage, treatment, and transport; 502.19 (iii) use of standing orders; and 502.20 (iv) the means by which medical control will be provided 24 502.21 hours a day. 502.22 The agreement shall be signed by the licensee's medical 502.23 director and the licensee or the licensee's designee and 502.24 maintained in the files of the licensee. 502.25 (e) When an ambulance service provides advanced life 502.26 support, the authority of an EMT-P, Minnesota registered 502.27 nurse-EMT, or Minnesota registered physician assistant-EMT to 502.28 determine the delivery of patient care prevails over the 502.29 authority of an EMT. 502.30 Subd. 8. [PART-TIME ADVANCED LIFE SUPPORT.] (a) A 502.31 part-time advanced life support service shall meet the staffing 502.32 requirements under subdivision 7, paragraph (a); provide service 502.33 as required under subdivision 7, paragraph (b), for less than 24 502.34 hours every day; and meet the equipment requirements specified 502.35 in section 144E.103. 502.36 (b) A part-time advanced life support service shall have a 503.1 written agreement with its medical director to ensure medical 503.2 control for patient care during the time the service offers 503.3 advanced life support. The terms of the agreement shall include 503.4 a written policy on the administration of medical control for 503.5 the service and address the issues specified in subdivision 7, 503.6 paragraph (d). 503.7 Subd. 9. [SPECIALIZED LIFE SUPPORT.] A specialized life 503.8 support service shall provide basic or advanced life support as 503.9 designated by the board, and shall be restricted by the board to: 503.10 (1) operation less than 24 hours of every day; 503.11 (2) designated segments of the population; 503.12 (3) certain types of medical conditions; or 503.13 (4) air ambulance service that includes fixed-wing and 503.14 rotor-wing. 503.15 Subd. 10. [DRIVER.] A driver of an ambulance must possess 503.16 a current driver's license issued by any state and must have 503.17 attended an emergency vehicle driving course approved by the 503.18 licensee. The emergency vehicle driving course must include 503.19 actual driving experience. 503.20 Subd. 11. [PERSONNEL ROSTER AND FILES.] (a) An ambulance 503.21 service shall maintain: 503.22 (1) at least two ambulance service personnel on a written 503.23 on-call schedule; 503.24 (2) a current roster of its ambulance service personnel, 503.25 including the name, address, and qualifications of its ambulance 503.26 service personnel; and 503.27 (3) files documenting personnel qualifications. 503.28 (b) A licensee shall maintain in its files the name and 503.29 address of its medical director and a written statement signed 503.30 by the medical director indicating acceptance of the 503.31 responsibilities specified in section 144E.265, subdivision 2. 503.32 Subd. 12. [MUTUAL AID AGREEMENT.] A licensee shall have a 503.33 written agreement with at least one neighboring licensed 503.34 ambulance service for coverage during times when the licensee's 503.35 ambulances are not available for service in its primary service 503.36 area. The agreement must specify the duties and 504.1 responsibilities of the agreeing parties. A copy of each mutual 504.2 aid agreement shall be maintained in the files of the licensee. 504.3 Subd. 13. [SERVICE OUTSIDE PRIMARY SERVICE AREA.] A 504.4 licensee may provide its services outside of its primary service 504.5 area only if requested by a transferring physician or ambulance 504.6 service licensed to provide service in the primary service area 504.7 when it can reasonably be expected that: 504.8 (1) the response is required by the immediate medical need 504.9 of an individual; and 504.10 (2) the ambulance service licensed to provide service in 504.11 the primary service area is unavailable for appropriate response. 504.12 Sec. 25. [144E.103] [EQUIPMENT.] 504.13 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Every ambulance 504.14 in service for patient care shall carry, at a minimum: 504.15 (1) oxygen; 504.16 (2) airway maintenance equipment in various sizes to 504.17 accommodate all age groups; 504.18 (3) splinting equipment in various sizes to accommodate all 504.19 age groups; 504.20 (4) dressings, bandages, and bandaging equipment; 504.21 (5) an emergency obstetric kit; 504.22 (6) equipment to determine vital signs in various sizes to 504.23 accommodate all age groups; 504.24 (7) a stretcher; 504.25 (8) a defibrillator; and 504.26 (9) a fire extinguisher. 504.27 (b) A basic life support service has until January 1, 2000, 504.28 to equip each ambulance in service for patient care with a 504.29 defibrillator. 504.30 Subd. 2. [ADVANCED LIFE SUPPORT REQUIREMENTS.] In addition 504.31 to the requirements in subdivision 1, an ambulance used in 504.32 providing advanced life support must carry drugs and drug 504.33 administration equipment and supplies as approved by the 504.34 licensee's medical director. 504.35 Subd. 3. [STORAGE.] All equipment carried in an ambulance 504.36 must be securely stored. 505.1 Subd. 4. [SAFETY RESTRAINTS.] An ambulance must be 505.2 equipped with safety straps for the stretcher and seat belts in 505.3 the patient compartment for the patient and ambulance personnel. 505.4 Sec. 26. Minnesota Statutes 1998, section 144E.11, is 505.5 amended by adding a subdivision to read: 505.6 Subd. 9. [RENEWAL REQUIREMENTS.] An ambulance service 505.7 license expires two years from the date of licensure. An 505.8 ambulance service must apply to the board for license renewal at 505.9 least one month prior to the expiration date of the license and 505.10 must submit: 505.11 (1) an application prescribed by the board specifying any 505.12 changes from the information provided for prior licensure and 505.13 any other information requested by the board to clarify 505.14 incomplete or ambiguous information presented in the 505.15 application; and 505.16 (2) the appropriate fee as required under section 144E.29. 505.17 Sec. 27. [144E.121] [AIR AMBULANCE SERVICE REQUIREMENTS.] 505.18 Subdivision 1. [AVIATION COMPLIANCE.] An air ambulance 505.19 service must comply with the regulations of the Federal Aviation 505.20 Administration and the rules of the Minnesota department of 505.21 transportation, aeronautics division. 505.22 Subd. 2. [PERSONNEL.] (a) With the exception of pilots, 505.23 each of the air ambulance emergency medical personnel must: 505.24 (1) possess current certification, appropriate to the type 505.25 of ambulance service being provided, according to section 505.26 144E.28, be a registered nurse, or be a physician assistant; and 505.27 (2) be trained to use the equipment on the air ambulance. 505.28 (b) Emergency medical personnel for an air ambulance 505.29 service must receive training approved by the licensee's medical 505.30 director that includes instruction in the physiological changes 505.31 due to decreased atmospheric pressure, acceleration, vibration, 505.32 and changes in altitude; medical conditions requiring special 505.33 precautions; and contraindications to air transport. 505.34 (c) A licensee's medical director must sign and file a 505.35 statement with the licensee that each of its emergency medical 505.36 personnel has successfully completed the training under 506.1 paragraph (b). 506.2 (d) A licensee shall retain documentation of compliance 506.3 with this subdivision in its files. 506.4 Subd. 3. [EQUIPMENT.] An air ambulance must carry 506.5 equipment appropriate to the level of service being provided. 506.6 Equipment that is not permanently stored on or in an air 506.7 ambulance must be kept separate from the air ambulance in a 506.8 modular prepackaged form. 506.9 Sec. 28. [144E.123] [PREHOSPITAL CARE DATA.] 506.10 Subdivision 1. [COLLECTION AND MAINTENANCE.] A licensee 506.11 shall collect and provide prehospital care data to the board in 506.12 a manner prescribed by the board. At a minimum, the data must 506.13 include items identified by the board that are part of the 506.14 National Uniform Emergency Medical Services Data Set. A 506.15 licensee shall maintain prehospital care data for every response. 506.16 Subd. 2. [COPY TO RECEIVING HOSPITAL.] If a patient is 506.17 transported to a hospital, a copy of the ambulance report 506.18 delineating prehospital medical care given shall be provided to 506.19 the receiving hospital. 506.20 Subd. 3. [REVIEW.] Prehospital care data may be reviewed 506.21 by the board or its designees. The data shall be classified as 506.22 private data on individuals under chapter 13, the Minnesota 506.23 Government Data Practices Act. 506.24 Subd. 4. [PENALTY.] Failure to report all information 506.25 required by the board under this section shall constitute 506.26 grounds for license revocation. 506.27 Sec. 29. [144E.125] [OPERATIONAL PROCEDURES.] 506.28 A licensee shall establish and implement written procedures 506.29 for responding to ambulance service complaints, maintaining 506.30 ambulances and equipment, procuring and storing drugs, and 506.31 controlling infection. The licensee shall maintain the 506.32 procedures in its files. 506.33 Sec. 30. [144E.127] [INTERHOSPITAL TRANSFER.] 506.34 When transporting a patient from one licensed hospital to 506.35 another, a licensee may substitute for one of the required 506.36 ambulance service personnel, a physician, a registered nurse, or 507.1 physician's assistant who has been trained to use the equipment 507.2 in the ambulance and is knowledgeable of the licensee's 507.3 ambulance service protocols. 507.4 Sec. 31. Minnesota Statutes 1998, section 144E.16, 507.5 subdivision 4, is amended to read: 507.6 Subd. 4. [TYPES OF SERVICES TO BE REGULATED.](a)The 507.7 board may adopt rules needed to regulate ambulance services in 507.8 the following areas: 507.9 (1) applications for licensure; 507.10 (2) personnel qualifications and staffing standards; 507.11 (3) quality of life support treatment; 507.12 (4) restricted treatments and procedures; 507.13 (5) equipment standards; 507.14 (6) ambulance standards; 507.15 (7) communication standards, equipment performance and 507.16 maintenance, and radio frequency assignments; 507.17 (8) advertising; 507.18 (9) scheduled ambulance services; 507.19 (10) ambulance services in time of disaster; 507.20 (11) basic, intermediate, advanced, and refresher emergency 507.21 care course programs; 507.22 (12) continuing education requirements; 507.23 (13) trip reports; 507.24 (14) license fees, vehicle fees, and expiration dates; and 507.25 (15) waivers and variances. 507.26(b) These rules shall apply to the following types of507.27ambulance service:507.28(1) basic ambulance service that provides a level of care507.29to ensure that life-threatening situations and potentially507.30serious injuries can be recognized, patients will be protected507.31from additional hazards, basic treatment to reduce the507.32seriousness of emergency situations will be administered, and507.33patients will be transported to an appropriate medical facility507.34for treatment;507.35(2) intermediate ambulance service that provides (i) basic507.36ambulance service, and (ii) intravenous infusions or508.1defibrillation or both;508.2(3) advanced ambulance service that provides (i) basic508.3ambulance service, and (ii) advanced airway management,508.4defibrillation, and administration of intravenous fluids and508.5pharmaceuticals. Vehicles of advanced ambulance service508.6licensees not equipped or staffed at the advanced ambulance508.7service level shall not be identified to the public as capable508.8of providing advanced ambulance service;508.9(4) specialized ambulance service that provides basic,508.10intermediate, or advanced service as designated by the board,508.11and is restricted by the board to (i) less than 24 hours of508.12every day, (ii) designated segments of the population, or (iii)508.13certain types of medical conditions; and508.14(5) air ambulance service, that includes fixed-wing and508.15helicopter, and is specialized ambulance service.508.16Until rules are promulgated, the current provisions of508.17Minnesota Rules shall govern these services.508.18 Sec. 32. Minnesota Statutes 1998, section 144E.18, is 508.19 amended to read: 508.20 144E.18 [INSPECTIONS.] 508.21 The board may inspect ambulance services as frequently as 508.22 deemed necessary to determine whether an ambulance service is in 508.23 compliance with sections 144E.001 to 144E.33 and rules adopted 508.24 under those sections.These inspections shall be for the508.25purpose of determining whether the ambulance and equipment is508.26clean and in proper working order and whether the operator is in508.27compliance with sections 144E.001 to 144E.16 and any rules that508.28the board adopts related to sections 144E.001 to 144E.16.The 508.29 board may review at any time documentation required to be on 508.30 file with a licensee. 508.31 Sec. 33. [144E.19] [DISCIPLINARY ACTION.] 508.32 Subdivision 1. [SUSPENSION; REVOCATION; NONRENEWAL.] The 508.33 board may suspend, revoke, refuse to renew, or place conditions 508.34 on the license of a licensee upon finding that the licensee has 508.35 violated a provision of this chapter or rules adopted under this 508.36 chapter or has ceased to provide the service for which the 509.1 licensee is licensed. 509.2 Subd. 2. [NOTICE; CONTESTED CASE.] (a) Before taking 509.3 action under subdivision 1, the board shall give notice to a 509.4 licensee of the right to a contested case hearing under chapter 509.5 14. If a licensee requests a contested case hearing within 30 509.6 days after receiving notice, the board shall initiate a 509.7 contested case hearing according to chapter 14. 509.8 (b) The administrative law judge shall issue a report and 509.9 recommendation within 30 days after closing the contested case 509.10 hearing record. The board shall issue a final order within 30 509.11 days after receipt of the administrative law judge's report. 509.12 Subd. 3. [TEMPORARY SUSPENSION.] (a) In addition to any 509.13 other remedy provided by law, the board may temporarily suspend 509.14 the license of a licensee after conducting a preliminary inquiry 509.15 to determine whether the board believes that the licensee has 509.16 violated a statute or rule that the board is empowered to 509.17 enforce and determining that the continued provision of service 509.18 by the licensee would create an imminent risk to public health 509.19 or harm to others. 509.20 (b) A temporary suspension order prohibiting a licensee 509.21 from providing ambulance service shall give notice of the right 509.22 to a preliminary hearing according to paragraph (d) and shall 509.23 state the reasons for the entry of the temporary suspension 509.24 order. 509.25 (c) Service of a temporary suspension order is effective 509.26 when the order is served on the licensee personally or by 509.27 certified mail, which is complete upon receipt, refusal, or 509.28 return for nondelivery to the most recent address provided to 509.29 the board for the licensee. 509.30 (d) At the time the board issues a temporary suspension 509.31 order, the board shall schedule a hearing, to be held before a 509.32 group of its members designated by the board, that shall begin 509.33 within 60 days after issuance of the temporary suspension order 509.34 or within 15 working days of the date of the board's receipt of 509.35 a request for a hearing from a licensee, whichever is sooner. 509.36 The hearing shall be on the sole issue of whether there is a 510.1 reasonable basis to continue, modify, or lift the temporary 510.2 suspension. A hearing under this paragraph is not subject to 510.3 chapter 14. 510.4 (e) Evidence presented by the board or licensee may be in 510.5 the form of an affidavit. The licensee or the licensee's 510.6 designee may appear for oral argument. 510.7 (f) Within five working days of the hearing, the board 510.8 shall issue its order and, if the suspension is continued, 510.9 notify the licensee of the right to a contested case hearing 510.10 under chapter 14. 510.11 (g) If a licensee requests a contested case hearing within 510.12 30 days after receiving notice under paragraph (f), the board 510.13 shall initiate a contested case hearing according to chapter 14. 510.14 The administrative law judge shall issue a report and 510.15 recommendation within 30 days after the closing of the contested 510.16 case hearing record. The board shall issue a final order within 510.17 30 days after receipt of the administrative law judge's report. 510.18 Sec. 34. [144E.265] [MEDICAL DIRECTOR.] 510.19 Subdivision 1. [REQUIREMENTS.] A medical director shall: 510.20 (1) be currently licensed as a physician in this state; 510.21 (2) have experience in, and knowledge of, emergency care of 510.22 acutely ill or traumatized patients; and 510.23 (3) be familiar with the design and operation of local, 510.24 regional, and state emergency medical service systems. 510.25 Subd. 2. [RESPONSIBILITIES.] Responsibilities of the 510.26 medical director shall include, but are not limited to: 510.27 (1) approving standards for training and orientation of 510.28 personnel that impact patient care; 510.29 (2) approving standards for purchasing equipment and 510.30 supplies that impact patient care; 510.31 (3) establishing standing orders for prehospital care; 510.32 (4) approving triage, treatment, and transportation 510.33 protocols; 510.34 (5) participating in the development and operation of 510.35 continuous quality improvement programs including, but not 510.36 limited to, case review and resolution of patient complaints; 511.1 (6) establishing procedures for the administration of 511.2 drugs; and 511.3 (7) maintaining the quality of care according to the 511.4 standards and procedures established under clauses (1) to (6). 511.5 Subd. 3. [ANNUAL ASSESSMENT; AMBULANCE SERVICE.] Annually, 511.6 the medical director or the medical director's designee shall 511.7 assess the practical skills of each person on the ambulance 511.8 service roster and sign a statement verifying the proficiency of 511.9 each person. The statements shall be maintained in the 511.10 licensee's files. 511.11 Sec. 35. Minnesota Statutes 1998, section 144E.27, is 511.12 amended by adding a subdivision to read: 511.13 Subd. 5. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 511.14 may deny, suspend, revoke, place conditions on, or refuse to 511.15 renew the registration of an individual who the board determines: 511.16 (1) violates sections 144E.001 to 144E.33 or the rules 511.17 adopted under those sections; 511.18 (2) misrepresents or falsifies information on an 511.19 application form for registration; 511.20 (3) is convicted or pleads guilty or nolo contendere to any 511.21 felony; any gross misdemeanor relating to assault, sexual 511.22 misconduct, or the illegal use of drugs or alcohol; or any 511.23 misdemeanor relating to sexual misconduct or the illegal use of 511.24 drugs or alcohol; 511.25 (4) is actually or potentially unable to provide emergency 511.26 medical services with reasonable skill and safety to patients by 511.27 reason of illness, use of alcohol, drugs, chemicals, or any 511.28 other material, or as a result of any mental or physical 511.29 condition; 511.30 (5) engages in unethical conduct, including, but not 511.31 limited to, conduct likely to deceive, defraud, or harm the 511.32 public, or demonstrating a willful or careless disregard for the 511.33 health, welfare, or safety of the public; or 511.34 (6) maltreats or abandons a patient. 511.35 (b) Before taking action under paragraph (a), the board 511.36 shall give notice to an individual of the right to a contested 512.1 case hearing under chapter 14. If an individual requests a 512.2 contested case hearing within 30 days after receiving notice, 512.3 the board shall initiate a contested case hearing according to 512.4 chapter 14. 512.5 (c) The administrative law judge shall issue a report and 512.6 recommendation within 30 days after closing the contested case 512.7 hearing record. The board shall issue a final order within 30 512.8 days after receipt of the administrative law judge's report. 512.9 (d) After six months from the board's decision to deny, 512.10 revoke, place conditions on, or refuse renewal of an 512.11 individual's registration for disciplinary action, the 512.12 individual shall have the opportunity to apply to the board for 512.13 reinstatement. 512.14 Sec. 36. Minnesota Statutes 1998, section 144E.27, is 512.15 amended by adding a subdivision to read: 512.16 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 512.17 other remedy provided by law, the board may temporarily suspend 512.18 the registration of an individual after conducting a preliminary 512.19 inquiry to determine whether the board believes that the 512.20 individual has violated a statute or rule that the board is 512.21 empowered to enforce and determining that the continued 512.22 provision of service by the individual would create an imminent 512.23 risk to public health or harm to others. 512.24 (b) A temporary suspension order prohibiting an individual 512.25 from providing emergency medical care shall give notice of the 512.26 right to a preliminary hearing according to paragraph (d) and 512.27 shall state the reasons for the entry of the temporary 512.28 suspension order. 512.29 (c) Service of a temporary suspension order is effective 512.30 when the order is served on the individual personally or by 512.31 certified mail, which is complete upon receipt, refusal, or 512.32 return for nondelivery to the most recent address provided to 512.33 the board for the individual. 512.34 (d) At the time the board issues a temporary suspension 512.35 order, the board shall schedule a hearing, to be held before a 512.36 group of its members designated by the board, that shall begin 513.1 within 60 days after issuance of the temporary suspension order 513.2 or within 15 working days of the date of the board's receipt of 513.3 a request for a hearing from the individual, whichever is 513.4 sooner. The hearing shall be on the sole issue of whether there 513.5 is a reasonable basis to continue, modify, or lift the temporary 513.6 suspension. A hearing under this paragraph is not subject to 513.7 chapter 14. 513.8 (e) Evidence presented by the board or the individual may 513.9 be in the form of an affidavit. The individual or the 513.10 individual's designee may appear for oral argument. 513.11 (f) Within five working days of the hearing, the board 513.12 shall issue its order and, if the suspension is continued, 513.13 notify the individual of the right to a contested case hearing 513.14 under chapter 14. 513.15 (g) If an individual requests a contested case hearing 513.16 within 30 days after receiving notice under paragraph (f), the 513.17 board shall initiate a contested case hearing according to 513.18 chapter 14. The administrative law judge shall issue a report 513.19 and recommendation within 30 days after the closing of the 513.20 contested case hearing record. The board shall issue a final 513.21 order within 30 days after receipt of the administrative law 513.22 judge's report. 513.23 Sec. 37. [144E.28] [CERTIFICATION OF EMT, EMT-I, AND 513.24 EMT-P.] 513.25 Subdivision 1. [REQUIREMENTS.] To be eligible for 513.26 certification by the board as an EMT, EMT-I, or EMT-P, an 513.27 individual shall: 513.28 (1) successfully complete the United States Department of 513.29 Transportation course, or its equivalent as approved by the 513.30 board, specific to the EMT, EMT-I, or EMT-P classification; 513.31 (2) pass the written and practical examinations approved by 513.32 the board and administered by the board or its designee, 513.33 specific to the EMT, EMT-I, or EMT-P classification; and 513.34 (3) submit the appropriate fee as required under section 513.35 144E.29. 513.36 Subd. 2. [EXPIRATION DATES.] Certification expiration 514.1 dates are as follows: 514.2 (1) for initial certification granted between January 1 and 514.3 June 30 of an even-numbered year, the expiration date is March 514.4 31 of the next even-numbered year; 514.5 (2) for initial certification granted between July 1 and 514.6 December 31 of an even-numbered year, the expiration date is 514.7 March 31 of the second odd-numbered year; 514.8 (3) for initial certification granted between January 1 and 514.9 June 30 of an odd-numbered year, the expiration date is March 31 514.10 of the next odd-numbered year; and 514.11 (4) for initial certification granted between July 1 and 514.12 December 31 of an odd-numbered year, the expiration date is 514.13 March 31 of the second even-numbered year. 514.14 Subd. 3. [RECIPROCITY.] The board may certify an 514.15 individual who possesses a current National Registry of 514.16 Emergency Medical Technicians registration from another 514.17 jurisdiction and submits the appropriate fee as required under 514.18 section 144E.29. The board certification classification shall 514.19 be the same as the National Registry's classification. 514.20 Certification shall be for the duration of the applicant's 514.21 registration period in another jurisdiction, not to exceed two 514.22 years. 514.23 Subd. 4. [FORMS OF DISCIPLINARY ACTION.] When the board 514.24 finds that a person certified under this section has violated a 514.25 provision or provisions of subdivision 5, it may do one or more 514.26 of the following: 514.27 (1) revoke the certification; 514.28 (2) suspend the certification; 514.29 (3) refuse to renew the certification; 514.30 (4) impose limitations or conditions on the person's 514.31 performance of regulated duties, including the imposition of 514.32 retraining or rehabilitation requirements; the requirement to 514.33 work under supervision; or the conditioning of continued 514.34 practice on demonstration of knowledge or skills by appropriate 514.35 examination or other review of skill and competence; 514.36 (5) order the person to provide unremunerated professional 515.1 service under supervision at a designated public hospital, 515.2 clinic, or other health care institution; or 515.3 (6) censure or reprimand the person. 515.4 Subd. 5. [DENIAL, SUSPENSION, REVOCATION.] (a) The board 515.5 may take any action authorized in subdivision 4 against an 515.6 individual who the board determines: 515.7 (1) violates sections 144E.001 to 144E.33 or the rules 515.8 adopted under those sections; 515.9 (2) misrepresents or falsifies information on an 515.10 application form for certification; 515.11 (3) is convicted or pleads guilty or nolo contendere to any 515.12 felony; any gross misdemeanor relating to assault, sexual 515.13 misconduct, or the illegal use of drugs or alcohol; or any 515.14 misdemeanor relating to sexual misconduct or the illegal use of 515.15 drugs or alcohol; 515.16 (4) is actually or potentially unable to provide emergency 515.17 medical services with reasonable skill and safety to patients by 515.18 reason of illness, use of alcohol, drugs, chemicals, or any 515.19 other material, or as a result of any mental or physical 515.20 condition; 515.21 (5) engages in unethical conduct, including, but not 515.22 limited to, conduct likely to deceive, defraud, or harm the 515.23 public or demonstrating a willful or careless disregard for the 515.24 health, welfare, or safety of the public; or 515.25 (6) maltreats or abandons a patient. 515.26 (b) Before taking action under paragraph (a), the board 515.27 shall give notice to an individual of the right to a contested 515.28 case hearing under chapter 14. If an individual requests a 515.29 contested case hearing within 30 days after receiving notice, 515.30 the board shall initiate a contested case hearing according to 515.31 chapter 14 and no disciplinary action shall be taken at that 515.32 time. 515.33 (c) The administrative law judge shall issue a report and 515.34 recommendation within 30 days after closing the contested case 515.35 hearing record. The board shall issue a final order within 30 515.36 days after receipt of the administrative law judge's report. 516.1 (d) After six months from the board's decision to deny, 516.2 revoke, place conditions on, or refuse renewal of an 516.3 individual's certification for disciplinary action, the 516.4 individual shall have the opportunity to apply to the board for 516.5 reinstatement. 516.6 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 516.7 other remedy provided by law, the board may temporarily suspend 516.8 the certification of an individual after conducting a 516.9 preliminary inquiry to determine whether the board believes that 516.10 the individual has violated a statute or rule that the board is 516.11 empowered to enforce and determining that the continued 516.12 provision of service by the individual would create an imminent 516.13 risk to public health or harm to others. 516.14 (b) A temporary suspension order prohibiting an individual 516.15 from providing emergency medical care shall give notice of the 516.16 right to a preliminary hearing according to paragraph (d) and 516.17 shall state the reasons for the entry of the temporary 516.18 suspension order. 516.19 (c) Service of a temporary suspension order is effective 516.20 when the order is served on the individual personally or by 516.21 certified mail, which is complete upon receipt, refusal, or 516.22 return for nondelivery to the most recent address provided to 516.23 the board for the individual. 516.24 (d) At the time the board issues a temporary suspension 516.25 order, the board shall schedule a hearing, to be held before a 516.26 group of its members designated by the board, that shall begin 516.27 within 60 days after issuance of the temporary suspension order 516.28 or within 15 working days of the date of the board's receipt of 516.29 a request for a hearing from the individual, whichever is 516.30 sooner. The hearing shall be on the sole issue of whether there 516.31 is a reasonable basis to continue, modify, or lift the temporary 516.32 suspension. A hearing under this paragraph is not subject to 516.33 chapter 14. 516.34 (e) Evidence presented by the board or the individual may 516.35 be in the form of an affidavit. The individual or individual's 516.36 designee may appear for oral argument. 517.1 (f) Within five working days of the hearing, the board 517.2 shall issue its order and, if the suspension is continued, 517.3 notify the individual of the right to a contested case hearing 517.4 under chapter 14. 517.5 (g) If an individual requests a contested case hearing 517.6 within 30 days of receiving notice under paragraph (f), the 517.7 board shall initiate a contested case hearing according to 517.8 chapter 14. The administrative law judge shall issue a report 517.9 and recommendation within 30 days after the closing of the 517.10 contested case hearing record. The board shall issue a final 517.11 order within 30 days after receipt of the administrative law 517.12 judge's report. 517.13 Subd. 7. [RENEWAL.] (a) Before the expiration date of 517.14 certification, an applicant for renewal of certification as an 517.15 EMT shall: 517.16 (1) successfully complete a course in cardiopulmonary 517.17 resuscitation that is approved by the board or the licensee's 517.18 medical director; 517.19 (2) take the United States Department of Transportation EMT 517.20 refresher course and successfully pass the practical skills test 517.21 portion of the course, or successfully complete 48 hours of 517.22 continuing education in EMT programs that are consistent with 517.23 the United States Department of Transportation National Standard 517.24 Curriculum or its equivalent as approved by the board or as 517.25 approved by the licensee's medical director and pass a practical 517.26 skills test approved by the board and administered by a training 517.27 program approved by the board. Twenty-four of the 48 hours must 517.28 include at least four hours of instruction in each of the 517.29 following six categories: 517.30 (i) airway management and resuscitation procedures; 517.31 (ii) circulation, bleeding control, and shock; 517.32 (iii) human anatomy and physiology, patient assessment, and 517.33 medical emergencies; 517.34 (iv) injuries involving musculoskeletal, nervous, 517.35 digestive, and genito-urinary systems; 517.36 (v) environmental emergencies and rescue techniques; and 518.1 (vi) emergency childbirth and other special situations; and 518.2 (3) submit the appropriate fee as required under section 518.3 144E.29. 518.4 (b) Before the expiration date of certification, an 518.5 applicant for renewal of certification as an EMT-I or EMT-P 518.6 shall: 518.7 (1) for an EMT-I, successfully complete a course in 518.8 cardiopulmonary resuscitation that is approved by the board or 518.9 the licensee's medical director and for an EMT-P, successfully 518.10 complete a course in advanced cardiac life support that is 518.11 approved by the board or the licensee's medical director; 518.12 (2) successfully complete 48 hours of continuing education 518.13 in emergency medical training programs, appropriate to the level 518.14 of the applicant's EMT-I or EMT-P certification, that are 518.15 consistent with the United States Department of Transportation 518.16 National Standard Curriculum or its equivalent as approved by 518.17 the board or as approved by the licensee's medical director. An 518.18 applicant may take the United States Department of 518.19 Transportation Emergency Medical Technician refresher course or 518.20 its equivalent without the written or practical test as approved 518.21 by the board, and as appropriate to the applicant's level of 518.22 certification, as part of the 48 hours of continuing education. 518.23 Each hour of the refresher course counts toward the 48-hour 518.24 continuing education requirement; and 518.25 (3) submit the appropriate fee required under section 518.26 144E.29. 518.27 (c) Certification shall be renewed every two years. 518.28 (d) If the applicant does not meet the renewal requirements 518.29 under this subdivision, the applicant's certification expires. 518.30 Subd. 8. [REINSTATEMENT.] (a) Within four years of a 518.31 certification expiration date, a person whose certification has 518.32 expired under subdivision 7, paragraph (d), may have the 518.33 certification reinstated upon submission of evidence to the 518.34 board of training equivalent to the continuing education 518.35 requirements of subdivision 7 and upon payment of the 518.36 certification fee. 519.1 (b) If more than four years have passed since a certificate 519.2 expiration date, an applicant must complete the initial 519.3 certification process required under subdivision 1. 519.4 Sec. 38. [144E.283] [EMT INSTRUCTOR CERTIFICATION.] 519.5 Subdivision 1. [QUALIFICATIONS.] The board shall grant 519.6 certification as an emergency medical technician instructor to 519.7 an applicant who files a completed application and furnishes 519.8 evidence satisfactory to the board that the applicant: 519.9 (1) possesses valid certification, registration, or 519.10 licensure as an EMT, EMT-I, EMT-P, physician, physician's 519.11 assistant, or registered nurse; 519.12 (2) has two years of active emergency medical practical 519.13 experience; 519.14 (3) is recommended by a medical director of a licensed 519.15 hospital, ambulance service, or training program approved by the 519.16 board; 519.17 (4) successfully completes the United States Department of 519.18 Transportation Emergency Medical Services Instructor Training 519.19 Program or its equivalent as approved by the board; and 519.20 (5) submits the appropriate fee as required under section 519.21 144E.29. 519.22 Subd. 2. [EXPIRATION.] Certification expires two years 519.23 from the date of the initial certification and must be renewed 519.24 every two years. 519.25 Subd. 3. [RENEWAL.] (a) An applicant shall submit an 519.26 application to the board for renewal at least three months prior 519.27 to the expiration date of the certification and must furnish 519.28 evidence satisfactory to the board that the applicant: 519.29 (1) complies with the requirements of subdivision 1; 519.30 (2) has at least 40 hours of experience as an instructor in 519.31 an emergency medical technician course approved by the board 519.32 under section 144E.285; and 519.33 (3) has attended at least eight hours of continuing 519.34 education encompassing the course topics of the United States 519.35 Department of Transportation National Standard Curriculum for an 519.36 Emergency Medical Services Instructor Training Program or its 520.1 equivalent as approved by the board. 520.2 (b) An emergency medical technician instructor whose 520.3 certification expires for nonrenewal must obtain a new 520.4 certification by applying to the board and meeting the 520.5 requirements of subdivision 1. 520.6 Sec. 39. [144E.285] [TRAINING PROGRAMS.] 520.7 Subdivision 1. [APPROVAL REQUIRED.] (a) All training 520.8 programs for an EMT, EMT-I, or EMT-P must be approved by the 520.9 board. 520.10 (b) To be approved by the board, a training program must: 520.11 (1) submit an application prescribed by the board that 520.12 includes: 520.13 (i) type and length of course to be offered; 520.14 (ii) names, addresses, and qualifications of the program 520.15 medical director, program training coordinator, and certified 520.16 instructors; 520.17 (iii) names and addresses of clinical sites, including a 520.18 contact person and telephone number; 520.19 (iv) admission criteria for students; and 520.20 (v) materials and equipment to be used; 520.21 (2) for each course, implement the most current version of 520.22 the United States Department of Transportation curriculum or its 520.23 equivalent as determined by the board applicable to EMT, EMT-I, 520.24 or EMT-P training; 520.25 (3) have a program medical director and a program 520.26 coordinator; 520.27 (4) utilize instructors certified under section 144E.283 520.28 for teaching at least 50 percent of the course content. The 520.29 remaining 50 percent of the course may be taught by guest 520.30 lecturers approved by the training program coordinator or 520.31 medical director; 520.32 (5) have at least one instructor for every ten students at 520.33 the practical skill stations; 520.34 (6) maintain a written agreement with a licensed hospital 520.35 or licensed ambulance service designating a clinical training 520.36 site; 521.1 (7) retain documentation of program approval by the board, 521.2 course outline, and student information; 521.3 (8) notify the board of the starting date of a course prior 521.4 to the beginning of a course; and 521.5 (9) submit the appropriate fee as required under section 521.6 144E.29. 521.7 Subd. 2. [EMT-P REQUIREMENTS.] (a) In addition to the 521.8 requirements under subdivision 1, paragraph (b), a training 521.9 program applying for approval to teach EMT-P curriculum must be 521.10 administered by an educational institution accredited by the 521.11 Commission of Accreditation of Allied Health Education Programs 521.12 (CAAHEP). 521.13 (b) An EMT-P training program that is administered by an 521.14 educational institution not accredited by CAAHEP, but that is in 521.15 the process of completing the accreditation process, may be 521.16 granted provisional approval by the board upon verification of 521.17 submission of its self-study report and the appropriate review 521.18 fee to CAAHEP. 521.19 (c) An educational institution that discontinues its 521.20 participation in the accreditation process must notify the board 521.21 immediately and provisional approval shall be withdrawn. 521.22 Subd. 3. [EXPIRATION.] Training program approval shall 521.23 expire two years from the date of approval. 521.24 Subd. 4. [REAPPROVAL.] A training program shall apply to 521.25 the board for reapproval at least three months prior to the 521.26 expiration date of its approval and must: 521.27 (1) submit an application prescribed by the board 521.28 specifying any changes from the information provided for prior 521.29 approval and any other information requested by the board to 521.30 clarify incomplete or ambiguous information presented in the 521.31 application; and 521.32 (2) comply with the requirements under subdivision 1, 521.33 paragraph (b), clauses (2) to (8). 521.34 Subd. 5. [DISCIPLINARY ACTION.] (a) The board may deny, 521.35 suspend, revoke, place conditions on, or refuse to renew 521.36 approval of a training program that the board determines: 522.1 (1) violated subdivisions 1 to 4 or rules adopted under 522.2 sections 144E.001 to 144E.33; or 522.3 (2) misrepresented or falsified information on an 522.4 application form provided by the board. 522.5 (b) Before taking action under paragraph (a), the board 522.6 shall give notice to a training program of the right to a 522.7 contested case hearing under chapter 14. If a training program 522.8 requests a contested case hearing within 30 days after receiving 522.9 notice, the board shall initiate a contested case hearing 522.10 according to chapter 14. 522.11 (c) The administrative law judge shall issue a report and 522.12 recommendation within 30 days after closing the contested case 522.13 hearing record. The board shall issue a final order within 30 522.14 days after receipt of the administrative law judge's report. 522.15 (d) After six months from the board's decision to deny, 522.16 revoke, place conditions on, or refuse approval of a training 522.17 program for disciplinary action, the training program shall have 522.18 the opportunity to apply to the board for reapproval. 522.19 Subd. 6. [TEMPORARY SUSPENSION.] (a) In addition to any 522.20 other remedy provided by law, the board may temporarily suspend 522.21 approval of the training program after conducting a preliminary 522.22 inquiry to determine whether the board believes that the 522.23 training program has violated a statute or rule that the board 522.24 is empowered to enforce and determining that the continued 522.25 provision of service by the training program would create an 522.26 imminent risk to public health or harm to others. 522.27 (b) A temporary suspension order prohibiting the training 522.28 program from providing emergency medical care training shall 522.29 give notice of the right to a preliminary hearing according to 522.30 paragraph (d) and shall state the reasons for the entry of the 522.31 temporary suspension order. 522.32 (c) Service of a temporary suspension order is effective 522.33 when the order is served on the training program personally or 522.34 by certified mail, which is complete upon receipt, refusal, or 522.35 return for nondelivery to the most recent address provided to 522.36 the board for the training program. 523.1 (d) At the time the board issues a temporary suspension 523.2 order, the board shall schedule a hearing, to be held before a 523.3 group of its members designated by the board, that shall begin 523.4 within 60 days after issuance of the temporary suspension order 523.5 or within 15 working days of the date of the board's receipt of 523.6 a request for a hearing from the training program, whichever is 523.7 sooner. The hearing shall be on the sole issue of whether there 523.8 is a reasonable basis to continue, modify, or lift the temporary 523.9 suspension. A hearing under this paragraph is not subject to 523.10 chapter 14. 523.11 (e) Evidence presented by the board or the individual may 523.12 be in the form of an affidavit. The training program or counsel 523.13 of record may appear for oral argument. 523.14 (f) Within five working days of the hearing, the board 523.15 shall issue its order and, if the suspension is continued, 523.16 notify the training program of the right to a contested case 523.17 hearing under chapter 14. 523.18 (g) If a training program requests a contested case hearing 523.19 within 30 days of receiving notice under paragraph (f), the 523.20 board shall initiate a contested case hearing according to 523.21 chapter 14. The administrative law judge shall issue a report 523.22 and recommendation within 30 days after the closing of the 523.23 contested case hearing record. The board shall issue a final 523.24 order within 30 days after receipt of the administrative law 523.25 judge's report. 523.26 Subd. 7. [AUDIT.] The board may audit training programs 523.27 approved by the board. The audit may include, but is not 523.28 limited to, investigation of complaints, course inspection, 523.29 classroom observation, review of instructor qualifications, and 523.30 student interviews. 523.31 Sec. 40. [144E.286] [EXAMINER QUALIFICATIONS FOR EMERGENCY 523.32 MEDICAL TECHNICIAN TESTING.] 523.33 Subdivision 1. [EMT TESTING.] An examiner testing basic 523.34 level EMT practical skills must: 523.35 (1) be certified as an EMT, EMT-I, or EMT-P; 523.36 (2) have two years or 4,000 hours' experience in emergency 524.1 medical care; 524.2 (3) be certified in basic cardiac life support; and 524.3 (4) be approved by the board. 524.4 Subd. 2. [EMT-I OR EMT-P TESTING.] (a) An examiner testing 524.5 EMT-I or EMT-P level practical skills must be approved by the 524.6 board and: 524.7 (1) be a physician or registered nurse; or 524.8 (2) be a certified EMT-P, have two years or 4,000 hours' 524.9 experience in emergency medical care and be certified in basic 524.10 cardiac life support. 524.11 (b) A physician must be available to answer questions 524.12 relating to the evaluation of skill performance at the practical 524.13 examination. 524.14 Sec. 41. [144E.29] [FEES.] 524.15 (a) The board shall charge the following fees: 524.16 (1) initial application for and renewal of an ambulance 524.17 service license, $150; 524.18 (2) each ambulance operated by a licensee, $96. The 524.19 licensee shall pay an additional $96 fee for the full licensing 524.20 period or $8 per month for any fraction of the period for each 524.21 ambulance added to the ambulance service during the licensing 524.22 period; 524.23 (3) initial application for and renewal of certification as 524.24 an EMT instructor, $10; 524.25 (4) initial application for and renewal of approval for a 524.26 training program, $100; and 524.27 (5) duplicate of an original license, certification, or 524.28 approval, $25. 524.29 (b) With the exception of paragraph (a), clause (5), all 524.30 fees are for a two-year period. All fees are nonrefundable. 524.31 (c) Fees collected by the board shall be deposited as 524.32 nondedicated receipts in the trunk highway fund. 524.33 Sec. 42. [144E.305] [REPORTING MISCONDUCT.] 524.34 Subdivision 1. [VOLUNTARY REPORTING.] A person who has 524.35 knowledge of any conduct constituting grounds for discipline 524.36 under section 144E.27, subdivision 5, or 144E.28, subdivision 4, 525.1 may report the alleged violation to the board. 525.2 Subd. 2. [MANDATORY REPORTING.] (a) A licensee shall 525.3 report to the board conduct by a first responder, EMT, EMT-I, or 525.4 EMT-P that they reasonably believe constitutes grounds for 525.5 disciplinary action under section 144E.27, subdivision 5, or 525.6 144E.28, subdivision 4. 525.7 (b) A licensee shall report to the board any dismissal from 525.8 employment of a first responder, EMT, EMT-I, or EMT-P. A 525.9 licensee shall report the resignation of a first responder, EMT, 525.10 EMT-I, or EMT-P before the conclusion of any disciplinary 525.11 proceeding or before commencement of formal charges but after 525.12 the first responder, EMT, EMT-I, or EMT-P has knowledge that 525.13 formal charges are contemplated or in preparation. 525.14 Subd. 3. [IMMUNITY.] (a) An individual, licensee, health 525.15 care facility, business, or organization is immune from civil 525.16 liability or criminal prosecution for submitting in good faith a 525.17 report to the board under subdivision 1 or 2 or for otherwise 525.18 reporting in good faith to the board violations or alleged 525.19 violations of sections 144E.001 to 144E.33. Reports are 525.20 classified as confidential data on individuals or protected 525.21 nonpublic data under section 13.02 while an investigation is 525.22 active. Except for the board's final determination, all 525.23 communications or information received by or disclosed to the 525.24 board relating to disciplinary matters of any person or entity 525.25 subject to the board's regulatory jurisdiction are confidential 525.26 and privileged and any disciplinary hearing shall be closed to 525.27 the public. 525.28 (b) Members of the board, persons employed by the board, 525.29 persons engaged in the investigation of violations and in the 525.30 preparation and management of charges of violations of sections 525.31 144E.001 to 144E.33 on behalf of the board, and persons 525.32 participating in the investigation regarding charges of 525.33 violations are immune from civil liability and criminal 525.34 prosecution for any actions, transactions, or publications, made 525.35 in good faith, in the execution of, or relating to, their duties 525.36 under sections 144E.001 to 144E.33. 526.1 (c) For purposes of this section, a member of the board is 526.2 considered a state employee under section 3.736, subdivision 9. 526.3 Sec. 43. [144E.31] [CORRECTION ORDER AND FINES.] 526.4 Subdivision 1. [CORRECTION ORDER.] (a) If the board finds 526.5 that a licensee or training program has failed to comply with an 526.6 applicable law or rule and the violation does not imminently 526.7 endanger the public's health or safety, the board may issue a 526.8 correction order to the licensee or training program. 526.9 (b) The correction order shall state: 526.10 (1) the conditions that constitute a violation of the law 526.11 or rule; 526.12 (2) the specific law or rule violated; and 526.13 (3) the time allowed to correct the violation. 526.14 Subd. 2. [RECONSIDERATION.] (a) If the licensee or 526.15 training program believes that the contents of the board's 526.16 correction order are in error, the licensee or training program 526.17 may ask the board to reconsider the parts of the correction 526.18 order that are alleged to be in error. 526.19 (b) The request for reconsideration must: 526.20 (1) be in writing; 526.21 (2) be delivered by certified mail; 526.22 (3) specify the parts of the correction order that are 526.23 alleged to be in error; 526.24 (4) explain why they are in error; and 526.25 (5) include documentation to support the allegation of 526.26 error. 526.27 (c) A request for reconsideration does not stay any 526.28 provision or requirement of the correction order. The board's 526.29 disposition of a request for reconsideration is final and not 526.30 subject to appeal under chapter 14. 526.31 Subd. 3. [FINE.] (a) The board may order a fine 526.32 concurrently with the issuance of a correction order, or after 526.33 the licensee or training program has not corrected the violation 526.34 within the time specified in the correction order. 526.35 (b) A licensee or training program that is ordered to pay a 526.36 fine shall be notified of the order by certified mail. The 527.1 notice shall be mailed to the address shown on the application 527.2 or the last known address of the licensee or training program. 527.3 The notice shall state the reasons the fine was ordered and 527.4 shall inform the licensee or training program of the right to a 527.5 contested case hearing under chapter 14. 527.6 (c) A licensee or training program may appeal the order to 527.7 pay a fine by notifying the board by certified mail within 15 527.8 calendar days after receiving the order. A timely appeal shall 527.9 stay payment of the fine until the board issues a final order. 527.10 (d) A licensee or training program shall pay the fine 527.11 assessed on or before the payment date specified in the board's 527.12 order. If a licensee or training program fails to fully comply 527.13 with the order, the board shall suspend the license or cancel 527.14 approval until there is full compliance with the order. 527.15 (e) Fines shall be assessed as follows: 527.16 (1) $150 for violation of section 144E.123; 527.17 (2) $400 for violation of sections 144E.06, 144E.07, 527.18 144E.101, 144E.103, 144E.121, 144E.125, 144E.265, 144E.285, and 527.19 144E.305; 527.20 (3) $750 for violation of rules adopted under section 527.21 144E.16, subdivision 4, clause (8); and 527.22 (4) $50 for violation of all other sections under this 527.23 chapter or rules adopted under this chapter that are not 527.24 specifically enumerated in clauses (1) to (3). 527.25 (f) Fines collected by the board shall be deposited as 527.26 nondedicated receipts in the trunk highway fund. 527.27 Subd. 4. [ADDITIONAL PENALTIES.] This section does not 527.28 prohibit the board from suspending, revoking, placing conditions 527.29 on, or refusing to renew a licensee's license or a training 527.30 program's approval in addition to ordering a fine. 527.31 Sec. 44. [144E.33] [PENALTY.] 527.32 A person who violates a provision of sections 144E.001 to 527.33 144E.33 is guilty of a misdemeanor. 527.34 Sec. 45. Minnesota Statutes 1998, section 144E.50, is 527.35 amended by adding a subdivision to read: 527.36 Subd. 6. [AUDITS.] (a) Each regional emergency medical 528.1 services board designated by the emergency medical services 528.2 regulatory board shall be audited biennially by an independent 528.3 auditor who is either a state or local government auditor or a 528.4 certified public accountant who meets the independence standards 528.5 specified by the General Accounting Office for audits of 528.6 governmental organizations, programs, activities, and 528.7 functions. The audit shall cover all funds received by the 528.8 regional board, including but not limited to, funds appropriated 528.9 under this section, section 144E.52, and section 169.686, 528.10 subdivision 3. Expenses associated with the audit are the 528.11 responsibility of the regional board. 528.12 (b) The audit specified in paragraph (a) shall be performed 528.13 within 60 days following the close of the biennium. Copies of 528.14 the audit and any accompanying materials shall be filed by 528.15 October 1 of each odd-numbered year, beginning in 1999, with the 528.16 emergency medical services regulatory board, the legislative 528.17 auditor, and the state auditor. 528.18 (c) If the audit is not conducted as required in paragraph 528.19 (a) or copies filed as required in paragraph (b), or if the 528.20 audit determines that funds were not spent in accordance with 528.21 this chapter, the emergency medical services regulatory board 528.22 shall immediately reduce funding to the regional emergency 528.23 medical services board as follows: 528.24 (1) if an audit was not conducted or if an audit was 528.25 conducted but copies were not provided as required, funding 528.26 shall be reduced by 100 percent; and 528.27 (2) if an audit was conducted and copies provided, and the 528.28 audit identifies expenditures made that are not in compliance 528.29 with this chapter, funding shall be reduced by the amount in 528.30 question plus ten percent. 528.31 A funding reduction under this paragraph is effective for the 528.32 fiscal year in which the reduction is taken and the following 528.33 fiscal year. 528.34 (d) The emergency medical services regulatory board shall 528.35 distribute any funds withheld from a regional board under 528.36 paragraph (c) to the remaining regional boards on a pro rata 529.1 basis. 529.2 Sec. 46. Minnesota Statutes 1998, section 145A.02, 529.3 subdivision 10, is amended to read: 529.4 Subd. 10. [EMERGENCY MEDICAL CARE.] "Emergency medical 529.5 care" means activities intended to protect the health of persons 529.6 suffering a medical emergency and to ensure rapid and effective 529.7 emergency medical treatment. These activities include the 529.8 coordination or provision of training, cooperation with public 529.9 safety agencies, communications, life-support transportationas529.10definedundersection 144E.16sections 144E.06 to 144E.19, 529.11 public information and involvement, and system management. 529.12 Sec. 47. Minnesota Statutes 1998, section 148B.32, 529.13 subdivision 1, is amended to read: 529.14 Subdivision 1. [UNLICENSED PRACTICE PROHIBITED.] After 529.15 adoption of rules by the board implementing sections 148B.29 to 529.16 148B.39, no individual shall engage in marriage and family 529.17 therapy practice unless that individual holds a valid license 529.18 issued under sections 148B.29 to 148B.39. 529.19Marriage and family therapists may not be reimbursed under529.20medical assistance, chapter 256B, except to the extent such care529.21is reimbursed under section 256B.0625, subdivision 5, or when529.22marriage and family therapists are employed by a managed care529.23organization with a contract to provide mental health care to529.24medical assistance enrollees, and are reimbursed through the529.25managed care organization.529.26 Sec. 48. Minnesota Statutes 1998, section 150A.10, 529.27 subdivision 1, is amended to read: 529.28 Subdivision 1. [DENTAL HYGIENISTS.] (a) Any licensed 529.29 dentist, public institution, or school authority may obtain 529.30 services from a licensed dental hygienist. Such licensed dental 529.31 hygienist may provide those services defined in section 150A.05, 529.32 subdivision 1a. Such services shall not include the 529.33 establishment of a final diagnosis or treatment plan for a 529.34 dental patient. Such services shall be provided under 529.35 supervision of a licensed dentist. Any licensed dentist who 529.36 shall permit any dental service by a dental hygienist other than 530.1 those authorized by the board of dentistry, shall be deemed to 530.2 be violating the provisions of sections 150A.01 to 150A.12, and 530.3 any such unauthorized dental service by a dental hygienist shall 530.4 constitute a violation of sections 150A.01 to 150A.12. 530.5 (b) Notwithstanding paragraph (a), a licensed dental 530.6 hygienist may provide those services defined in section 150A.05, 530.7 subdivision 1a, clauses (1) and (2), and in Minnesota Rules, 530.8 part 3100.8700, subpart 1, without the supervision of a licensed 530.9 dentist if the following circumstances are met: 530.10 (1) the services are authorized by a licensed dentist; 530.11 (2) the services are performed on a limited access patient; 530.12 and 530.13 (3) a licensed dentist reviews the dental hygienist's 530.14 findings. 530.15 For purposes of this paragraph, "limited access patient" means a 530.16 patient who, due to age, disability, or geographic location, is 530.17 unable to receive regular dental services in a dental office. 530.18 Services that are authorized by a licensed dentist under this 530.19 paragraph may be performed by a licensed dental hygienist 530.20 without the presence of a dentist and may be performed at a 530.21 location other than the usual place of practice of the dentist 530.22 or dental hygienist. 530.23 Sec. 49. [REVISOR'S INSTRUCTION.] 530.24 In each section of Minnesota Statutes referred to in column 530.25 A, the revisor of statutes shall delete the reference in column 530.26 B and insert the reference in column C. 530.27 Column A Column B Column C 530.28 144E.10, subd. 2 144E.16 144E.101 to 144E.127 530.29 144E.12 144E.16 144E.121 to 144E.127 530.30 144E.13 144E.16 144E.101 to 144E.127 530.31 144E.14 144E.16 144E.101 to 144E.127 530.32 144E.35, subd. 1 144E.16 144E.285 530.33 144E.41 144E.16 144E.265 or 144E.28 530.34 353.64, subd. 10 144E.16 144E.28 530.35 147A.09, subd. 2 144E.16, 144E.127 530.36 subd. 2, 531.1 para. (c) 531.2 Sec. 50. [REPEALER.] 531.3 Minnesota Statutes 1998, sections 144E.16, subdivisions 1, 531.4 2, 3, and 6; 144E.17; 144E.25; and 144E.30, subdivisions 1, 2, 531.5 and 6, are repealed. Minnesota Rules, parts 4690.0100, subparts 531.6 4, 13, 15, 19, 20, 21, 22, 23, 24, 26, 27, and 29; 4690.0300; 531.7 4690.0400; 4690.0500; 4690.0600; 4690.0700; 4690.0800, subparts 531.8 1 and 2; 4690.0900; 4690.1000; 4690.1100; 4690.1200; 4690.1300; 531.9 4690.1600; 4690.1700; 4690.2100; 4690.2200, subparts 1, 3, 4, 531.10 and 5; 4690.2300; 4690.2400, subparts 1, 2, and 3; 4690.2500; 531.11 4690.2900; 4690.3000; 4690.3700; 4690.3900; 4690.4000; 531.12 4690.4100; 4690.4200; 4690.4300; 4690.4400; 4690.4500; 531.13 4690.4600; 4690.4700; 4690.4800; 4690.4900; 4690.5000; 531.14 4690.5100; 4690.5200; 4690.5300; 4690.5400; 4690.5500; 531.15 4690.5700; 4690.5800; 4690.5900; 4690.6000; 4690.6100; 531.16 4690.6200; 4690.6300; 4690.6400; 4690.6500; 4690.6600; 531.17 4690.6700; 4690.6800; 4690.7000; 4690.7100; 4690.7200; 531.18 4690.7300; 4690.7400; 4690.7500; 4690.7600; 4690.7700; 531.19 4690.7800; 4690.8300, subparts 1, 2, 3, 4, and 5; and 4735.5000, 531.20 are repealed. 531.21 ARTICLE 10 531.22 TOBACCO SETTLEMENT PAYMENTS 531.23 Section 1. [10.57] [MINNESOTA FAMILIES FOUNDATION.] 531.24 Subdivision 1. [ESTABLISHMENT.] The legislature finds that 531.25 the Minnesota families foundation will foster a public-private 531.26 partnership that will provide improved services to clients, a 531.27 more effective coordination of services, and a more efficient 531.28 allocation of resources. The Minnesota families foundation is a 531.29 nonprofit foundation established to support self-sufficiency and 531.30 reduce long-term dependency on government. The foundation shall 531.31 operate as a supporting organization under chapter 317A and the 531.32 Internal Revenue Code, section 509(a). The foundation is not 531.33 subject to chapters 13, 14, 16A, 16B, 16C, 43A, and 179A. 531.34 Subd. 2. [BOARD MEMBERSHIP.] The foundation shall be 531.35 governed by a 15-member board of directors consisting of: 531.36 (1) four members who are not state employees, appointed by 532.1 the governor; 532.2 (2) four members who are not members of the legislature, 532.3 two of whom are appointed by the senate and two of whom are 532.4 appointed by the house of representatives; and 532.5 (3) seven members appointed by the board itself. 532.6 Subd. 3. [TERMS; COMPENSATION; REMOVAL.] (a) Board members 532.7 appointed by the governor and the legislature shall serve during 532.8 the term of the appointing authority. The governor and the 532.9 legislature shall make initial appointments of board members, as 532.10 specified in subdivision 2, as soon as possible after the 532.11 effective date of this section. Initially appointed board 532.12 members' terms shall begin on July 1, 1999. Two of the 532.13 governor's initial appointments shall be for two-year terms. 532.14 Subsequent appointments shall be made at the beginning of each 532.15 regular session of the legislature. The board members appointed 532.16 by the governor and the legislature shall appoint seven board 532.17 members no later than January 1, 2000. Board members appointed 532.18 by the board shall serve four-year terms. A vacancy on the 532.19 board shall be filled for the unexpired portion of the term in 532.20 the same manner as the original appointment. 532.21 (b) Board members shall be reimbursed for reasonable 532.22 out-of-pocket expenses actually incurred. 532.23 (c) Board members must disclose fully to the board of 532.24 directors whenever they may have a conflict of interest within 532.25 the meaning of section 317A.255, subdivision 2. 532.26 (d) Liability of board members shall be governed by section 532.27 317A.257. 532.28 Subd. 4. [ORGANIZATION.] The board of directors shall 532.29 adopt bylaws necessary for the conduct of the business of the 532.30 foundation. The board shall select a chairperson from its 532.31 members, and any other officers the board deems necessary. 532.32 Board meetings shall be open to the public, and all grants, 532.33 contracts, and meeting minutes of the foundation shall be 532.34 available to the public. 532.35 Subd. 5. [EXECUTIVE DIRECTOR; EMPLOYEES OF THE 532.36 FOUNDATION.] (a) The board members appointed by the governor and 533.1 the legislature shall convene prior to January 1, 2000, and hire 533.2 an executive director. The executive director shall serve at 533.3 the pleasure of the board of directors. The executive director 533.4 shall serve as a nonvoting member of the board. The executive 533.5 director's compensation shall be capped at 95 percent of the 533.6 governor's salary. 533.7 (b) The executive director shall oversee the daily 533.8 operations of the foundation, including the hiring of necessary 533.9 staff. Employees of the foundation are not state employees. 533.10 (c) The executive director shall prepare an annual budget 533.11 for the foundation for review and approval by the board of 533.12 directors. 533.13 (d) To the extent that the board of directors makes funds 533.14 available, the commissioner of finance shall provide 533.15 administrative support to the foundation until June 30, 2000, 533.16 including but not limited to processing of payroll for the 533.17 executive director and foundation staff, payment of expenses to 533.18 board members, and payment of rent. The board of directors 533.19 shall make up to $200,000 available to the commissioner of 533.20 finance to cover payroll, expenses of board members, rent, and 533.21 other administrative expenses incurred to support the foundation 533.22 in fiscal year 2000. 533.23 Subd. 6. [FOUNDATION FUNDS.] (a) The board of directors 533.24 shall be responsible for managing the investment of the 533.25 foundation funds as follows: 533.26 (1) the foundation funds shall be audited annually by an 533.27 independent certified public accountant in accordance with 533.28 generally accepted accounting principles; 533.29 (2) the foundation funds shall be invested and managed 533.30 according to rules applicable to trust investments, as provided 533.31 in the Minnesota Prudent Investor Act, sections 501B.151 and 533.32 501B.152; 533.33 (3) reasonable and necessary administrative and investment 533.34 expenses directly associated with the management and investment 533.35 of the foundation funds may be paid from the foundation trusts; 533.36 and 534.1 (4) according to limits established by the board and 534.2 consistent with the limitations in the Uniform Management of 534.3 Institutional Funds Act, sections 309.62 to 309.71, earnings on 534.4 foundation funds shall be expended to cover administrative 534.5 expenses of the foundation and grant awards under subdivision 7. 534.6 (b) The board may contract with a third party, including 534.7 the state board of investment, to carry out the provisions of 534.8 paragraph (a). 534.9 (c) The foundation may accept gifts from private donors. 534.10 Such gifts to the foundation must be accounted for and expended 534.11 in a manner consistent with this section. 534.12 Subd. 7. [FOUNDATION GRANTS.] (a) Beginning July 1, 2000, 534.13 the foundation shall provide grants to nonprofit, 534.14 community-based organizations for activities that: 534.15 (1) are flexible and innovative and that close the gap 534.16 between dependence on government and independence from 534.17 government programs; 534.18 (2) support the efforts of working families and working 534.19 individuals to remain self-sufficient by building assets that 534.20 promote healthy family functioning and stability; 534.21 (3) will ensure that core public sector efforts to 534.22 encourage self-sufficiency have every opportunity to succeed; 534.23 (4) focus resources in a way that can demonstrate impact on 534.24 a single goal or a single set of goals; 534.25 (5) have demonstrated success in reducing future government 534.26 expenditures; 534.27 (6) contribute to increasing the understanding of the 534.28 development of young children's brains or to developing new 534.29 methods to increase the effectiveness of stimulation and 534.30 educational activities that will improve brain development in 534.31 young children; or 534.32 (7) enhance public education, awareness, and understanding 534.33 necessary for the promotion and encouragement of activities and 534.34 decisions that protect and stimulate young children's 534.35 development. 534.36 (b) All grantees must match funds received from the 535.1 foundation, dollar for dollar. The match may include up to 25 535.2 percent in kind. The match cannot be made with federal, state, 535.3 or local government funds except in collaborative projects 535.4 between governmental entities and the private sector. 535.5 (c) The foundation grants must not be used as a substitute 535.6 for traditional state or local sources of funding activities for 535.7 families and young children, but the endowment fund may be used 535.8 to supplement traditional state or local sources, including 535.9 sources used to support the activities described in this 535.10 subdivision. 535.11 Subd. 8. [REPORTS TO THE LEGISLATURE.] (a) The foundation 535.12 shall annually report to the governor and the legislature on 535.13 January 15 of each year. The report must include: 535.14 (1) a financial report that details the foundation's 535.15 earnings; 535.16 (2) an expense report detailing the amounts and purposes 535.17 for which funds were expended; 535.18 (3) a list of grant awards; 535.19 (4) a report on the performance results of these grants; 535.20 and 535.21 (5) a copy of the independent audit reports for the two 535.22 previous years. 535.23 (b) The foundation shall also report to the governor and 535.24 the legislature on January 15, 2000. This report shall include 535.25 a copy of the foundation's mission statement, bylaws, and 535.26 policies adopted by the board of directors; and a financial 535.27 report that details the foundation's returns and the amounts and 535.28 purposes for which funds were expended. 535.29 Subd. 9. [DISSOLUTION OF THE FOUNDATION.] By June 30, 535.30 2009, the foundation shall transfer all foundation assets to the 535.31 commissioner of finance, who shall record them as assets of the 535.32 general fund and cause them to be liquidated or invested, as 535.33 appropriate, by the state board of investment. On June 30, 535.34 2009, the foundation is dissolved. If the legal status of the 535.35 foundation or the foundation funds is successfully challenged in 535.36 state or federal court, the foundation must be dissolved and the 536.1 assets likewise returned to commissioner of finance for credit 536.2 to the general fund and investment by the state board of 536.3 investment. 536.4 (Effective Date: Section 1 (10.57) is effective the day 536.5 following final enactment.) 536.6 Sec. 2. Minnesota Statutes 1998, section 62J.69, is 536.7 amended to read: 536.8 62J.69 [MEDICAL EDUCATIONAND RESEARCH TRUST FUND.] 536.9 Subdivision 1. [DEFINITIONS.] For purposes of this 536.10 section, the following definitions apply: 536.11 (a) "Medical education" means the accredited clinical 536.12 training of physicians (medical students and residents), doctor 536.13 of pharmacy practitioners, doctors of chiropractic, dentists, 536.14 advanced practice nurses (clinical nurse specialist, certified 536.15 registered nurse anesthetists, nurse practitioners, and 536.16 certified nurse midwives), and physician assistants. 536.17 (b) "Clinical training" means accredited training for the 536.18 health care practitioners listed in paragraph (a) that is funded 536.19 in part by patient care revenues and that occurs in either an 536.20 inpatient or ambulatory patient care training site. 536.21 (c) "Trainee" means students involved in an accredited 536.22 clinical training program for medical education as defined in 536.23 paragraph (a). 536.24 (d) "Eligible trainee" means a student involved in an 536.25 accredited training program for medical education as defined in 536.26 paragraph (a), which meets the definition of clinical training 536.27 in paragraph (b), who is in a training site that is located in 536.28 Minnesota and which has a medical assistance provider number. 536.29 (e)"Health care research" means approved clinical,536.30outcomes, and health services investigations that are funded by536.31patient out-of-pocket expenses or a third-party payer.536.32(f)"Commissioner" means the commissioner of health. 536.33(g)(f) "Teaching institutions" means any hospital, medical 536.34 center, clinic, or other organization that currently sponsors or 536.35 conducts accredited medical education programs or clinical 536.36 research in Minnesota. 537.1(h)(g) "Accredited training" means training provided by a 537.2 program that is accredited through an organization recognized by 537.3 the department of education or the health care financing 537.4 administration as the official accrediting body for that program. 537.5(i)(h) "Sponsoring institution" means a hospital, school, 537.6 or consortium located in Minnesota that sponsors and maintains 537.7 primary organizational and financial responsibility for an 537.8 accredited medical education program in Minnesota and which is 537.9 accountable to the accrediting body. 537.10 Subd. 1a. [ADVISORY COMMITTEE.] The commissioner shall 537.11 appoint an advisory committee to provide advice and oversight on 537.12 the distribution of funds from the medical education and 537.13 research endowment fund. If a committee is appointed, the 537.14 commissioner shall: 537.15 (1) consider the interest of all stakeholders when 537.16 selecting committee members; 537.17 (2) select members that represent both urban and rural 537.18 interests; and 537.19 (3) select members that include ambulatory care as well as 537.20 inpatient perspectives. 537.21 The commissioner shall appoint to the advisory committee 537.22 representatives of the following groups: medical researchers; 537.23 public and private academic medical centers, including a 537.24 representative from each academic center offering an accredited 537.25 training program for physicians, pharmacists, chiropractors, 537.26 dentists, and nurses; managed care organizations; Blue Cross and 537.27 Blue Shield of Minnesota; commercial carriers; Minnesota Medical 537.28 Association; Minnesota Nurses Association; Minnesota 537.29 Chiropractic Association; medical product manufacturers; 537.30 employers; and other relevant stakeholders, including 537.31 consumers. The advisory committee is governed by section 15.059 537.32 for membership terms and removal of members, and expires on June 537.33 30, 2001. 537.34 Subd. 2. [ALLOCATION AND FUNDING FOR MEDICAL EDUCATIONAND537.35RESEARCH.] (a)The commissioner may establish a trust fund for537.36the purposes of funding medical education and research538.1activities in the state of Minnesota.538.2(b) By January 1, 1997, the commissioner may appoint an538.3advisory committee to provide advice and oversight on the538.4distribution of funds from the medical education and research538.5trust fund. If a committee is appointed, the commissioner538.6shall: (1) consider the interest of all stakeholders when538.7selecting committee members; (2) select members that represent538.8both urban and rural interest; and (3) select members that538.9include ambulatory care as well as inpatient perspectives. The538.10commissioner shall appoint to the advisory committee538.11representatives of the following groups: medical researchers,538.12public and private academic medical centers, managed care538.13organizations, Blue Cross and Blue Shield of Minnesota,538.14commercial carriers, Minnesota Medical Association, Minnesota538.15Nurses Association, medical product manufacturers, employers,538.16and other relevant stakeholders, including consumers. The538.17advisory committee is governed by section 15.059, for membership538.18terms and removal of members and will sunset on June 30, 1999.538.19(c)Eligible applicants for funds are accredited medical 538.20 education teaching institutions, consortia, and programs 538.21 operating in Minnesota. Applications must be submitted by the 538.22 sponsoring institution on behalf of the teaching program, and 538.23 must be received by September 30 of each year for distribution 538.24 in January of the following year. An application for funds must 538.25 include the following: 538.26 (1) the official name and address of the sponsoring 538.27 institution and the official name and address of the facility or 538.28 programs on whose behalf the institution is applying for 538.29 funding; 538.30 (2) the name, title, and business address of those persons 538.31 responsible for administering the funds; 538.32 (3) for each accredited medical education program for which 538.33 funds are being sought the type and specialty orientation of 538.34 trainees in the program, the name, address, and medical 538.35 assistance provider number of each training site used in the 538.36 program, the total number of trainees at each site, and the 539.1 total number of eligible trainees at each training site; 539.2 (4) audited clinical training costs per trainee for each 539.3 medical education program where available or estimates of 539.4 clinical training costs based on audited financial data; 539.5 (5) a description of current sources of funding for medical 539.6 education costs including a description and dollar amount of all 539.7 state and federal financial support, including Medicare direct 539.8 and indirect payments; 539.9 (6) other revenue received for the purposes of clinical 539.10 training; and 539.11 (7) other supporting information the commissioner, with 539.12 advice from the advisory committee, determines is necessary for 539.13 the equitable distribution of funds. 539.14(d)(b) The commissioner shall distribute medical education 539.15 funds to all qualifying applicants based on the following basic 539.16 criteria: (1) total medical education funds available; (2) 539.17 total eligible trainees in each eligible education program;and539.18 (3) the statewide average cost per trainee, by type of trainee, 539.19 in each medical education program; (4) the degree to which the 539.20 applicant's training programs are funded with patient care 539.21 revenues; (5) the degree to which the training of eligible 539.22 trainees takes place in patient care settings that face 539.23 increased financial pressure as a result of competition with 539.24 nonteaching patient care entities; and (6) whether the eligible 539.25 education program emphasizes primary care or specialties that 539.26 are in undersupply in Minnesota. Funds distributed shall not be 539.27 used to displace current funding appropriations from federal or 539.28 state sources. Funds shall be distributed to the sponsoring 539.29 institutions indicating the amount to be paid to each of the 539.30 sponsor's medical education programs based on the criteria in 539.31 this paragraph. Sponsoring institutions which receive funds 539.32 from thetrustfund must distribute approved funds to the 539.33 medical education program according to the commissioner's 539.34 approval letter. Further, programs must distribute funds among 539.35 the sites of training as specified in the commissioner's 539.36 approval letter. Any funds not distributed as directed by the 540.1 commissioner's approval letter shall be returned to the medical 540.2 education and researchtrustfund within 30 days of a notice 540.3 from the commissioner. The commissioner shall distribute 540.4 returned funds to the appropriate entities in accordance with 540.5 the commissioner's approval letter. 540.6(e)(c) Medical education programs receiving funds from the 540.7trustfund must submit a medical education and research grant 540.8 verification report (GVR) through the sponsoring institution 540.9 based on criteria established by the commissioner. If the 540.10 sponsoring institution fails to submit the GVR by the stated 540.11 deadline, or to request and meet the deadline for an extension, 540.12 the sponsoring institution is required to return the full amount 540.13 of the medical education and researchtrustfund grant to the 540.14 medical education and researchtrustfund within 30 days of a 540.15 notice from the commissioner. The commissioner shall distribute 540.16 returned funds to the appropriate entities in accordance with 540.17 the commissioner's approval letter. The reports must include: 540.18 (1) the total number of eligible trainees in the program; 540.19 (2) the programs and residencies funded, the amounts of 540.20trustfund payments to each program, and within each program, 540.21 the dollar amount distributed to each training site; and 540.22 (3) other information the commissioner, with advice from 540.23 the advisory committee, deems appropriate to evaluate the 540.24 effectiveness of the use of funds for clinical training. 540.25 The commissioner, with advice from the advisory committee, 540.26 will provide an annual summary report to the legislature on 540.27 program implementation due February 15 of each year. 540.28(f)(d) The commissioner is authorized to distribute funds 540.29 made available through: 540.30 (1) voluntary contributions by employers or other entities; 540.31 (2) allocations for the department of human services to 540.32 support medical education and research; and 540.33 (3) other sources as identified and deemed appropriate by 540.34 the legislaturefor inclusion in the trust fund. 540.35(g) The advisory committee shall continue to study and make540.36recommendations on:541.1(1) the funding of medical research consistent with work541.2currently mandated by the legislature and under way at the541.3department of health; and541.4(2) the costs and benefits associated with medical541.5education and research.541.6Subd. 3. [MEDICAL ASSISTANCE AND GENERAL ASSISTANCE541.7SERVICE.] The commissioner of health, in consultation with the541.8medical education and research costs advisory committee, shall541.9develop a system to recognize those teaching programs which541.10serve higher numbers or high proportions of public program541.11recipients and shall report to the legislative commission on541.12health care access by January 15, 1998, on an allocation formula541.13to implement this system.541.14 Subd. 4. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 541.15 SERVICES.] (a) The amount transferred according to section 541.16 256B.69, subdivision 5c, shall be distributed by the 541.17 commissioner to qualifying applicants based on a distribution 541.18 formula that reflects a summation of two factors: 541.19 (1) an education factor, which is determined by the total 541.20 number of eligible trainees and the total statewide average 541.21 costs per trainee, by type of trainee, in each program; and 541.22 (2) a public program volume factor, which is determined by 541.23 the total volume of public program revenue received by each 541.24 training site as a percentage of all public program revenue 541.25 received by all training sites in thetrustfundpool. 541.26 In this formula, the education factor shall be weighted at 541.27 50 percent and the public program volume factor shall be 541.28 weighted at 50 percent. 541.29 (b) Public program revenue for the formula in paragraph (a) 541.30 shall include revenue from medical assistance, prepaid medical 541.31 assistance, general assistance medical care, and prepaid general 541.32 assistance medical care. 541.33 (c) Training sites that receive no public program revenue 541.34 shall be ineligible for payments from the prepaid medical 541.35 assistance program transfer pool. 541.36 Subd. 5. [REVIEW OF ELIGIBLE PROVIDERS.](a) Provider542.1groups added after January 1, 1998, to the list of providers542.2eligible for the trust fund shall not receive funding from the542.3trust fund without prior evaluation by the commissioner and the542.4medical education and research costs advisory committee. The542.5evaluation shall consider the degree to which the training of542.6the provider group:542.7(1) takes place in patient care settings, which are542.8consistent with the purposes of this section;542.9(2) is funded with patient care revenues;542.10(3) takes place in patient care settings, which face542.11increased financial pressure as a result of competition with542.12nonteaching patient care entities; and542.13(4) emphasizes primary care or specialties, which are in542.14undersupply in Minnesota.542.15Results of this evaluation shall be reported to the542.16legislative commission on health care access. The legislative542.17commission on health care access must approve funding for the542.18provider group prior to their receiving any funding from the542.19trust fund. In the event that a reviewed provider group is not542.20approved by the legislative commission on health care access,542.21trainees in that provider group shall be considered ineligible542.22trainees for the trust fund distribution.542.23(b)The commissioner and the medical education and research 542.24 costs advisory committee mayalsoreview the eligible list of 542.25 provider groups, which were added to the eligible list of542.26provider groups prior to January 1, 1998,to assure that the 542.27trustfund moneycontinues to beis distributed consistent with 542.28 the purpose of this section. The results of any such reviews 542.29 must be reported to the legislative commission on health care 542.30 access. Trainees in provider groups,which were added prior to542.31January 1, 1998, andwhich are reviewed by the commissioner and 542.32 the medical education and research costs advisory committee, 542.33 shall be considered eligible trainees for purposes of thetrust542.34 fund distribution unless and until the legislative commission on 542.35 health care access disapproves their eligibility, in which case 542.36 they shall be considered ineligible trainees. 543.1 (Effective Date: Section 2 (62J.69) is effective the day 543.2 following final enactment.) 543.3 Sec. 3. [62J.691] [MEDICAL EDUCATION AND RESEARCH 543.4 ENDOWMENT FUND.] 543.5 Subdivision 1. [CREATION.] The medical education and 543.6 research endowment fund is created as an account in the state 543.7 treasury. The commissioner of finance shall credit to the fund 543.8 20.25 percent of the tobacco settlement payments received by the 543.9 state on January 3, 2000, January 2, 2001, January 2, 2002, and 543.10 January 2, 2003, as a result of the settlement of the lawsuit 543.11 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 543.12 District Court, Second Judicial District). The state board of 543.13 investment shall invest the fund under section 11A.24. All 543.14 earnings of the fund must be credited to the fund. The 543.15 principal of the fund must be maintained inviolate. 543.16 Subd. 2. [ENDOWMENT FUND EXPENDITURES.] (a) Earnings of 543.17 the fund, up to five percent of the fair market value of the 543.18 fund on the preceding July 1, shall be spent for medical 543.19 education and research activities in the state of Minnesota. 543.20 (b) Beginning July 1, 2000, and on July 1 of each year 543.21 thereafter, 50 percent of the amount in paragraph (a) is 543.22 appropriated from the fund to the commissioner of health to be 543.23 distributed for medical education under section 62J.69. 543.24 (c) Beginning July 1, 2000, and July 1 of each year 543.25 thereafter, 25 percent of the amount in paragraph (a) is 543.26 appropriated from the fund to the commissioner of health to be 543.27 distributed for medical research according to the 543.28 recommendations submitted under section 62J.692. 543.29 (d) Beginning July 1, 2000, and on July 1 of each year 543.30 thereafter, 25 percent of the amount in paragraph (a) may be 543.31 appropriated by another law for the instructional costs of 543.32 health professional programs at publicly funded academic health 543.33 centers. 543.34 Subd. 3. [AUDITS REQUIRED.] The legislative auditor shall 543.35 audit endowment fund expenditures to ensure that the money is 543.36 spent for the purposes set out in this section. 544.1 Subd. 4. [SUNSET.] The medical education and research 544.2 endowment fund expires June 30, 2015. Upon expiration, the 544.3 commissioner of finance shall transfer the principal and any 544.4 remaining interest to the general fund. 544.5 (Effective Date: Section 3 (62J.691) is effective the day 544.6 following final enactment.) 544.7 Sec. 4. [62J.692] [MEDICAL RESEARCH.] 544.8 The commissioner of health, in consultation with the 544.9 medical education and research costs advisory committee, shall 544.10 make recommendations for a process for the submission, review, 544.11 and approval of research grant applications. The process shall 544.12 give priority for grants to applications that are intended to 544.13 gather preliminary data for submission for a subsequent proposal 544.14 for funding from a federal agency or foundation, which awards 544.15 research money on a competitive, peer-reviewed basis. Grant 544.16 recipients must be able to demonstrate the ability to comply 544.17 with federal regulations on human subjects research in 544.18 accordance with Code of Federal Regulations, title 45, section 544.19 46, and shall conduct the proposed research. Grants may be 544.20 awarded to the University of Minnesota, the Mayo clinic, or any 544.21 other public or private organization in the state involved in 544.22 medical research. The commissioner shall report to the 544.23 legislature by January 15, 2000, with recommendations. 544.24 (Effective Date: Section 4 (62J.692) is effective the day 544.25 following final enactment.) 544.26 Sec. 5. [62J.82] [HEALTH CARE FUND.] 544.27 The health care fund is created as an account in the state 544.28 treasury. The commissioner of finance shall credit to the fund 544.29 $38,000,000 of each tobacco settlement payment received by the 544.30 state in the month of December, beginning December 2003, as a 544.31 result of the settlement of the lawsuit styled as State v. 544.32 Philip Morris Inc., No. C1-94-8565 (Minnesota District Court, 544.33 Second Judicial District). The state board of investment shall 544.34 invest the fund under section 11A.24. All earnings of the fund 544.35 must be credited to the fund. 544.36 (Effective Date: Section 5 (62J.82) is effective the day 545.1 following final enactment.) 545.2 Sec. 6. [137.44] [HEALTH PROFESSIONAL EDUCATION BUDGET 545.3 PLAN.] 545.4 The board of regents is requested to adopt a biennial 545.5 budget plan for making expenditures from the medical education 545.6 and research endowment fund dedicated for the instructional 545.7 costs of health professional programs at publicly funded 545.8 academic health centers. The budget plan may be submitted as 545.9 part of the University of Minnesota's biennial budget request. 545.10 (Effective Date: Section 6 (137.44) is effective the day 545.11 following final enactment.) 545.12 Sec. 7. [144.395] [TOBACCO PREVENTION ENDOWMENT FUND.] 545.13 Subdivision 1. [CREATION.] The tobacco prevention 545.14 endowment fund is created as an account in the state treasury. 545.15 The commissioner of finance shall credit to the fund 50 percent 545.16 of the tobacco settlement payments received by the state on 545.17 January 3, 2000, January 2, 2001, January 2, 2002, and January 545.18 2, 2003, as a result of the settlement of the lawsuit styled as 545.19 State v. Philip Morris Inc., No. C1-94-8565 (Minnesota District 545.20 Court, Second Judicial District). The state board of investment 545.21 shall invest the fund under section 11A.24. All earnings of the 545.22 fund must be credited to the fund. The principal of the fund 545.23 must be maintained inviolate. 545.24 Subd. 2. [ENDOWMENT FUND EXPENDITURES.] (a) Earnings from 545.25 the fund shall be spent to reduce the human and economic 545.26 consequences of tobacco use through tobacco prevention 545.27 measures. Beginning July 1, 2000, and on July 1 of each year 545.28 thereafter, earnings from the fund, up to five percent of the 545.29 fair market value of the fund on the preceding July 1 and up to 545.30 a prorated five percent of deposits received during the 545.31 preceding year, are appropriated from the fund to the 545.32 commissioner of health, who shall pay that amount to the 545.33 Minnesota partnership for action against tobacco. 545.34 (b) Minnesota partnership for action against tobacco shall 545.35 use the amounts received for tobacco use prevention measures, 545.36 except that a maximum of $200,000 of the first year's 546.1 appropriation and $300,000 of each annual appropriation 546.2 thereafter may be used for staffing and other expenses related 546.3 to this section. Members of the board of directors of the 546.4 partnership, and members of any advisory committees appointed by 546.5 the board to make recommendations for implementing tobacco use 546.6 prevention efforts, may be reimbursed for reasonable expenses 546.7 actually incurred in connection with activities related to 546.8 carrying out this section, but not for expenses reimbursed from 546.9 any other source. 546.10 (c) The Minnesota partnership for action against tobacco 546.11 shall not award any grants from the annual appropriations 546.12 received under this subdivision to any project in which a 546.13 partnership board member or staff member has a substantial 546.14 financial interest. 546.15 Subd. 3. [AUDITS REQUIRED.] The legislative auditor shall 546.16 audit endowment fund expenditures to ensure that the money is 546.17 spent for tobacco prevention measures. 546.18 Subd. 4. [REPORT.] (a) The Minnesota partnership for 546.19 action against tobacco must submit an annual report to the 546.20 legislature by January 15 of each year, beginning in 2001, on 546.21 prevention measures and initiatives undertaken during the 546.22 preceding year. The report must include: 546.23 (1) an accounting of expenses, detailing the amounts and 546.24 purposes for which money was spent; 546.25 (2) a list of grant awards; 546.26 (3) a report on the results of the tobacco prevention 546.27 measures; 546.28 (4) a copy of the legislative auditor's report; and 546.29 (5) how the statewide prevention efforts have been 546.30 coordinated and delivered through local public health agencies. 546.31 (b) The initial report submitted under this subdivision 546.32 must include a copy of the partnership's bylaws and tobacco 546.33 prevention policies or plans adopted by the board of directors. 546.34 Subd. 5. [SUNSET.] The tobacco prevention endowment fund 546.35 expires on June 30, 2010. Upon expiration, the commissioner of 546.36 finance shall transfer the principal and any remaining interest 547.1 to the general fund. 547.2 (Effective Date: Section 7 (144.395) is effective the day 547.3 following final enactment.) 547.4 Sec. 8. [256.956] [SENIOR PRESCRIPTION DRUG ENDOWMENT 547.5 FUND.] 547.6 Subdivision 1. [CREATION.] The senior prescription drug 547.7 endowment fund is created as an account in the state treasury. 547.8 The commissioner of finance shall credit to the fund 6.75 547.9 percent of the tobacco settlement payments received by the state 547.10 on January 3, 2000, January 2, 2001, January 2, 2002, and 547.11 January 2, 2003, as a result of the settlement of the lawsuit 547.12 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 547.13 District Court, Second Judicial District). The state board of 547.14 investment shall invest the fund under section 11A.24. All 547.15 earnings of the fund must be credited to the fund. 547.16 Subd. 2. [EXPENDITURES.] (a) As part of each biennial and 547.17 supplemental budget, the commissioner of finance shall forecast 547.18 the cost of providing coverage to the enrollees of the senior 547.19 citizen drug program under section 256.955 whose income is 547.20 between 120 percent and 200 percent of the federal poverty 547.21 guidelines. The commissioner of finance shall recognize the 547.22 projected costs of the program in the fund balance. 547.23 (b) Beginning July 1, 2000, and on July 1 of each year 547.24 thereafter, a sum equal to the projected costs as determined in 547.25 paragraph (a) for the following fiscal year is appropriated from 547.26 the fund to the commissioner of human services to be used for 547.27 the senior citizen drug program. 547.28 (Effective Date: Section 8 (256.956) is effective the day 547.29 following final enactment.) 547.30 Sec. 9. [APPROPRIATIONS.] 547.31 (a) $93,312,000 is appropriated from the general fund to 547.32 the commissioner of finance for transfer to the medical 547.33 education and research endowment fund in the fiscal year ending 547.34 June 30, 1999. 547.35 (b) $105,984,000 is appropriated from the general fund to 547.36 the commissioner of finance for payment to the Minnesota 548.1 families foundation in the fiscal year ending June 30, 1999. 548.2 (c) $230,400,000 is appropriated from the general fund to 548.3 the commissioner of finance for transfer to the tobacco 548.4 prevention endowment fund in the fiscal year ending June 30, 548.5 1999. 548.6 (d) $31,104,000 is appropriated from the general fund to 548.7 the commissioner of finance for transfer to the senior 548.8 prescription drug endowment fund in the fiscal year ending June 548.9 30, 1999. 548.10 (e) Of the tobacco settlement payments received by the 548.11 state on January 3, 2000, January 2, 2001, January 2, 2002, and 548.12 January 2, 2003, as a result of the settlement of the lawsuit 548.13 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 548.14 District Court, Second Judicial District), 23 percent is 548.15 appropriated to the commissioner of finance for payment to the 548.16 Minnesota families foundation. 548.17 Sec. 10. [EFFECTIVE DATE.] 548.18 When preparing the conference committee report for adoption 548.19 by the legislature, the revisor shall combine all effective date 548.20 notations in this article into this effective date section. 548.21 ARTICLE 11 548.22 MISCELLANEOUS 548.23 Section 1. Minnesota Statutes 1998, section 116L.02, is 548.24 amended to read: 548.25 116L.02 [JOB SKILLS PARTNERSHIP PROGRAM.] 548.26 (a) The Minnesota job skills partnership program is created 548.27 to act as a catalyst to bring together employers with specific 548.28 training needs with educational or other nonprofit institutions 548.29 which can design programs to fill those needs. The partnership 548.30 shall work closely with employers to train and place workers in 548.31 identifiable positions as well as assisting educational or other 548.32 nonprofit institutions in developing training programs that 548.33 coincide with current and future employer requirements. The 548.34 partnership shall provide grants to educational or other 548.35 nonprofit institutions for the purpose of training displaced 548.36 workers. A participating business must match the grant-in-aid 549.1 made by the Minnesota job skills partnership. The match may be 549.2 in the form of funding, equipment, or faculty. 549.3 (b) The partnership program shall administer the health 549.4 care and human services worker training and retention program 549.5 under sections 116L.10 to 116L.15. 549.6 Sec. 2. [116L.10] [PROGRAM ESTABLISHED.] 549.7 A health care and human services worker training and 549.8 retention program is established to: 549.9 (1) alleviate critical worker shortages confronting 549.10 specific geographical areas of the state, specific health care 549.11 and human services industries, or specific providers when 549.12 employers are not currently offering sufficient worker training 549.13 and retention options and are unable to do so because of the 549.14 limited size of the employer, economic circumstances, or other 549.15 limiting factors described in the grant application and verified 549.16 by the board; and 549.17 (2) increase opportunities for current and potential direct 549.18 care employees to qualify for advanced employment in the health 549.19 care or human services fields through experience, training, and 549.20 education. 549.21 Sec. 3. [116L.11] [DEFINITIONS.] 549.22 Subdivision 1. [SCOPE.] For the purposes of sections 549.23 116L.10 to 116L.15, the terms defined in this section have the 549.24 meanings given them unless the context clearly indicates 549.25 otherwise. 549.26 Subd. 2. [ELIGIBLE EMPLOYER.] "Eligible employer" means a 549.27 nursing facility, small rural hospital, intermediate care 549.28 facility for persons with mental retardation or related 549.29 conditions, waivered services provider, home health services 549.30 provider, personal care assistant services provider, 549.31 semi-independent living services provider, day training and 549.32 habilitation services provider, or similar provider of health 549.33 care or human services. 549.34 Subd. 3. [POTENTIAL EMPLOYEE TARGET GROUPS.] "Potential 549.35 employee target groups" means high school students, past and 549.36 present recipients of Minnesota family investment program 550.1 benefits, immigrants, senior citizens, current health care and 550.2 human services workers, and persons who are underemployed or 550.3 unemployed. 550.4 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 550.5 means an entity that may include a public or private institution 550.6 of higher education, work force center, county, and one or more 550.7 eligible employers, but must include a public or private 550.8 institution of higher education and one or more eligible 550.9 employers. 550.10 Sec. 4. [116L.12] [FUNDING MECHANISM.] 550.11 Subdivision 1. [APPLICATIONS.] A qualifying consortium 550.12 shall apply to the board in the manner specified by the board. 550.13 Subd. 2. [FISCAL REQUIREMENTS.] The application must 550.14 specify how the consortium will make maximum use of available 550.15 federal and state training, education, and employment funds to 550.16 minimize the need for training and retention grants. A 550.17 consortium must designate a lead agency as the fiscal agent for 550.18 reporting, claiming, and receiving payments. An institution of 550.19 higher learning may be designated as a lead agency, but the 550.20 governing board of a multicampus higher education system may not 550.21 be given that designation. 550.22 Subd. 3. [PROGRAM TARGETS.] Applications for grants must 550.23 describe targeted employers or types of employers and must 550.24 describe the specific critical work force shortage the program 550.25 is designed to alleviate. Programs may be limited 550.26 geographically or be statewide. The application must include 550.27 verification that in the process of determining that a critical 550.28 work force shortage exists in the target area, the applicant has: 550.29 (1) consulted available data on worker shortages; 550.30 (2) conferred with other employers in the target area; and 550.31 (3) compared shortages in the target area with shortages at 550.32 the regional or statewide level. 550.33 Subd. 4. [GRANTS.] Within the limits of available 550.34 appropriations, the board shall make grants to qualifying 550.35 consortia to operate local, regional, or statewide training and 550.36 retention programs. Grant awards must establish specific, 551.1 measurable outcomes and timelines for achieving those outcomes. 551.2 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 551.3 provide at least a 50 percent match from local resources for 551.4 money appropriated under this section. The local match 551.5 requirement may be reduced for consortia that include a 551.6 relatively large number of small employers whose financial 551.7 contribution has been reduced in accordance with section 116L.15. 551.8 In-kind services and expenditures under section 116L.13, 551.9 subdivision 2, may be used to meet this local match 551.10 requirement. The grant application must specify the financial 551.11 contribution from each member of the consortium. 551.12 Subd. 6. [INELIGIBLE WORKER CATEGORIES.] Grants shall not 551.13 be made to alleviate shortages of physicians, physician 551.14 assistants, or advanced practice nurses. 551.15 Subd. 7. [EVALUATION.] The board shall evaluate the 551.16 success of consortia that receive grants in achieving expected 551.17 outcomes and shall report to the legislature annually. The 551.18 report must compare consortia in terms of overall program costs, 551.19 costs per client, retention rates, advancement rates, and other 551.20 outcome measurements established in the grantmaking process. 551.21 The first report shall be due on March 15, 2000, and on January 551.22 15 annually in succeeding years. The report shall include any 551.23 recommendations from the board to modify the grant program. 551.24 Sec. 5. [116L.13] [PROGRAM REQUIREMENTS.] 551.25 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 551.26 consortium must implement a marketing and outreach strategy to 551.27 recruit into the health care and human services fields persons 551.28 from one or more of the potential employee target groups. 551.29 Recruitment strategies must include a screening process to 551.30 evaluate whether potential employees may be disqualified as the 551.31 result of a required background check or are otherwise unlikely 551.32 to succeed in the position for which they are being recruited. 551.33 Subd. 2. [RECRUITMENT AND RETENTION INCENTIVES.] Employer 551.34 members of a consortium must provide incentives to train and 551.35 retain employees. These incentives may include, but are not 551.36 limited to: 552.1 (1) paid salary during initial training periods, but only 552.2 if specifically approved by the board, which must certify that 552.3 the employer has not formerly paid employees during the initial 552.4 training period and is unable to do so because of the employer's 552.5 limited size, financial condition, or other factors; 552.6 (2) scholarship programs under which a specified amount is 552.7 deposited into an educational account for the employee for each 552.8 hour worked; 552.9 (3) the provision of advanced education to employees so 552.10 that they may qualify for advanced positions in the health care 552.11 or human services fields. This education may be provided at the 552.12 employer's site, at the site of a nearby employer, or at a local 552.13 educational institution or other site. Preference shall be 552.14 given to grantees that offer flexible advanced training to 552.15 employees at convenient sites, allow workers time off with pay 552.16 during the work day to participate, and provide education at no 552.17 cost to students or through employer-based scholarships that pay 552.18 expenses prior to the start of classes rather than upon 552.19 completion; 552.20 (4) work maturity or soft skills training, adult basic 552.21 education, English as a second language instruction, and basic 552.22 computer orientation for persons with limited previous 552.23 attachment to the work force due to a lack of these skills; 552.24 (5) child care subsidies during training or educational 552.25 activities; 552.26 (6) transportation to training and education programs; and 552.27 (7) programs to coordinate efforts by employer members of 552.28 the consortium to share staff among employers where feasible, to 552.29 pool employee and employer benefit contributions in order to 552.30 enhance benefit packages, and to coordinate education and 552.31 training opportunities for staff in order to increase the 552.32 availability and flexibility of education and training programs. 552.33 Subd. 3. [WORK HOUR LIMITS.] High school students 552.34 participating in a training and retention program shall not be 552.35 permitted to work more than 20 hours per week when school is in 552.36 session. 553.1 Sec. 6. [116L.14] [CAREER ENHANCEMENT REQUIREMENTS.] 553.2 All consortium members must work cooperatively to establish 553.3 and maintain a career ladder program under which direct care 553.4 staff have the opportunity to advance along a career development 553.5 path that includes regular educational opportunities, 553.6 coordination between job duties and educational opportunities, 553.7 and a planned series of promotions for which qualified employees 553.8 will be eligible. 553.9 Sec. 7. [116L.15] [SMALL EMPLOYER PROTECTION.] 553.10 Grantees must guarantee that small employers, including 553.11 licensed personal care assistant organizations, be allowed to 553.12 participate in consortium programs. The financial contribution 553.13 required from a small employer must be adjusted to reflect the 553.14 employer's financial circumstances.