Minnesota Legislature
SF 2361
as introduced - 82nd Legislature (2001 - 2002) Posted on 12/15/2009 12:00am
KEY: stricken = removed, old language.
underscored = added, new language.
1.1 A bill for an act 1.2 relating to the operation of state government; 1.3 modifying provisions relating to health; health 1.4 department; human services; human services department; 1.5 long-term care; medical assistance; general assistance 1.6 medical care; MinnesotaCare; prescription drug 1.7 program; home and community-based waivers; services 1.8 for persons with disabilities; group residential 1.9 housing; state-operated services; chemical dependency; 1.10 mental health; Minnesota family investment program; 1.11 general assistance program; child support enforcement; 1.12 adoption; children in need of protection or services; 1.13 termination of parental rights; child protection; 1.14 veterans nursing homes board; health-related licensing 1.15 boards; emergency medical services regulatory board; 1.16 Minnesota state council on disability; ombudsman for 1.17 mental health and mental retardation; ombudsman for 1.18 families; requiring reports; appropriating money; 1.19 amending Minnesota Statutes 2000, sections 13.46, 1.20 subdivision 4; 13.461, subdivision 17; 13B.06, 1.21 subdivision 7; 15A.083, subdivision 4; 16A.06, by 1.22 adding a subdivision; 16A.87; 62A.095, subdivision 1; 1.23 62A.48, subdivision 4, by adding subdivisions; 1.24 62J.152, subdivision 8; 62J.451, subdivision 5; 1.25 62J.692, subdivision 7; 62J.694, subdivision 2; 1.26 62Q.19, subdivision 1; 62S.01, by adding subdivisions; 1.27 62S.26; 103I.101, subdivision 6; 103I.112; 103I.208, 1.28 subdivisions 1, 2; 103I.235, subdivision 1; 103I.525, 1.29 subdivisions 2, 6, 8, 9; 103I.531, subdivisions 2, 6, 1.30 8, 9; 103I.535, subdivisions 2, 6, 8, 9; 103I.541, 1.31 subdivisions 2b, 4, 5; 103I.545; 116L.11, subdivision 1.32 4; 116L.12, subdivisions 4, 5; 116L.13, subdivision 1; 1.33 121A.15, by adding subdivisions; 144.057; 144.0721, 1.34 subdivision 1; 144.1202, subdivision 4; 144.122; 1.35 144.1464; 144.1494, subdivisions 1, 3, 4; 144.1496; 1.36 144.226, subdivision 4; 144.396, subdivision 7; 1.37 144.98, subdivision 3; 144A.071, subdivisions 1, 1a, 1.38 2, 4a; 144A.073, subdivision 2; 144D.01, subdivision 1.39 4; 145.881, subdivision 2; 145.882, subdivision 7, by 1.40 adding a subdivision; 145.885, subdivision 2; 148.212; 1.41 148.263, subdivision 2; 148.284; 150A.10, by adding a 1.42 subdivision; 157.16, subdivision 3; 157.22; 214.001, 1.43 by adding a subdivision; 214.002, subdivision 1; 1.44 214.01, by adding a subdivision; 214.104; 241.272, 1.45 subdivision 6; 242.192; 245.462, subdivision 18, by 1.46 adding subdivisions; 245.466, subdivision 2; 245.470, 2.1 by adding a subdivision; 245.474, subdivision 2, by 2.2 adding a subdivision; 245.4871, subdivision 27, by 2.3 adding subdivisions; 245.4875, subdivision 2; 2.4 245.4876, subdivision 1, by adding a subdivision; 2.5 245.488, by adding a subdivision; 245.4885, 2.6 subdivision 1; 245.4886, subdivision 1; 245.98, by 2.7 adding a subdivision; 245.982; 245.99, subdivision 4; 2.8 245A.03, subdivision 2b; 245A.04, subdivisions 3, 3a, 2.9 3b, 3c, 3d; 245A.05; 245A.06; 245A.07; 245A.08; 2.10 245A.13, subdivisions 7, 8; 245A.16, subdivision 1; 2.11 245B.08, subdivision 3; 252.275, subdivision 4b; 2.12 253.28, by adding a subdivision; 253B.02, subdivision 2.13 10; 253B.03, subdivisions 5, 10, by adding a 2.14 subdivision; 253B.04, subdivisions 1, 1a, by adding a 2.15 subdivision; 253B.045, subdivision 6; 253B.05, 2.16 subdivision 1; 253B.07, subdivision 1; 253B.09, 2.17 subdivision 1; 253B.10, subdivision 4; 254B.03, 2.18 subdivision 1; 254B.09, by adding a subdivision; 2.19 256.01, subdivision 2, by adding a subdivision; 2.20 256.045, subdivisions 3, 3b, 4; 256.476, subdivisions 2.21 1, 2, 3, 4, 5, 8, by adding a subdivision; 256.741, 2.22 subdivisions 1, 5, 8; 256.955, subdivisions 2, 2a, 7, 2.23 by adding a subdivision; 256.9657, subdivision 2; 2.24 256.969, subdivision 3a, by adding a subdivision; 2.25 256.975, by adding subdivisions; 256.979, subdivisions 2.26 5, 6; 256.98, subdivision 8; 256B.04, by adding a 2.27 subdivision; 256B.055, subdivision 3a; 256B.056, 2.28 subdivisions 1a, 4b; 256B.057, subdivisions 2, 9, by 2.29 adding subdivisions; 256B.061; 256B.0625, subdivisions 2.30 7, 13, 13a, 17, 17a, 18a, 19a, 19c, 20, 30, 34, by 2.31 adding subdivisions; 256B.0627, subdivisions 1, 2, 4, 2.32 5, 7, 8, 10, 11, by adding subdivisions; 256B.0635, 2.33 subdivisions 1, 2; 256B.0644; 256B.0911, subdivisions 2.34 1, 3, 5, 6, 7, by adding subdivisions; 256B.0913, 2.35 subdivisions 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 2.36 14; 256B.0915, subdivisions 1d, 3, 5; 256B.0917, by 2.37 adding a subdivision; 256B.093, subdivision 3; 2.38 256B.431, subdivision 2e, by adding subdivisions; 2.39 256B.433, subdivision 3a; 256B.434, subdivision 4; 2.40 256B.49, by adding subdivisions; 256B.5012, 2.41 subdivision 3, by adding subdivisions; 256B.69, 2.42 subdivisions 4, 5c, 23, by adding a subdivision; 2.43 256B.75; 256B.76; 256D.053, subdivision 1; 256D.35, by 2.44 adding subdivisions; 256D.425, subdivision 1; 256D.44, 2.45 subdivision 5; 256I.05, subdivisions 1d, 1e, by adding 2.46 a subdivision; 256J.08, subdivision 55a, by adding a 2.47 subdivision; 256J.21, subdivision 2; 256J.24, 2.48 subdivisions 2, 9, 10; 256J.31, subdivision 12; 2.49 256J.32, subdivision 4; 256J.37, subdivision 9; 2.50 256J.39, subdivision 2; 256J.42, subdivisions 1, 3, 4, 2.51 5; 256J.45, subdivisions 1, 2; 256J.46, subdivision 1; 2.52 256J.48, subdivision 1, by adding a subdivision; 2.53 256J.49, subdivisions 2, 13, by adding a subdivision; 2.54 256J.50, subdivisions 5, 10, by adding a subdivision; 2.55 256J.515; 256J.52, subdivisions 2, 3, 6; 256J.53, 2.56 subdivisions 1, 2, 3; 256J.56; 256J.62, subdivisions 2.57 2a, 9; 256J.625; 256J.645; 256K.03, subdivisions 1, 5; 2.58 256K.07; 256L.01, subdivision 4; 256L.02, subdivision 2.59 4; 256L.04, subdivision 2; 256L.05, subdivision 2; 2.60 256L.06, subdivision 3; 256L.07, subdivisions 1, 2, 3, 2.61 by adding subdivisions; 256L.12, by adding a 2.62 subdivision; 256L.15, subdivisions 1, 2; 256L.16; 2.63 260C.201, subdivision 1; 326.38; 393.07, by adding a 2.64 subdivision; 518.551, subdivision 13; 518.5513, 2.65 subdivision 5; 518.575, subdivision 1; 518.5851, by 2.66 adding a subdivision; 518.5853, by adding a 2.67 subdivision; 518.6111, subdivision 5; 518.6195; 2.68 518.64, subdivision 2; 518.641, subdivisions 1, 2, 3, 2.69 by adding a subdivision; 548.091, subdivision 1a; 2.70 609.115, subdivision 9; 611.23; 626.556, subdivisions 2.71 2, 10, 10b, 10d, 10e, 10f, 10i, 11, 12, by adding a 3.1 subdivision; 626.557, subdivisions 3, 9d, 12b; 3.2 626.5572, subdivision 17; 626.559, subdivision 2; Laws 3.3 1998, chapter 404, section 18, subdivision 4; Laws 3.4 1998, chapter 407, article 8, section 9; Laws 1999, 3.5 chapter 152, section 4; Laws 1999, chapter 216, 3.6 article 1, section 13, subdivision 4; Laws 1999, 3.7 chapter 245, article 3, section 45, as amended; Laws 3.8 1999, chapter 245, article 4, section 110; Laws 1999, 3.9 chapter 245, article 10, section 10, as amended; Laws 3.10 2000, chapter 364, section 2; proposing coding for new 3.11 law in Minnesota Statutes, chapters 62Q; 62S; 116L; 3.12 144; 144A; 144D; 145; 214; 244; 246; 256; 256B; 256J; 3.13 299A; repealing Minnesota Statutes 2000, sections 3.14 116L.12, subdivisions 2, 7; 144.148, subdivision 8; 3.15 144A.16; 145.882, subdivisions 3, 4; 145.9245; 3.16 145.927; 256.01, subdivision 18; 256.476, subdivision 3.17 7; 256.955, subdivision 2b; 256B.0635, subdivision 3; 3.18 256B.0911, subdivisions 2, 2a, 4, 8, 9; 256B.0912; 3.19 256B.0913, subdivisions 3, 15a, 15b, 15c, 16; 3.20 256B.0915, subdivisions 3a, 3b, 3c; 256B.434, 3.21 subdivision 5; 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 3.22 7, 8, 9, 10; 256D.066; 256E.06, subdivision 2b; 3.23 256J.08, subdivision 50a; 256J.12, subdivision 3; 3.24 256J.32, subdivision 7a; 256J.43; 256J.49, subdivision 3.25 11; 256J.53, subdivision 4; 256L.15, subdivision 3; 3.26 518.641, subdivisions 4, 5; Laws 1997, chapter 203, 3.27 article 9, section 21; Laws 1998, chapter 407, article 3.28 6, section 111; Laws 2000, chapter 488, article 10, 3.29 section 28; Laws 2000, chapter 488, article 10, 3.30 section 30; Minnesota Rules, parts 4655.6810; 3.31 4655.6820; 4655.6830; 4658.1600; 4658.1605; 4658.1610; 3.32 4658.1690; 9505.2390; 9505.2395; 9505.2396; 9505.2400; 3.33 9505.2405; 9505.2410; 9505.2413; 9505.2415; 9505.2420; 3.34 9505.2425; 9505.2426; 9505.2430; 9505.2435; 9505.2440; 3.35 9505.2445; 9505.2450; 9505.2455; 9505.2458; 9505.2460; 3.36 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 3.37 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 3.38 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 3.39 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 3.40 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 3.41 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 3.42 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 3.43 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 3.44 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 3.45 9505.3660; 9505.3670; 9546.0010; 9546.0020; 9546.0030; 3.46 9546.0040; 9546.0050; 9546.0060. 3.47 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF MINNESOTA: 3.48 ARTICLE 1 3.49 APPROPRIATIONS 3.50 Section 1. [HEALTH AND HUMAN SERVICES APPROPRIATIONS.] 3.51 The sums shown in the columns marked "APPROPRIATIONS" are 3.52 appropriated from the general fund, or any other fund named, to 3.53 the agencies and for the purposes specified in the following 3.54 sections of this article, to be available for the fiscal years 3.55 indicated for each purpose. The figures "2002" and "2003" where 3.56 used in this article, mean that the appropriation or 3.57 appropriations listed under them are available for the fiscal 3.58 year ending June 30, 2002, or June 30, 2003, respectively. 4.1 Where a dollar amount appears in parentheses, it means a 4.2 reduction of an appropriation. 4.3 SUMMARY BY FUND 4.4 APPROPRIATIONS BIENNIAL 4.5 2002 2003 TOTAL 4.6 General $3,193,708,000 $3,538,372,000 $6,732,080,000 4.7 State Government 4.8 Special Revenue 38,548,000 40,671,000 79,219,000 4.9 Health Care 4.10 Access 233,995,000 307,873,000 541,868,000 4.11 Federal TANF 295,060,000 302,841,000 597,901,000 4.12 Lottery Cash Flow 4,090,000 3,540,000 7,630,000 4.13 TOTAL $3,765,401,000 $4,193,297,000 $7,958,698,000 4.14 APPROPRIATIONS 4.15 Available for the Year 4.16 Ending June 30 4.17 2002 2003 4.18 Sec. 2. COMMISSIONER OF 4.19 HUMAN SERVICES 4.20 Subdivision 1. Total 4.21 Appropriation $3,586,384,000 $4,014,475,000 4.22 Summary by Fund 4.23 General 3,073,644,000 3,413,594,000 4.24 State Government 4.25 Special Revenue 520,000 534,000 4.26 Health Care 4.27 Access 222,060,000 300,506,000 4.28 Federal TANF 288,520,000 296,301,000 4.29 Lottery Cash Flow 4,090,000 3,540,000 4.30 TOTAL 3,586,384,000 4,014,475,000 4.31 [RECEIPTS FOR SYSTEMS PROJECTS.] 4.32 Appropriations and federal receipts for 4.33 information system projects for MAXIS, 4.34 PRISM, MMIS, and SSIS must be deposited 4.35 in the state system account authorized 4.36 in Minnesota Statutes, section 4.37 256.014. Money appropriated for 4.38 computer projects approved by the 4.39 Minnesota office of technology, funded 4.40 by the legislature, and approved by the 4.41 commissioner of finance may be 4.42 transferred from one project to another 4.43 and from development to operations as 4.44 the commissioner of human services 4.45 considers necessary. Any unexpended 4.46 balance in the appropriation for these 4.47 projects does not cancel but is 4.48 available for ongoing development and 4.49 operations. 4.50 [GIFTS.] Notwithstanding Minnesota 5.1 Statutes, chapter 7, the commissioner 5.2 may accept on behalf of the state 5.3 additional funding from sources other 5.4 than state funds for the purpose of 5.5 financing the cost of assistance 5.6 program grants or nongrant 5.7 administration. All additional funding 5.8 is appropriated to the commissioner for 5.9 use as designated by the grantor of 5.10 funding. 5.11 [SYSTEMS CONTINUITY.] In the event of 5.12 disruption of technical systems or 5.13 computer operations, the commissioner 5.14 may use available grant appropriations 5.15 to ensure continuity of payments for 5.16 maintaining the health, safety, and 5.17 well-being of clients served by 5.18 programs administered by the department 5.19 of human services. Grant funds must be 5.20 used in a manner consistent with the 5.21 original intent of the appropriation. 5.22 [SPECIAL REVENUE FUND INFORMATION.] On 5.23 December 1, 2001, and December 1, 2002, 5.24 the commissioner shall provide the 5.25 chairs of the house health and human 5.26 services finance committee and the 5.27 senate health, human services, and 5.28 corrections budget division with 5.29 detailed fund balance information for 5.30 each special revenue fund account. 5.31 [FEDERAL ADMINISTRATIVE REIMBURSEMENT.] 5.32 Federal administrative reimbursement 5.33 resulting from MinnesotaCare outreach 5.34 grants and the Minnesota senior health 5.35 options project are appropriated to the 5.36 commissioner for these activities. 5.37 [NONFEDERAL SHARE TRANSFERS.] The 5.38 nonfederal share of activities for 5.39 which federal administrative 5.40 reimbursement is appropriated to the 5.41 commissioner may be transferred to the 5.42 special revenue fund. 5.43 [MAJOR SYSTEMS ONE-TIME TRANSFER.] 5.44 $29,000,000 of funds available in the 5.45 state systems account authorized in 5.46 Minnesota Statutes, section 256.014, is 5.47 transferred in fiscal year 2002 to the 5.48 general fund. 5.49 [TANF FUNDS APPROPRIATED TO OTHER 5.50 ENTITIES.] Any expenditures from the 5.51 TANF block grant shall be expended in 5.52 accordance with the requirements and 5.53 limitations of part A of title IV of 5.54 the Social Security Act, as amended, 5.55 and any other applicable federal 5.56 requirement or limitation. Prior to 5.57 any expenditure of these funds, the 5.58 commissioner shall assure that funds 5.59 are expended in compliance with the 5.60 requirements and limitations of federal 5.61 law and that any reporting requirements 5.62 of federal law are met. It shall be 5.63 the responsibility of any entity to 5.64 which these funds are appropriated to 5.65 implement a memorandum of understanding 6.1 with the commissioner that provides the 6.2 necessary assurance of compliance prior 6.3 to any expenditure of funds. The 6.4 commissioner shall receipt TANF funds 6.5 appropriated to other state agencies 6.6 and coordinate all related interagency 6.7 accounting transactions necessary to 6.8 implement these appropriations. 6.9 Unexpended TANF funds appropriated to 6.10 any state, local, or nonprofit entity 6.11 cancel at the end of the state fiscal 6.12 year unless appropriating language 6.13 permits otherwise. 6.14 [TANF FUNDS TRANSFERRED TO OTHER 6.15 FEDERAL GRANTS.] The commissioner must 6.16 authorize transfers from TANF to other 6.17 federal block grants so that funds are 6.18 available to meet the annual 6.19 expenditure needs as appropriated. 6.20 Transfers may be authorized prior to 6.21 the expenditure year with the agreement 6.22 of the receiving entity. Transferred 6.23 funds must be expended in the year for 6.24 which the funds were appropriated 6.25 unless appropriation language permits 6.26 otherwise. In accelerating transfer 6.27 authorizations, the commissioner must 6.28 aim to preserve the future potential 6.29 transfer capacity from TANF to other 6.30 block grants. 6.31 [TANF MAINTENANCE OF EFFORT.] (a) In 6.32 order to meet the basic maintenance of 6.33 effort (MOE) requirements of the TANF 6.34 block grant specified under Code of 6.35 Federal Regulations, title 45, section 6.36 263.1, the commissioner may only report 6.37 nonfederal money expended for allowable 6.38 activities listed in the following 6.39 clauses as TANF MOE expenditures: 6.40 (1) MFIP cash and food assistance 6.41 benefits under Minnesota Statutes, 6.42 chapter 256J; 6.43 (2) the child care assistance programs 6.44 under Minnesota Statutes, sections 6.45 119B.03 and 119B.05, and county child 6.46 care administrative costs under 6.47 Minnesota Statutes, section 119B.15; 6.48 (3) state and county MFIP 6.49 administrative costs under Minnesota 6.50 Statutes, chapters 256J and 256K; 6.51 (4) state, county, and tribal MFIP 6.52 employment services under Minnesota 6.53 Statutes, chapters 256J and 256K; and 6.54 (5) expenditures made on behalf of 6.55 noncitizen MFIP recipients who qualify 6.56 for the medical assistance without 6.57 federal financial participation program 6.58 under Minnesota Statutes, section 6.59 256B.06, subdivision 4, paragraphs (d), 6.60 (e), and (j). 6.61 (b) The commissioner shall ensure that 6.62 sufficient qualified nonfederal 6.63 expenditures are made each year to meet 7.1 the state's TANF MOE requirements. For 7.2 the activities listed in paragraph (a), 7.3 clauses (2) to (5), the commissioner 7.4 may only report expenditures that are 7.5 excluded from the definition of 7.6 assistance under Code of Federal 7.7 Regulations, title 45, section 260.31. 7.8 (c) By August 31 of each year, the 7.9 commissioner shall make a preliminary 7.10 calculation to determine the likelihood 7.11 that the state will meet its annual 7.12 federal work participation requirement 7.13 under Code of Federal Regulations, 7.14 title 45, sections 261.21 and 261.23, 7.15 after adjustment for any caseload 7.16 reduction credit under Code of Federal 7.17 Regulations, title 45, section 261.41. 7.18 If the commissioner determines that the 7.19 state will meet its federal work 7.20 participation rate for the federal 7.21 fiscal year ending that September, the 7.22 commissioner may reduce the expenditure 7.23 under paragraph (a), clause (1), to the 7.24 extent allowed under Code of Federal 7.25 Regulations, title 45, section 7.26 263.1(a)(2). 7.27 (d) For fiscal years beginning with 7.28 state fiscal year 2003, the 7.29 commissioner shall assure that the 7.30 maintenance of effort used by the 7.31 commissioner of finance for the 7.32 February and November forecasts 7.33 required under Minnesota Statutes, 7.34 section 16A.103, contains expenditures 7.35 under paragraph (a), clause (1), equal 7.36 to at least 25 percent of the total 7.37 required under Code of Federal 7.38 Regulations, title 45, section 263.1. 7.39 (e) If nonfederal expenditures for the 7.40 programs and purposes listed in 7.41 paragraph (a) are insufficient to meet 7.42 the state's TANF MOE requirements, the 7.43 commissioner shall recommend additional 7.44 allowable sources of nonfederal 7.45 expenditures to the legislature, if the 7.46 legislature is or will be in session to 7.47 take action to specify additional 7.48 sources of nonfederal expenditures for 7.49 TANF MOE before a federal penalty is 7.50 imposed. The commissioner shall 7.51 otherwise provide notice to the 7.52 legislative commission on planning and 7.53 fiscal policy under paragraph (g). 7.54 (f) If the commissioner uses authority 7.55 granted under Laws 1999, chapter 245, 7.56 article 1, section 10, or similar 7.57 authority granted by a subsequent 7.58 legislature, to meet the state's TANF 7.59 MOE requirements in a reporting period, 7.60 the commissioner shall inform the 7.61 chairs of the appropriate legislative 7.62 committees about all transfers made 7.63 under that authority for this purpose. 7.64 (g) If the commissioner determines that 7.65 nonfederal expenditures for the 7.66 programs under paragraph (a), are 8.1 insufficient to meet TANF MOE 8.2 expenditure requirements, and if the 8.3 legislature is not or will not be in 8.4 session to take timely action to avoid 8.5 a federal penalty, the commissioner may 8.6 report nonfederal expenditures from 8.7 other allowable sources as TANF MOE 8.8 expenditures after the requirements of 8.9 this paragraph are met. The 8.10 commissioner may report nonfederal 8.11 expenditures in addition to those 8.12 specified under paragraph (a) as 8.13 nonfederal TANF MOE expenditures, but 8.14 only ten days after the commissioner of 8.15 finance has first submitted the 8.16 commissioner's recommendations for 8.17 additional allowable sources of 8.18 nonfederal TANF MOE expenditures to the 8.19 members of the legislative commission 8.20 on planning and fiscal policy for their 8.21 review. 8.22 (h) The commissioner of finance shall 8.23 not incorporate any changes in federal 8.24 TANF expenditures or nonfederal 8.25 expenditures for TANF MOE that may 8.26 result from reporting additional 8.27 allowable sources of nonfederal TANF 8.28 MOE expenditures under the interim 8.29 procedures in paragraph (g) into the 8.30 February or November forecasts required 8.31 under Minnesota Statutes, section 8.32 16A.103, unless the commissioner of 8.33 finance has approved the additional 8.34 sources of expenditures under paragraph 8.35 (g). 8.36 (i) The provisions of Minnesota 8.37 Statutes, section 256.011, subdivision 8.38 3, which require that federal grants or 8.39 aids secured or obtained under that 8.40 subdivision be used to reduce any 8.41 direct appropriations provided by law, 8.42 do not apply if the grants or aids are 8.43 federal TANF funds. 8.44 (j) Notwithstanding section 14 of this 8.45 article, paragraphs (a) to (j) expire 8.46 June 30, 2005. 8.47 Subd. 2. Agency Management 8.48 General 38,519,000 38,053,000 8.49 State Government 8.50 Special Revenue 403,000 415,000 8.51 Health Care 8.52 Access 3,631,000 3,673,000 8.53 Federal TANF 165,000 165,000 8.54 The amounts that may be spent from the 8.55 appropriation for each purpose are as 8.56 follows: 8.57 (a) Financial Operations 8.58 General 6,872,000 7,041,000 8.59 Health Care 9.1 Access 815,000 828,000 9.2 Federal TANF 165,000 165,000 9.3 (b) Legal & Regulation Operations 9.4 General 8,405,000 8,239,000 9.5 State Government 9.6 Special Revenue 403,000 415,000 9.7 Health Care 9.8 Access 239,000 244,000 9.9 (c) Management Operations 9.10 General 23,242,000 22,773,000 9.11 Health Care 9.12 Access 2,577,000 2,601,000 9.13 Subd. 3. Administrative Reimbursement/ 9.14 Passthrough 9.15 Federal TANF 58,605 56,992 9.16 Subd. 4. Children's Services Grants 9.17 General 66,147,000 71,129,000 9.18 Federal TANF 6,290,000 6,290,000 9.19 [ADOPTION ASSISTANCE INCENTIVE GRANTS.] 9.20 Federal funds available during the 9.21 biennium ending June 30, 2003, for 9.22 adoption incentive grants are 9.23 appropriated to the commissioner for 9.24 these purposes. 9.25 [TANF TRANSFER TO SOCIAL SERVICES.] 9.26 $4,650,000 is appropriated to the 9.27 commissioner in fiscal year 2002 and in 9.28 fiscal year 2003 for purposes of 9.29 increasing services for families with 9.30 children whose incomes are at or below 9.31 200 percent of the federal poverty 9.32 guidelines. The commissioner shall 9.33 authorize a sufficient transfer of 9.34 funds from the state's federal TANF 9.35 block grant to the state's federal 9.36 social services block grant to meet 9.37 this appropriation. 9.38 [SOCIAL SERVICES BLOCK GRANT FUNDS FOR 9.39 CONCURRENT PERMANENCY PLANNING.] 9.40 Notwithstanding Minnesota Statutes, 9.41 section 256E.07, $4,650,000 in fiscal 9.42 year 2002 and $4,650,000 in fiscal year 9.43 2003 in social services block grant 9.44 funds allocated to the commissioner 9.45 under title XX of the Social Security 9.46 Act are available for distribution to 9.47 counties under the formula in Minnesota 9.48 Statutes, section 260C.213, for the 9.49 purposes of concurrent permanency 9.50 planning. 9.51 [CHILDREN'S MENTAL HEALTH GRANTS.] Of 9.52 the general fund appropriation, 9.53 $1,000,000 in fiscal year 2002 and 9.54 $1,000,000 in fiscal year 2003 is for 9.55 children's mental health grants under 10.1 Minnesota Statutes, section 245.4886. 10.2 Subd. 5. Children's Services Management 10.3 General 5,645,000 5,724,000 10.4 [FEDERAL FINANCIAL PARTICIPATION 10.5 MAXIMIZATION FOR OUT-OF-HOME CARE.] The 10.6 commissioner of human services and the 10.7 commissioner of corrections shall 10.8 cooperate in efforts to maximize 10.9 federal financial participation in the 10.10 costs of providing out-of-home 10.11 placements for juveniles. 10.12 Subd. 6. Basic Health Care Grants 10.13 Summary by Fund 10.14 General 1,164,615,000 1,387,879,000 10.15 Health Care 10.16 Access 198,568,000 277,349,000 10.17 The amounts that may be spent from this 10.18 appropriation for each purpose are as 10.19 follows: 10.20 (a) MinnesotaCare Grants 10.21 Health Care 10.22 Access 197,818,000 276,599,000 10.23 [MINNESOTACARE FEDERAL RECEIPTS.] 10.24 Receipts received as a result of 10.25 federal participation pertaining to 10.26 administrative costs of the Minnesota 10.27 health care reform waiver shall be 10.28 deposited as nondedicated revenue in 10.29 the health care access fund. Receipts 10.30 received as a result of federal 10.31 participation pertaining to grants 10.32 shall be deposited in the federal fund 10.33 and shall offset health care access 10.34 funds for payments to providers. 10.35 [MINNESOTACARE FUNDING.] The 10.36 commissioner may expend money 10.37 appropriated from the health care 10.38 access fund for MinnesotaCare in either 10.39 fiscal year of the biennium. 10.40 [DENTAL ACCESS GRANTS.] Of this 10.41 appropriation, $1,000,000 in fiscal 10.42 year 2002 is to be distributed as 10.43 dental access grants in accordance with 10.44 Minnesota Statutes, section 256B.53. 10.45 If the amount appropriated is not used 10.46 within the fiscal year, the 10.47 commissioner of finance shall transfer 10.48 any remaining amount to the 10.49 commissioner of health to be 10.50 distributed as rural hospital capital 10.51 improvement grants for fiscal year 2003. 10.52 [HEALTH CARE SAFETY NET ENDOWMENT 10.53 FUND.] The commissioner of finance 10.54 shall transfer $150,000,000 from the 10.55 health care access fund to the health 10.56 care safety net endowment fund. 10.57 (b) MA Basic Health Care Grants - 11.1 Families and Children 11.2 General 475,611,000 577,293,000 11.3 [INDIAN HEALTH SERVICES FEDERAL MATCH.] 11.4 In the event the federal medical 11.5 assistance percentage rate increases to 11.6 100 percent for services provided as a 11.7 result of a referral by the federal 11.8 Indian health service or a tribal 11.9 provider, the commissioner is 11.10 authorized to increase the payment rate 11.11 for referrals by ten percent as an 11.12 incentive for the completion of 11.13 documentation required for increased 11.14 federal participation. Unspent state 11.15 medical assistance appropriations 11.16 resulting from the increase in the 11.17 federal medical assistance percentage 11.18 rate shall be transferred to the 11.19 appropriate account and are available 11.20 to the commissioner for covering the 11.21 costs of out-stationed health care 11.22 program eligibility services on 11.23 reservations. The base appropriation 11.24 for the 2004-2005 biennium for these 11.25 services must not exceed the state 11.26 medical assistance savings. These 11.27 actions are intended to improve access 11.28 to health care and assist in 11.29 eliminating disparities in health 11.30 status for American Indian people. 11.31 [PROVIDER SURCHARGE OFFSET.] The 11.32 commissioner shall reduce future 11.33 billings under Minnesota Statutes, 11.34 section 256.9657, to offset $1,600,000 11.35 in excess provider surcharges 11.36 erroneously collected from a health 11.37 care system established in 1994. The 11.38 future billings must be reduced by 11.39 $400,000 in each of the fiscal years 11.40 beginning with fiscal year 2002 through 11.41 fiscal year 2005, for a total reduction 11.42 of $1,600,000. Notwithstanding section 11.43 14, this provision expires on June 30, 11.44 2005. 11.45 [PMAP RATES.] Prepaid medical 11.46 assistance, general assistance medical 11.47 care, and MinnesotaCare program rates 11.48 set by the commissioner under Minnesota 11.49 Statutes, section 256B.69, effective on 11.50 or after January 1, 2002, shall not 11.51 reflect any increase in cost due to 11.52 changes made to Minnesota Statutes, 11.53 sections 62Q.56 and 62Q.58, by the 2001 11.54 legislature. Notwithstanding section 11.55 14, this paragraph shall not expire. 11.56 [COLLECTION OF HOSPITAL OVERPAYMENTS.] 11.57 (a) The commissioner shall not commence 11.58 collection of hospital overpayments 11.59 resulting from a determination that 11.60 medical assistance and general 11.61 assistance payments exceeded the charge 11.62 limit during the period from 1994 to 11.63 1997 until after any available appeals 11.64 have been exhausted. 11.65 (b) For small rural hospitals, as 12.1 defined in Minnesota Statutes, section 12.2 144.148, any amounts then due to the 12.3 state may be funded through the grant 12.4 program provided in section 3 for those 12.5 hospitals. 12.6 (c) MA Basic Health Care Grants - 12.7 Elderly and Disabled 12.8 General 520,190,000 609,372,000 12.9 (d) General Assistance Medical Care 12.10 General 157,384,000 179,229,000 12.11 (e) Health Care Grants - Other Assistance 12.12 General 11,430,000 21,985,000 12.13 Health Care Access 750,000 750,000 12.14 [STOP-LOSS FUND ACCOUNT.] Of the 12.15 general fund appropriation, $200,000 in 12.16 fiscal year 2002 and $385,000 in fiscal 12.17 year 2003 is to the commissioner to be 12.18 deposited in the stop-loss fund account 12.19 to be distributed in accordance with 12.20 Minnesota Statutes, section 256.956. 12.21 Subd. 7. Basic Health Care Management 12.22 General 21,967,000 21,341,000 12.23 Health Care 12.24 Access 16,528,000 18,135,000 12.25 The amounts that may be spent from this 12.26 appropriation for each purpose are as 12.27 follows: 12.28 (a) Health Care Policy Administration 12.29 General 3,095,000 3,188,000 12.30 Health Care 12.31 Access 578,000 595,000 12.32 [OUTREACH EFFORTS.] (a) Of the general 12.33 fund appropriation, $120,000 each year 12.34 is to the commissioner to: 12.35 (1) coordinate a public/private 12.36 partnership to provide a statewide 12.37 outreach campaign on the importance of 12.38 health coverage and the availability of 12.39 coverage through both public assistance 12.40 health care programs and the private 12.41 health insurance market. The campaign 12.42 shall include messages directed to the 12.43 general population as well as 12.44 culturally specific and community-based 12.45 messages; and 12.46 (2) award grants to public or private 12.47 organizations to provide local 12.48 community-based outreach to assist 12.49 families with children in obtaining 12.50 health coverage. In awarding these 12.51 grants, the commissioner shall consider 12.52 the following: 13.1 (i) the ability to contact or serve 13.2 non-English-speaking families; 13.3 (ii) the ability to provide trained 13.4 workers at accessible outreach centers 13.5 to assist families with children by 13.6 offering services ranging from 13.7 providing information up to on-site 13.8 enrollment in a health care program; 13.9 and 13.10 (iii) the ability to serve geographic 13.11 areas and populations with the greatest 13.12 disparity in health coverage and health 13.13 status. 13.14 (b) The commissioner shall include 13.15 specific performance expectations that 13.16 will require grantees to track the 13.17 number of enrollees in state programs, 13.18 monitor these grants, and may terminate 13.19 a grant if the outreach effort does not 13.20 increase enrollment in the state health 13.21 care programs. 13.22 (c) The commissioner shall provide 13.23 applications and other health care 13.24 program information to provider 13.25 offices, hospitals, local human 13.26 services agencies, community health 13.27 sites, and elementary schools to 13.28 encourage and assist these sites in 13.29 conducting outreach efforts. These 13.30 sites may assist families with children 13.31 by offering services ranging from 13.32 providing information up to on-site 13.33 enrollment in public assistance 13.34 programs. 13.35 (b) Health Care Operations 13.36 General 18,872,000 19,153,000 13.37 Health Care 13.38 Access 15,950,000 17,540,000 13.39 [PREPAID MEDICAL PROGRAMS.] The 13.40 nonfederal share of the prepaid medical 13.41 assistance program fund, which has been 13.42 appropriated to fund county managed 13.43 care advocacy and enrollment operating 13.44 costs, shall be disbursed as grants 13.45 using either a reimbursement or block 13.46 grant mechanism and may also be 13.47 transferred between grants and nongrant 13.48 administration costs with approval of 13.49 the commissioner of finance. 13.50 Subd. 8. State-Operated Services 13.51 General 211,440,000 206,465,000 13.52 [MITIGATION RELATED TO STATE-OPERATED 13.53 SERVICES RESTRUCTURING.] Money 13.54 appropriated to finance mitigation 13.55 expenses related to restructuring 13.56 state-operated services programs and 13.57 administrative services may be 13.58 transferred between fiscal years within 13.59 the biennium. 14.1 [STATE-OPERATED SERVICES CHEMICAL 14.2 DEPENDENCY PROGRAMS.] When the 14.3 operations of the state-operated 14.4 services chemical dependency fund 14.5 created in Minnesota Statutes, section 14.6 246.18, subdivision 2, are impeded by 14.7 projected cash deficiencies resulting 14.8 from delays in the receipt of grants, 14.9 dedicated income, or other similar 14.10 receivables, and when the deficiencies 14.11 would be corrected within the budget 14.12 period involved, the commissioner of 14.13 finance may transfer general fund cash 14.14 reserves into this account as necessary 14.15 to meet cash demands. The cash flow 14.16 transfers must be returned to the 14.17 general fund in the fiscal year that 14.18 the transfer was made. Any interest 14.19 earned on general fund cash flow 14.20 transfers accrues to the general fund 14.21 and not the state-operated services 14.22 chemical dependency fund. 14.23 [STATE-OPERATED SERVICES 14.24 RESTRUCTURING.] For purposes of 14.25 restructuring state-operated services, 14.26 any state-operated services employee 14.27 whose position is to be eliminated 14.28 shall be afforded the options provided 14.29 in applicable collective bargaining 14.30 agreements. All salary and mitigation 14.31 allocations from fiscal year 2002 shall 14.32 be carried forward into fiscal year 14.33 2003. Provided there is no conflict 14.34 with any collective bargaining 14.35 agreement, any state-operated services 14.36 position reduction must only be 14.37 accomplished through mitigation, 14.38 attrition, transfer, and other measures 14.39 as provided in state or applicable 14.40 collective bargaining agreements and in 14.41 Minnesota Statutes, section 252.50, 14.42 subdivision 11, and not through layoff. 14.43 [REPAIRS AND BETTERMENTS.] The 14.44 commissioner may transfer unencumbered 14.45 appropriation balances between fiscal 14.46 years for the state residential 14.47 facilities repairs and betterments 14.48 account and special equipment. 14.49 [NAMES REQUIRED ON GRAVES.] (a) Of this 14.50 appropriation, $300,000 in fiscal year 14.51 2002 is to replace numbers with the 14.52 names of individuals at all graves 14.53 located at regional treatment centers 14.54 operated or formerly operated by the 14.55 commissioner. 14.56 (b) Twenty percent of this 14.57 appropriation must be transferred to a 14.58 consumer run disability rights 14.59 organization located in St. Paul for 14.60 community organizing, coordination, 14.61 fundraising, and administrative costs. 14.62 (c) Any unexpended portion of this 14.63 appropriation shall not cancel but 14.64 shall be available in fiscal year 2003 14.65 for these purposes. This is a one-time 14.66 appropriation and shall not become part 15.1 of the base level funding for the 15.2 2004-2005 biennium. 15.3 [BUILDING REMODELING.] The commissioner 15.4 shall use $400,000 from the 15.5 appropriation for repairs and 15.6 betterments to remodel building 6 at 15.7 the Brainerd regional human services 15.8 center to make the structure suitable 15.9 for school programs. The Brainerd 15.10 school district shall reimburse the 15.11 commissioner $200,000 in fiscal year 15.12 2002 and $200,000 in fiscal year 2003 15.13 through a lease agreement for these 15.14 remodeling costs. 15.15 Subd. 9. Continuing Care Grants 15.16 General 1,363,147,000 1,474,989,000 15.17 Lottery Cash Flow 3,850,000 3,300,000 15.18 The amounts that may be spent from this 15.19 appropriation for each purpose are as 15.20 follows: 15.21 (a) Community Social Services 15.22 Block Grants 15.23 48,910,000 49,836,000 15.24 [CSSA TRADITIONAL APPROPRIATION.] 15.25 Notwithstanding Minnesota Statutes, 15.26 section 256E.06, subdivisions 1 and 2, 15.27 the appropriations available under that 15.28 section in fiscal years 2002 and 2003 15.29 must be distributed to each county 15.30 proportionately to the aid received by 15.31 the county in calendar year 2000. 15.32 (b) Aging Adult Service Grants 15.33 14,117,000 13,788,000 15.34 [AGING AND ADULT SERVICE GRANT 15.35 CARRYFORWARD AUTHORITY.] Unexpended 15.36 funds appropriated for Senior LinkAge 15.37 line, community services grants, and 15.38 access demonstration project grants for 15.39 fiscal year 2002 do not cancel but are 15.40 available to the commissioner for these 15.41 purposes for fiscal year 2003. 15.42 [HOME-SHARING GRANTS.] Of this 15.43 appropriation, $225,000 in fiscal year 15.44 2002 and $400,000 in fiscal year 2003 15.45 is for the home-sharing grant program 15.46 under Minnesota Statutes, section 15.47 256.973. This appropriation shall 15.48 become part of the base level funding 15.49 for the 2004-2005 biennium. 15.50 [THE CENTER FOR VICTIMS OF TORTURE.] Of 15.51 the appropriation for fiscal year 2002, 15.52 $450,000 is for a grant to the center 15.53 for victims of torture. The grant is 15.54 to be used to conduct continuing 15.55 education and training of health care 15.56 and human service workers on how to 15.57 identify torture survivors, provide 15.58 appropriate care and make referrals, 16.1 and to establish a network of care 16.2 providers who will offer pro bono 16.3 services for survivors of politically 16.4 motivated torture. This is a one-time 16.5 appropriation requiring a one-to-one, 16.6 nonstate, in-kind match, and is 16.7 available until expended. 16.8 (c) Deaf and Hard-of-Hearing 16.9 Services Grants 16.10 2,169,000 1,943,000 16.11 [SERVICES TO DEAF PERSONS WITH MENTAL 16.12 ILLNESS.] (a) Of this appropriation, 16.13 $125,000 in fiscal year 2002 and 16.14 $60,000 in fiscal year 2003 is for a 16.15 grant to a nonprofit agency that 16.16 currently serves deaf and 16.17 hard-of-hearing adults with mental 16.18 illness through residential programs 16.19 and supportive housing outreach 16.20 activities. The grant must be used to 16.21 continue and maintain community support 16.22 services for deaf and hard-of-hearing 16.23 adults with mental illness who use or 16.24 wish to use sign language as their 16.25 primary means of communication. 16.26 (b) The grant for fiscal year 2003 16.27 shall be increased by $65,000 minus 16.28 earnings achieved by the grantee 16.29 through participation in the medical 16.30 assistance rehabilitation option for 16.31 persons with mental illness under 16.32 Minnesota Statutes, section 256B.0623. 16.33 The grant shall not be less than 16.34 $60,000. 16.35 (c) The base level funding for the 16.36 2004-2005 biennium shall be $125,000 16.37 minus earnings achieved by the grantee 16.38 through participation in the medical 16.39 assistance rehabilitation option for 16.40 persons with mental illness under 16.41 Minnesota Statutes, section 256B.0623. 16.42 [COMMISSION SERVING DEAF AND 16.43 HARD-OF-HEARING PEOPLE.] Of this 16.44 appropriation, $5,000 in fiscal year 16.45 2002 is to the commissioner for the 16.46 Minnesota commission serving deaf and 16.47 hard-of-hearing people to carry out the 16.48 duties under Minnesota Statutes, 16.49 section 256C.28. 16.50 [DEAF-BLIND SERVICES.] Of this 16.51 appropriation, $212,000 in fiscal year 16.52 2002 and $150,000 in fiscal year 2003 16.53 are for grants to providers to provide 16.54 deaf-blind persons with residential 16.55 training and self-sufficiency supports. 16.56 (d) Mental Health Grants 16.57 General 52,694,000 54,386,000 16.58 Lottery Cash Flow 3,850,000 3,300,000 16.59 [MENTAL HEALTH COUNSELING FOR FARM 16.60 FAMILIES.] Of the general fund 17.1 appropriation, $150,000 in fiscal year 17.2 2002 and $150,000 in fiscal year 2003 17.3 is to be transferred to the board of 17.4 trustees of the Minnesota state 17.5 colleges and universities for mental 17.6 health counseling support to farm 17.7 families and business operators through 17.8 the farm business management program at 17.9 Central Lakes College and Ridgewater 17.10 College. This appropriation is 17.11 available until June 30, 2003. 17.12 [COSTS ASSOCIATED WITH STATE INMATES 17.13 WITH MENTAL ILLNESS.] (a) Of the 17.14 general fund appropriation, $125,000 in 17.15 fiscal year 2002 and $185,000 in fiscal 17.16 year 2003 is for evaluation and support 17.17 staff to do discharge planning under 17.18 Minnesota Statutes, section 244.054, 17.19 for persons with serious and persistent 17.20 mental illness being discharged from 17.21 prison. These staff shall be employed 17.22 by the commissioner but assigned at the 17.23 direction of the commissioner of 17.24 corrections. 17.25 (b) Of the general fund appropriation, 17.26 the following amounts shall be 17.27 transferred to the commissioner of 17.28 corrections for the purposes indicated: 17.29 (1) $258,000 in fiscal year 2002 and 17.30 $258,000 in fiscal year 2003 for the 17.31 staff and travel costs associated with 17.32 discharge planning under Minnesota 17.33 Statutes, section 244.054, for persons 17.34 with serious and persistent mental 17.35 illness; 17.36 (2) $769,000 in fiscal year 2002 and 17.37 $638,000 in fiscal year 2003 for grants 17.38 to counties under the transitional 17.39 housing and community support program 17.40 for former state inmates with serious 17.41 and persistent mental illness; and 17.42 (3) $24,000 in fiscal year 2002 and 17.43 $24,000 in fiscal year 2003 for the 17.44 cost of medications for state inmates 17.45 with serious and persistent mental 17.46 illness. 17.47 [ADULT MENTAL HEALTH EMERGENCY 17.48 SERVICES.] Of the general fund 17.49 appropriation, $1,000,000 in fiscal 17.50 year 2002 and $1,000,000 in fiscal year 17.51 2003 is for adult mental health 17.52 emergency services under Minnesota 17.53 Statutes, section 245.469. 17.54 [COMPULSIVE GAMBLING.] Of the 17.55 appropriation from the lottery prize 17.56 fund to the commissioner for the 17.57 compulsive gambling treatment program: 17.58 (1) $1,500,000 in fiscal year 2002 and 17.59 $1,500,000 in fiscal year 2003 is for 17.60 treatment of pathological and problem 17.61 gambling as specified under Minnesota 17.62 Statutes, section 245.98, subdivision 17.63 6; 18.1 (2) $100,000 in fiscal year 2002 and 18.2 $200,000 in fiscal year 2003 is for 18.3 compulsive gambling treatment for 18.4 minority groups or persons with 18.5 disabilities on a grant basis to at 18.6 least two different providers serving 18.7 different populations; 18.8 (3) $500,000 in fiscal year 2003 is for 18.9 grants to be used as start-up funding 18.10 for new treatment programs in 18.11 underserved areas of the state. This 18.12 is a one-time appropriation and shall 18.13 not become part of the base level 18.14 funding for the 2004-2005 biennium; 18.15 (4) $300,000 in fiscal year 2002 is for 18.16 a prevalence study required by Laws 18.17 1998, chapter 407, article 8, section 18.18 9, paragraph (a). This is a one-time 18.19 appropriation and shall not become part 18.20 of the base appropriation for the 18.21 2004-2005 biennium; 18.22 (5) $100,000 for fiscal year 2002 is 18.23 for study on the impact of problem 18.24 gambling as required by Laws 1998, 18.25 chapter 407, article 8, section 9, 18.26 paragraph (b). This is a one-time 18.27 appropriation and shall not become part 18.28 of the base level funding for the 18.29 2004-2005 biennium; 18.30 (6) $50,000 in fiscal year 2002 and 18.31 $50,000 in fiscal year 2003 is for the 18.32 purposes of assessing the results of 18.33 treatment provided through the 18.34 compulsive gambling program. This is a 18.35 one-time appropriation and shall not 18.36 become part of the base level funding 18.37 for the 2004-2005 biennium; 18.38 (7) $100,000 in fiscal year 2002 and 18.39 $100,000 in fiscal year 2003 is for a 18.40 grant to the University of Minnesota 18.41 medical school for research on the 18.42 effectiveness of pharmaceutical 18.43 treatment of pathological gambling. 18.44 This is a one-time appropriation and 18.45 shall not become part of the base 18.46 appropriation for the 2004-2005 18.47 biennium; 18.48 (8) $600,000 in fiscal year 2002 and 18.49 $600,000 in fiscal year 2003 is for the 18.50 state problem gambling help line and 18.51 for initiatives to increase public 18.52 awareness of problem and pathological 18.53 gambling and to assist in its 18.54 prevention; 18.55 (9) $150,000 in fiscal year 2002 and 18.56 $150,000 in fiscal year 2003 is for 18.57 grants for educating and training in 18.58 the the identification of individuals 18.59 who may need treatment for problem or 18.60 pathological gambling and counseling 18.61 individuals or families on treatment 18.62 options. This is a one-time 18.63 appropriation and shall not become part 18.64 of the base level funding for the 19.1 2004-2005 biennium; 19.2 (10) $50,000 in fiscal year 2002 and 19.3 $50,000 in fiscal year 2003 is for 19.4 training of individuals who will 19.5 provide treatment and prevention for 19.6 minority or underserved populations. 19.7 This is a one-time appropriation and 19.8 shall not become part of the base level 19.9 funding for the 2004-2005 biennium; 19.10 (11) $750,000 in fiscal year 2002 is 19.11 for a grant to reconstruct project 19.12 turnabout in Granite Falls that was 19.13 destroyed by the Granite Falls 19.14 tornado. This is a one-time 19.15 appropriation and shall not become part 19.16 of the base appropriation for the 19.17 2004-2005 biennium; and 19.18 (12) $150,000 in fiscal year 2002 and 19.19 $150,000 in fiscal year 2003 is for a 19.20 grant to a compulsive gambling council 19.21 located in St. Louis county. The 19.22 gambling council shall provide a 19.23 statewide compulsive gambling 19.24 prevention and education project for 19.25 adolescents. This is a one-time 19.26 appropriation and shall not become part 19.27 of the base appropriation for the 19.28 2004-2005 biennium. 19.29 The unencumbered balance of the 19.30 appropriation from the lottery prize 19.31 fund in the first year of the biennium 19.32 does not cancel but is available for 19.33 the second year. 19.34 (e) Community Support Grants 19.35 12,555,000 12,815,000 19.36 (f) Medical Assistance Long-Term 19.37 Care Waivers and Home Care 19.38 452,925,000 536,099,000 19.39 [NURSING FACILITY OPERATED BY THE RED 19.40 LAKE BAND OF CHIPPEWA INDIANS.] (1) The 19.41 medical assistance payment rates for 19.42 the 47-bed nursing facility operated by 19.43 the Red Lake Band of Chippewa Indians 19.44 must be calculated according to 19.45 allowable reimbursement costs under the 19.46 medical assistance program, as 19.47 specified in Minnesota Statutes, 19.48 section 246.50, and are subject to the 19.49 facility-specific Medicare upper limits. 19.50 (2) In addition, the commissioner shall 19.51 make available rate adjustments for the 19.52 biennium beginning July 1, 2001, on the 19.53 same basis as the adjustments provided 19.54 to nursing facilities under Minnesota 19.55 Statutes, section 256B.431. The 19.56 commissioner must use the facility's 19.57 final 2000 and 2001 Medicare cost 19.58 reports to calculate the adjustments. 19.59 This rate increase shall become part of 19.60 the facility's base rate for future 19.61 rate years. 20.1 (g) Medical Assistance Long-Term 20.2 Care Facilities 20.3 574,687,000 575,318,000 20.4 [LONG-TERM CARE CONSULTATION SERVICES.] 20.5 Long-term care consultation services 20.6 payments to all counties shall continue 20.7 at the payment amount in effect for 20.8 preadmission screening in fiscal year 20.9 2001, as adjusted for county 20.10 participation in the access 20.11 demonstration project. 20.12 [MORATORIUM EXCEPTION ADMINISTRATIVE 20.13 PROCESS.] Of this appropriation, 20.14 $350,000 in fiscal year 2002 and 20.15 $650,000 in fiscal year 2003 is for the 20.16 moratorium exception administrative 20.17 process under Minnesota Statutes, 20.18 section 144A.073. The annualized state 20.19 share of medical assistance costs for 20.20 projects approved during each year of 20.21 the biennium must not exceed $1,400,000. 20.22 [RATE INCREASE APPLICABILITY.] The 20.23 nursing facility rate increase provided 20.24 under Minnesota Statutes, section 20.25 256B.431, subdivision 32, for the first 20.26 90 paid days of an admission shall 20.27 apply only to admissions occurring on 20.28 or after July 1, 2001. 20.29 (h) Alternative Care Grants 20.30 General 76,204,000 90,680,000 20.31 [ALTERNATIVE CARE TRANSFER.] Any money 20.32 allocated to the alternative care 20.33 program that is not spent for the 20.34 purposes indicated does not cancel but 20.35 shall be transferred to the medical 20.36 assistance account. 20.37 [ALTERNATIVE CARE APPROPRIATION.] The 20.38 commissioner may expend the money 20.39 appropriated for the alternative care 20.40 program for that purpose in either year 20.41 of the biennium. 20.42 (i) Group Residential Housing 20.43 General 80,228,000 88,583,000 20.44 (j) Chemical Dependency 20.45 Entitlement Grants 20.46 General 42,330,000 45,213,000 20.47 (k) Chemical Dependency 20.48 Nonentitlement Grants 20.49 General 6,328,000 6,328,000 20.50 Subd. 10. Continuing Care Management 20.51 General 22,215,000 22,421,000 20.52 State Government 20.53 Special Revenue 117,000 119,000 21.1 Lottery Cash Flow 240,000 240,000 21.2 [COUNTY INVOLVEMENT COSTS.] Of the 21.3 general fund appropriation, up to 21.4 $384,000 in fiscal year 2002 and up to 21.5 $514,000 in fiscal year 2003 is for the 21.6 commissioner to allocate to counties 21.7 for resident relocation costs resulting 21.8 from planned closures under Minnesota 21.9 Statutes, section 256B.437, and 21.10 resident relocations under Minnesota 21.11 Statutes, section 144A.161. Unexpended 21.12 funds for fiscal year 2002 do not 21.13 cancel but are available to the 21.14 commissioner for this purpose in fiscal 21.15 year 2003. 21.16 [COMPULSIVE GAMBLING ADMINISTRATION.] 21.17 Of the lottery cash flow appropriation, 21.18 $240,000 in fiscal year 2002 and 21.19 $240,000 in fiscal year 2003 is for 21.20 administration of the compulsive 21.21 gambling treatment program. 21.22 Subd. 11. Economic Support Grants 21.23 General 134,006,000 137,928,000 21.24 Federal TANF 223,257,000 232,111,000 21.25 The amounts that may be spent from this 21.26 appropriation for each purpose are as 21.27 follows: 21.28 (a) Assistance to Families Grants 21.29 General 69,932,000 72,531,000 21.30 Federal TANF 115,732,000 107,116,000 21.31 (b) Work Grants 21.32 General 9,844,000 9,844,000 21.33 Federal TANF 68,513,000 68,513,000 21.34 [LOCAL INTERVENTION GRANTS FOR 21.35 SELF-SUFFICIENCY CARRYFORWARD.] 21.36 Unexpended funds appropriated for local 21.37 intervention grants under Minnesota 21.38 Statutes, section 256J.625, for fiscal 21.39 year 2002 do not cancel but are 21.40 available to the commissioner for these 21.41 purposes in fiscal year 2003. 21.42 [SOUTHEAST ASIAN TRANSITIONAL 21.43 EMPLOYMENT TRAINING PROJECT.] (a) 21.44 Federal TANF funds, as specified in 21.45 this paragraph, are appropriated to the 21.46 commissioner for a grant to a nonprofit 21.47 collaborative in Hennepin county 21.48 specializing in services to Southeast 21.49 Asians for an "intensive intervention" 21.50 transitional employment training 21.51 project to move refugee and immigrant 21.52 welfare recipients into unsubsidized 21.53 employment leading to 21.54 self-sufficiency. $800,000 in fiscal 21.55 year 2002 and $800,000 in fiscal year 21.56 2003 is appropriated to the 21.57 commissioner for a grant to a nonprofit 22.1 collaborative in Hennepin county 22.2 specializing in services to Southeast 22.3 Asians. This is a one-time 22.4 appropriation and shall not become part 22.5 of the base level funding for the 22.6 2004-2005 biennium. 22.7 (b) One of the five partners in the 22.8 collaborative shall be chosen as the 22.9 fiscal agent by the commissioner. The 22.10 primary effort must be on intensive 22.11 employment skills training, including 22.12 workplace English and overcoming 22.13 cultural barriers, and on specialized 22.14 training in fields of work which 22.15 involve a credit-based curriculum. For 22.16 recipients without a high school 22.17 diploma or a GED, extra effort shall be 22.18 made to help the recipient meet the 22.19 "ability to benefit test" so the 22.20 recipient can receive financial aid for 22.21 further training. During the 22.22 specialized training, efforts shall be 22.23 made to involve the recipients with an 22.24 internship program and retention 22.25 specialist. Up to ten percent of the 22.26 grant shall be used for other efforts 22.27 to make the recipient families more 22.28 self-sufficient as provided within TANF 22.29 rules. 22.30 (c) Economic Support Grants - 22.31 Other Assistance 22.32 General 2,907,000 3,065,000 22.33 Federal TANF 38,752,000 56,222,000 22.34 [TANF TRANSFER TO CHILD CARE BLOCK 22.35 GRANT.] $2,009,000 for fiscal year 2002 22.36 and $16,097,000 for fiscal year 2003 is 22.37 appropriated to the commissioner of 22.38 children, families, and learning for 22.39 the purposes of Minnesota Statutes, 22.40 section 119B.05. The commissioner of 22.41 human services shall authorize a 22.42 sufficient transfer of funds from the 22.43 state's federal TANF block grant to the 22.44 state's child care development fund 22.45 block grant to meet this appropriation. 22.46 [CHILD CARE APPROPRIATION.] (a) General 22.47 funds appropriated for child care in 22.48 the 2001 E-12 Omnibus Appropriations 22.49 Act are reduced by $34,243,000 in 22.50 fiscal year 2002 and by $34,055,000 in 22.51 fiscal year 2003. General fund base 22.52 level funding for child care is reduced 22.53 by $25,957,000 in fiscal year 2004 and 22.54 by $16,435,000 in fiscal year 2005. 22.55 (b) $34,243,000 in fiscal year 2002 and 22.56 $34,055,000 in fiscal year 2003 is 22.57 appropriated from the state's federal 22.58 TANF block grant to the commissioner of 22.59 children, families, and learning for 22.60 child care purposes. The base level 22.61 funding for this purpose from the 22.62 state's federal TANF block grant is 22.63 increased by $25,957,000 in fiscal year 22.64 2004 and by $16,435,000 in fiscal year 23.1 2005. 23.2 [WORKING FAMILY CREDIT.] (a) On a 23.3 regular basis, the commissioner of 23.4 revenue, with the assistance of the 23.5 commissioner of human services, shall 23.6 calculate the value of the refundable 23.7 portion of the Minnesota working family 23.8 credits provided under Minnesota 23.9 Statutes, section 290.0671, that 23.10 qualifies for federal reimbursement 23.11 from the TANF block grant. The 23.12 commissioner of revenue shall provide 23.13 the commissioner of human services with 23.14 such expenditure records and 23.15 information as are necessary to support 23.16 draw-down of federal funds. 23.17 (b) Federal TANF funds, as specified in 23.18 this paragraph, are appropriated to the 23.19 commissioner of human services on 23.20 calculations under paragraph (a) of 23.21 working family tax credit expenditures 23.22 that qualify for reimbursement from the 23.23 TANF block grant for income tax refunds 23.24 payable in federal fiscal years 23.25 beginning October 1, 2001. The 23.26 draw-down of federal TANF funds shall 23.27 be made on a regular basis based on 23.28 calculations of credit expenditures by 23.29 the commissioner of revenue. 23.30 $1,500,000 in fiscal year 2002, 23.31 $5,070,000 in fiscal year 2003, 23.32 $11,763,000 in fiscal year 2004, and 23.33 $23,714,000 in fiscal year 2005 are 23.34 appropriated to the commissioner of 23.35 human services. These funds shall be 23.36 transferred to the commissioner of 23.37 revenue to deposit into the general 23.38 fund. 23.39 [PRIOR YEAR APPROPRIATION REPEALED.] 23.40 Notwithstanding Laws 2000, chapter 488, 23.41 article 8, section 2, subdivision 6, as 23.42 amended by Laws 2000, chapter 499, 23.43 sections 22 and 39, the commissioner 23.44 shall not transfer $7,500,000 from the 23.45 state's federal TANF block grant to the 23.46 state's federal Title XX block grant in 23.47 fiscal year 2002 for purposes of 23.48 increasing services for families with 23.49 children whose incomes are at or below 23.50 200 percent of the federal poverty 23.51 guidelines. 23.52 [MINNESOTA FOOD ASSISTANCE PROGRAM.] Of 23.53 the general fund appropriation, 23.54 $225,000 in fiscal year 2002 and 23.55 $1,134,000 in fiscal year 2003 is for 23.56 the Minnesota food assistance program. 23.57 (d) Child Support Enforcement 23.58 General 4,239,000 4,239,000 23.59 Federal TANF 260,000 260,000 23.60 [CHILD SUPPORT PAYMENT CENTER.] 23.61 Payments to the commissioner from other 23.62 governmental units, private 23.63 enterprises, and individuals for 24.1 services performed by the child support 24.2 payment center must be deposited in the 24.3 state systems account authorized under 24.4 Minnesota Statutes, section 256.014. 24.5 These payments are appropriated to the 24.6 commissioner for the operation of the 24.7 child support payment center or system, 24.8 according to Minnesota Statutes, 24.9 section 256.014. 24.10 (e) General Assistance 24.11 General 17,156,000 16,648,000 24.12 [GENERAL ASSISTANCE STANDARD.] The 24.13 commissioner shall set the monthly 24.14 standard of assistance for general 24.15 assistance units consisting of an adult 24.16 recipient who is childless and 24.17 unmarried or living apart from his or 24.18 her parents or a legal guardian at 24.19 $203. The commissioner may reduce this 24.20 amount in accordance with Laws 1997, 24.21 chapter 85, article 3, section 54. 24.22 (f) Minnesota Supplemental Aid 24.23 General 29,678,000 31,351,000 24.24 (g) Refugee Services 24.25 General 250,000 250,000 24.26 Subd. 12. Economic Support 24.27 Management 24.28 General 45,943,000 46,665,000 24.29 Health Care 24.30 Access 1,333,000 1,349,000 24.31 Federal TANF 743,000 743,000 24.32 The amounts that may be spent from this 24.33 appropriation for each purpose are as 24.34 follows: 24.35 (a) Economic Support Policy 24.36 Administration 24.37 General 8,655,000 8,789,000 24.38 Federal TANF 743,000 743,000 24.39 [FOOD STAMP ADMINISTRATIVE 24.40 REIMBURSEMENT.] The commissioner shall 24.41 reduce quarterly food stamp 24.42 administrative reimbursement to 24.43 counties in fiscal years 2002 and 2003 24.44 by the amount that the United States 24.45 Department of Health and Human Services 24.46 determines to be the county random 24.47 moment study share of the food stamp 24.48 adjustment under Public Law Number 24.49 105-185. The reductions shall be 24.50 allocated to each county in proportion 24.51 to each county's contribution, if any, 24.52 to the amount of the adjustment. Any 24.53 adjustment to medical assistance 24.54 administrative reimbursement that is 24.55 based on the United States Department 25.1 of Health and Human Services' 25.2 determinations under Public Law Number 25.3 105-185 shall be distributed to 25.4 counties in the same manner. 25.5 (b) Economic Support Operations 25.6 General 37,288,000 37,876,000 25.7 Health Care 25.8 Access 1,333,000 1,349,000 25.9 [SPENDING AUTHORITY FOR FOOD STAMP 25.10 ENHANCED FUNDING.] In the event that 25.11 Minnesota qualifies for United States 25.12 Department of Agriculture Food and 25.13 Nutrition Services Food Stamp Program 25.14 enhanced funding beginning in federal 25.15 fiscal year 1998, the money is 25.16 appropriated to the commissioner for 25.17 the purposes of the program. The 25.18 commissioner may retain 25 percent of 25.19 the enhanced funding, with the 25.20 remaining 75 percent divided among the 25.21 counties according to a formula that 25.22 takes into account each county's impact 25.23 on the statewide food stamp error rate. 25.24 [FINANCIAL INSTITUTION DATA MATCH AND 25.25 PAYMENT OF FEES.] The commissioner is 25.26 authorized to allocate up to $310,000 25.27 in each year of the biennium from the 25.28 PRISM special revenue account to make 25.29 payments to financial institutions in 25.30 exchange for performing data matches 25.31 between account information held by 25.32 financial institutions and the public 25.33 authority's database of child support 25.34 obligors as authorized by Minnesota 25.35 Statutes, section 13B.06, subdivision 7. 25.36 Sec. 3. COMMISSIONER OF HEALTH 25.37 Subdivision 1. Total 25.38 Appropriation 131,062,000 130,155,000 25.39 Summary by Fund 25.40 General 83,758,000 87,535,000 25.41 State Government 25.42 Special Revenue 26,829,000 28,713,000 25.43 Health Care 25.44 Access 13,935,000 7,367,000 25.45 Federal TANF 6,540,000 6,540,000 25.46 Subd. 2. Family and 25.47 Community Health 68,329,000 72,485,000 25.48 Summary by Fund 25.49 General 57,146,000 60,246,000 25.50 State Government 25.51 Special Revenue 961,000 1,987,000 25.52 Health Care 25.53 Access 3,682,000 3,712,000 26.1 Federal TANF 6,540,000 6,540,000 26.2 [HEALTH DISPARITIES.] (a) Of the 26.3 general fund appropriation, $6,450,000 26.4 in fiscal year 2002 and $7,450,000 in 26.5 fiscal year 2003 is for reducing health 26.6 disparities to be spent as follows: 26.7 (1) $3,400,000 the first year and 26.8 $4,150,000 the second year for grants 26.9 to community organizations for 26.10 prevention services targeted to 26.11 populations affected by health 26.12 disparities; 26.13 (2) $2,150,000 the first year and 26.14 $2,350,000 the second year for grants 26.15 to community health boards. 26.16 (3) $500,000 each year for grants to 26.17 tribal governments to support efforts 26.18 to identify and implement culturally 26.19 based community interventions that 26.20 reduce health disparities for American 26.21 Indians; 26.22 (4) $200,000 the first year and 26.23 $250,000 the second year for grants to 26.24 local public health agencies to fund 26.25 access to health screenings and 26.26 follow-up services; and 26.27 (5) $200,000 each year for state 26.28 administrative costs. 26.29 [IMMUNIZATION INFORMATION SERVICE.] Of 26.30 the general fund appropriation, 26.31 $1,000,000 the first year and 26.32 $2,000,000 the second year is available 26.33 to the commissioner for grants to 26.34 community health boards as defined in 26.35 Minnesota Statutes, section 145A.02, to 26.36 support the development of a statewide 26.37 immunization information service and to 26.38 support maintenance of current registry 26.39 activities related to tracking medical 26.40 assistance-eligible children. 26.41 [PROMOTING HEALTHY LIFESTYLES.] 26.42 $6,540,000 from the TANF fund in fiscal 26.43 years 2002 and 2003 is appropriated to 26.44 the commissioner to award grants to 26.45 promote healthy behaviors among youth 26.46 in accordance with Minnesota Statutes, 26.47 section 145.9263. 26.48 Of this amount, $3,000,000 is for local 26.49 grants under Minnesota Statutes, 26.50 section 145.9263, subdivision 2; 26.51 $3,000,000 is for community youth 26.52 grants under Minnesota Statutes, 26.53 section 145.9263, subdivision 3; 26.54 $480,000 is for a statewide outreach 26.55 campaign under Minnesota Statutes, 26.56 section 145.9263, subdivision 4; and 26.57 $60,000 is for training and technical 26.58 assistance. 26.59 [PROMOTING HEALTHY LIFESTYLES 26.60 CARRYFORWARD.] Any unexpended balance 26.61 of the TANF funds appropriated for the 27.1 promoting healthy lifestyles grant 27.2 program established under Minnesota 27.3 Statutes, section 145.9263, in the 27.4 first fiscal year of the biennium does 27.5 not cancel but is available for the 27.6 second year. 27.7 [HEALTH WORKFORCE DEVELOPMENT.] Of the 27.8 general fund appropriation, $1,003,000 27.9 in the first year and $1,967,000 in the 27.10 second year is to expand the health 27.11 professionals loan program, of which 27.12 $963,000 in the first year and 27.13 $1,927,000 in the second year is for 27.14 direct grants to increase the placement 27.15 of physicians, dentists, pharmacists, 27.16 mental health providers, health care 27.17 technicians in rural communities, and 27.18 nurses in nursing homes, ICFs/MR, and 27.19 home health care agencies statewide. 27.20 [POISON INFORMATION SYSTEM.] Of the 27.21 general fund appropriation, $1,360,000 27.22 each fiscal year is for poison control 27.23 system grants under Minnesota Statutes, 27.24 section 145.93. 27.25 [WIC TRANSFERS.] The general fund 27.26 appropriation for the women, infants, 27.27 and children (WIC) food supplement 27.28 program is available for either year of 27.29 the biennium. Transfers of these funds 27.30 between fiscal years must be either to 27.31 maximize federal funds or to minimize 27.32 fluctuations in the number of program 27.33 participants. 27.34 [MINNESOTA CHILDREN WITH SPECIAL HEALTH 27.35 NEEDS CARRYFORWARD.] General fund 27.36 appropriations for treatment services 27.37 in the services for Minnesota children 27.38 with special health needs program are 27.39 available for either year of the 27.40 biennium. 27.41 [HOME VISITING PROGRAM.] Of the general 27.42 fund appropriation, $7,000,000 each 27.43 year is for distribution to county 27.44 boards according to the formula in 27.45 Minnesota Statutes, section 256J.625, 27.46 subdivision 3, to be used by county 27.47 public health boards to serve families 27.48 with incomes at or below 200 percent of 27.49 the federal poverty guidelines, in the 27.50 manner specified by Minnesota Statutes, 27.51 section 145A.16, subdivision 3, clauses 27.52 (2), (3), (4), (5), and (6). Training, 27.53 evaluation, and technical assistance 27.54 shall be provided in accordance with 27.55 Minnesota Statutes, section 145A.16, 27.56 subdivisions 5, 6, and 7. This 27.57 appropriation shall not become a part 27.58 of the agency's base funding for the 27.59 2004-2005 biennium. 27.60 [HOME VISITING TANF BASE REDUCTION.] 27.61 Notwithstanding Laws 2000, chapter 488, 27.62 article 8, section 2, subdivision 6, as 27.63 amended by Laws 2000, chapter 499, 27.64 sections 22 and 39, base level funding 27.65 from the state's federal TANF block 28.1 grant for the home visiting program 28.2 under Minnesota Statutes, section 28.3 145A.16, for fiscal year 2002 and 28.4 fiscal year 2003 is zero. 28.5 [SUICIDE PREVENTION.] Of the general 28.6 fund appropriation, $1,025,000 each 28.7 year is to fund community-based suicide 28.8 prevention programs under Minnesota 28.9 Statutes, section 145.56, subdivision 28.10 2, and $75,000 each year is for the 28.11 commissioner for suicide prevention 28.12 activities under Minnesota Statutes, 28.13 section 145.56, subdivisions 1, 3, 4, 28.14 and 5. 28.15 Subd. 3. Access and Quality 28.16 Improvement 27,028,000 20,480,000 28.17 Summary by Fund 28.18 General 8,263,000 8,231,000 28.19 State Government 28.20 Special Revenue 8,512,000 8,594,000 28.21 Health Care 28.22 Access 10,253,000 3,655,000 28.23 [STOP-LOSS FUND.] Of the health care 28.24 access fund appropriation, $200,000 the 28.25 first year and $50,000 the second year 28.26 is for grants to organizations 28.27 developing health care purchasing 28.28 alliances established under Minnesota 28.29 Statutes, chapter 62T. Of this 28.30 appropriation, $50,000 the first year 28.31 is for a grant to the University of 28.32 Minnesota-Crookston to support the 28.33 northwest purchasing alliance; $50,000 28.34 the first year is for a grant to the 28.35 southwest regional development 28.36 commission to support the southwest 28.37 purchasing alliance; $50,000 the first 28.38 year is for a grant to the arrowhead 28.39 regional development commission to 28.40 support the development of a northeast 28.41 Minnesota purchasing alliance; and 28.42 $50,000 each year is for a grant to the 28.43 Brainerd lakes area chamber of commerce 28.44 education association to support the 28.45 north central purchasing alliance. The 28.46 state grants must be matched on a 28.47 one-to-one basis by nonstate funds. 28.48 This is a one-time appropriation and 28.49 shall not become part of the base level 28.50 funding for the 2004-2005 biennium. 28.51 [HEALTH CARE SAFETY NET.] Of the health 28.52 care access fund appropriation, 28.53 $6,500,000 the first year is to provide 28.54 financial support to Minnesota health 28.55 care safety net providers. This 28.56 appropriation shall not become part of 28.57 base funding for the agency for the 28.58 2004-2005 biennium. Of the amounts 28.59 available: 28.60 (1) $2,000,000 is for a grant program 28.61 to aid safety net community clinics; 29.1 (2) $2,000,000 is to be transferred to 29.2 the Minnesota comprehensive health 29.3 association (MCHA); and 29.4 (3) $2,500,000 is for a grant program 29.5 to provide rural hospital capital 29.6 improvement grants described in 29.7 Minnesota Statutes, section 144.148. 29.8 [GRANTS TO COMMUNITY CLINICS.] Of the 29.9 general fund appropriation, $2,000,000 29.10 each year is for grants to eligible 29.11 community clinics under Minnesota 29.12 Statutes, section 145.9268, to improve 29.13 the ongoing viability of Minnesota's 29.14 clinic-based safety net providers. 29.15 This appropriation is contingent on 29.16 federal approval of the 29.17 intergovernmental transfers and 29.18 payments to safety net hospitals 29.19 authorized under Minnesota Statutes, 29.20 section 256B.195. This appropriation 29.21 shall become part of base level funding 29.22 for the 2004-2005 biennium. 29.23 [HOME CARE PROVIDERS FEE WAIVER.] 29.24 Notwithstanding the provisions of 29.25 Minnesota Rules, chapter 4669, and 29.26 Minnesota Statutes, section 144A.4605, 29.27 subdivision 5, the commissioner of 29.28 health may, during the biennium 29.29 beginning July 1, 2001, waive license 29.30 fees for all home care providers who 29.31 hold a current license as of June 30, 29.32 2001, for the purpose of reducing 29.33 surplus home care fees in the state 29.34 government special revenue fund. 29.35 [RURAL AMBULANCE STUDY.] (a) The 29.36 commissioner shall direct the rural 29.37 health advisory committee to conduct a 29.38 study and make recommendations 29.39 regarding the challenges faced by rural 29.40 ambulance services related to: 29.41 personnel shortages for volunteer 29.42 ambulance services; personnel shortages 29.43 for full-time, paid ambulance services; 29.44 funding for ambulance operations; and 29.45 the impact on rural ambulance services 29.46 from changes in ambulance reimbursement 29.47 as a result of the federal Balanced 29.48 Budget Act of 1997, Public Law Number 29.49 105-33. 29.50 (b) The advisory committee may also 29.51 examine and make recommendations on: 29.52 (1) whether state law allows adequate 29.53 flexibility to address operational and 29.54 staffing problems encountered by rural 29.55 ambulance services; and 29.56 (2) whether current incentive programs, 29.57 such as the volunteer ambulance 29.58 recruitment program and state 29.59 reimbursement for volunteer training, 29.60 are adequate to ensure ambulance 29.61 service volunteers will be available in 29.62 rural areas. 29.63 (c) The advisory committee shall 30.1 identify existing state, regional, and 30.2 local resources supporting the 30.3 provision of local ambulance services 30.4 in rural areas. 30.5 (d) The advisory committee shall, if 30.6 appropriate, make recommendations for 30.7 addressing alternative delivery models 30.8 for rural volunteer ambulance 30.9 services. Such alternatives may 30.10 include, but are not limited to, 30.11 multiprovider service coalitions, 30.12 purchasing cooperatives, regional 30.13 response strategies, and different 30.14 utilization of first responder and 30.15 rescue squads. 30.16 (e) In conducting its study, the 30.17 advisory committee shall consult with 30.18 groups broadly representative of rural 30.19 health and emergency medical services. 30.20 Such groups may include: local elected 30.21 officials; ambulance and emergency 30.22 medical services associations; 30.23 hospitals and nursing homes; 30.24 physicians, nurses, and mid-level 30.25 practitioners; rural health groups; the 30.26 emergency medical services regulatory 30.27 board and regional emergency medical 30.28 services boards; and fire and sheriff's 30.29 departments. 30.30 (f) The advisory committee shall report 30.31 its findings and recommendations to the 30.32 commissioner by September 1, 2002. 30.33 Subd. 4. Health Protection 30,250,000 31,323,000 30.34 Summary by Fund 30.35 General 13,045,000 13,346,000 30.36 State Government 30.37 Special Revenue 17,205,000 17,977,000 30.38 [EMERGING HEALTH THREATS.] (a) Of the 30.39 general fund appropriation, $750,000 in 30.40 the first year and $850,000 in the 30.41 second year is to maintain the state 30.42 capacity to identify and respond to 30.43 emerging health threats. 30.44 (b) Of these amounts, $450,000 in the 30.45 first year and $550,000 in the second 30.46 year is to expand state laboratory 30.47 capacity to identify infectious disease 30.48 organisms, evaluate environmental 30.49 contaminants, and develop new 30.50 analytical techniques to deal with 30.51 biological and chemical health threats. 30.52 (c) $300,000 each year is to train, 30.53 consult, and otherwise assist local 30.54 officials responding to clandestine 30.55 drug laboratories and minimizing health 30.56 risks to responders and the public. 30.57 The commissioner is authorized to bill 30.58 local governments to reimburse the 30.59 general fund for the costs incurred. 30.60 [SEXUALLY TRANSMITTED INFECTIONS.] Of 31.1 the general fund appropriation, 31.2 $150,000 each year is to increase 31.3 access to free screening for sexually 31.4 transmitted infections, including 31.5 efforts to provide screening to members 31.6 of high-risk communities, and $250,000 31.7 each year is for grants to 31.8 community-based organizations and local 31.9 public health entities to increase the 31.10 screening of members of high-risk 31.11 communities. These appropriations 31.12 shall become part of the base level 31.13 funding for the 2004-2005 biennium. 31.14 [BASE FUNDING TRANSFER.] $250,000 each 31.15 fiscal year is transferred from the 31.16 base appropriation for sexually 31.17 transmitted disease program operations 31.18 to the HIV grants program and shall 31.19 become part of base level funding for 31.20 the HIV grants program for the 31.21 2004-2005 biennium. 31.22 [COMMUNITY HEALTH EDUCATION AND 31.23 PROMOTION PROGRAM ON FOOD SAFETY.] (a) 31.24 Of the general fund appropriation, 31.25 $200,000 each year is for a grant to 31.26 the city of Minneapolis to establish a 31.27 community-based health education and 31.28 promotion program on food safety in the 31.29 Latino, Somali, and Southeast Asian 31.30 communities. 31.31 (b) The program shall consist of direct 31.32 training of food industry operators and 31.33 workers on safe handling of food and 31.34 proper operation of food establishments 31.35 and a community consumer awareness 31.36 campaign to increase community 31.37 awareness of food safety and access to 31.38 food regulatory services. 31.39 (c) This is a one-time appropriation 31.40 and shall not become part of the base 31.41 level funding for the 2004-2005 31.42 biennium. 31.43 Subd. 5. Management and 31.44 Support Services 5,455,000 5,867,000 31.45 Summary by Fund 31.46 General 5,304,000 5,712,000 31.47 State Government 31.48 Special Revenue 151,000 155,000 31.49 Sec. 4. VETERANS NURSING 31.50 HOMES BOARD 30,948,000 32,030,000 31.51 [VETERANS HOMES SPECIAL REVENUE 31.52 ACCOUNT.] The general fund 31.53 appropriations made to the board may be 31.54 transferred to a veterans homes special 31.55 revenue account in the special revenue 31.56 fund in the same manner as other 31.57 receipts are deposited according to 31.58 Minnesota Statutes, section 198.34, and 31.59 are appropriated to the board for the 31.60 operation of board facilities and 31.61 programs. 32.1 [SETTING COST OF CARE.] The cost of 32.2 care for the domiciliary residents at 32.3 the Minneapolis veterans home for 32.4 fiscal year 2002 and fiscal year 2003 32.5 shall be calculated based on 100 32.6 percent occupancy. 32.7 [DEFICIENCY FUNDING.] Of the general 32.8 fund appropriation in fiscal year 2002, 32.9 $2,000,000 is available with the 32.10 approval of the commissioner of 32.11 finance. Approval of the commissioner 32.12 of finance is contingent upon review of 32.13 the board's submittal of a report 32.14 outlining the following: 32.15 (1) a long-term revenue outlook for the 32.16 homes; 32.17 (2) a review and recommendation of 32.18 alternative funding sources for the 32.19 homes' operations; and 32.20 (3) administrative and service options 32.21 to bring cost growth in line with 32.22 revenues. 32.23 Sec. 5. HEALTH-RELATED BOARDS 32.24 Subdivision 1. Total 32.25 Appropriation 11,199,000 11,424,000 32.26 [STATE GOVERNMENT SPECIAL REVENUE 32.27 FUND.] The appropriations in this 32.28 section are from the state government 32.29 special revenue fund. 32.30 [NO SPENDING IN EXCESS OF REVENUES.] 32.31 The commissioner of finance shall not 32.32 permit the allotment, encumbrance, or 32.33 expenditure of money appropriated in 32.34 this section in excess of the 32.35 anticipated biennial revenues or 32.36 accumulated surplus revenues from fees 32.37 collected by the boards. Neither this 32.38 provision nor Minnesota Statutes, 32.39 section 214.06, applies to transfers 32.40 from the general contingent account. 32.41 Subd. 2. Board of Chiropractic 32.42 Examiners 372,000 384,000 32.43 Subd. 3. Board of Dentistry 946,000 855,000 32.44 [EXPANDED DUTIES.] Of this 32.45 appropriation, $115,000 in fiscal year 32.46 2002 is to the board for the costs 32.47 associated with the expanded duties 32.48 relative to the regulation of dental 32.49 hygienists and foreign-trained 32.50 dentists. This is a one-time 32.51 appropriation and shall not become part 32.52 of the base level funding for the 32.53 2004-2005 biennium. 32.54 Subd. 4. Board of Dietetic 32.55 and Nutrition Practice 98,000 101,000 32.56 Subd. 5. Board of Marriage and 32.57 Family Therapy 114,000 118,000 33.1 Subd. 6. Board of Medical 33.2 Practice 3,334,000 3,400,000 33.3 Subd. 7. Board of Nursing 2,789,000 2,902,000 33.4 [DEVELOPMENT OF POSTERS.] Of this 33.5 appropriation, $20,000 in fiscal year 33.6 2002 is for the board to develop and 33.7 distribute posters that may be used by 33.8 facilities to satisfy the requirements 33.9 of Minnesota Statutes, section 144.582, 33.10 subdivision 4. 33.11 [HEALTH PROFESSIONAL SERVICES 33.12 ACTIVITY.] Of these appropriations, 33.13 $284,000 the first year and $292,000 33.14 the second year are for the health 33.15 professional services activity. 33.16 Subd. 8. Board of Nursing 33.17 Home Administrators 200,000 200,000 33.18 Subd. 9. Board of Optometry 93,000 96,000 33.19 Subd. 10. Board of Pharmacy 1,336,000 1,386,000 33.20 [ADMINISTRATIVE SERVICES UNIT.] Of this 33.21 appropriation, $68,000 the first year 33.22 and $69,000 the second year are for the 33.23 health boards administrative services 33.24 unit. The administrative services unit 33.25 may receive and expend reimbursements 33.26 for services performed for other 33.27 agencies. 33.28 Subd. 11. Board of Physical Therapy 191,000 197,000 33.29 Subd. 12. Board of Podiatry 53,000 45,000 33.30 Subd. 13. Board of Psychology 669,000 680,000 33.31 Subd. 14. Board of Social Work 846,000 873,000 33.32 Subd. 15. Board of Veterinary 33.33 Medicine 158,000 189,000 33.34 Sec. 6. EMERGENCY MEDICAL 33.35 SERVICES BOARD 2,663,000 2,675,000 33.36 [COMPREHENSIVE ADVANCED LIFE SUPPORT 33.37 EDUCATIONAL PROGRAM.] Of this 33.38 appropriation, $200,000 in fiscal year 33.39 2002 and $200,000 in fiscal year 2003 33.40 is to increase funding for the 33.41 comprehensive advanced life support 33.42 educational program under Minnesota 33.43 Statutes, section 144E.37. This 33.44 appropriation shall become part of base 33.45 level funding for the 2004-2005 33.46 biennium. 33.47 [AUTOMATIC DEFIBRILLATOR STUDY.] Of 33.48 this appropriation, $25,000 in fiscal 33.49 year 2002 is to the board to study, in 33.50 consultation with the commissioner of 33.51 public safety, and report to the 33.52 legislature by December 15, 2002, 33.53 regarding the availability of automatic 33.54 defibrillators outside the seven-county 33.55 metropolitan area. The report shall 33.56 include recommendations to make these 34.1 devices accessible within a reasonable 34.2 distance through the nonmetropolitan 34.3 area, including recommendations for 34.4 funding their acquisition and 34.5 distribution. 34.6 Sec. 7. COUNCIL ON DISABILITY 692,000 714,000 34.7 Sec. 8. OMBUDSMAN FOR MENTAL 34.8 HEALTH AND MENTAL RETARDATION 1,752,000 1,568,000 34.9 [CENTER FOR OMBUDSMAN SERVICES.] (a) Of 34.10 this appropriation, $250,000 in fiscal 34.11 year 2002 is for the one-time costs of 34.12 establishing a center for Minnesota 34.13 ombudsman services. Unexpended funds 34.14 for fiscal year 2002 do not cancel but 34.15 are available for this purpose in 34.16 fiscal year 2003. 34.17 (b) The following agencies shall 34.18 colocate to establish the center: the 34.19 ombudsman for corrections, the crime 34.20 victims ombudsman, the ombudsman for 34.21 mental health and mental retardation, 34.22 the ombudsman for older Minnesotans, 34.23 the ombudsman for state-managed health 34.24 care programs, and the ombudsman for 34.25 families. 34.26 (c) Each agency described in paragraph 34.27 (b) shall retain its statutory 34.28 authority and funding for the special 34.29 populations served. 34.30 (d) Each agency described in paragraph 34.31 (b) shall contribute to the shared 34.32 operational expenses and shall pool 34.33 administrative capabilities and 34.34 resources as appropriate in at least 34.35 the following areas: purchasing, 34.36 payroll, human resources, information 34.37 technology, inventory, leasing, 34.38 contracts, and telecommunications. 34.39 (e) The functions described in 34.40 paragraph (d) shall be administered by 34.41 a board composed of the six 34.42 ombudspersons referenced in paragraph 34.43 (b). 34.44 (f) The center shall make a preliminary 34.45 report to the legislature by January 34.46 15, 2003, and a final report by January 34.47 15, 2004, on implementation of the 34.48 colocation requirement. 34.49 Sec. 9. OMBUDSMAN 34.50 FOR FAMILIES 251,000 256,000 34.51 Sec. 10. TRANSFERS 34.52 Subdivision 1. Grants 34.53 The commissioner of human services, 34.54 with the approval of the commissioner 34.55 of finance, and after notification of 34.56 the chair of the senate health and 34.57 family security budget division and the 34.58 chair of the house health and human 34.59 services finance committee, may 35.1 transfer unencumbered appropriation 35.2 balances for the biennium ending June 35.3 30, 2003, within fiscal years among the 35.4 MFIP, general assistance, general 35.5 assistance medical care, medical 35.6 assistance, Minnesota supplemental aid, 35.7 and group residential housing programs, 35.8 and the entitlement portion of the 35.9 chemical dependency consolidated 35.10 treatment fund, and between fiscal 35.11 years of the biennium. 35.12 Subd. 2. Administration 35.13 Positions, salary money, and nonsalary 35.14 administrative money may be transferred 35.15 within the departments of human 35.16 services and health and within the 35.17 programs operated by the veterans 35.18 nursing homes board as the 35.19 commissioners and the board consider 35.20 necessary, with the advance approval of 35.21 the commissioner of finance. The 35.22 commissioner or the board shall inform 35.23 the chairs of the house health and 35.24 human services finance committee and 35.25 the senate health and family security 35.26 budget division quarterly about 35.27 transfers made under this provision. 35.28 Subd. 3. Prohibited Transfers 35.29 Grant money shall not be transferred to 35.30 operations within the departments of 35.31 human services and health and within 35.32 the programs operated by the veterans 35.33 nursing homes board without the 35.34 approval of the legislature. 35.35 Sec. 11. MINNESOTACARE AVAILABILITY 35.36 Of the appropriation for MinnesotaCare 35.37 for fiscal year 2002, an amount 35.38 sufficient to fund a fiscal year 2001 35.39 deficiency is available in fiscal year 35.40 2001. This amount shall be determined 35.41 by the commissioner of human services 35.42 with the approval of the commissioner 35.43 of finance. 35.44 Sec. 12. INDIRECT COSTS NOT TO 35.45 FUND PROGRAMS. 35.46 The commissioners of health and of 35.47 human services shall not use indirect 35.48 cost allocations to pay for the 35.49 operational costs of any program for 35.50 which they are responsible. 35.51 Sec. 13. CARRYOVER LIMITATION 35.52 None of the appropriations in this act 35.53 which are allowed to be carried forward 35.54 from fiscal year 2002 to fiscal year 35.55 2003 shall become part of the base 35.56 level funding for the 2004-2005 35.57 biennial budget, unless specifically 35.58 directed by the legislature. 35.59 Sec. 14. SUNSET OF UNCODIFIED LANGUAGE 36.1 All uncodified language contained in 36.2 this article expires on June 30, 2003, 36.3 unless a different expiration date is 36.4 explicit. 36.5 Sec. 15. Minnesota Statutes 2000, section 16A.06, is 36.6 amended by adding a subdivision to read: 36.7 Subd. 10. [TRANSFERS TO HEALTH CARE ACCESS FUND.] For 36.8 fiscal years beginning on or after July 1, 2002, the 36.9 commissioner shall transfer from the general fund to the health 36.10 care access fund an amount equal to the state share of the cost 36.11 of covering children in families with income under 185 percent 36.12 of the federal poverty guidelines. In determining the amount of 36.13 this transfer, the commissioner shall disregard MinnesotaCare 36.14 program changes enacted after July 1, 2001. 36.15 Sec. 16. [246.141] [PROJECT LABOR.] 36.16 Wages for project labor may be paid by the commissioner out 36.17 of repairs and betterments money if the individual is to be 36.18 engaged in a construction project or a repair project of 36.19 short-term and nonrecurring nature. Compensation for project 36.20 labor shall be based on the prevailing wage rates, as defined in 36.21 section 177.42, subdivision 6. Project laborers are excluded 36.22 from the provisions of sections 43A.22 to 43A.30, and shall not 36.23 be eligible for state-paid insurance and benefits. 36.24 Sec. 17. Laws 1998, chapter 404, section 18, subdivision 36.25 4, is amended to read: 36.26 Subd. 4. People, Inc. North Side Community 36.27 Support Program 375,000 36.28 For a grant toHennepin countyPeople, 36.29 Inc. to purchase, remodel, and complete 36.30 accessibility upgrades to an existing 36.31 building or to acquire land or 36.32 construct a building to be used by the 36.33 People, Inc. North Side Community 36.34 Support Program which may provide 36.35 office space for state employees. 36.36 This appropriation is from the general 36.37 fund. 36.38 Sec. 18. [EFFECTIVE DATE.] 36.39 Section 11 is effective the day following final enactment. 36.40 ARTICLE 2 36.41 DEPARTMENT OF HEALTH 36.42 Section 1. Minnesota Statutes 2000, section 62J.152, 37.1 subdivision 8, is amended to read: 37.2 Subd. 8. [REPEALER.] This section and sections 62J.15 and 37.3 62J.156 are repealed effective July 1,20012005. 37.4 Sec. 2. Minnesota Statutes 2000, section 62J.451, 37.5 subdivision 5, is amended to read: 37.6 Subd. 5. [HEALTH CARE ELECTRONIC DATA INTERCHANGE 37.7 SYSTEM.](a)The health data institute shall establish an 37.8 electronic data interchange system that electronically 37.9 transmits, collects, archives, and provides users of data with 37.10 the data necessary for their specific interests, in order to 37.11 promote a high quality, cost-effective, consumer-responsive 37.12 health care system. This public-private information system 37.13 shall be developed to make health care claims processing and 37.14 financial settlement transactions more efficient and to provide 37.15 an efficient, unobtrusive method for meeting the shared 37.16 electronic data interchange needs of consumers, group 37.17 purchasers, providers, and the state. 37.18(b) The health data institute shall operate the Minnesota37.19center for health care electronic data interchange established37.20in section 62J.57, and shall integrate the goals, objectives,37.21and activities of the center with those of the health data37.22institute's electronic data interchange system.37.23 Sec. 3. Minnesota Statutes 2000, section 103I.101, 37.24 subdivision 6, is amended to read: 37.25 Subd. 6. [FEES FOR VARIANCES.] The commissioner shall 37.26 charge a nonrefundable application fee of$120$150 to cover the 37.27 administrative cost of processing a request for a variance or 37.28 modification of rules adopted by the commissioner under this 37.29 chapter. 37.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 37.31 Sec. 4. Minnesota Statutes 2000, section 103I.112, is 37.32 amended to read: 37.33 103I.112 [FEE EXEMPTIONS FOR STATE AND LOCAL GOVERNMENT.] 37.34 (a) The commissioner of health may not charge fees required 37.35 under this chapter to a federal agency, state agency, or a local 37.36 unit of government or to a subcontractor performing work for the 38.1 state agency or local unit of government. 38.2 (b) "Local unit of government" means a statutory or home 38.3 rule charter city, town, county, or soil and water conservation 38.4 district, watershed district, an organization formed for the 38.5 joint exercise of powers under section 471.59, a board of health 38.6 or community health board, or other special purpose district or 38.7 authority with local jurisdiction in water and related land 38.8 resources management. 38.9 [EFFECTIVE DATE.] This section is effective July 1, 2002. 38.10 Sec. 5. Minnesota Statutes 2000, section 103I.208, 38.11 subdivision 1, is amended to read: 38.12 Subdivision 1. [WELL NOTIFICATION FEE.] The well 38.13 notification fee to be paid by a property owner is: 38.14 (1) for a new well,$120$150, which includes the state 38.15 core function fee; 38.16 (2) for a well sealing,$20$30 for each well, which 38.17 includes the state core function fee, except that for monitoring 38.18 wells constructed on a single property, having depths within a 38.19 25 foot range, and sealed within 48 hours of start of 38.20 construction, a single fee of$20$30; and 38.21 (3) for construction of a dewatering well,$120$150, which 38.22 includes the state core function fee, for each well except a 38.23 dewatering project comprising five or more wells shall be 38.24 assessed a single fee of$600$750 for the wells recorded on the 38.25 notification. 38.26 [EFFECTIVE DATE.] This section is effective July 1, 2002. 38.27 Sec. 6. Minnesota Statutes 2000, section 103I.208, 38.28 subdivision 2, is amended to read: 38.29 Subd. 2. [PERMIT FEE.] The permit fee to be paid by a 38.30 property owner is: 38.31 (1) for a well that is not in use under a maintenance 38.32 permit,$100$125 annually; 38.33 (2) for construction of a monitoring well,$120$150, which 38.34 includes the state core function fee; 38.35 (3) for a monitoring well that is unsealed under a 38.36 maintenance permit,$100$125 annually; 39.1 (4) for monitoring wells used as a leak detection device at 39.2 a single motor fuel retail outlet, a single petroleum bulk 39.3 storage site excluding tank farms, or a single agricultural 39.4 chemical facility site, the construction permit fee 39.5 is$120$150, which includes the state core function fee, per 39.6 site regardless of the number of wells constructed on the site, 39.7 and the annual fee for a maintenance permit for unsealed 39.8 monitoring wells is$100$125 per site regardless of the number 39.9 of monitoring wells located on site; 39.10 (5) for a groundwater thermal exchange device, in addition 39.11 to the notification fee for wells,$120$150, which includes the 39.12 state core function fee; 39.13 (6) for a vertical heat exchanger,$120$150; 39.14 (7) for a dewatering well that is unsealed under a 39.15 maintenance permit,$100$125 annually for each well, except a 39.16 dewatering project comprising more than five wells shall be 39.17 issued a single permit for$500$625 annually for wells recorded 39.18 on the permit; and 39.19 (8) for excavating holes for the purpose of installing 39.20 elevator shafts,$120$150 for each hole. 39.21 [EFFECTIVE DATE.] This section is effective July 1, 2002. 39.22 Sec. 7. Minnesota Statutes 2000, section 103I.235, 39.23 subdivision 1, is amended to read: 39.24 Subdivision 1. [DISCLOSURE OF WELLS TO BUYER.] (a) Before 39.25 signing an agreement to sell or transfer real property, the 39.26 seller must disclose in writing to the buyer information about 39.27 the status and location of all known wells on the property, by 39.28 delivering to the buyer either a statement by the seller that 39.29 the seller does not know of any wells on the property, or a 39.30 disclosure statement indicating the legal description and 39.31 county, and a map drawn from available information showing the 39.32 location of each well to the extent practicable. In the 39.33 disclosure statement, the seller must indicate, for each well, 39.34 whether the well is in use, not in use, or sealed. 39.35 (b) At the time of closing of the sale, the disclosure 39.36 statement information, name and mailing address of the buyer, 40.1 and the quartile, section, township, and range in which each 40.2 well is located must be provided on a well disclosure 40.3 certificate signed by the seller or a person authorized to act 40.4 on behalf of the seller. 40.5 (c) A well disclosure certificate need not be provided if 40.6 the seller does not know of any wells on the property and the 40.7 deed or other instrument of conveyance contains the statement: 40.8 "The Seller certifies that the Seller does not know of any wells 40.9 on the described real property." 40.10 (d) If a deed is given pursuant to a contract for deed, the 40.11 well disclosure certificate required by this subdivision shall 40.12 be signed by the buyer or a person authorized to act on behalf 40.13 of the buyer. If the buyer knows of no wells on the property, a 40.14 well disclosure certificate is not required if the following 40.15 statement appears on the deed followed by the signature of the 40.16 grantee or, if there is more than one grantee, the signature of 40.17 at least one of the grantees: "The Grantee certifies that the 40.18 Grantee does not know of any wells on the described real 40.19 property." The statement and signature of the grantee may be on 40.20 the front or back of the deed or on an attached sheet and an 40.21 acknowledgment of the statement by the grantee is not required 40.22 for the deed to be recordable. 40.23 (e) This subdivision does not apply to the sale, exchange, 40.24 or transfer of real property: 40.25 (1) that consists solely of a sale or transfer of severed 40.26 mineral interests; or 40.27 (2) that consists of an individual condominium unit as 40.28 described in chapters 515 and 515B. 40.29 (f) For an area owned in common under chapter 515 or 515B 40.30 the association or other responsible person must report to the 40.31 commissioner by July 1, 1992, the location and status of all 40.32 wells in the common area. The association or other responsible 40.33 person must notify the commissioner within 30 days of any change 40.34 in the reported status of wells. 40.35 (g) For real property sold by the state under section 40.36 92.67, the lessee at the time of the sale is responsible for 41.1 compliance with this subdivision. 41.2 (h) If the seller fails to provide a required well 41.3 disclosure certificate, the buyer, or a person authorized to act 41.4 on behalf of the buyer, may sign a well disclosure certificate 41.5 based on the information provided on the disclosure statement 41.6 required by this section or based on other available information. 41.7 (i) A county recorder or registrar of titles may not record 41.8 a deed or other instrument of conveyance dated after October 31, 41.9 1990, for which a certificate of value is required under section 41.10 272.115, or any deed or other instrument of conveyance dated 41.11 after October 31, 1990, from a governmental body exempt from the 41.12 payment of state deed tax, unless the deed or other instrument 41.13 of conveyance contains the statement made in accordance with 41.14 paragraph (c) or (d) or is accompanied by the well disclosure 41.15 certificate containing all the information required by paragraph 41.16 (b) or (d). The county recorder or registrar of titles must not 41.17 accept a certificate unless it contains all the required 41.18 information. The county recorder or registrar of titles shall 41.19 note on each deed or other instrument of conveyance accompanied 41.20 by a well disclosure certificate that the well disclosure 41.21 certificate was received. The notation must include the 41.22 statement "No wells on property" if the disclosure certificate 41.23 states there are no wells on the property. The well disclosure 41.24 certificate shall not be filed or recorded in the records 41.25 maintained by the county recorder or registrar of titles. After 41.26 noting "No wells on property" on the deed or other instrument of 41.27 conveyance, the county recorder or registrar of titles shall 41.28 destroy or return to the buyer the well disclosure certificate. 41.29 The county recorder or registrar of titles shall collect from 41.30 the buyer or the person seeking to record a deed or other 41.31 instrument of conveyance, a fee of$20$30 for receipt of a 41.32 completed well disclosure certificate. By the tenth day of each 41.33 month, the county recorder or registrar of titles shall transmit 41.34 the well disclosure certificates to the commissioner of health. 41.35 By the tenth day after the end of each calendar quarter, the 41.36 county recorder or registrar of titles shall transmit to the 42.1 commissioner of health$17.50$27.50 of the fee for each well 42.2 disclosure certificate received during the quarter. The 42.3 commissioner shall maintain the well disclosure certificate for 42.4 at least six years. The commissioner may store the certificate 42.5 as an electronic image. A copy of that image shall be as valid 42.6 as the original. 42.7 (j) No new well disclosure certificate is required under 42.8 this subdivision if the buyer or seller, or a person authorized 42.9 to act on behalf of the buyer or seller, certifies on the deed 42.10 or other instrument of conveyance that the status and number of 42.11 wells on the property have not changed since the last previously 42.12 filed well disclosure certificate. The following statement, if 42.13 followed by the signature of the person making the statement, is 42.14 sufficient to comply with the certification requirement of this 42.15 paragraph: "I am familiar with the property described in this 42.16 instrument and I certify that the status and number of wells on 42.17 the described real property have not changed since the last 42.18 previously filed well disclosure certificate." The 42.19 certification and signature may be on the front or back of the 42.20 deed or on an attached sheet and an acknowledgment of the 42.21 statement is not required for the deed or other instrument of 42.22 conveyance to be recordable. 42.23 (k) The commissioner in consultation with county recorders 42.24 shall prescribe the form for a well disclosure certificate and 42.25 provide well disclosure certificate forms to county recorders 42.26 and registrars of titles and other interested persons. 42.27 (l) Failure to comply with a requirement of this 42.28 subdivision does not impair: 42.29 (1) the validity of a deed or other instrument of 42.30 conveyance as between the parties to the deed or instrument or 42.31 as to any other person who otherwise would be bound by the deed 42.32 or instrument; or 42.33 (2) the record, as notice, of any deed or other instrument 42.34 of conveyance accepted for filing or recording contrary to the 42.35 provisions of this subdivision. 42.36 [EFFECTIVE DATE.] This section is effective July 1, 2002. 43.1 Sec. 8. Minnesota Statutes 2000, section 103I.525, 43.2 subdivision 2, is amended to read: 43.3 Subd. 2. [APPLICATION FEE.] The application fee for a well 43.4 contractor's license is$50$75. The commissioner may not act 43.5 on an application until the application fee is paid. 43.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 43.7 Sec. 9. Minnesota Statutes 2000, section 103I.525, 43.8 subdivision 6, is amended to read: 43.9 Subd. 6. [LICENSE FEE.] The fee for a well contractor's 43.10 license is $250, except the fee for an individual well 43.11 contractor's license is$50$75. 43.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 43.13 Sec. 10. Minnesota Statutes 2000, section 103I.525, 43.14 subdivision 8, is amended to read: 43.15 Subd. 8. [RENEWAL.] (a) A licensee must file an 43.16 application and a renewal application fee to renew the license 43.17 by the date stated in the license. 43.18 (b) The renewal application feeshall be set by the43.19commissioner under section 16A.1285for a well contractor's 43.20 license is $250. 43.21 (c) The renewal application must include information that 43.22 the applicant has met continuing education requirements 43.23 established by the commissioner by rule. 43.24 (d) At the time of the renewal, the commissioner must have 43.25 on file all properly completed well reports, well sealing 43.26 reports, reports of excavations to construct elevator shafts, 43.27 well permits, and well notifications for work conducted by the 43.28 licensee since the last license renewal. 43.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 43.30 Sec. 11. Minnesota Statutes 2000, section 103I.525, 43.31 subdivision 9, is amended to read: 43.32 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 43.33 to submit all information required for renewal in subdivision 8 43.34 or submits the application and information after the required 43.35 renewal date: 43.36 (1) the licensee must includean additionala late feeset44.1by the commissionerof $75; and 44.2 (2) the licensee may not conduct activities authorized by 44.3 the well contractor's license until the renewal application, 44.4 renewal application fee, late fee, and all other information 44.5 required in subdivision 8 are submitted. 44.6 [EFFECTIVE DATE.] This section is effective July 1, 2002. 44.7 Sec. 12. Minnesota Statutes 2000, section 103I.531, 44.8 subdivision 2, is amended to read: 44.9 Subd. 2. [APPLICATION FEE.] The application fee for a 44.10 limited well/boring contractor's license is$50$75. The 44.11 commissioner may not act on an application until the application 44.12 fee is paid. 44.13 [EFFECTIVE DATE.] This section is effective July 1, 2002. 44.14 Sec. 13. Minnesota Statutes 2000, section 103I.531, 44.15 subdivision 6, is amended to read: 44.16 Subd. 6. [LICENSE FEE.] The fee for a limited well/boring 44.17 contractor's license is$50$75. 44.18 [EFFECTIVE DATE.] This section is effective July 1, 2002. 44.19 Sec. 14. Minnesota Statutes 2000, section 103I.531, 44.20 subdivision 8, is amended to read: 44.21 Subd. 8. [RENEWAL.] (a) A person must file an application 44.22 and a renewal application fee to renew the limited well/boring 44.23 contractor's license by the date stated in the license. 44.24 (b) The renewal application feeshall be set by the44.25commissioner under section 16A.1285for a limited well/boring 44.26 contractor's license is $75. 44.27 (c) The renewal application must include information that 44.28 the applicant has met continuing education requirements 44.29 established by the commissioner by rule. 44.30 (d) At the time of the renewal, the commissioner must have 44.31 on file all properly completed well sealing reports, well 44.32 permits, vertical heat exchanger permits, and well notifications 44.33 for work conducted by the licensee since the last license 44.34 renewal. 44.35 [EFFECTIVE DATE.] This section is effective July 1, 2002. 44.36 Sec. 15. Minnesota Statutes 2000, section 103I.531, 45.1 subdivision 9, is amended to read: 45.2 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 45.3 to submit all information required for renewal in subdivision 8 45.4 or submits the application and information after the required 45.5 renewal date: 45.6 (1) the licensee must includean additionala late feeset45.7by the commissionerof $75; and 45.8 (2) the licensee may not conduct activities authorized by 45.9 the limited well/boring contractor's license until the renewal 45.10 application, renewal application fee, and late fee, and all 45.11 other information required in subdivision 8 are submitted. 45.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 45.13 Sec. 16. Minnesota Statutes 2000, section 103I.535, 45.14 subdivision 2, is amended to read: 45.15 Subd. 2. [APPLICATION FEE.] The application fee for an 45.16 elevator shaft contractor's license is$50$75. The 45.17 commissioner may not act on an application until the application 45.18 fee is paid. 45.19 [EFFECTIVE DATE.] This section is effective July 1, 2002. 45.20 Sec. 17. Minnesota Statutes 2000, section 103I.535, 45.21 subdivision 6, is amended to read: 45.22 Subd. 6. [LICENSE FEE.] The fee for an elevator shaft 45.23 contractor's license is$50$75. 45.24 [EFFECTIVE DATE.] This section is effective July 1, 2002. 45.25 Sec. 18. Minnesota Statutes 2000, section 103I.535, 45.26 subdivision 8, is amended to read: 45.27 Subd. 8. [RENEWAL.] (a) A person must file an application 45.28 and a renewal application fee to renew the license by the date 45.29 stated in the license. 45.30 (b) The renewal application feeshall be set by the45.31commissioner under section 16A.1285for an elevator shaft 45.32 contractor's license is $75. 45.33 (c) The renewal application must include information that 45.34 the applicant has met continuing education requirements 45.35 established by the commissioner by rule. 45.36 (d) At the time of renewal, the commissioner must have on 46.1 file all reports and permits for elevator shaft work conducted 46.2 by the licensee since the last license renewal. 46.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 46.4 Sec. 19. Minnesota Statutes 2000, section 103I.535, 46.5 subdivision 9, is amended to read: 46.6 Subd. 9. [INCOMPLETE OR LATE RENEWAL.] If a licensee fails 46.7 to submit all information required for renewal in subdivision 8 46.8 or submits the application and information after the required 46.9 renewal date: 46.10 (1) the licensee must includean additionala late feeset46.11by the commissionerof $75; and 46.12 (2) the licensee may not conduct activities authorized by 46.13 the elevator shaft contractor's license until the renewal 46.14 application, renewal application fee, and late fee, and all 46.15 other information required in subdivision 8 are submitted. 46.16 [EFFECTIVE DATE.] This section is effective July 1, 2002. 46.17 Sec. 20. Minnesota Statutes 2000, section 103I.541, 46.18 subdivision 2b, is amended to read: 46.19 Subd. 2b. [APPLICATION FEE.] The application fee for a 46.20 monitoring well contractor registration is$50$75. The 46.21 commissioner may not act on an application until the application 46.22 fee is paid. 46.23 [EFFECTIVE DATE.] This section is effective July 1, 2002. 46.24 Sec. 21. Minnesota Statutes 2000, section 103I.541, 46.25 subdivision 4, is amended to read: 46.26 Subd. 4. [RENEWAL.] (a) A person must file an application 46.27 and a renewal application fee to renew the registration by the 46.28 date stated in the registration. 46.29 (b) The renewal application feeshall be set by the46.30commissioner under section 16A.1285for a monitoring well 46.31 contractor's registration is $75. 46.32 (c) The renewal application must include information that 46.33 the applicant has met continuing education requirements 46.34 established by the commissioner by rule. 46.35 (d) At the time of the renewal, the commissioner must have 46.36 on file all well reports, well sealing reports, well permits, 47.1 and notifications for work conducted by the registered person 47.2 since the last registration renewal. 47.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 47.4 Sec. 22. Minnesota Statutes 2000, section 103I.541, 47.5 subdivision 5, is amended to read: 47.6 Subd. 5. [INCOMPLETE OR LATE RENEWAL.] If a registered 47.7 person submits a renewal application after the required renewal 47.8 date: 47.9 (1) the registered person must includean additionala late 47.10 feeset by the commissionerof $75; and 47.11 (2) the registered person may not conduct activities 47.12 authorized by the monitoring well contractor's registration 47.13 until the renewal application, renewal application fee, late 47.14 fee, and all other information required in subdivision 4 are 47.15 submitted. 47.16 [EFFECTIVE DATE.] This section is effective July 1, 2002. 47.17 Sec. 23. Minnesota Statutes 2000, section 103I.545, is 47.18 amended to read: 47.19 103I.545 [REGISTRATION OF DRILLING MACHINES REQUIRED.] 47.20 Subdivision 1. [DRILLING MACHINE.] (a) A person may not 47.21 use a drilling machine such as a cable tool, rotary tool, hollow 47.22 rod tool, or auger for a drilling activity requiring a license 47.23 or registration under this chapter unless the drilling machine 47.24 is registered with the commissioner. 47.25 (b) A person must apply for the registration on forms 47.26 prescribed by the commissioner and submit a$50$75 registration 47.27 fee. 47.28 (c) A registration is valid for one year. 47.29 Subd. 2. [PUMP HOIST.] (a) A person may not use a machine 47.30 such as a pump hoist for an activity requiring a license or 47.31 registration under this chapter to repair wells or borings, seal 47.32 wells or borings, or install pumps unless the machine is 47.33 registered with the commissioner. 47.34 (b) A person must apply for the registration on forms 47.35 prescribed by the commissioner and submit a$50$75 registration 47.36 fee. 48.1 (c) A registration is valid for one year. 48.2 [EFFECTIVE DATE.] This section is effective July 1, 2002. 48.3 Sec. 24. Minnesota Statutes 2000, section 121A.15, is 48.4 amended by adding a subdivision to read: 48.5 Subd. 1a. [IMMUNIZATIONS REQUIRED; ANNUAL 48.6 DETERMINATION.] (a) Using the procedures established under 48.7 subdivision 1c, the commissioner of health shall annually 48.8 determine the immunizations required and the manner and 48.9 frequency of their administration to the persons specified in 48.10 subdivision 1 and to the persons specified in section 135A.14, 48.11 subdivision 2. The commissioner of health shall not include an 48.12 immunization on the immunization schedule unless the 48.13 immunization is part of the current immunization recommendations 48.14 of each of the following organizations: the United States 48.15 Public Health Service's Advisory Committee on Immunization 48.16 Practices, the American Academy of Family Physicians, and the 48.17 American Academy of Pediatrics. In annually determining the 48.18 immunization schedule, the commissioner of health shall: 48.19 (1) consult with the commissioner of children, families, 48.20 and learning; the commissioner of human services; the chancellor 48.21 of the Minnesota state colleges and universities; and the 48.22 president of the University of Minnesota; and 48.23 (2) consider the following criteria: the epidemiology of 48.24 the disease, the morbidity and mortality rates for the disease, 48.25 the safety and efficacy of the vaccine, the cost of a 48.26 vaccination program, the cost of enforcing vaccination 48.27 requirements, and a cost-benefit analysis of vaccination. 48.28 (b) In addition to the publication requirements of 48.29 subdivision 1c, the commissioner of health shall inform all 48.30 immunization providers of any changes in the immunization 48.31 schedule in a timely manner. 48.32 (c) After such reasonable efforts as the circumstances 48.33 allow to facilitate the consultation requirements in paragraph 48.34 (a), clause (1), the commissioner of health may modify the 48.35 immunization schedule at any time during the year when necessary 48.36 to address a vaccine shortage or an emergency situation. In 49.1 modifying the immunization schedule under this paragraph, the 49.2 commissioner of health is exempt from the rules procedure in 49.3 subdivision 1c. 49.4 [EFFECTIVE DATE.] This section is effective January 1, 49.5 2003, and applies to the 2003-2004 school term and later. 49.6 Sec. 25. Minnesota Statutes 2000, section 121A.15, is 49.7 amended by adding a subdivision to read: 49.8 Subd. 1b. [RULEMAKING EXEMPTION.] The commissioner of 49.9 health is exempt from chapter 14, including section 14.386, in 49.10 implementing this section. 49.11 [EFFECTIVE DATE.] This section is effective January 1, 49.12 2003, and applies to the 2003-2004 school term and later. 49.13 Sec. 26. Minnesota Statutes 2000, section 121A.15, is 49.14 amended by adding a subdivision to read: 49.15 Subd 1c. [RULES PROCEDURE.] (a) The commissioner of health 49.16 shall publish proposed immunization rules in the State Register. 49.17 (b) Interested parties shall have 30 days to comment in 49.18 writing on the proposed rules. After the commissioner of health 49.19 has considered all timely comments, the commissioner of health 49.20 shall publish notice in the State Register that the rules have 49.21 been adopted. The rules shall take effect on the 31st day after 49.22 publication. 49.23 (c) If the adopted rules are the same as the proposed 49.24 rules, the notice shall state that the rules have been adopted 49.25 as proposed and shall cite the prior publication. If the 49.26 adopted rules differ from the proposed rules, the portions of 49.27 the adopted rules that differ from the proposed rules shall be 49.28 included in the notice of adoption together with a citation to 49.29 the prior State Register that contained the notice of the 49.30 proposed rules. 49.31 [EFFECTIVE DATE.] This section is effective January 1, 49.32 2003, and applies to the 2003-2004 school term and later. 49.33 Sec. 27. Minnesota Statutes 2000, section 121A.15, is 49.34 amended by adding a subdivision to read: 49.35 Subd. 13. [REPORT.] By January 15, 2004, and every 49.36 even-numbered year thereafter, the commissioner of health shall 50.1 report to the legislature on the current immunization schedule 50.2 and all changes made to the schedule in the previous two-year 50.3 period. 50.4 [EFFECTIVE DATE.] This section is effective January 1, 50.5 2003, and applies to the 2003-2004 school term and later. 50.6 Sec. 28. Minnesota Statutes 2000, section 144.1202, 50.7 subdivision 4, is amended to read: 50.8 Subd. 4. [AGREEMENT; CONDITIONS OF IMPLEMENTATION.] (a) An 50.9 agreement entered into before August 2,20022003, must remain 50.10 in effect until terminated under the Atomic Energy Act of 1954, 50.11 United States Code, title 42, section 2021, paragraph (j). The 50.12 governor may not enter into an initial agreement with the 50.13 Nuclear Regulatory Commission after August 1,20022003. If an 50.14 agreement is not entered into by August 1,20022003, any rules 50.15 adopted under this section are repealed effective August 1,200250.16 2003. 50.17 (b) An agreement authorized under subdivision 1 must be 50.18 approved by law before it may be implemented. 50.19 Sec. 29. [144.1205] [RADIOACTIVE MATERIAL; SOURCE AND 50.20 SPECIAL NUCLEAR MATERIAL; FEES; INSPECTION.] 50.21 Subdivision 1. [APPLICATION AND LICENSE RENEWAL FEE.] When 50.22 a license is required for radioactive material or source or 50.23 special nuclear material by a rule adopted under section 50.24 144.1202, subdivision 2, an application fee according to 50.25 subdivision 4 must be paid upon initial application for a 50.26 license. The licensee must renew the license 60 days before the 50.27 expiration date of the license by paying a license renewal fee 50.28 equal to the application fee under subdivision 4. The 50.29 expiration date of a license is the date set by the United 50.30 States Nuclear Regulatory Commission before transfer of the 50.31 licensing program under section 144.1202 and thereafter as 50.32 specified by rule of the commissioner of health. 50.33 Subd. 2. [ANNUAL FEE.] A licensee must pay an annual fee 50.34 at least 60 days before the anniversary date of the issuance of 50.35 the license. The annual fee is an amount equal to 80 percent of 50.36 the application fee under subdivision 4, rounded to the nearest 51.1 whole dollar. 51.2 Subd. 3. [FEE CATEGORIES; INCORPORATION OF FEDERAL 51.3 LICENSING CATEGORIES.] (a) Fee categories under this section are 51.4 equivalent to the licensing categories used by the United States 51.5 Nuclear Regulatory Commission under Code of Federal Regulations, 51.6 title 10, parts 30 to 36, 39, 40, 70, 71, and 150, except as 51.7 provided in paragraph (b). 51.8 (b) The category of "Academic, small" is the type of 51.9 license required for the use of radioactive materials in a 51.10 teaching institution. Radioactive materials are limited to ten 51.11 radionuclides not to exceed a total activity amount of one curie. 51.12 Subd. 4. [APPLICATION FEE.] A licensee must pay an 51.13 application fee as follows: 51.14 Radioactive material, Application U.S. Nuclear Regulatory 51.15 source and fee Commission licensing 51.16 special material category as reference 51.18 Type A broadscope $20,000 Medical institution type A 51.19 Type B broadscope $15,000 Research and development 51.20 type B 51.21 Type C broadscope $10,000 Academic type C 51.22 Medical use $4,000 Medical 51.23 Medical institution 51.24 Medical private practice 51.25 Mobile nuclear 51.26 medical laboratory $4,000 Mobile medical laboratory 51.27 Medical special use 51.28 sealed sources $6,000 Teletherapy 51.29 High dose rate remote 51.30 afterloaders 51.31 Stereotactic 51.32 radiosurgery devices 51.33 In vitro testing $2,300 In vitro testing 51.34 laboratories 51.35 Measuring gauge, 51.36 sealed sources $2,000 Fixed gauges 52.1 Portable gauges 52.2 Analytical instruments 52.3 Measuring systems - other 52.4 Gas chromatographs $1,200 Gas chromatographs 52.5 Manufacturing and 52.6 distribution $14,700 Manufacturing and 52.7 distribution - other 52.8 Distribution only $8,800 Distribution of 52.9 radioactive material 52.10 for commercial use only 52.11 Other services $1,500 Other services 52.12 Nuclear medicine 52.13 pharmacy $4,100 Nuclear pharmacy 52.14 Waste disposal $9,400 Waste disposal service 52.15 prepackage 52.16 Waste disposal service 52.17 processing/repackage 52.18 Waste storage only $7,000 To receive and store 52.19 radioactive material waste 52.20 Industrial 52.21 radiography $8,400 Industrial radiography 52.22 fixed location 52.23 Industrial radiography 52.24 portable/temporary sites 52.25 Irradiator - 52.26 self-shielded $4,100 Irradiators self-shielded 52.27 less than 10,000 curies 52.28 Irradiator - 52.29 less than 10,000 Ci $7,500 Irradiators less than 52.30 10,000 curies 52.31 Irradiator - 52.32 more than 10,000 Ci $11,500 Irradiators greater than 52.33 10,000 curies 52.34 Research and 52.35 development, 52.36 no distribution $4,100 Research and development 53.1 Radioactive material 53.2 possession only $1,000 Byproduct possession only 53.3 Source material $1,000 Source material shielding 53.4 Special nuclear 53.5 material, less than 53.6 200 grams $1,000 Special nuclear material 53.7 plutonium-neutron sources 53.8 less than 200 grams 53.9 Pacemaker 53.10 manufacturing $1,000 Pacemaker byproduct 53.11 and/or special nuclear 53.12 material - medical 53.13 institution 53.14 General license 53.15 distribution $2,100 General license 53.16 distribution 53.17 General license 53.18 distribution, exempt $1,500 General license 53.19 distribution - 53.20 certain exempt items 53.21 Academic, small $1,000 Possession limit of ten 53.22 radionuclides, not to 53.23 exceed a total of one curie 53.24 of activity 53.25 Veterinary $2,000 Veterinary use 53.26 Well logging $5,000 Well logging 53.27 Subd. 5. [PENALTY FOR LATE PAYMENT.] An annual fee or a 53.28 license renewal fee submitted to the commissioner after the due 53.29 date specified by rule must be accompanied by an additional 53.30 amount equal to 25 percent of the fee due. 53.31 Subd. 6. [INSPECTIONS.] The commissioner of health shall 53.32 make periodic safety inspections of the radioactive material and 53.33 source and special nuclear material of a licensee. The 53.34 commissioner shall prescribe the frequency of safety inspections 53.35 by rule. 53.36 Subd. 7. [RECOVERY OF REINSPECTION COST.] If the 54.1 commissioner finds serious violations of public health standards 54.2 during an inspection under subdivision 6, the licensee must pay 54.3 all costs associated with subsequent reinspection of the 54.4 source. The costs shall be the actual costs incurred by the 54.5 commissioner and include, but are not limited to, labor, 54.6 transportation, per diem, materials, legal fees, testing, and 54.7 monitoring costs. 54.8 Subd. 8. [RECIPROCITY FEE.] A licensee submitting an 54.9 application for reciprocal recognition of a materials license 54.10 issued by another agreement state or the United States Nuclear 54.11 Regulatory Commission for a period of 180 days or less during a 54.12 calendar year must pay one-half of the application fee specified 54.13 under subdivision 4. For a period of 181 days or more, the 54.14 licensee must pay the entire application fee under subdivision 4. 54.15 Subd. 9. [FEES FOR LICENSE AMENDMENTS.] A licensee must 54.16 pay a fee to amend a license as follows: 54.17 (1) to amend a license requiring no license review 54.18 including, but not limited to, facility name change or removal 54.19 of a previously authorized user, no fee; 54.20 (2) to amend a license requiring review including, but not 54.21 limited to, addition of isotopes, procedure changes, new 54.22 authorized users, or a new radiation safety officer, $200; and 54.23 (3) to amend a license requiring review and a site visit 54.24 including, but not limited to, facility move or addition of 54.25 processes, $400. 54.26 [EFFECTIVE DATE.] This section is effective July 1, 2002. 54.27 Sec. 30. Minnesota Statutes 2000, section 144.122, is 54.28 amended to read: 54.29 144.122 [LICENSE, PERMIT, AND SURVEY FEES.] 54.30 (a) The state commissioner of health, by rule, may 54.31 prescribe reasonable procedures and fees for filing with the 54.32 commissioner as prescribed by statute and for the issuance of 54.33 original and renewal permits, licenses, registrations, and 54.34 certifications issued under authority of the commissioner. The 54.35 expiration dates of the various licenses, permits, 54.36 registrations, and certifications as prescribed by the rules 55.1 shall be plainly marked thereon. Fees may include application 55.2 and examination fees and a penalty fee for renewal applications 55.3 submitted after the expiration date of the previously issued 55.4 permit, license, registration, and certification. The 55.5 commissioner may also prescribe, by rule, reduced fees for 55.6 permits, licenses, registrations, and certifications when the 55.7 application therefor is submitted during the last three months 55.8 of the permit, license, registration, or certification period. 55.9 Fees proposed to be prescribed in the rules shall be first 55.10 approved by the department of finance. All fees proposed to be 55.11 prescribed in rules shall be reasonable. The fees shall be in 55.12 an amount so that the total fees collected by the commissioner 55.13 will, where practical, approximate the cost to the commissioner 55.14 in administering the program. All fees collected shall be 55.15 deposited in the state treasury and credited to the state 55.16 government special revenue fund unless otherwise specifically 55.17 appropriated by law for specific purposes. 55.18 (b) The commissioner may charge a fee for voluntary 55.19 certification of medical laboratories and environmental 55.20 laboratories, and for environmental and medical laboratory 55.21 services provided by the department, without complying with 55.22 paragraph (a) or chapter 14. Fees charged for environment and 55.23 medical laboratory services provided by the department must be 55.24 approximately equal to the costs of providing the services. 55.25 (c) The commissioner may develop a schedule of fees for 55.26 diagnostic evaluations conducted at clinics held by the services 55.27 for children with handicaps program. All receipts generated by 55.28 the program are annually appropriated to the commissioner for 55.29 use in the maternal and child health program. 55.30 (d) The commissioner, for fiscal years 1996 and beyond, 55.31 shall set license fees for hospitals and nursing homes that are 55.32 not boarding care homes at the following levels: 55.33 Joint Commission on Accreditation of Healthcare 55.34 Organizations (JCAHO hospitals)$1,01755.35 $7,055 55.36 Non-JCAHO hospitals$762 plus $34 per bed56.1 $4,680 plus $234 per bed 56.2 Nursing home $78 plus $19 per bed 56.3 For fiscal years 1996 and beyond, the commissioner shall 56.4 set license fees for outpatient surgical centers, boarding care 56.5 homes, and supervised living facilities at the following levels: 56.6 Outpatient surgical centers$51756.7 $1,512 56.8 Boarding care homes$78 plus $19 per bed56.9 $183 plus $91 per bed 56.10 Supervised living facilities$78 plus $19 per bed56.11 $183 plus $91 per bed. 56.12 (e) Unless prohibited by federal law, the commissioner of 56.13 health shall charge applicants the following fees to cover the 56.14 cost of any initial certification surveys required to determine 56.15 a provider's eligibility to participate in the Medicare or 56.16 Medicaid program: 56.17 Prospective payment surveys for $ 900 56.18 hospitals 56.20 Swing bed surveys for nursing homes $1,200 56.22 Psychiatric hospitals $1,400 56.24 Rural health facilities $1,100 56.26 Portable X-ray providers $ 500 56.28 Home health agencies $1,800 56.30 Outpatient therapy agencies $ 800 56.32 End stage renal dialysis providers $2,100 56.34 Independent therapists $ 800 56.36 Comprehensive rehabilitation $1,200 56.37 outpatient facilities 56.39 Hospice providers $1,700 56.41 Ambulatory surgical providers $1,800 56.43 Hospitals $4,200 56.45 Other provider categories or Actual surveyor costs: 56.46 additional resurveys required average surveyor cost x 56.47 to complete initial certification number of hours for the 56.48 survey process. 56.49 These fees shall be submitted at the time of the 56.50 application for federal certification and shall not be 56.51 refunded. All fees collected after the date that the imposition 57.1 of fees is not prohibited by federal law shall be deposited in 57.2 the state treasury and credited to the state government special 57.3 revenue fund. 57.4 Sec. 31. Minnesota Statutes 2000, section 144.1464, is 57.5 amended to read: 57.6 144.1464 [SUMMER HEALTH CARE INTERNS.] 57.7 Subdivision 1. [SUMMER INTERNSHIPS.] The commissioner of 57.8 health, through a contract with a nonprofit organization as 57.9 required by subdivision 4, shall award grants to hospitalsand, 57.10 clinics, nursing facilities, and home care providers to 57.11 establish a secondary and post-secondary summer health care 57.12 intern program. The purpose of the program is to expose 57.13 interested secondary and post-secondary pupils to various 57.14 careers within the health care profession. 57.15 Subd. 2. [CRITERIA.] (a) The commissioner, through the 57.16 organization under contract, shall award grants to 57.17 hospitalsand, clinics, nursing facilities, and home care 57.18 providers that agree to: 57.19 (1) provide secondary and post-secondary summer health care 57.20 interns with formal exposure to the health care profession; 57.21 (2) provide an orientation for the secondary and 57.22 post-secondary summer health care interns; 57.23 (3) pay one-half the costs of employing the secondary and 57.24 post-secondary summer health care intern, based on an overall57.25hourly wage that is at least the minimum wage but does not57.26exceed $6 an hour; 57.27 (4) interview and hire secondary and post-secondary pupils 57.28 for a minimum of six weeks and a maximum of 12 weeks; and 57.29 (5) employ at least one secondary student for each 57.30 post-secondary student employed, to the extent that there are 57.31 sufficient qualifying secondary student applicants. 57.32 (b) In order to be eligible to be hired as a secondary 57.33 summer health intern by a hospitalor, clinic, nursing facility, 57.34 or home care provider, a pupil must: 57.35 (1) intend to complete high school graduation requirements 57.36 and be between the junior and senior year of high school; and 58.1 (2) be from a school district in proximity to the facility;58.2and58.3(3) provide the facility with a letter of recommendation58.4from a health occupations or science educator. 58.5 (c) In order to be eligible to be hired as a post-secondary 58.6 summer health care intern by a hospital or clinic, a pupil must: 58.7 (1) intend to complete a health care training program or a 58.8 two-year or four-year degree program and be planning on 58.9 enrolling in or be enrolled in that training program or degree 58.10 program; and 58.11 (2) be enrolled in a Minnesota educational institution or 58.12 be a resident of the state of Minnesota; priority must be given 58.13 to applicants from a school district or an educational 58.14 institution in proximity to the facility; and58.15(3) provide the facility with a letter of recommendation58.16from a health occupations or science educator. 58.17 (d) Hospitalsand, clinics, nursing facilities, and home 58.18 care providers awarded grants may employ pupils as secondary and 58.19 post-secondary summer health care interns beginning on or after 58.20 June 15, 1993, if they agree to pay the intern, during the 58.21 period before disbursement of state grant money, with money 58.22 designated as the facility's 50 percent contribution towards 58.23 internship costs. 58.24 Subd. 3. [GRANTS.] The commissioner, through the 58.25 organization under contract, shall award separate grants to 58.26 hospitalsand, clinics, nursing facilities, and home care 58.27 providers meeting the requirements of subdivision 2. The grants 58.28 must be used to pay one-half of the costs of employing secondary 58.29 and post-secondary pupils in a hospitalor, clinic, nursing 58.30 facility, or home care setting during the course of the 58.31 program. No more than 50 percent of the participants may be 58.32 post-secondary students, unless the program does not receive 58.33 enough qualified secondary applicants per fiscal year. No more 58.34 than five pupils may be selected from any secondary or 58.35 post-secondary institution to participate in the program and no 58.36 more than one-half of the number of pupils selected may be from 59.1 the seven-county metropolitan area. 59.2 Subd. 4. [CONTRACT.] The commissioner shall contract with 59.3 a statewide, nonprofit organization representing facilities at 59.4 which secondary and post-secondary summer health care interns 59.5 will serve, to administer the grant program established by this 59.6 section. Grant funds that are not used in one fiscal year may 59.7 be carried over to the next fiscal year. The organization 59.8 awarded the grant shall provide the commissioner with any 59.9 information needed by the commissioner to evaluate the program, 59.10 in the form and at the times specified by the commissioner. 59.11 Sec. 32. Minnesota Statutes 2000, section 144.1494, 59.12 subdivision 1, is amended to read: 59.13 Subdivision 1. [CREATION OF ACCOUNT.]A rural physician59.14 Educationaccount isaccounts are established in the health care 59.15 access fund and the general fund. The commissioner shall use 59.16 money from the account to establish a loan forgiveness program 59.17 for medical residents agreeing to practice in designated rural 59.18 areas, as defined by the commissioner. Appropriations made 59.19 tothis accountthese accounts do not cancel and are available 59.20 until expended, except that at the end of each biennium the 59.21 commissioner shall cancel to the health care access fund or 59.22 general fund, as applicable, any remaining unobligated 59.23 balancein this accounts. 59.24 Sec. 33. Minnesota Statutes 2000, section 144.1494, 59.25 subdivision 3, is amended to read: 59.26 Subd. 3. [LOAN FORGIVENESS.]For each fiscal year after59.271995,The commissioner may accept up to1222 applicants a year 59.28 who are medical residents for participation in the loan 59.29 forgiveness program with payment for the first 12 applicants 59.30 accepted to be made out of the health care access fund education 59.31 account and payment for the remaining applicants accepted to be 59.32 made out of the general fund education account. The12 resident59.33 applicants may be in any year of residency training; however, 59.34 priority must be given to the following categories of residents 59.35 in descending order: third year residents, second year 59.36 residents, and first year residents. Applicants are responsible 60.1 for securing their own loans. Applicants chosen to participate 60.2 in the loan forgiveness program may designate for each year of 60.3 medical school, up to a maximum of four years, an agreed amount, 60.4 not to exceed $10,000, as a qualified loan. For each year that 60.5 a participant serves as a physician in a designated rural area, 60.6 up to a maximum of four years, the commissioner shall annually 60.7 pay an amount equal to one year of qualified loans. 60.8 Participants who move their practice from one designated rural 60.9 area to another remain eligible for loan repayment. In 60.10 addition, in any year that a resident participating in the loan 60.11 forgiveness program serves at least four weeks during a year of 60.12 residency substituting for a rural physician to temporarily 60.13 relieve the rural physician of rural practice commitments to 60.14 enable the rural physician to take a vacation, engage in 60.15 activities outside the practice area, or otherwise be relieved 60.16 of rural practice commitments, the participating resident may 60.17 designate up to an additional $2,000, above the $10,000 yearly 60.18 maximum. 60.19 Sec. 34. Minnesota Statutes 2000, section 144.1494, 60.20 subdivision 4, is amended to read: 60.21 Subd. 4. [PENALTY FOR NONFULFILLMENT.] If a participant 60.22 does not fulfill the required three-year minimum commitment of 60.23 service in a designated rural area, the commissioner shall 60.24 collect from the participant the amount paid under the loan 60.25 forgiveness program. The commissioner shall deposit themoney60.26collected in the rural physician education accountcollections 60.27 in the health care access fund or the general fund, as 60.28 applicable, to be credited to the accounts established in 60.29 subdivision 1. The commissioner shall allow waivers of all or 60.30 part of the money owed the commissioner if emergency 60.31 circumstances prevented fulfillment of the three-year service 60.32 commitment. 60.33 Sec. 35. Minnesota Statutes 2000, section 144.1496, is 60.34 amended to read: 60.35 144.1496 [NURSES IN NURSING HOMESOR, ICFMRS, OR HOME 60.36 HEALTH CARE AGENCIES.] 61.1 Subdivision 1. [CREATION OF THE ACCOUNT.]AnEducation 61.2accountaccounts in the health care access fundisand the 61.3 general fund are established for a loan forgiveness program for 61.4 nurses who agree to practice nursing in a nursing homeor, 61.5 intermediate care facility for persons with mental retardation 61.6 or related conditions, or home health care agency. Theaccount61.7consistsaccounts consist of money appropriated by the 61.8 legislature and repayments and penalties collected under 61.9 subdivision 4. Money from theaccountaccounts must be used for 61.10 a loan forgiveness program. 61.11 Subd. 2. [ELIGIBILITY.] To be eligible to participate in 61.12 the loan forgiveness program, a person enrolled in a program of 61.13 study designed to prepare the person to become a registered 61.14 nurse or licensed practical nurse must submit an application to 61.15 the commissioner before completion of a nursing education 61.16 program. A nurse who is selected to participate must sign a 61.17 contract to agree to serve a minimum one-year service obligation 61.18 providing nursing services in a licensed nursing homeor, 61.19 intermediate care facility for persons with mental retardation 61.20 or related conditions, or home health care agency, which shall 61.21 begin no later than March following completion of a nursing 61.22 program or loan forgiveness program selection. 61.23 Subd. 3. [LOAN FORGIVENESS.] The commissioner may accept 61.24 up toten177 applicants a year with payment for the first ten 61.25 applicants accepted to be made out of the health care access 61.26 fund education account and payment for the remaining applicants 61.27 accepted to be made out of the general fund education account. 61.28 Applicants are responsible for securing their own loans. For 61.29 each year of nursing education, for up to two years, applicants 61.30 accepted into the loan forgiveness program may designate an 61.31 agreed amount, not to exceed $3,000, as a qualified loan. For 61.32 each year that a participant practices nursing in a nursing home 61.33or, intermediate care facility for persons with mental 61.34 retardation or related conditions, or home health care agency, 61.35 up to a maximum of two years, the commissioner shall annually 61.36 repay an amount equal to one year of qualified loans. 62.1 Participants who move from one nursing homeor, intermediate 62.2 care facility for persons with mental retardation or related 62.3 conditions, or home health care agency to another remain 62.4 eligible for loan repayment. 62.5 Subd. 4. [PENALTY FOR NONFULFILLMENT.] If a participant 62.6 does not fulfill the service commitment required under 62.7 subdivision 3 for full repayment of all qualified loans, the 62.8 commissioner shall collect from the participant 100 percent of 62.9 any payments made for qualified loans and interest at a rate 62.10 established according to section 270.75. The commissioner shall 62.11 deposit the collections in the health care access fund or the 62.12 general fund, as applicable, to be credited to theaccount62.13 accounts established in subdivision 1. The commissioner may 62.14 grant a waiver of all or part of the money owed as a result of a 62.15 nonfulfillment penalty if emergency circumstances prevented 62.16 fulfillment of the required service commitment. 62.17 Subd. 5. [RULES.] The commissioner may adopt rules to 62.18 implement this section. 62.19 Sec. 36. [144.1499] [PROMOTION OF HEALTH CARE AND 62.20 LONG-TERM CARE CAREERS.] 62.21 The commissioner of health, in consultation with an 62.22 organization representing health care employers, long-term care 62.23 employers, and educational institutions, may make grants to 62.24 qualifying consortia as defined in section 116L.11, subdivision 62.25 4, for intergenerational programs to encourage middle and high 62.26 school students to work and volunteer in health care and 62.27 long-term care settings. To qualify for a grant under this 62.28 section, a consortium shall: 62.29 (1) develop a health and long-term care careers curriculum 62.30 that provides career exploration and training in national skill 62.31 standards for health care and long-term care and that is 62.32 consistent with Minnesota graduation standards and other related 62.33 requirements; 62.34 (2) offer programs for high school students that provide 62.35 training in health and long-term care careers with credits that 62.36 articulate into post-secondary programs; and 63.1 (3) provide technical support to the participating health 63.2 care and long-term care employer to enable the use of the 63.3 employer's facilities and programs for kindergarten to grade 12 63.4 health and long-term care careers education. 63.5 Sec. 37. [144.1501] [RURAL PHARMACISTS LOAN FORGIVENESS.] 63.6 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 63.7 section, the terms defined in this subdivision have the meanings 63.8 given them. 63.9 (b) "Designated rural area" means: 63.10 (1) an area in Minnesota outside the counties of Anoka, 63.11 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 63.12 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 63.13 and St. Cloud; or 63.14 (2) a municipal corporation, as defined under section 63.15 471.634, that is physically located, in whole or in part, in an 63.16 area defined as a designated rural area under clause (1). 63.17 Designated rural areas may be further defined by the 63.18 commissioner of health to reflect a shortage of pharmacists as 63.19 indicated by the ratio of pharmacists to population and the 63.20 distance to the next nearest pharmacy. 63.21 (c) "Qualifying educational loans" means government, 63.22 commercial, and foundation loans for actual costs paid for 63.23 tuition, reasonable education expenses, and reasonable living 63.24 expenses related to the graduate or undergraduate education of a 63.25 pharmacist. 63.26 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 63.27 PROGRAM.] A rural pharmacist education account is established in 63.28 the general fund. The commissioner of health shall use money 63.29 from the account to establish a loan forgiveness program for 63.30 pharmacists who agree to practice in designated rural areas. 63.31 The commissioner may seek advice in establishing the program 63.32 from the pharmacists association, the University of Minnesota, 63.33 and other interested parties. 63.34 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 63.35 the loan forgiveness program, a pharmacy student must submit an 63.36 application to the commissioner of health while attending a 64.1 program of study designed to prepare the individual to become a 64.2 licensed pharmacist. For fiscal year 2002, applicants may have 64.3 graduated from a pharmacy program in calendar year 2001. A 64.4 pharmacy student who is accepted into the loan forgiveness 64.5 program must sign a contract to agree to serve a minimum 64.6 three-year service obligation within a designated rural area, 64.7 which shall begin no later than March 31 of the first year 64.8 following completion of a pharmacy program or residency. If 64.9 fewer applications are submitted by pharmacy students than there 64.10 are participant slots available, the commissioner may consider 64.11 applications submitted by pharmacy program graduates who are 64.12 licensed pharmacists. Pharmacists selected for loan forgiveness 64.13 must comply with all terms and conditions of this section. 64.14 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 64.15 may accept up to 14 applicants per year for participation in the 64.16 loan forgiveness program. Applicants are responsible for 64.17 securing their own loans. The commissioner shall select 64.18 participants based on their suitability for rural practice, as 64.19 indicated by rural experience or training. The commissioner 64.20 shall give preference to applicants closest to completing their 64.21 training. For each year that a participant serves as a 64.22 pharmacist in a designated rural area as required under 64.23 subdivision 3, up to a maximum of four years, the commissioner 64.24 shall make annual disbursements directly to the participant 64.25 equivalent to $5,000 per year of service, not to exceed $20,000 64.26 or the balance of the qualifying educational loans, whichever is 64.27 less. Before receiving loan repayment disbursements and as 64.28 requested, the participant must complete and return to the 64.29 commissioner an affidavit of practice form provided by the 64.30 commissioner verifying that the participant is practicing as 64.31 required in an eligible area. The participant must provide the 64.32 commissioner with verification that the full amount of loan 64.33 repayment disbursement received by the participant has been 64.34 applied toward the qualifying educational loans. After each 64.35 disbursement, verification must be received by the commissioner 64.36 and approved before the next loan repayment disbursement is 65.1 made. Participants who move their practice from one designated 65.2 rural area to another remain eligible for loan repayment. 65.3 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 65.4 does not fulfill the service commitment under subdivision 3, the 65.5 commissioner of health shall collect from the participant 100 65.6 percent of any payments made for qualified educational loans and 65.7 interest at a rate established according to section 270.75. The 65.8 commissioner shall deposit the money collected in the rural 65.9 pharmacist education account established under subdivision 2. 65.10 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 65.11 service obligations cancel in the event of a participant's 65.12 death. The commissioner of health may waive or suspend payment 65.13 or service obligations in cases of total and permanent 65.14 disability or long-term temporary disability lasting for more 65.15 than two years. The commissioner shall evaluate all other 65.16 requests for suspension or waivers on a case-by-case basis and 65.17 may grant a waiver of all or part of the money owed as a result 65.18 of a nonfulfillment penalty if emergency circumstances prevented 65.19 fulfillment of the required service commitment. 65.20 Sec. 38. [144.1502] [DENTISTS LOAN FORGIVENESS.] 65.21 Subdivision 1. [DEFINITION.] For purposes of this section, 65.22 "qualifying educational loans" means government, commercial, and 65.23 foundation loans for actual costs paid for tuition, reasonable 65.24 education expenses, and reasonable living expenses related to 65.25 the graduate or undergraduate education of a dentist. 65.26 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 65.27 PROGRAM.] A dentist education account is established in the 65.28 general fund. The commissioner of health shall use money from 65.29 the account to establish a loan forgiveness program for dentists 65.30 who agree to care for substantial numbers of state public 65.31 program participants and other low- to moderate-income uninsured 65.32 patients. 65.33 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 65.34 the loan forgiveness program, a dental student must submit an 65.35 application to the commissioner of health while attending a 65.36 program of study designed to prepare the individual to become a 66.1 licensed dentist. For fiscal year 2002, applicants may have 66.2 graduated from a dentistry program in calendar year 2001. A 66.3 dental student who is accepted into the loan forgiveness program 66.4 must sign a contract to agree to serve a minimum three-year 66.5 service obligation during which at least 25 percent of the 66.6 dentist's yearly patient encounters are delivered to state 66.7 public program enrollees or patients receiving sliding fee 66.8 schedule discounts through a formal sliding fee schedule meeting 66.9 the standards established by the United States Department of 66.10 Health and Human Services under Code of Federal Regulations, 66.11 title 42, section 51, chapter 303. The service obligation shall 66.12 begin no later than March 31 of the first year following 66.13 completion of training. If fewer applications are submitted by 66.14 dental students than there are participant slots available, the 66.15 commissioner may consider applications submitted by dental 66.16 program graduates who are licensed dentists. Dentists selected 66.17 for loan forgiveness must comply with all terms and conditions 66.18 of this section. 66.19 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 66.20 may accept up to 14 applicants per year for participation in the 66.21 loan forgiveness program. Applicants are responsible for 66.22 securing their own loans. The commissioner shall select 66.23 participants based on their suitability for practice serving 66.24 public program patients, as indicated by experience or 66.25 training. The commissioner shall give preference to applicants 66.26 who have attended a Minnesota dentistry educational institution 66.27 and to applicants closest to completing their training. For 66.28 each year that a participant meets the service obligation 66.29 required under subdivision 3, up to a maximum of four years, the 66.30 commissioner shall make annual disbursements directly to the 66.31 participant equivalent to $10,000 per year of service, not to 66.32 exceed $40,000 or the balance of the qualifying educational 66.33 loans, whichever is less. Before receiving loan repayment 66.34 disbursements and as requested, the participant must complete 66.35 and return to the commissioner an affidavit of practice form 66.36 provided by the commissioner verifying that the participant is 67.1 practicing as required under subdivision 3. The participant 67.2 must provide the commissioner with verification that the full 67.3 amount of loan repayment disbursement received by the 67.4 participant has been applied toward the designated loans. After 67.5 each disbursement, verification must be received by the 67.6 commissioner and approved before the next loan repayment 67.7 disbursement is made. Participants who move their practice 67.8 remain eligible for loan repayment as long as they practice as 67.9 required under subdivision 3. 67.10 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 67.11 does not fulfill the service commitment under subdivision 3, the 67.12 commissioner of health shall collect from the participant 100 67.13 percent of any payments made for qualified educational loans and 67.14 interest at a rate established according to section 270.75. The 67.15 commissioner shall deposit the money collected in the dentist 67.16 education account established under subdivision 2. 67.17 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 67.18 service obligations cancel in the event of a participant's 67.19 death. The commissioner of health may waive or suspend payment 67.20 or service obligations in cases of total and permanent 67.21 disability or long-term temporary disability lasting for more 67.22 than two years. The commissioner shall evaluate all other 67.23 requests for suspension or waivers on a case-by-case basis and 67.24 may grant a waiver of all or part of the money owed as a result 67.25 of a nonfulfillment penalty if emergency circumstances prevented 67.26 fulfillment of the required service commitment. 67.27 Sec. 39. [144.1503] [RURAL MENTAL HEALTH PROFESSIONAL LOAN 67.28 FORGIVENESS.] 67.29 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 67.30 section, the terms defined in this subdivision have the meanings 67.31 given them. 67.32 (b) "Designated rural area" means: 67.33 (1) an area in Minnesota outside the counties of Anoka, 67.34 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 67.35 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 67.36 and St. Cloud; or 68.1 (2) a municipal corporation, as defined under section 68.2 471.634, that is physically located, in whole or in part, in an 68.3 area defined as a designated rural area under clause (1). 68.4 (c) "Mental health professional" means a psychologist, 68.5 clinical social worker, marriage and family therapist, or 68.6 psychiatric nurse. 68.7 (d) "Qualifying educational loans" means government, 68.8 commercial, and foundation loans for actual costs paid for 68.9 tuition, reasonable education expenses, and reasonable living 68.10 expenses related to the graduate or undergraduate education of a 68.11 mental health professional. 68.12 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 68.13 PROGRAM.] A rural mental health professional education account 68.14 is established in the general fund. The commissioner of health 68.15 shall use money from the account to establish a loan forgiveness 68.16 program for mental health professionals who agree to practice in 68.17 designated rural areas. 68.18 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 68.19 the loan forgiveness program, a mental health professional 68.20 student must submit an application to the commissioner of health 68.21 while attending a program of study designed to prepare the 68.22 individual to become a mental health professional. For fiscal 68.23 year 2002, applicants may have graduated from a mental health 68.24 professional educational program in calendar year 2001. A 68.25 mental health professional student who is accepted into the loan 68.26 forgiveness program must sign a contract to agree to serve a 68.27 minimum three-year service obligation within a designated rural 68.28 area, which shall begin no later than March 31 of the first year 68.29 following completion of a mental health professional educational 68.30 program. 68.31 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 68.32 may accept up to 12 applicants per year for participation in the 68.33 loan forgiveness program. Applicants are responsible for 68.34 securing their own loans. The commissioner shall select 68.35 participants based on their suitability for rural practice, as 68.36 indicated by rural experience or training. The commissioner 69.1 shall give preference to applicants who have attended a 69.2 Minnesota mental health professional educational institution and 69.3 to applicants closest to completing their training. For each 69.4 year that a participant serves as a mental health professional 69.5 in a designated rural area as required under subdivision 3, up 69.6 to a maximum of four years, the commissioner shall make annual 69.7 disbursements directly to the participant equivalent to $4,000 69.8 per year of service, not to exceed $16,000 or the balance of the 69.9 qualifying educational loans, whichever is less. Before 69.10 receiving loan repayment disbursements and as requested, the 69.11 participant must complete and return to the commissioner an 69.12 affidavit of practice form provided by the commissioner 69.13 verifying that the participant is practicing as required in an 69.14 eligible area. The participant must provide the commissioner 69.15 with verification that the full amount of loan repayment 69.16 disbursement received by the participant has been applied toward 69.17 the qualifying educational loans. After each disbursement, 69.18 verification must be received by the commissioner and approved 69.19 before the next loan repayment disbursement is made. 69.20 Participants who move their practice from one designated rural 69.21 area to another remain eligible for loan repayment. 69.22 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 69.23 does not fulfill the service commitment under subdivision 3, the 69.24 commissioner of health shall collect from the participant 100 69.25 percent of any payments made for qualified educational loans and 69.26 interest at a rate established according to section 270.75. The 69.27 commissioner shall deposit the money collected in the rural 69.28 mental health professional education account established under 69.29 subdivision 2. 69.30 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 69.31 service obligations cancel in the event of a participant's 69.32 death. The commissioner of health may waive or suspend payment 69.33 or service obligations in cases of total and permanent 69.34 disability or long-term temporary disability lasting for more 69.35 than two years. The commissioner shall evaluate all other 69.36 requests for suspension or waivers on a case-by-case basis and 70.1 may grant a waiver of all or part of the money owed as a result 70.2 of a nonfulfillment penalty if emergency circumstances prevented 70.3 fulfillment of the required service commitment. 70.4 Sec. 40. [144.1504] [RURAL HEALTH CARE TECHNICIANS LOAN 70.5 FORGIVENESS.] 70.6 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 70.7 section, the terms defined in this subdivision have the meanings 70.8 given them. 70.9 (b) "Clinical laboratory scientist" means a person who 70.10 performs and interprets results of medical tests that require 70.11 the exercise of independent judgment and responsibility, with 70.12 minimal supervision by the director or supervisor, in only those 70.13 specialties or subspecialties in which the person is qualified 70.14 by education, training, and experience and has demonstrated 70.15 ongoing competency by certification or other means. A clinical 70.16 laboratory scientist may also be called a medical technologist. 70.17 (c) "Clinical laboratory technician" means any person other 70.18 than a medical laboratory director, clinical laboratory 70.19 scientist, or trainee who functions under the supervision of a 70.20 medical laboratory director or clinical laboratory scientist and 70.21 performs diagnostic and analytical laboratory tests in only 70.22 those specialties or subspecialties in which the person is 70.23 qualified by education, training, and experience and has 70.24 demonstrated ongoing competency by certification or other 70.25 means. A clinical laboratory technician may also be called a 70.26 medical technician. 70.27 (d) "Designated rural area" means: 70.28 (1) an area in Minnesota outside the counties of Anoka, 70.29 Carver, Dakota, Hennepin, Ramsey, Scott, and Washington, 70.30 excluding the cities of Duluth, Mankato, Moorhead, Rochester, 70.31 and St. Cloud; or 70.32 (2) a municipal corporation, as defined under section 70.33 471.634, that is physically located, in whole or in part, in an 70.34 area defined as a designated rural area under clause (1). 70.35 (e) "Health care technician" means a clinical laboratory 70.36 scientist, clinical laboratory technician, radiologic 71.1 technologist, dental hygienist, dental assistant, or paramedic. 71.2 (f) "Paramedic" means a person certified under chapter 144E 71.3 by the emergency medical services regulatory board as an 71.4 emergency medical technician-paramedic. 71.5 (g) "Qualifying educational loans" means government, 71.6 commercial, and foundation loans for actual costs paid for 71.7 tuition, reasonable education expenses, and reasonable living 71.8 expenses related to the graduate or undergraduate education of a 71.9 health care technician. 71.10 (h) "Radiologic technologist" means a person, other than a 71.11 licensed physician, who has demonstrated competency by 71.12 certification, registration, or other means for administering 71.13 medical imaging or radiation therapy procedures to other persons 71.14 for medical purposes. Radiologic technologist includes, but is 71.15 not limited to, radiographers, radiation therapists, and nuclear 71.16 medicine technologists. 71.17 Subd. 2. [CREATION OF ACCOUNT; LOAN FORGIVENESS 71.18 PROGRAM.] A rural health care technician education account is 71.19 established in the general fund. The commissioner of health 71.20 shall use money from the account to establish a loan forgiveness 71.21 program for health care technicians who agree to practice in 71.22 designated rural areas. 71.23 Subd. 3. [ELIGIBILITY.] To be eligible to participate in 71.24 the loan forgiveness program, a health care technician student 71.25 must submit an application to the commissioner of health while 71.26 attending a program of study designed to prepare the individual 71.27 to become a health care technician. For fiscal year 2002, 71.28 applicants may have graduated from a health care technician 71.29 program in calendar year 2001. A health care technician student 71.30 who is accepted into the loan forgiveness program must sign a 71.31 contract to agree to serve a minimum one-year service obligation 71.32 within a designated rural area, which shall begin no later than 71.33 March 31 of the first year following completion of a health care 71.34 technician program. 71.35 Subd. 4. [LOAN FORGIVENESS.] The commissioner of health 71.36 may accept up to 30 applicants per year for participation in the 72.1 loan forgiveness program. Applicants are responsible for 72.2 securing their own loans. The commissioner shall select 72.3 participants based on their suitability for rural practice, as 72.4 indicated by rural experience or training. The commissioner 72.5 shall give preference to applicants who have attended a 72.6 Minnesota health care technician educational institution and to 72.7 applicants closest to completing their training. For each year 72.8 that a participant serves as a health care technician in a 72.9 designated rural area as required under subdivision 3, up to a 72.10 maximum of two years, the commissioner shall make annual 72.11 disbursements directly to the participant equivalent to $2,500 72.12 per year of service, not to exceed $5,000 or the balance of the 72.13 qualifying educational loans, whichever is less. Before 72.14 receiving loan repayment disbursements and as requested, the 72.15 participant must complete and return to the commissioner an 72.16 affidavit of practice form provided by the commissioner 72.17 verifying that the participant is practicing as required in an 72.18 eligible area. The participant must provide the commissioner 72.19 with verification that the full amount of loan repayment 72.20 disbursement received by the participant has been applied toward 72.21 the qualifying educational loans. After each disbursement, 72.22 verification must be received by the commissioner and approved 72.23 before the next loan repayment disbursement is made. 72.24 Participants who move their practice from one designated rural 72.25 area to another remain eligible for loan repayment. 72.26 Subd. 5. [PENALTY FOR NONFULFILLMENT.] If a participant 72.27 does not fulfill the service commitment under subdivision 3, the 72.28 commissioner of health shall collect from the participant 100 72.29 percent of any payments made for qualified educational loans and 72.30 interest at a rate established according to section 270.75. The 72.31 commissioner shall deposit the money collected in the rural 72.32 health care technician education account established under 72.33 subdivision 2. 72.34 Subd. 6. [SUSPENSION OR WAIVER OF OBLIGATION.] Payment or 72.35 service obligations cancel in the event of a participant's 72.36 death. The commissioner of health may waive or suspend payment 73.1 or service obligations in cases of total and permanent 73.2 disability or long-term temporary disability lasting for more 73.3 than two years. The commissioner shall evaluate all other 73.4 requests for suspension or waivers on a case-by-case basis and 73.5 may grant a waiver of all or part of the money owed as a result 73.6 of a nonfulfillment penalty if emergency circumstances prevented 73.7 fulfillment of the required service commitment. 73.8 Sec. 41. Minnesota Statutes 2000, section 144.226, 73.9 subdivision 4, is amended to read: 73.10 Subd. 4. [VITAL RECORDS SURCHARGE.] In addition to any fee 73.11 prescribed under subdivision 1, there is a nonrefundable 73.12 surcharge of$3$2 for each certified and noncertified birth or 73.13 death record, and for a certification that the record cannot be 73.14 found. The local or state registrar shall forward this amount 73.15 to the state treasurer to be deposited into the state government 73.16 special revenue fund. This surcharge shall not be charged under 73.17 those circumstances in which no fee for a birth or death record 73.18 is permitted under subdivision 1, paragraph (a).This surcharge73.19requirement expires June 30, 2002.73.20 Sec. 42. Minnesota Statutes 2000, section 144.396, 73.21 subdivision 7, is amended to read: 73.22 Subd. 7. [LOCAL PUBLIC HEALTH PROMOTION AND PROTECTION.] 73.23 The commissioner shall distribute the funds available under 73.24 section 144.395, subdivision 2, paragraph (c), clause (3) for 73.25 the following: 73.26 (1) to community health boards for local health promotion 73.27 and protection activities for local health initiatives other 73.28 than tobacco prevention aimed at high risk health behaviors 73.29 among youth. The commissioner shall distribute these funds to 73.30 the community health boards based on demographics and other 73.31 need-based factors relating to health; 73.32 (2) for activities that improve the health and learning 73.33 environment of school-aged children; and 73.34 (3) for competitive grants to public-private partnerships 73.35 focusing on the state school health issues identified by the 73.36 commissioner. 74.1 Sec. 43. Minnesota Statutes 2000, section 144.98, 74.2 subdivision 3, is amended to read: 74.3 Subd. 3. [FEES.] (a) An application for certification 74.4 under subdivision 1 must be accompanied by the biennial fee 74.5 specified in this subdivision. The fees are for: 74.6 (1) nonrefundable base certification fee,$500$1,200; and 74.7 (2) test category certification fees: 74.8 Test Category Certification Fee 74.9 Clean water program bacteriology$200$600 74.10 Safe drinking water program bacteriology $600 74.11 Clean water program inorganic chemistry,74.12fewer than four constituents$100$600 74.13 Safe drinking water program inorganic chemistry,74.14four or more constituents$300$600 74.15 Clean water program chemistry metals,74.16fewer than four constituents$200$800 74.17 Safe drinking water program chemistry metals,74.18four or more constituents$500$800 74.19 Resource conservation and recovery program 74.20 chemistry metals $800 74.21 Clean water program volatile organic compounds$600$1,200 74.22 Safe drinking water program 74.23 volatile organic compounds $1,200 74.24 Resource conservation and recovery program 74.25 volatile organic compounds $1,200 74.26 Underground storage tank program 74.27 volatile organic compounds $1,200 74.28 Clean water program other organic compounds$600$1,200 74.29 Safe drinking water program other organic compounds $1,200 74.30 Resource conservation and recovery program 74.31 other organic compounds $1,200 74.32 (b) The total biennial certification fee is the base fee 74.33 plus the applicable test category fees.The biennial74.34certification fee for a contract laboratory is 1.5 times the74.35total certification fee.74.36 (c) Laboratories located outside of this state that require 75.1 an on-site survey will be assessed an additional$1,200$2,500 75.2 fee. 75.3 (d) Fees must be set so that the total fees support the 75.4 laboratory certification program. Direct costs of the 75.5 certification service include program administration, 75.6 inspections, the agency's general support costs, and attorney 75.7 general costs attributable to the fee function. 75.8 (e) A change fee shall be assessed if a laboratory requests 75.9 additional analytes or methods at any time other than when 75.10 applying for or renewing its certification. The change fee is 75.11 equal to the test category certification fee for the analyte. 75.12 (f) A variance fee shall be assessed if a laboratory 75.13 requests and is granted a variance from a rule adopted under 75.14 this section. The variance fee is $500 per variance. 75.15 (g) Refunds or credits shall not be made for analytes or 75.16 methods requested but not approved. 75.17 (h) Certification of a laboratory shall not be awarded 75.18 until all fees are paid. 75.19 Sec. 44. [145.56] [SUICIDE PREVENTION.] 75.20 Subdivision 1. [SUICIDE PREVENTION PLAN.] The commissioner 75.21 of health shall refine, coordinate, and implement the state's 75.22 suicide prevention plan using an evidence-based, public health 75.23 approach focused on prevention, in collaboration with the 75.24 commissioner of human services; the commissioner of public 75.25 safety; the commissioner of children, families, and learning; 75.26 and appropriate agencies, organizations, and institutions in the 75.27 community. 75.28 Subd. 2. [COMMUNITY-BASED PROGRAMS.] (a) The commissioner 75.29 shall establish a grant program to fund: 75.30 (1) community-based programs to provide education, 75.31 outreach, and advocacy services to populations who may be at 75.32 risk for suicide; 75.33 (2) community-based programs that educate community helpers 75.34 and gatekeepers, such as family members, spiritual leaders, 75.35 coaches, and business owners, employers, and coworkers on how to 75.36 prevent suicide by encouraging help-seeking behaviors; 76.1 (3) community-based programs that educate populations at 76.2 risk for suicide and community helpers and gatekeepers that must 76.3 include information on the symptoms of depression and other 76.4 psychiatric illnesses, the warning signs of suicide, skills for 76.5 preventing suicides, and making or seeking effective referrals 76.6 to intervention and community resources; and 76.7 (4) community-based programs to provide evidence-based 76.8 suicide prevention and intervention education to school staff, 76.9 parents, and students in grades kindergarten through 12. 76.10 Subd. 3. [WORKPLACE AND PROFESSIONAL EDUCATION.] (a) The 76.11 commissioner shall promote the use of employee assistance and 76.12 workplace programs to support employees with depression and 76.13 other psychiatric illnesses and substance abuse disorders, and 76.14 refer them to services. The commissioner shall collaborate with 76.15 employer and professional associations, unions, and safety 76.16 councils. 76.17 (b) The commissioner shall provide training and technical 76.18 assistance to local public health and other community-based 76.19 professionals to provide for integrated implementation of best 76.20 practices for preventing suicide. 76.21 Subd. 4. [COLLECTION AND REPORTING SUICIDE DATA.] The 76.22 commissioner shall coordinate with federal, regional, local, and 76.23 other state agencies to collect, analyze, and annually issue a 76.24 public report on Minnesota-specific data on suicide and suicidal 76.25 behaviors. 76.26 Subd. 5. [PERIODIC EVALUATIONS; BIENNIAL REPORTS.] The 76.27 commissioner shall conduct periodic evaluations of the impact of 76.28 and outcomes from implementation of the state's suicide 76.29 prevention plan and each of the activities specified in this 76.30 section. Beginning July 1, 2004, and July 1 of each 76.31 even-numbered year thereafter, the commissioner shall report the 76.32 results of these evaluations to the chairs of the policy and 76.33 finance committees in the house and senate with jurisdiction 76.34 over health and human services issues. 76.35 Sec. 45. Minnesota Statutes 2000, section 145.881, 76.36 subdivision 2, is amended to read: 77.1 Subd. 2. [DUTIES.] The advisory task force shall meet on a 77.2 regular basis to perform the following duties: 77.3 (a) review and report on the health care needs of mothers 77.4 and children throughout the state of Minnesota; 77.5 (b) review and report on the type, frequency and impact of 77.6 maternal and child health care services provided to mothers and 77.7 children under existing maternal and child health care programs, 77.8 including programs administered by the commissioner of health; 77.9 (c) establish, review, and report to the commissioner a 77.10 list of program guidelines and criteria which the advisory task 77.11 force considers essential to providing an effective maternal and 77.12 child health care program to low income populations and high 77.13 risk persons and fulfilling the purposes defined in section 77.14 145.88; 77.15 (d) review staff recommendations of the department of 77.16 health regarding maternal and child health grant awards before 77.17 the awards are made; 77.18 (e) make recommendations to the commissioner for the use of 77.19 other federal and state funds available to meet maternal and 77.20 child health needs; 77.21 (f) make recommendations to the commissioner of health on 77.22 priorities for funding the following maternal and child health 77.23 services: (1) prenatal, delivery and postpartum care, (2) 77.24 comprehensive health care for children, especially from birth 77.25 through five years of age, (3) adolescent health services, (4) 77.26 family planning services, (5) preventive dental care, (6) 77.27 special services for chronically ill and handicapped children 77.28 and (7) any other services which promote the health of mothers 77.29 and children;and77.30 (g) make recommendations to the commissioner of health on 77.31 the process to distribute, award and administer the maternal and 77.32 child health block grant funds; and 77.33 (h) review the measures that are used to define the 77.34 variables of the funding distribution formula in section 77.35 145.882, subdivision 4a, every two years and make 77.36 recommendations to the commissioner of health for changes based 78.1 upon principles established by the advisory task force for this 78.2 purpose. 78.3 Sec. 46. Minnesota Statutes 2000, section 145.882, is 78.4 amended by adding a subdivision to read: 78.5 Subd. 4a. [ALLOCATION TO COMMUNITY HEALTH BOARDS.] (a) 78.6 Federal maternal and child health block grant money remaining 78.7 after distributions made under subdivision 2 and money 78.8 appropriated for allocation to community health boards must be 78.9 allocated according to paragraphs (b) to (d) to community health 78.10 boards as defined in section 145A.02, subdivision 5. 78.11 (b) All community health boards must receive 95 percent of 78.12 the funding awarded to them for the 1998-1999 funding cycle. If 78.13 the amount of state and federal funding available is less than 78.14 95 percent of the amount awarded to community health boards for 78.15 the 1998-1999 funding cycle, the available funding must be 78.16 apportioned to reflect a proportional decrease for each 78.17 recipient. 78.18 (c) The federal and state funding remaining after 78.19 distributions made under paragraph (b) must be allocated to each 78.20 community health board based on the following three variables: 78.21 (1) 25 percent based on the maternal and child population 78.22 in the area served by the community health board; 78.23 (2) 50 percent based on the following factors as determined 78.24 by averaging the data available for the three most current years: 78.25 (i) the proportion of infants in the area served by the 78.26 community health board whose weight at birth is less than 2,500 78.27 grams; 78.28 (ii) the proportion of mothers in the area served by the 78.29 community health board who received inadequate or no prenatal 78.30 care; 78.31 (iii) the proportion of births in the area served by the 78.32 community health board to women under age 19; and 78.33 (iv) the proportion of births in the area served by the 78.34 community health board to American Indians and women of color; 78.35 and 78.36 (3) 25 percent based on the income of the maternal and 79.1 child population in the area served by the community health 79.2 board. 79.3 (d) Each variable must be expressed as a city or county 79.4 score consisting of the city or county frequency of each 79.5 variable divided by the statewide frequency of the variable. A 79.6 total score for each city or county jurisdiction must be 79.7 computed by totaling the scores of the three variables. Each 79.8 community health board must be allocated an amount equal to the 79.9 total score obtained for the city, county, or counties in its 79.10 area multiplied by the amount of money available. 79.11 Sec. 47. Minnesota Statutes 2000, section 145.882, 79.12 subdivision 7, is amended to read: 79.13 Subd. 7. [USE OF BLOCK GRANT MONEY.] (a) Maternal and 79.14 child health block grant money allocated to a community health 79.15 board or community health services area under this section must 79.16 be used for qualified programs for high risk and low-income 79.17 individuals. Block grant money must be used for programs that: 79.18 (1) specifically address the highest risk populations, 79.19 particularly low-income and minority groups with a high rate of 79.20 infant mortality and children with low birth weight, by 79.21 providing services, including prepregnancy family planning 79.22 services, calculated to produce measurable decreases in infant 79.23 mortality rates, instances of children with low birth weight, 79.24 and medical complications associated with pregnancy and 79.25 childbirth, including infant mortality, low birth rates, and 79.26 medical complications arising from chemical abuse by a mother 79.27 during pregnancy; 79.28 (2) specifically target pregnant women whose age, medical 79.29 condition, maternal history, or chemical abuse substantially 79.30 increases the likelihood of complications associated with 79.31 pregnancy and childbirth or the birth of a child with an 79.32 illness, disability, or special medical needs; 79.33 (3) specifically address the health needs of young children 79.34 who have or are likely to have a chronic disease or disability 79.35 or special medical needs, including physical, neurological, 79.36 emotional, and developmental problems that arise from chemical 80.1 abuse by a mother during pregnancy; 80.2 (4) provide family planning and preventive medical care for 80.3 specifically identified target populations, such as minority and 80.4 low-income teenagers, in a manner calculated to decrease the 80.5 occurrence of inappropriate pregnancy and minimize the risk of 80.6 complications associated with pregnancy and childbirth; or 80.7 (5) specifically address the frequency and severity of 80.8 childhood injuries and other child and adolescent health 80.9 problems in high risk target populations by providing services 80.10 calculated to produce measurable decreases in mortality and 80.11 morbidity.However, money may be used for this purpose only if80.12the community health board's application includes program80.13components for the purposes in clauses (1) to (4) in the80.14proposed geographic service area and the total expenditure for80.15injury-related programs under this clause does not exceed ten80.16percent of the total allocation under subdivision 3.80.17(b) Maternal and child health block grant money may be used80.18for purposes other than the purposes listed in this subdivision80.19only under the following conditions:80.20(1) the community health board or community health services80.21area can demonstrate that existing programs fully address the80.22needs of the highest risk target populations described in this80.23subdivision; or80.24(2) the money is used to continue projects that received80.25funding before creation of the maternal and child health block80.26grant in 1981.80.27(c)(b) Projects that received funding before creation of 80.28 the maternal and child health block grant in 1981, must be80.29allocated at least the amount of maternal and child health80.30special project grant funds received in 1989, unless (1) the80.31local board of health provides equivalent alternative funding80.32for the project from another source; or (2) the local board of80.33health demonstrates that the need for the specific services80.34provided by the project has significantly decreased as a result80.35of changes in the demographic characteristics of the population,80.36or other factors that have a major impact on the demand for81.1services. If the amount of federal funding to the state for the81.2maternal and child health block grant is decreased, these81.3projects must receive a proportional decrease as required in81.4subdivision 1. Increases in allocation amounts to local boards81.5of health under subdivision 4 may be used to increase funding81.6levels for these projectsmay be continued at the discretion of 81.7 the community health board. 81.8 Sec. 48. Minnesota Statutes 2000, section 145.885, 81.9 subdivision 2, is amended to read: 81.10 Subd. 2. [ADDITIONAL REQUIREMENTS FOR COMMUNITY BOARDS OF 81.11 HEALTH.] Applications by community health boards as defined in 81.12 section 145A.02, subdivision 5, under section 145.882, 81.13 subdivision34a, must also contain a summary of the process 81.14 used to develop the local program, including evidence that the 81.15 community health board notified local public and private 81.16 providers of the availability of funding through the community 81.17 health board for maternal and child health services; a list of 81.18 all public and private agency requests for grants submitted to 81.19 the community health board indicating which requests were 81.20 included in the grant application; and an explanation of how 81.21 priorities were established for selecting the requests to be 81.22 included in the grant application. The community health board 81.23 shall include, with the grant application, a written statement 81.24 of the criteria to be applied to public and private agency 81.25 requests for funding. 81.26 Sec. 49. [145.9263] [PROMOTING HEALTHY LIFESTYLES AMONG 81.27 YOUTH.] 81.28 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 81.29 establish a grant program to promote healthy behavior among 81.30 youth. 81.31 Subd. 2. [LOCAL GRANTS.] The commissioner shall award 81.32 competitive grants to eligible applicants for projects and 81.33 initiatives directed at promoting healthy lifestyles such as 81.34 proper nutrition, the need for physical exercise, and the 81.35 avoidance of other unhealthy behaviors. The project areas for 81.36 grants include; 82.1 (1) after-school programs that focus on leadership, youth 82.2 mentoring and peer counseling, academic support, and 82.3 after-school enrichment; 82.4 (2) programs that provide education and support for youth 82.5 and parents that support healthy behaviors and self-sufficiency; 82.6 (3) youth development programs; or 82.7 (4) programs that focus on ethnic or cultural enrichment. 82.8 Subd. 3. [HIGH-RISK COMMUNITY YOUTH GRANTS.] (a) the 82.9 commissioner shall award grants to communities that have 82.10 significant risk factors for unhealthy youth behaviors and that 82.11 currently have in place youth development programs. 82.12 (b) To be eligible for a grant under this subdivision, an 82.13 applicant must be a tribal government or a community health 82.14 board as defined in section 145A.02. Applicants must submit 82.15 proposals to the commissioner. A proposal must specify the 82.16 strategies to be implemented. Strategies may include youth 82.17 mentoring programs, academic support programs, and parent 82.18 support and education programs. Applicants must demonstrate 82.19 that a proposed project: 82.20 (1) is research-based or based on proven effective 82.21 strategies; 82.22 (2) is designed to coordinate with related youth risk 82.23 behavior reduction activities; 82.24 (3) involves youth and parents in the project's development 82.25 and implementation; 82.26 (4) reflects racially and ethnically appropriate 82.27 approaches; and 82.28 (5) will be implemented through or with persons or 82.29 community-based organizations that reflect the race or ethnicity 82.30 of the population to be reached. 82.31 Subd. 4. [PUBLIC AWARENESS.] The commissioner shall 82.32 coordinate a public/private partnership to provide a statewide 82.33 outreach campaign directed at youth on the importance of a 82.34 healthy lifestyle and the health consequences of poor nutrition 82.35 and the lack of physical exercise in terms of obesity and other 82.36 health problems. The campaign shall include culturally specific 83.1 and community-based messages. 83.2 Subd. 5. [PROCESS.] (a) The commissioner, in consultation 83.3 with community partners, shall develop the criteria and 83.4 procedures to allocate the grants under this section. In 83.5 developing the criteria, the commissioner shall establish an 83.6 administrative cost limit for grant recipients. The outcomes 83.7 established under subdivision 6 must be specified to the grant 83.8 recipients receiving grants under this section at the time the 83.9 grant is awarded. The commissioner may require an applicant to 83.10 enter into a collaborative agreement with the local public 83.11 health entity. 83.12 (b) Eligible applicants may include, but are not limited 83.13 to, nonprofit organizations, community clinics, and social 83.14 service organizations. Applicants must submit proposals to the 83.15 commissioner. The proposals must specify the strategies to be 83.16 implemented and must take into account the need for a 83.17 coordinated local effort. 83.18 (c) The commissioner shall give priority to programs that: 83.19 (1) are designed to coordinate with related youth risk 83.20 behavior reduction activities; 83.21 (2) involve youth and parents in the development and 83.22 implementation; 83.23 (3) are implemented through or with community-based 83.24 organizations reflecting the race and ethnicity of the 83.25 population to be needed; and 83.26 (4) reflect racial and ethnic appropriate approaches. 83.27 Subd. 6. [MEASURABLE OUTCOMES.] The commissioner, in 83.28 consultation with other public and private nonprofit 83.29 organizations interested in youth development efforts, shall 83.30 establish measurable outcomes to determine the effectiveness of 83.31 the grants receiving funds under this section. 83.32 Subd. 7. [COORDINATION.] The commissioner shall coordinate 83.33 the projects and initiatives funded under this section with 83.34 other efforts at the local, state, and national level to avoid 83.35 duplication and promote complimentary efforts. 83.36 Subd. 8. [EVALUATION.] (a) Using the outcome measures 84.1 established in subdivision 6, the commissioner shall conduct a 84.2 biennial evaluation of the efforts funded under this section. 84.3 (b) Grant recipients shall cooperate with the commissioner 84.4 of health in the evaluation and provide the commissioner with 84.5 the information necessary to conduct the evaluation. 84.6 Subd. 9. [REPORT.] The commissioner shall submit biennial 84.7 reports to the legislature on the activities of the projects 84.8 funded under this section and the results of the biennial 84.9 evaluation. These reports are due by January 15 of every other 84.10 year, beginning in the year 2004. 84.11 Sec. 50. [145.9268] [COMMUNITY CLINIC GRANTS.] 84.12 Subdivision 1. [DEFINITION.] For purposes of this section, 84.13 "eligible community clinic" means: 84.14 (1) a clinic that provides services under conditions as 84.15 defined in Minnesota Rules, part 9505.0255, and utilizes a 84.16 sliding fee scale to determine eligibility for charity care; 84.17 (2) an Indian tribal government or Indian health service 84.18 unit; or 84.19 (3) a consortium of clinics comprised of entities under 84.20 clause (1) or (2). 84.21 Subd. 2. [GRANTS AUTHORIZED.] The commissioner of health 84.22 shall award grants to eligible community clinics to improve the 84.23 ongoing viability of Minnesota's clinic-based safety net 84.24 providers. Grants shall be awarded to support the capacity of 84.25 eligible community clinics to serve low-income populations, 84.26 reduce current or future uncompensated care burdens, or provide 84.27 for improved care delivery infrastructure. 84.28 Subd. 3. [ALLOCATION OF GRANTS.] (a) To receive a grant 84.29 under this section, an eligible community clinic must submit an 84.30 application to the commissioner of health by the deadline 84.31 established by the commissioner. A grant may be awarded upon 84.32 the signing of a grant contract. 84.33 (b) An application must be on a form and contain 84.34 information as specified by the commissioner but at a minimum 84.35 must contain: 84.36 (1) a description of the project for which grant funds will 85.1 be used; 85.2 (2) a description of the problem the proposed project will 85.3 address; and 85.4 (3) a description of achievable objectives, a workplan, and 85.5 a timeline for project completion. 85.6 (c) The commissioner shall review each application to 85.7 determine whether the application is complete and whether the 85.8 applicant and the project are eligible for a grant. In 85.9 evaluating applications according to paragraph (e), the 85.10 commissioner shall establish criteria including, but not limited 85.11 to: the priority level of the project; the applicant's 85.12 thoroughness and clarity in describing the problem; a 85.13 description of the applicant's proposed project; the manner in 85.14 which the applicant will demonstrate the effectiveness of the 85.15 project; and evidence of efficiencies and effectiveness gained 85.16 through collaborative efforts. The commissioner may also take 85.17 into account other relevant factors, including, but not limited 85.18 to, the percentage for which uninsured patients represent the 85.19 applicant's patient base. During application review, the 85.20 commissioner may request additional information about a proposed 85.21 project, including information on project cost. Failure to 85.22 provide the information requested disqualifies an applicant. 85.23 The commissioner has discretion over the number of grants 85.24 awarded. 85.25 (d) In determining which eligible community clinics will 85.26 receive grants under this section, the commissioner shall give 85.27 preference to those grant applications that show evidence of 85.28 collaboration with other eligible community clinics, hospitals, 85.29 health care providers, or community organizations. In addition, 85.30 the commissioner shall give priority, in declining order, to 85.31 grant applications for projects that: 85.32 (1) establish, update, or improve information, data 85.33 collection, or billing systems; 85.34 (2) procure, modernize, remodel, or replace equipment used 85.35 an the delivery of direct patient care at a clinic; 85.36 (3) provide improvements for care delivery, such as 86.1 increased translation and interpretation services; 86.2 (4) provide a direct offset to expenses incurred for 86.3 charity care services; or 86.4 (5) other projects determined by the commissioner to 86.5 improve the ability of applicants to provide care to the 86.6 vulnerable populations they serve. 86.7 Subd. 4. [EVALUATION.] The commissioner of health shall 86.8 evaluate the overall effectiveness of the grant program. The 86.9 commissioner shall collect progress reports to evaluate the 86.10 grant program from the eligible community clinics receiving 86.11 grants. 86.12 Sec. 51. [145.9269] [ELIMINATING HEALTH DISPARITIES.] 86.13 Subdivision 1. [STATE-COMMUNITY PARTNERSHIPS.] The 86.14 commissioner, in partnership with culturally based community 86.15 organizations; the Indian affairs council as defined in section 86.16 3.922; the council on affairs of Chicano/Latino people as 86.17 defined in section 3.9223; the council on Black Minnesotans as 86.18 defined in section 3.9225; the council on Asian-Pacific 86.19 Minnesotans as defined in section 3.9226; community health 86.20 boards; and tribal governments, shall develop and implement a 86.21 comprehensive coordinated plan to reduce health disparities 86.22 experienced by American Indians and communities of color in 86.23 infant mortality, breast and cervical cancer screening, 86.24 HIV/AIDS/STDs, immunizations, cardiovascular disease, diabetes, 86.25 injury, and violence. 86.26 Subd. 2. [MEASURABLE OUTCOMES.] The commissioner, in 86.27 consultation with community partners, shall establish measurable 86.28 outcomes to determine the effectiveness of the grants and other 86.29 activities receiving funds under this section in reducing health 86.30 disparities. The goal of the grants shall be to decrease by 86.31 one-half the ratio of American Indians and communities of color 86.32 specific health condition rates to white rates in the areas 86.33 identified in subdivision 1. 86.34 Subd. 3. [STATEWIDE ASSESSMENT.] The commissioner shall 86.35 enhance current data tools to assure a statewide assessment of 86.36 the risk behaviors associated with the areas identified in 87.1 subdivision 1. This statewide assessment must be used to 87.2 establish a baseline to measure the effect of activities funded 87.3 under this section. To the extent feasible, the commissioner of 87.4 health must conduct the assessment so that the results may be 87.5 compared to nationwide data. 87.6 Subd. 4. [TECHNICAL ASSISTANCE.] The commissioner shall 87.7 provide the necessary expertise to community organizations to 87.8 ensure that submitted proposals are likely to be successful in 87.9 reducing health disparities. The commissioner shall provide 87.10 grant recipients with guidance and training on strategies 87.11 related to reducing the health disparities identified in this 87.12 section. The commissioner shall also provide grant recipients 87.13 with assistance in the development of evaluation of local 87.14 community activities. 87.15 Subd. 5. [PROCESS.] (a) The commissioner shall, in 87.16 consultation with community partners, develop the criteria and 87.17 procedures to allocate the grants under this section. In 87.18 developing the criteria, the commissioner shall establish an 87.19 administrative cost limit for grant recipients. The outcomes 87.20 established under subdivision 2 must be specified to the grant 87.21 recipients receiving grants under this section at the time the 87.22 grant is awarded. 87.23 (b) A grant recipient must coordinate the activities 87.24 related to reducing health disparities with other grant 87.25 recipients receiving funding under this section within the 87.26 recipient's service area. 87.27 Subd. 6. [COMMUNITY GRANT PROGRAM.] (a) The commissioner 87.28 shall award grants to eligible applicants for local or regional 87.29 projects and initiatives directed at reducing health 87.30 disparities. Grant proposals must address one or more of the 87.31 following priority areas: 87.32 (1) decreasing racial and ethnic disparities in infant 87.33 mortality rates; 87.34 (2) decreasing racial and ethnic disparities in morbidity 87.35 and mortality rates relating to breast and cervical cancer; 87.36 (3) decreasing racial and ethnic disparities in morbidity 88.1 and mortality rates relating to HIV/AIDS/STDs; 88.2 (4) increasing adult and child immunization rates in racial 88.3 and ethnic populations; 88.4 (5) decreasing racial and ethnic disparities in morbidity 88.5 and mortality rates relating to cardiovascular disease; 88.6 (6) decreasing racial and ethnic disparities in morbidity 88.7 and mortality rates relating to diabetes; and 88.8 (7) decreasing racial and ethnic disparities in morbidity 88.9 and mortality rates relating to injury or violence. 88.10 (b) The commissioner may award up to 20 percent of the 88.11 funds available as planning grants. Planning grant proposals 88.12 must be used to address such areas as community assessment, 88.13 determining community priority areas, coordination activities, 88.14 and development of community-supported strategies. 88.15 (c) Eligible applicants may include, but are not limited 88.16 to, faith-based organizations, social service organizations, 88.17 community nonprofit organizations, and community clinics. 88.18 Applicants must submit proposals to the commissioner and must 88.19 demonstrate partnerships with local public health. The 88.20 proposals must specify the strategies to be implemented to 88.21 reduce one or more of the project areas listed under subdivision 88.22 6, paragraph (a), and must be targeted to achieve the outcomes 88.23 established in subdivision 2. 88.24 (d) The commissioner must give priority to applicants who 88.25 demonstrate that the proposed project or initiative: 88.26 (1) is supported by the community the applicant will be 88.27 serving; 88.28 (2) is research based or based on promising strategies; 88.29 (3) is designed to compliment other related community 88.30 activities; 88.31 (4) utilizes strategies that positively impacts more than 88.32 one priority area; and 88.33 (5) is implemented through or with community-based 88.34 organizations that reflect the race or ethnicity of the 88.35 population to be reached. 88.36 Subd. 7. [LOCAL PUBLIC HEALTH.] The commissioner shall 89.1 award grants to community health boards for local health 89.2 promotion and protection activities aimed at reducing maternal 89.3 and child health disparities between whites and American Indians 89.4 and populations of color. Local public health must submit 89.5 proposals to the commissioner and must demonstrate partnerships 89.6 with culturally based community organizations or with tribal 89.7 governments. The commissioner shall distribute these funds to 89.8 community health boards according to the formula in section 89.9 145.882, subdivision 4. 89.10 Subd. 8. [TRIBAL GOVERNMENTS.] The commissioner shall 89.11 award grants to American Indian tribal governments for 89.12 implementation of community interventions to reduce health 89.13 disparities for the project areas listed under subdivision 6, 89.14 paragraph (a), and must be targeted to achieve the outcomes 89.15 established in subdivision 2. Tribal governments must submit 89.16 proposals to the commissioner and must demonstrate partnerships 89.17 with local public health. The distribution formula shall be 89.18 determined by the commissioner, in consultation with the tribal 89.19 governments. 89.20 Subd. 9. [REFUGEE AND IMMIGRANT HEALTH.] The commissioner 89.21 shall award grants to community health boards for health 89.22 screening and follow-up services for foreign-born persons. 89.23 Subd. 10. [COORDINATION.] The commissioner shall 89.24 coordinate the projects and initiatives funded under this 89.25 section with other efforts at the local, state, or national 89.26 level to avoid duplication of effort and promote complimentary 89.27 efforts. 89.28 Subd. 11. [EVALUATION.] Using the outcome measures 89.29 established in subdivision 2, the commissioner shall conduct a 89.30 biennial evaluation of the community grants program, community 89.31 health board activities, and tribal government activities funded 89.32 under this section. Grant recipients, tribal governments, and 89.33 community health boards shall cooperate with the commissioner in 89.34 the evaluation and provide the commissioner with the information 89.35 necessary to conduct the evaluation. 89.36 Subd. 12. [REPORT.] The commissioner shall submit a 90.1 biennial report to the legislature on the local community 90.2 projects, tribal government, and community health board 90.3 prevention activities funded under this section. These reports 90.4 must include information on grant recipients, activities that 90.5 were conducted using grant funds, evaluation data and outcome 90.6 measures, if available. These reports are due by January 15 of 90.7 every other year, beginning in the year 2004. 90.8 Sec. 52. Minnesota Statutes 2000, section 157.16, 90.9 subdivision 3, is amended to read: 90.10 Subd. 3. [ESTABLISHMENT FEES; DEFINITIONS.] (a) The 90.11 following fees are required for food and beverage service 90.12 establishments, hotels, motels, lodging establishments, and 90.13 resorts licensed under this chapter. Food and beverage service 90.14 establishments must pay the highest applicable fee under 90.15 paragraph (e), clause (1), (2), (3), or (4), and establishments 90.16 serving alcohol must pay the highest applicable fee under 90.17 paragraph (e), clause (6) or (7). The license fee for new 90.18 operators previously licensed under this chapter for the same 90.19 calendar year is one-half of the appropriate annual license fee, 90.20 plus any penalty that may be required. The license fee for 90.21 operators opening on or after October 1 is one-half of the 90.22 appropriate annual license fee, plus any penalty that may be 90.23 required. 90.24 (b) All food and beverage service establishments, except 90.25 special event food stands, and all hotels, motels, lodging 90.26 establishments, and resorts shall pay an annual base fee of 90.27$100$145. 90.28 (c) A special event food stand shall pay a flat fee 90.29 of$30$35 annually. "Special event food stand" means a fee 90.30 category where food is prepared or served in conjunction with 90.31 celebrations, county fairs, or special events from a special 90.32 event food stand as defined in section 157.15. 90.33 (d) In addition to the base fee in paragraph (b), each food 90.34 and beverage service establishment, other than a special event 90.35 food stand, and each hotel, motel, lodging establishment, and 90.36 resort shall pay an additional annual fee for each fee category 91.1 as specified in this paragraph: 91.2 (1) Limited food menu selection,$30$40. "Limited food 91.3 menu selection" means a fee category that provides one or more 91.4 of the following: 91.5 (i) prepackaged food that receives heat treatment and is 91.6 served in the package; 91.7 (ii) frozen pizza that is heated and served; 91.8 (iii) a continental breakfast such as rolls, coffee, juice, 91.9 milk, and cold cereal; 91.10 (iv) soft drinks, coffee, or nonalcoholic beverages; or 91.11 (v) cleaning for eating, drinking, or cooking utensils, 91.12 when the only food served is prepared off site. 91.13 (2) Small establishment, including boarding establishments, 91.14$55$75. "Small establishment" means a fee category that has no 91.15 salad bar and meets one or more of the following: 91.16 (i) possesses food service equipment that consists of no 91.17 more than a deep fat fryer, a grill, two hot holding containers, 91.18 and one or more microwave ovens; 91.19 (ii) serves dipped ice cream or soft serve frozen desserts; 91.20 (iii) serves breakfast in an owner-occupied bed and 91.21 breakfast establishment; 91.22 (iv) is a boarding establishment; or 91.23 (v) meets the equipment criteria in clause (3), item (i) or 91.24 (ii), and has a maximum patron seating capacity of not more than 91.25 50. 91.26 (3) Medium establishment,$150$210. "Medium establishment" 91.27 means a fee category that meets one or more of the following: 91.28 (i) possesses food service equipment that includes a range, 91.29 oven, steam table, salad bar, or salad preparation area; 91.30 (ii) possesses food service equipment that includes more 91.31 than one deep fat fryer, one grill, or two hot holding 91.32 containers; or 91.33 (iii) is an establishment where food is prepared at one 91.34 location and served at one or more separate locations. 91.35 Establishments meeting criteria in clause (2), item (v), 91.36 are not included in this fee category. 92.1 (4) Large establishment,$250$350. "Large establishment" 92.2 means either: 92.3 (i) a fee category that (A) meets the criteria in clause 92.4 (3), items (i) or (ii), for a medium establishment, (B) seats 92.5 more than 175 people, and (C) offers the full menu selection an 92.6 average of five or more days a week during the weeks of 92.7 operation; or 92.8 (ii) a fee category that (A) meets the criteria in clause 92.9 (3), item (iii), for a medium establishment, and (B) prepares 92.10 and serves 500 or more meals per day. 92.11 (5) Other food and beverage service, including food carts, 92.12 mobile food units, seasonal temporary food stands, and seasonal 92.13 permanent food stands,$30$40. 92.14 (6) Beer or wine table service,$30$40. "Beer or wine 92.15 table service" means a fee category where the only alcoholic 92.16 beverage service is beer or wine, served to customers seated at 92.17 tables. 92.18 (7) Alcoholic beverage service, other than beer or wine 92.19 table service,$75$105. 92.20 "Alcohol beverage service, other than beer or wine table 92.21 service" means a fee category where alcoholic mixed drinks are 92.22 served or where beer or wine are served from a bar. 92.23 (8) Lodging per sleeping accommodation unit,$4$6, 92.24 including hotels, motels, lodging establishments, and resorts, 92.25 up to a maximum of$400$600. "Lodging per sleeping 92.26 accommodation unit" means a fee category including the number of 92.27 guest rooms, cottages, or other rental units of a hotel, motel, 92.28 lodging establishment, or resort; or the number of beds in a 92.29 dormitory. 92.30 (9) First public swimming pool,$100$140; each additional 92.31 public swimming pool,$50$80. "Public swimming pool" means a 92.32 fee category that has the meaning given in Minnesota Rules, part 92.33 4717.0250, subpart 8. 92.34 (10) First spa,$50$80; each additional spa,$25$40. 92.35 "Spa pool" means a fee category that has the meaning given in 92.36 Minnesota Rules, part 4717.0250, subpart 9. 93.1 (11) Private sewer or water,$30$40. "Individual private 93.2 water" means a fee category with a water supply other than a 93.3 community public water supply as defined in Minnesota Rules, 93.4 chapter 4720. "Individual private sewer" means a fee category 93.5 with an individual sewage treatment system which uses subsurface 93.6 treatment and disposal. 93.7 (e)A fee is not required for a food and beverage service93.8establishment operated by a school as defined in sections93.9120A.05, subdivisions 9, 11, 13, and 17 and 120A.22.93.10(f)A fee of $150 for review of the construction plans must 93.11 accompany the initial license application for food and beverage 93.12 service establishments, hotels, motels, lodging establishments, 93.13 or resorts. 93.14(g)(f) When existing food and beverage service 93.15 establishments, hotels, motels, lodging establishments, or 93.16 resorts are extensively remodeled, a fee of $150 must be 93.17 submitted with the remodeling plans. 93.18(h)(g) Seasonal temporary food stands and special event 93.19 food stands are not required to submit construction or 93.20 remodeling plans for review. 93.21 Sec. 53. Minnesota Statutes 2000, section 157.22, is 93.22 amended to read: 93.23 157.22 [EXEMPTIONS.] 93.24 This chapter shall not be construed to apply to: 93.25 (1) interstate carriers under the supervision of the United 93.26 States Department of Health and Human Services; 93.27 (2) any building constructed and primarily used for 93.28 religious worship; 93.29 (3) any building owned, operated, and used by a college or 93.30 university in accordance with health regulations promulgated by 93.31 the college or university under chapter 14; 93.32 (4) any person, firm, or corporation whose principal mode 93.33 of business is licensed under sections 28A.04 and 28A.05, is 93.34 exempt at that premises from licensure as a food or beverage 93.35 establishment; provided that the holding of any license pursuant 93.36 to sections 28A.04 and 28A.05 shall not exempt any person, firm, 94.1 or corporation from the applicable provisions of this chapter or 94.2 the rules of the state commissioner of health relating to food 94.3 and beverage service establishments; 94.4 (5) family day care homes and group family day care homes 94.5 governed by sections 245A.01 to 245A.16; 94.6 (6) nonprofit senior citizen centers for the sale of 94.7 home-baked goods;and94.8 (7) food not prepared at an establishment and brought in by 94.9 individuals attending a potluck event for consumption at the 94.10 potluck event. An organization sponsoring a potluck event under 94.11 this clause may advertise the potluck event to the public 94.12 through any means. Individuals who are not members of an 94.13 organization sponsoring a potluck event under this clause may 94.14 attend the potluck event and consume the food at the event. 94.15 Licensed food establishments cannot be sponsors of potluck 94.16 events. Potluck event food shall not be brought into a licensed 94.17 food establishment kitchen; and 94.18 (8) a home school in which a child is provided instruction 94.19 at home. 94.20 Sec. 54. Minnesota Statutes 2000, section 326.38, is 94.21 amended to read: 94.22 326.38 [LOCAL REGULATIONS.] 94.23 Any city having a system of waterworks or sewerage, or any 94.24 town in which reside over 5,000 people exclusive of any 94.25 statutory cities located therein, or the metropolitan airports 94.26 commission, may, by ordinance, adopt local regulations providing 94.27 for plumbing permits, bonds, approval of plans, and inspections 94.28 of plumbing, which regulations are not in conflict with the 94.29 plumbing standards on the same subject prescribed by the state 94.30 commissioner of health. No city or such town shall prohibit 94.31 plumbers licensed by the state commissioner of health from 94.32 engaging in or working at the business, except cities and 94.33 statutory cities which, prior to April 21, 1933, by ordinance 94.34 required the licensing of plumbers. Any city by ordinance may 94.35 prescribe regulations, reasonable standards, and inspections and 94.36 grant permits to any person, firm, or corporation engaged in the 95.1 business of installing water softeners, who is not licensed as a 95.2 master plumber or journeyman plumber by the state commissioner 95.3 of health, to connect water softening and water filtering 95.4 equipment to private residence water distribution systems, where 95.5 provision has been previously made therefor and openings left 95.6 for that purpose or by use of cold water connections to a 95.7 domestic water heater; where it is not necessary to rearrange, 95.8 make any extension or alteration of, or addition to any pipe, 95.9 fixture or plumbing connected with the water system except to 95.10 connect the water softener, and provided the connections so made 95.11 comply with minimum standards prescribed by the state 95.12 commissioner of health. 95.13 Sec. 55. [IMMUNIZATION SCHEDULE.] 95.14 The commissioner of health shall submit to the legislature 95.15 by January 15, 2002, a report on the immunization schedule 95.16 established by the commissioner in accordance with Minnesota 95.17 Statutes, section 121A.15, subdivision 1a, and shall submit all 95.18 statutory changes needed to implement the immunization schedule 95.19 established by the commissioner. 95.20 Sec. 56. [MEDICATIONS DISPENSED IN SCHOOLS STUDY.] 95.21 (a) The commissioner of health, in consultation with the 95.22 board of nursing, shall study the relationship between the Nurse 95.23 Practice Act, Minnesota Statutes, sections 148.171 to 148.285; 95.24 and 121A.22, which specifies the administration of medications 95.25 in schools and the activities authorized under these sections, 95.26 including the administration of prescription and nonprescription 95.27 medications and medications needed by students to manage a 95.28 chronic illness. The commissioner shall also make 95.29 recommendations on necessary statutory changes needed to promote 95.30 student health and safety in relation to administering 95.31 medications in schools and addressing the changing health needs 95.32 of students. 95.33 (b) The commissioner shall convene a work group to assist 95.34 in the study and recommendations. The work group shall consist 95.35 of representatives of the commissioner of human services; the 95.36 commissioner of children, families, and learning; the board of 96.1 nursing; the board of teaching; school nurses; parents; school 96.2 administrators; school board associations; the American Academy 96.3 of Pediatrics; and the Minnesota Nurse's Association. 96.4 (c) The commissioner shall submit these recommendations and 96.5 any recommended statutory changes to the legislature by January 96.6 15, 2002. 96.7 Sec. 57. [REPEALER.] 96.8 Minnesota Statutes 2000, sections 144.148, subdivision 8; 96.9 145.882, subdivisions 3 and 4; and 145.927, are repealed. 96.10 ARTICLE 3 96.11 HEALTH CARE 96.12 Section 1. Minnesota Statutes 2000, section 16A.87, is 96.13 amended to read: 96.14 16A.87 [TOBACCO SETTLEMENT FUND.] 96.15 Subdivision 1. [ESTABLISHMENT; PURPOSE.] The tobacco 96.16 settlement fund is established as a clearing account in the 96.17 state treasury. 96.18 Subd. 2. [DEPOSIT OF MONEY.] The commissioner shall credit 96.19 to the tobacco settlement fund the tobacco settlement payments 96.20 received by the state on September 5, 1998, January 4, 1999, 96.21 January 3, 2000,andJanuary 2, 2001, January 2, 2002, and 96.22 January 2, 2003, as a result of the settlement of the lawsuit 96.23 styled as State v. Philip Morris Inc., No. C1-94-8565 (Minnesota 96.24 District Court, Second Judicial District). 96.25 Subd. 3. [APPROPRIATION.] (a) Of the amounts credited to 96.26 the fund prior to June 30, 2001, 61 percent is appropriated for 96.27 transfer to the tobacco use prevention and local public health 96.28 endowment fund created in section 144.395 and 39 percent is 96.29 appropriated for transfer to the medical education endowment 96.30 fund created in section 62J.694. 96.31 (b) The entire amount credited to the fund from the 96.32 payments made on January 2, 2002, and on January 2, 2003, are 96.33 appropriated for transfer to the children's health care 96.34 endowment fund created in section 256.952. 96.35 Subd. 4. [SUNSET.] The tobacco settlement fund expires 96.36 June 30, 2015. 97.1 Sec. 2. Minnesota Statutes 2000, section 62A.095, 97.2 subdivision 1, is amended to read: 97.3 Subdivision 1. [APPLICABILITY.] (a) No health plan shall 97.4 be offered, sold, or issued to a resident of this state, or to 97.5 cover a resident of this state, unless the health plan complies 97.6 with subdivision 2. 97.7 (b) Health plans providing benefits under health care 97.8 programs administered by the commissioner of human services are 97.9 not subject to the limits described in subdivision 2 but are 97.10 subject to the right of subrogation provisions under section 97.11 256B.37 and the lien provisions under section 256.015; 256B.042; 97.12 256D.03, subdivision 8; or 256L.03, subdivision 6. 97.13 Sec. 3. Minnesota Statutes 2000, section 62J.692, 97.14 subdivision 7, is amended to read: 97.15 Subd. 7. [TRANSFERS FROM THE COMMISSIONER OF HUMAN 97.16 SERVICES.] (a) The amount transferred according to section 97.17 256B.69, subdivision 5c, paragraph (a), clause (3), shall be 97.18 distributed to the University of Minnesota academic health 97.19 center. 97.20 (b) The amount transferred according to section 256B.69, 97.21 subdivision 5c, paragraph (a), clause (4), shall be distributed 97.22 to the Hennepin county medical center. 97.23 (c) The amount transferred according to section 256B.69, 97.24 subdivision 5c, paragraph (a), clause (2), shall be distributed 97.25 by the commissioner to clinical medical education programs that 97.26 meet the qualifications of subdivision 3 based on a distribution 97.27 formula that reflects a summation of two factors: 97.28 (1) an education factor, which is determined by the total 97.29 number of eligible trainee FTEs and the total statewide average 97.30 costs per trainee, by type of trainee, in each clinical medical 97.31 education program; and 97.32 (2) a public program volume factor, which is determined by 97.33 the total volume of public program revenue received by each 97.34 training site as a percentage of all public program revenue 97.35 received by all training sites in the fund pool created under 97.36 this subdivision. 98.1 In this formula, the education factor shall be weighted at 98.2 50 percent and the public program volume factor shall be 98.3 weighted at 50 percent. 98.4(b)(d) Public program revenue for the formula in paragraph 98.5(a)(c) shall include revenue from medical assistance, prepaid 98.6 medical assistance, general assistance medical care, and prepaid 98.7 general assistance medical care. 98.8(c)Training sites that receive no public program revenue 98.9 shall be ineligible for funds available underthis98.10subdivisionparagraph (c). 98.11 Sec. 4. Minnesota Statutes 2000, section 62J.694, 98.12 subdivision 2, is amended to read: 98.13 Subd. 2. [EXPENDITURES.] (a) Up to five percent of the 98.14 fair market value of the fund is appropriated for medical 98.15 education activities in the state of Minnesota. The 98.16 appropriations are to be transferred quarterly for the purposes 98.17 identified in the following paragraphs. 98.18 (b) For fiscal year 2000, 70 percent of the appropriation 98.19 in paragraph (a) is for transfer to the board of regents for the 98.20 instructional costs of health professional programs at the 98.21 academic health center and affiliated teaching institutions, and 98.22 30 percent of the appropriation is for transfer to the 98.23 commissioner of health to be distributed for medical education 98.24 under section 62J.692. 98.25 (c) For fiscal year 2001, 49 percent of the appropriation 98.26 in paragraph (a) is for transfer to the board of regents for the 98.27 instructional costs of health professional programs at the 98.28 academic health center and affiliated teaching institutions, and 98.29 51 percent is for transfer to the commissioner of health to be 98.30 distributed for medical education under section 62J.692. 98.31 (d) For fiscal year 2002, and each year thereafter, 42 98.32 percent of the appropriation in paragraph (a)may be98.33appropriated by another law for the instructional costs of98.34health professional programs at publicly funded academic health98.35centers and affiliated teaching institutionsis for transfer to 98.36 the commissioner of human services to be used to increase the 99.1 capitation payments under section 256B.69, and 58 percent is for 99.2 transfer to the commissioner of health to be distributed for 99.3 medical education under section 62J.692. 99.4 (e) A maximum of $150,000 of each annual appropriation to 99.5 the commissioner of health in paragraph (d) may be used by the 99.6 commissioner for administrative expenses associated with 99.7 implementing section 62J.692. 99.8 Sec. 5. Minnesota Statutes 2000, section 62Q.19, 99.9 subdivision 1, is amended to read: 99.10 Subdivision 1. [DESIGNATION.] The commissioner shall 99.11 designate essential community providers. The criteria for 99.12 essential community provider designation shall be the following: 99.13 (1) a demonstrated ability to integrate applicable 99.14 supportive and stabilizing services with medical care for 99.15 uninsured persons and high-risk and special needs populations as 99.16 defined in section 62Q.07, subdivision 2, paragraph (e), 99.17 underserved, and other special needs populations; and 99.18 (2) a commitment to serve low-income and underserved 99.19 populations by meeting the following requirements: 99.20 (i) has nonprofit status in accordance with chapter 317A; 99.21 (ii) has tax exempt status in accordance with the Internal 99.22 Revenue Service Code, section 501(c)(3); 99.23 (iii) charges for services on a sliding fee schedule based 99.24 on current poverty income guidelines; and 99.25 (iv) does not restrict access or services because of a 99.26 client's financial limitation; 99.27 (3) status as a local government unit as defined in section 99.28 62D.02, subdivision 11, a hospital district created or 99.29 reorganized under sections 447.31 to 447.37, an Indian tribal 99.30 government, an Indian health service unit, or a community health 99.31 board as defined in chapter 145A; 99.32 (4) a former state hospital that specializes in the 99.33 treatment of cerebral palsy, spina bifida, epilepsy, closed head 99.34 injuries, specialized orthopedic problems, and other disabling 99.35 conditions;or99.36 (5) a rural hospital that has qualified for a sole 100.1 community hospital financial assistance grant in the past three 100.2 years under section 144.1484, subdivision 1. For these rural 100.3 hospitals, the essential community provider designation applies 100.4 to all health services provided, including both inpatient and 100.5 outpatient services; or 100.6 (6) an alternative school authorized under sections 123A.05 100.7 to 123A.08 or under section 124D.68 and a charter school 100.8 authorized under section 124D.10. For these schools the 100.9 essential community provider designation applies for mental 100.10 health services delivered by a licensed health care or social 100.11 services practitioner to a child currently enrolled in the 100.12 school. 100.13 Prior to designation, the commissioner shall publish the 100.14 names of all applicants in the State Register. The public shall 100.15 have 30 days from the date of publication to submit written 100.16 comments to the commissioner on the application. No designation 100.17 shall be made by the commissioner until the 30-day period has 100.18 expired. 100.19 The commissioner may designate an eligible provider as an 100.20 essential community provider for all the services offered by 100.21 that provider or for specific services designated by the 100.22 commissioner. 100.23 For the purpose of this subdivision, supportive and 100.24 stabilizing services include at a minimum, transportation, child 100.25 care, cultural, and linguistic services where appropriate. 100.26 [EFFECTIVE DATE.] This section is effective the day 100.27 following final enactment. 100.28 Sec. 6. [145.495] [HEALTH CARE SAFETY NET ENDOWMENT FUND.] 100.29 Subdivision 1. [CREATION.] The health care safety net 100.30 endowment fund is created in the state treasury. The state 100.31 board of investment shall invest the fund under section 11A.24. 100.32 All earnings of the fund must be credited to the fund. The 100.33 principal of the fund must be maintained inviolate, except that 100.34 the principal may be used to make expenditures from the fund for 100.35 the purposes specified in this section. 100.36 Subd. 2. [EXPENDITURES.] (a) For fiscal year 2003, and 101.1 each year thereafter, up to five percent of the average of the 101.2 fair market values of the fund for the preceding 12 months is 101.3 appropriated for the purposes identified in clauses (1) to (4): 101.4 (1) 26.7 percent is appropriated to the commissioner of 101.5 health to distributed as grants to community clinics in 101.6 accordance in section 145.928; 101.7 (2) 26.7 percent is appropriated to the commissioner of 101.8 commerce to be paid to the Minnesota comprehensive health 101.9 association for the exclusive purpose of reducing the 101.10 association's operating deficit assessment for the year; 101.11 (3) 33.3 percent is appropriated to the commissioner of 101.12 health to be distributed as rural hospital capital improvement 101.13 grants in accordance with section 144.148; and 101.14 (4) 13.3 percent is appropriated to the commissioner of 101.15 human services to be distributed as dental access grants in 101.16 accordance with section 256B.53. If the amount appropriated is 101.17 not used within that fiscal year for dental access grants, the 101.18 commissioner of finance shall transfer the remaining amount to 101.19 the commissioner of health to be added to the amount to be 101.20 distributed as rural hospital capital improvement grants for the 101.21 next fiscal year. 101.22 Subd. 3. [ENDOWMENT FUND NOT TO SUPPLANT EXISTING 101.23 FUNDS.] Appropriations from the fund must not be used as a 101.24 substitute for traditional sources of funding for health care 101.25 programs. Any local political subdivision of the state 101.26 receiving money under this section must ensure that existing 101.27 local financial efforts remain in place. 101.28 Subd. 4. [HEALTH CARE SAFETY NET ENDOWMENT FUND.] 101.29 If the health care safety net endowment fund created under 101.30 subdivision 1 is repealed, the commissioner of finance shall 101.31 transfer the principal and any remaining interest to the health 101.32 care access fund. 101.33 Sec. 7. Minnesota Statutes 2000, section 150A.10, is 101.34 amended by adding a subdivision to read: 101.35 Subd. 1a. [LIMITED AUTHORIZATION FOR DENTAL 101.36 HYGIENISTS.] (a) Notwithstanding subdivision 1, a dental 102.1 hygienist licensed under this chapter may be employed or 102.2 retained by a health care facility to perform dental hygiene 102.3 services described under paragraph (b) without the patient first 102.4 being examined by a licensed dentist if the dental hygienist: 102.5 (1) has two years practical clinical experience with a 102.6 licensed dentist within the preceding five years; and 102.7 (2) has entered into a collaborative agreement with a 102.8 licensed dentist that designates authorization for the services 102.9 provided by the dental hygienist. 102.10 (b) The dental hygiene services authorized to be performed 102.11 by a dental hygienist under this subdivision are limited to 102.12 removal of deposits and stains from the surfaces of the teeth, 102.13 application of topical preventive or prophylactic agents, 102.14 polishing and smoothing restorations, and performance of root 102.15 planing and soft-tissue curettage. The dental hygienist shall 102.16 not place pit and fissure sealants, unless the patient has been 102.17 recently examined and the treatment planned by a licensed 102.18 dentist. The dental hygienist shall not perform injections of 102.19 anesthetic agents or the administration of nitrous oxide unless 102.20 under the indirect supervision of a licensed dentist. The 102.21 performance of dental hygiene services in a health care facility 102.22 is limited to patients, students, and residents of the 102.23 facility. A dental hygienist must refer patients to a licensed 102.24 dentist for dental diagnosis, treatment planning, and dental 102.25 treatment. 102.26 (c) A collaborating dentist must be licensed under this 102.27 chapter and may enter into a collaborative agreement with more 102.28 than one dental hygienist. The collaborative agreement must be 102.29 maintained by the dentist and the dental hygienist and must be 102.30 made available to the board upon request. 102.31 (d) For the purposes of this subdivision, a "health care 102.32 facility" is limited to a hospital; nursing home; home health 102.33 agency; group home serving the elderly, disabled, or juveniles; 102.34 state-operated facility licensed by the commissioner of human 102.35 services or the commissioner of corrections; and federal, state, 102.36 or local public health facility, community clinic, or tribal 103.1 clinic. 103.2 (e) For purposes of this subdivision, "a collaborative 103.3 agreement" means an agreement with a licensed dentist who 103.4 authorizes and accepts responsibility for the services performed 103.5 by the dental hygienist. The services authorized under this 103.6 subdivision and the collaborative agreement may be performed 103.7 without the presence of a licensed dentist and may be performed 103.8 at a location other than the usual place of practice of the 103.9 dentist or dental hygienist and without a dentist's diagnosis 103.10 and treatment plan. 103.11 Sec. 8. Minnesota Statutes 2000, section 256.01, 103.12 subdivision 2, is amended to read: 103.13 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 103.14 section 241.021, subdivision 2, the commissioner of human 103.15 services shall: 103.16 (1) Administer and supervise all forms of public assistance 103.17 provided for by state law and other welfare activities or 103.18 services as are vested in the commissioner. Administration and 103.19 supervision of human services activities or services includes, 103.20 but is not limited to, assuring timely and accurate distribution 103.21 of benefits, completeness of service, and quality program 103.22 management. In addition to administering and supervising human 103.23 services activities vested by law in the department, the 103.24 commissioner shall have the authority to: 103.25 (a) require county agency participation in training and 103.26 technical assistance programs to promote compliance with 103.27 statutes, rules, federal laws, regulations, and policies 103.28 governing human services; 103.29 (b) monitor, on an ongoing basis, the performance of county 103.30 agencies in the operation and administration of human services, 103.31 enforce compliance with statutes, rules, federal laws, 103.32 regulations, and policies governing welfare services and promote 103.33 excellence of administration and program operation; 103.34 (c) develop a quality control program or other monitoring 103.35 program to review county performance and accuracy of benefit 103.36 determinations; 104.1 (d) require county agencies to make an adjustment to the 104.2 public assistance benefits issued to any individual consistent 104.3 with federal law and regulation and state law and rule and to 104.4 issue or recover benefits as appropriate; 104.5 (e) delay or deny payment of all or part of the state and 104.6 federal share of benefits and administrative reimbursement 104.7 according to the procedures set forth in section 256.017; 104.8 (f) make contracts with and grants to public and private 104.9 agencies and organizations, both profit and nonprofit, and 104.10 individuals, using appropriated funds; and 104.11 (g) enter into contractual agreements with federally 104.12 recognized Indian tribes with a reservation in Minnesota to the 104.13 extent necessary for the tribe to operate a federally approved 104.14 family assistance program or any other program under the 104.15 supervision of the commissioner. The commissioner shall consult 104.16 with the affected county or counties in the contractual 104.17 agreement negotiations, if the county or counties wish to be 104.18 included, in order to avoid the duplication of county and tribal 104.19 assistance program services. The commissioner may establish 104.20 necessary accounts for the purposes of receiving and disbursing 104.21 funds as necessary for the operation of the programs. 104.22 (2) Inform county agencies, on a timely basis, of changes 104.23 in statute, rule, federal law, regulation, and policy necessary 104.24 to county agency administration of the programs. 104.25 (3) Administer and supervise all child welfare activities; 104.26 promote the enforcement of laws protecting handicapped, 104.27 dependent, neglected and delinquent children, and children born 104.28 to mothers who were not married to the children's fathers at the 104.29 times of the conception nor at the births of the children; 104.30 license and supervise child-caring and child-placing agencies 104.31 and institutions; supervise the care of children in boarding and 104.32 foster homes or in private institutions; and generally perform 104.33 all functions relating to the field of child welfare now vested 104.34 in the state board of control. 104.35 (4) Administer and supervise all noninstitutional service 104.36 to handicapped persons, including those who are visually 105.1 impaired, hearing impaired, or physically impaired or otherwise 105.2 handicapped. The commissioner may provide and contract for the 105.3 care and treatment of qualified indigent children in facilities 105.4 other than those located and available at state hospitals when 105.5 it is not feasible to provide the service in state hospitals. 105.6 (5) Assist and actively cooperate with other departments, 105.7 agencies and institutions, local, state, and federal, by 105.8 performing services in conformity with the purposes of Laws 105.9 1939, chapter 431. 105.10 (6) Act as the agent of and cooperate with the federal 105.11 government in matters of mutual concern relative to and in 105.12 conformity with the provisions of Laws 1939, chapter 431, 105.13 including the administration of any federal funds granted to the 105.14 state to aid in the performance of any functions of the 105.15 commissioner as specified in Laws 1939, chapter 431, and 105.16 including the promulgation of rules making uniformly available 105.17 medical care benefits to all recipients of public assistance, at 105.18 such times as the federal government increases its participation 105.19 in assistance expenditures for medical care to recipients of 105.20 public assistance, the cost thereof to be borne in the same 105.21 proportion as are grants of aid to said recipients. 105.22 (7) Establish and maintain any administrative units 105.23 reasonably necessary for the performance of administrative 105.24 functions common to all divisions of the department. 105.25 (8) Act as designated guardian of both the estate and the 105.26 person of all the wards of the state of Minnesota, whether by 105.27 operation of law or by an order of court, without any further 105.28 act or proceeding whatever, except as to persons committed as 105.29 mentally retarded. For children under the guardianship of the 105.30 commissioner whose interests would be best served by adoptive 105.31 placement, the commissioner may contract with a licensed 105.32 child-placing agency to provide adoption services. A contract 105.33 with a licensed child-placing agency must be designed to 105.34 supplement existing county efforts and may not replace existing 105.35 county programs, unless the replacement is agreed to by the 105.36 county board and the appropriate exclusive bargaining 106.1 representative or the commissioner has evidence that child 106.2 placements of the county continue to be substantially below that 106.3 of other counties. Funds encumbered and obligated under an 106.4 agreement for a specific child shall remain available until the 106.5 terms of the agreement are fulfilled or the agreement is 106.6 terminated. 106.7 (9) Act as coordinating referral and informational center 106.8 on requests for service for newly arrived immigrants coming to 106.9 Minnesota. 106.10 (10) The specific enumeration of powers and duties as 106.11 hereinabove set forth shall in no way be construed to be a 106.12 limitation upon the general transfer of powers herein contained. 106.13 (11) Establish county, regional, or statewide schedules of 106.14 maximum fees and charges which may be paid by county agencies 106.15 for medical, dental, surgical, hospital, nursing and nursing 106.16 home care and medicine and medical supplies under all programs 106.17 of medical care provided by the state and for congregate living 106.18 care under the income maintenance programs. 106.19 (12) Have the authority to conduct and administer 106.20 experimental projects to test methods and procedures of 106.21 administering assistance and services to recipients or potential 106.22 recipients of public welfare. To carry out such experimental 106.23 projects, it is further provided that the commissioner of human 106.24 services is authorized to waive the enforcement of existing 106.25 specific statutory program requirements, rules, and standards in 106.26 one or more counties. The order establishing the waiver shall 106.27 provide alternative methods and procedures of administration, 106.28 shall not be in conflict with the basic purposes, coverage, or 106.29 benefits provided by law, and in no event shall the duration of 106.30 a project exceed four years. It is further provided that no 106.31 order establishing an experimental project as authorized by the 106.32 provisions of this section shall become effective until the 106.33 following conditions have been met: 106.34 (a) The secretary of health and human services of the 106.35 United States has agreed, for the same project, to waive state 106.36 plan requirements relative to statewide uniformity. 107.1 (b) A comprehensive plan, including estimated project 107.2 costs, shall be approved by the legislative advisory commission 107.3 and filed with the commissioner of administration. 107.4 (13) According to federal requirements, establish 107.5 procedures to be followed by local welfare boards in creating 107.6 citizen advisory committees, including procedures for selection 107.7 of committee members. 107.8 (14) Allocate federal fiscal disallowances or sanctions 107.9 which are based on quality control error rates for the aid to 107.10 families with dependent children program formerly codified in 107.11 sections 256.72 to 256.87, medical assistance, or food stamp 107.12 program in the following manner: 107.13 (a) One-half of the total amount of the disallowance shall 107.14 be borne by the county boards responsible for administering the 107.15 programs. For the medical assistance and the AFDC program 107.16 formerly codified in sections 256.72 to 256.87, disallowances 107.17 shall be shared by each county board in the same proportion as 107.18 that county's expenditures for the sanctioned program are to the 107.19 total of all counties' expenditures for the AFDC program 107.20 formerly codified in sections 256.72 to 256.87, and medical 107.21 assistance programs. For the food stamp program, sanctions 107.22 shall be shared by each county board, with 50 percent of the 107.23 sanction being distributed to each county in the same proportion 107.24 as that county's administrative costs for food stamps are to the 107.25 total of all food stamp administrative costs for all counties, 107.26 and 50 percent of the sanctions being distributed to each county 107.27 in the same proportion as that county's value of food stamp 107.28 benefits issued are to the total of all benefits issued for all 107.29 counties. Each county shall pay its share of the disallowance 107.30 to the state of Minnesota. When a county fails to pay the 107.31 amount due hereunder, the commissioner may deduct the amount 107.32 from reimbursement otherwise due the county, or the attorney 107.33 general, upon the request of the commissioner, may institute 107.34 civil action to recover the amount due. 107.35 (b) Notwithstanding the provisions of paragraph (a), if the 107.36 disallowance results from knowing noncompliance by one or more 108.1 counties with a specific program instruction, and that knowing 108.2 noncompliance is a matter of official county board record, the 108.3 commissioner may require payment or recover from the county or 108.4 counties, in the manner prescribed in paragraph (a), an amount 108.5 equal to the portion of the total disallowance which resulted 108.6 from the noncompliance, and may distribute the balance of the 108.7 disallowance according to paragraph (a). 108.8 (15) Develop and implement special projects that maximize 108.9 reimbursements and result in the recovery of money to the 108.10 state. For the purpose of recovering state money, the 108.11 commissioner may enter into contracts with third parties. Any 108.12 recoveries that result from projects or contracts entered into 108.13 under this paragraph shall be deposited in the state treasury 108.14 and credited to a special account until the balance in the 108.15 account reaches $1,000,000. When the balance in the account 108.16 exceeds $1,000,000, the excess shall be transferred and credited 108.17 to the general fund. All money in the account is appropriated 108.18 to the commissioner for the purposes of this paragraph. 108.19 (16) Have the authority to make direct payments to 108.20 facilities providing shelter to women and their children 108.21 according to section 256D.05, subdivision 3. Upon the written 108.22 request of a shelter facility that has been denied payments 108.23 under section 256D.05, subdivision 3, the commissioner shall 108.24 review all relevant evidence and make a determination within 30 108.25 days of the request for review regarding issuance of direct 108.26 payments to the shelter facility. Failure to act within 30 days 108.27 shall be considered a determination not to issue direct payments. 108.28 (17) Have the authority to establish and enforce the 108.29 following county reporting requirements: 108.30 (a) The commissioner shall establish fiscal and statistical 108.31 reporting requirements necessary to account for the expenditure 108.32 of funds allocated to counties for human services programs. 108.33 When establishing financial and statistical reporting 108.34 requirements, the commissioner shall evaluate all reports, in 108.35 consultation with the counties, to determine if the reports can 108.36 be simplified or the number of reports can be reduced. 109.1 (b) The county board shall submit monthly or quarterly 109.2 reports to the department as required by the commissioner. 109.3 Monthly reports are due no later than 15 working days after the 109.4 end of the month. Quarterly reports are due no later than 30 109.5 calendar days after the end of the quarter, unless the 109.6 commissioner determines that the deadline must be shortened to 109.7 20 calendar days to avoid jeopardizing compliance with federal 109.8 deadlines or risking a loss of federal funding. Only reports 109.9 that are complete, legible, and in the required format shall be 109.10 accepted by the commissioner. 109.11 (c) If the required reports are not received by the 109.12 deadlines established in clause (b), the commissioner may delay 109.13 payments and withhold funds from the county board until the next 109.14 reporting period. When the report is needed to account for the 109.15 use of federal funds and the late report results in a reduction 109.16 in federal funding, the commissioner shall withhold from the 109.17 county boards with late reports an amount equal to the reduction 109.18 in federal funding until full federal funding is received. 109.19 (d) A county board that submits reports that are late, 109.20 illegible, incomplete, or not in the required format for two out 109.21 of three consecutive reporting periods is considered 109.22 noncompliant. When a county board is found to be noncompliant, 109.23 the commissioner shall notify the county board of the reason the 109.24 county board is considered noncompliant and request that the 109.25 county board develop a corrective action plan stating how the 109.26 county board plans to correct the problem. The corrective 109.27 action plan must be submitted to the commissioner within 45 days 109.28 after the date the county board received notice of noncompliance. 109.29 (e) The final deadline for fiscal reports or amendments to 109.30 fiscal reports is one year after the date the report was 109.31 originally due. If the commissioner does not receive a report 109.32 by the final deadline, the county board forfeits the funding 109.33 associated with the report for that reporting period and the 109.34 county board must repay any funds associated with the report 109.35 received for that reporting period. 109.36 (f) The commissioner may not delay payments, withhold 110.1 funds, or require repayment under paragraph (c) or (e) if the 110.2 county demonstrates that the commissioner failed to provide 110.3 appropriate forms, guidelines, and technical assistance to 110.4 enable the county to comply with the requirements. If the 110.5 county board disagrees with an action taken by the commissioner 110.6 under paragraph (c) or (e), the county board may appeal the 110.7 action according to sections 14.57 to 14.69. 110.8 (g) Counties subject to withholding of funds under 110.9 paragraph (c) or forfeiture or repayment of funds under 110.10 paragraph (e) shall not reduce or withhold benefits or services 110.11 to clients to cover costs incurred due to actions taken by the 110.12 commissioner under paragraph (c) or (e). 110.13 (18) Allocate federal fiscal disallowances or sanctions for 110.14 audit exceptions when federal fiscal disallowances or sanctions 110.15 are based on a statewide random sample for the foster care 110.16 program under title IV-E of the Social Security Act, United 110.17 States Code, title 42, in direct proportion to each county's 110.18 title IV-E foster care maintenance claim for that period. 110.19 (19) Be responsible for ensuring the detection, prevention, 110.20 investigation, and resolution of fraudulent activities or 110.21 behavior by applicants, recipients, and other participants in 110.22 the human services programs administered by the department. 110.23 (20) Require county agencies to identify overpayments, 110.24 establish claims, and utilize all available and cost-beneficial 110.25 methodologies to collect and recover these overpayments in the 110.26 human services programs administered by the department. 110.27 (21) Have the authority to administer a drug rebate program 110.28 for drugs purchased pursuant to the prescription drug program 110.29 established under section 256.955 after the beneficiary's 110.30 satisfaction of any deductible established in the program. The 110.31 commissioner shall require a rebate agreement from all 110.32 manufacturers of covered drugs as defined in section 256B.0625, 110.33 subdivision 13. Rebate agreements for prescription drugs 110.34 delivered on or after July 1, 2002, must include rebates for 110.35 individuals covered under the prescription drug program who are 110.36 under 65 years of age. For each drug, the amount of the rebate 111.1 shall be equal to the basic rebate as defined for purposes of 111.2 the federal rebate program in United States Code, title 42, 111.3 section 1396r-8(c)(1). This basic rebate shall be applied to 111.4 single-source and multiple-source drugs. The manufacturers must 111.5 provide full payment within 30 days of receipt of the state 111.6 invoice for the rebate within the terms and conditions used for 111.7 the federal rebate program established pursuant to section 1927 111.8 of title XIX of the Social Security Act. The manufacturers must 111.9 provide the commissioner with any information necessary to 111.10 verify the rebate determined per drug. The rebate program shall 111.11 utilize the terms and conditions used for the federal rebate 111.12 program established pursuant to section 1927 of title XIX of the 111.13 Social Security Act. 111.14 (22) Have the authority to administer the federal drug 111.15 rebate program for drugs purchased under the medical assistance 111.16 program as allowed by section 1927 of title XIX of the Social 111.17 Security Act and according to the terms and conditions of 111.18 section 1927. Rebates shall be collected for all drugs that 111.19 have been dispensed or administered in an outpatient setting and 111.20 that are from manufacturers who have signed a rebate agreement 111.21 with the United States Department of Health and Human Services. 111.22(22)(23) Operate the department's communication systems 111.23 account established in Laws 1993, First Special Session chapter 111.24 1, article 1, section 2, subdivision 2, to manage shared 111.25 communication costs necessary for the operation of the programs 111.26 the commissioner supervises. A communications account may also 111.27 be established for each regional treatment center which operates 111.28 communications systems. Each account must be used to manage 111.29 shared communication costs necessary for the operations of the 111.30 programs the commissioner supervises. The commissioner may 111.31 distribute the costs of operating and maintaining communication 111.32 systems to participants in a manner that reflects actual usage. 111.33 Costs may include acquisition, licensing, insurance, 111.34 maintenance, repair, staff time and other costs as determined by 111.35 the commissioner. Nonprofit organizations and state, county, 111.36 and local government agencies involved in the operation of 112.1 programs the commissioner supervises may participate in the use 112.2 of the department's communications technology and share in the 112.3 cost of operation. The commissioner may accept on behalf of the 112.4 state any gift, bequest, devise or personal property of any 112.5 kind, or money tendered to the state for any lawful purpose 112.6 pertaining to the communication activities of the department. 112.7 Any money received for this purpose must be deposited in the 112.8 department's communication systems accounts. Money collected by 112.9 the commissioner for the use of communication systems must be 112.10 deposited in the state communication systems account and is 112.11 appropriated to the commissioner for purposes of this section. 112.12(23)(24) Receive any federal matching money that is made 112.13 available through the medical assistance program for the 112.14 consumer satisfaction survey. Any federal money received for 112.15 the survey is appropriated to the commissioner for this 112.16 purpose. The commissioner may expend the federal money received 112.17 for the consumer satisfaction survey in either year of the 112.18 biennium. 112.19(24)(25) Incorporate cost reimbursement claims from First 112.20 Call Minnesota and Greater Twin Cities United Way into the 112.21 federal cost reimbursement claiming processes of the department 112.22 according to federal law, rule, and regulations. Any 112.23 reimbursement received is appropriated to the commissioner and 112.24 shall be disbursed to First Call Minnesota and Greater Twin 112.25 Cities United Way according to normal department payment 112.26 schedules. 112.27(25)(26) Develop recommended standards for foster care 112.28 homes that address the components of specialized therapeutic 112.29 services to be provided by foster care homes with those services. 112.30 Sec. 9. [256.952] [CHILDREN'S HEALTH CARE ENDOWMENT FUND.] 112.31 Subdivision 1. [CREATION.] The children's health care 112.32 endowment fund is created in the state treasury. The state 112.33 board of investment shall invest the fund under section 11A.24. 112.34 All earnings of the fund must be credited to the fund. The 112.35 principal of the fund must be maintained inviolate, except that 112.36 the principal may be used to make expenditures from the fund for 113.1 the purposes specified in this section. 113.2 Subd. 2. [EXPENDITURES.] (a) For fiscal year 2003, up to 113.3 five percent of the average of the fair market values of the 113.4 fund for the preceding six months is appropriated to the 113.5 commissioner of human services to provide coverage for 113.6 low-income children in the MinnesotaCare program. 113.7 (b) For fiscal year 2004 and each year thereafter, up to 113.8 five percent of the average of the fair market values of the 113.9 fund for the preceding 12 months is appropriated to the 113.10 commissioner of human services to provide coverage for 113.11 low-income children in the MinnesotaCare program. 113.12 Sec. 10. Minnesota Statutes 2000, section 256.955, 113.13 subdivision 2, is amended to read: 113.14 Subd. 2. [DEFINITIONS.] (a) For purposes of this section, 113.15 the following definitions apply. 113.16 (b) "Health plan" has the meaning provided in section 113.17 62Q.01, subdivision 3. 113.18 (c) "Health plan company" has the meaning provided in 113.19 section 62Q.01, subdivision 4. 113.20 (d) "Qualified individual" means an individual who meets 113.21 the requirements described in subdivision 2aor 2b, and: 113.22 (1) who is not determined eligible for medical assistance 113.23 according to section 256B.0575, who is not determined eligible 113.24 for medical assistance or general assistance medical care 113.25 without a spenddown, or who is not enrolled in MinnesotaCare; 113.26 (2) is not enrolled in prescription drug coverage under a 113.27 health plan; 113.28 (3) is not enrolled in prescription drug coverage under a 113.29 Medicare supplement plan, as defined in sections 62A.31 to 113.30 62A.44, or policies, contracts, or certificates that supplement 113.31 Medicare issued by health maintenance organizations or those 113.32 policies, contracts, or certificates governed by section 1833 or 113.33 1876 of the federal Social Security Act, United States Code, 113.34 title 42, section 1395, et seq., as amended; 113.35 (4) has not had coverage described in clauses (2) and (3) 113.36 for at least four months prior to application for the program; 114.1 and 114.2 (5) is a permanent resident of Minnesota as defined in 114.3 section 256L.09. 114.4 (e) For purposes of clauses (2) and (3), prescription drug 114.5 coverage does not include: 114.6 (1) a Medicare risk product that provides prescription drug 114.7 coverage of less than $450 per year; or 114.8 (2) a Medicare cost product that provides prescription drug 114.9 coverage that provides a maximum benefit on brand name drugs of 114.10 nor more than $500 per year. 114.11 [EFFECTIVE DATE.] This section is effective January 1, 2002. 114.12 Sec. 11. Minnesota Statutes 2000, section 256.955, 114.13 subdivision 2a, is amended to read: 114.14 Subd. 2a. [ELIGIBILITY.] An individual satisfying the 114.15 following requirements and the requirements described in 114.16 subdivision 2, paragraph (d), is eligible for the prescription 114.17 drug program: 114.18 (1) isat least 65 years of age or older; and114.19(2) is eligible asaqualifiedMedicarebeneficiary114.20according to section 256B.057, subdivision 3 or 3a, or is114.21eligible under section 256B.057, subdivision 3 or 3a, and is114.22also eligible for medical assistance or general assistance114.23medical care with a spenddown as defined in section 256B.056,114.24subdivision 5enrollee whose assets are no more than $10,000 for 114.25 a single individual and $18,000 for a married couple or family 114.26 of two or more, using the asset methodology for aged, blind, or 114.27 disabled individuals specified in section 256B.056, subdivision 114.28 1a; and 114.29 (2) has a household income that does not exceed 150 percent 114.30 of the federal poverty guidelines, using the income methodology 114.31 for aged, blind, or disabled individuals specified in section 114.32 256B.056, subdivision 1a. 114.33 [EFFECTIVE DATE.] This section is effective January 1, 2002. 114.34 Sec. 12. Minnesota Statutes 2000, section 256.955, 114.35 subdivision 7, is amended to read: 114.36 Subd. 7. [COST SHARING.] Program enrollees must satisfy 115.1 a$420 annualmonthly deductible, based upon expenditures for 115.2 prescription drugs, to be paid in $35 monthly increments. The 115.3 monthly deductible must be calculated by the commissioner based 115.4 upon the household income of the enrollee expressed as a 115.5 percentage of the federal poverty guidelines, using the 115.6 following sliding scale: 115.7 Household Income Monthly Deductible 115.8 of Enrollee 115.9 not more than 120 percent $35 115.10 more than 120 percent 115.11 but not more than 125 percent $43 115.12 more than 125 percent 115.13 but not more than 130 percent $52 115.14 more than 130 percent 115.15 but not more than 135 percent $60 115.16 more than 135 percent 115.17 but not more than 140 percent $68 115.18 more than 140 percent 115.19 but not more than 145 percent $77 115.20 more than 145 percent 115.21 but not more than 150 percent $85 115.22 [EFFECTIVE DATE.] This section is effective January 1, 2002. 115.23 Sec. 13. Minnesota Statutes 2000, section 256.955, is 115.24 amended by adding a subdivision to read: 115.25 Subd. 10. [DEDICATED ACCOUNT.] (a) The Minnesota 115.26 prescription drug dedicated account is established in the state 115.27 treasury. The commissioner of finance shall credit to the 115.28 account all rebates paid under section 256.01, subdivision 1, 115.29 clause (21), any appropriations designated for the prescription 115.30 drug program and any federal funds received by the state to 115.31 implement a senior prescription drug program. The commissioner 115.32 of finance shall ensure that account money is invested under 115.33 section 11A.25. All money earned by the account must be 115.34 credited to the account. 115.35 (b) Money in the account is appropriated to the 115.36 commissioner of human services for the prescription drug program. 116.1 [EFFECTIVE DATE.] This section is effective July 1, 2001. 116.2 Sec. 14. [256.956] [PURCHASING ALLIANCE STOP-LOSS FUND.] 116.3 Subdivision 1. [DEFINITIONS.] For purposes of this 116.4 section, the following definitions apply: 116.5 (a) "Commissioner" means the commissioner of human services. 116.6 (b) "Health plan" means a policy, contract, or certificate 116.7 issued by a health plan company to a qualifying purchasing 116.8 alliance. Any health plan issued to the members of a qualifying 116.9 purchasing alliance must meet the requirements of chapter 62L. 116.10 (c) "Health plan company" means: 116.11 (1) a health carrier as defined under section 62A.011, 116.12 subdivision 2; 116.13 (2) a community integrated service network operating under 116.14 chapter 62N; or 116.15 (3) an accountable provider network operating under chapter 116.16 62T. 116.17 (d) "Qualifying employer" means an employer who: 116.18 (1) is a member of a qualifying purchasing alliance; 116.19 (2) has at least one employee but no more than ten 116.20 employees or is a sole proprietor or farmer; 116.21 (3) did not offer employer-subsidized health care coverage 116.22 to its employees for at least 12 months prior to joining the 116.23 purchasing alliance; and 116.24 (4) is offering health coverage through the purchasing 116.25 alliance to all employees who work at least 20 hours per week 116.26 unless the employee is eligible for Medicare. 116.27 For purposes of this subdivision, "employer-subsidized health 116.28 coverage" means health coverage for which the employer pays at 116.29 least 50 percent of the cost of coverage for the employee. 116.30 (e) "Qualifying enrollee" means an employee of a qualifying 116.31 employer or the employee's dependent covered by a health plan. 116.32 (f) "Qualifying purchasing alliance" means a purchasing 116.33 alliance as defined in section 62T.01, subdivision 2, that: 116.34 (1) meets the requirements of chapter 62T; 116.35 (2) services a geographic area located in outstate 116.36 Minnesota, excluding the city of Duluth; and 117.1 (3) is organized and operating before May 1, 2001. 117.2 The criteria used by the qualifying purchasing alliance for 117.3 membership must be approved by the commissioner of health. A 117.4 qualifying purchasing alliance may begin enrolling qualifying 117.5 employers after July 1, 2001, with enrollment ending by December 117.6 31, 2003. 117.7 Subd. 2. [CREATION OF ACCOUNT.] A purchasing alliance 117.8 stop-loss fund account is established in the general fund. The 117.9 commissioner shall use the money to establish a stop-loss fund 117.10 from which a health plan company may receive reimbursement for 117.11 claims paid for qualifying enrollees. The account consists of 117.12 money appropriated by the legislature. Money from the account 117.13 must be used for the stop-loss fund. 117.14 Subd. 3. [REIMBURSEMENT.] (a) A health plan company may 117.15 receive reimbursement from the fund for 90 percent of the 117.16 portion of the claim that exceeds $30,000 but not of the portion 117.17 that exceeds $100,000 in a calendar year for a qualifying 117.18 enrollee. 117.19 (b) Claims shall be reported and funds shall be distributed 117.20 on a calendar-year basis. Claims shall be eligible for 117.21 reimbursement only for the calendar year in which the claims 117.22 were paid. 117.23 (c) Once claims paid on behalf of a qualifying enrollee 117.24 reach $100,000 in a given calendar year, no further claims may 117.25 be submitted for reimbursement on behalf of that enrollee in 117.26 that calendar year. 117.27 Subd. 4. [REQUEST PROCESS.] (a) Each health plan company 117.28 must submit a request for reimbursement from the fund on a form 117.29 prescribed by the commissioner. Requests for payment must be 117.30 submitted no later than April 1 following the end of the 117.31 calendar year for which the reimbursement request is being made, 117.32 beginning April 1, 2002. 117.33 (b) The commissioner may require a health plan company to 117.34 submit claims data as needed in connection with the 117.35 reimbursement request. 117.36 Subd. 5. [DISTRIBUTION.] (a) The commissioner shall 118.1 calculate the total claims reimbursement amount for all 118.2 qualifying health plan companies for the calendar year for which 118.3 claims are being reported and shall distribute the stop-loss 118.4 funds on an annual basis. 118.5 (b) In the event that the total amount requested for 118.6 reimbursement by the health plan companies for a calendar year 118.7 exceeds the funds available for distribution for claims paid by 118.8 all health plan companies during the same calendar year, the 118.9 commissioner shall provide for the pro rata distribution of the 118.10 available funds. Each health plan company shall be eligible to 118.11 receive only a proportionate amount of the available funds as 118.12 the health plan company's total eligible claims paid compares to 118.13 the total eligible claims paid by all health plan companies. 118.14 (c) In the event that funds available for distribution for 118.15 claims paid by all health plan companies during a calendar year 118.16 exceed the total amount requested for reimbursement by all 118.17 health plan companies during the same calendar year, any excess 118.18 funds shall be reallocated for distribution in the next calendar 118.19 year. 118.20 Subd. 6. [DATA.] Upon the request of the commissioner, 118.21 each health plan company shall furnish such data as the 118.22 commissioner deems necessary to administer the fund. The 118.23 commissioner may require that such data be submitted on a per 118.24 enrollee, aggregate, or categorical basis. Any data submitted 118.25 under this section shall be classified as private data or 118.26 nonpublic data as defined in section 13.02. 118.27 Subd. 7. [DELEGATION.] The commissioner may delegate any 118.28 or all of the commissioner's administrative duties to another 118.29 state agency or to a private contractor. 118.30 Subd. 8. [REPORT.] The commissioner of commerce, in 118.31 consultation with the office of rural health and the qualifying 118.32 purchasing alliances, shall evaluate the extent to which the 118.33 purchasing alliance stop-loss fund increases the availability of 118.34 employer-subsidized health care coverage for residents residing 118.35 in the geographic areas served by the qualifying purchasing 118.36 alliances. A preliminary report must be submitted to the 119.1 legislature by February 15, 2003, and a final report must be 119.2 submitted by February 15, 2004. 119.3 Subd. 9. [SUNSET.] This section shall expire January 1, 119.4 2005. 119.5 Sec. 15. [256.958] [RETIRED DENTIST PROGRAM.] 119.6 Subdivision 1. [PROGRAM.] The commissioner of human 119.7 services shall establish a program to reimburse a retired 119.8 dentist for the dentist's license fee and for the reasonable 119.9 cost of malpractice insurance compared to other dentists in the 119.10 community in exchange for the dentist providing 100 hours of 119.11 dental services on a volunteer basis within a 12-month period at 119.12 a community dental clinic or a dental training clinic located at 119.13 a Minnesota state college or university. 119.14 Subd. 2. [DOCUMENTATION.] Upon completion of the required 119.15 hours, the retired dentist shall submit to the commissioner the 119.16 following: 119.17 (1) documentation of the service provided; 119.18 (2) the cost of malpractice insurance for the 12-month 119.19 period; and 119.20 (3) the cost of the license. 119.21 Subd. 3. [REIMBURSEMENT.] Upon receipt of the information 119.22 described in subdivision 2, the commissioner shall provide 119.23 reimbursement to the retired dentist for the cost of malpractice 119.24 insurance for the previous 12-month period and the cost of the 119.25 license. 119.26 Sec. 16. [256.959] [DENTAL PRACTICE DONATION PROGRAM.] 119.27 Subdivision 1. [ESTABLISHMENT.] The commissioner of human 119.28 services shall establish a dental practice donation program that 119.29 coordinates the donation of a qualifying dental practice to a 119.30 qualified charitable organization and assists in locating a 119.31 dentist licensed under chapter 150A who wishes to maintain the 119.32 dental practice. 119.33 Subd. 2. [QUALIFYING DENTAL PRACTICE.] To qualify for the 119.34 dental practice donation program, a dental practice must meet 119.35 the following requirements: 119.36 (1) the dental practice must be owned by the donating 120.1 dentist; 120.2 (2) the dental practice must be located in a designated 120.3 underserved area of the state as defined by the commissioner; 120.4 and 120.5 (3) the practice must be equipped with the basic dental 120.6 equipment necessary to maintain a dental practice as determined 120.7 by the commissioner. 120.8 Subd. 3. [COORDINATION.] The commissioner shall establish 120.9 a procedure for dentists to donate their dental practices to a 120.10 qualified charitable organization. The commissioner shall 120.11 authorize a practice for donation only if it meets the 120.12 requirements of subdivision 2 and there is a licensed dentist 120.13 who is interested in entering into an agreement as described in 120.14 subdivision 4. Upon donation of the practice, the commissioner 120.15 shall provide the donating dentist with a statement verifying 120.16 that a donation of the practice was made to a qualifying 120.17 charitable organization for purposes of state and federal income 120.18 tax returns. 120.19 Subd. 4. [DONATED DENTAL PRACTICE AGREEMENT.] (a) A 120.20 dentist accepting the donated practice must enter into an 120.21 agreement with the qualified charitable organization to maintain 120.22 the dental practice for a minimum of five years at the donated 120.23 practice site and to provide services to underserved populations 120.24 up to a preagreed percentage of patients served. 120.25 (b) The agreement must include the terms for the recovery 120.26 of the donated dental practice if the dentist accepting the 120.27 practice does not fulfill the service commitment required under 120.28 this subdivision. 120.29 (c) Any costs associated with operating the dental practice 120.30 during the service commitment time period are the financial 120.31 responsibility of the dentist accepting the practice. 120.32 Sec. 17. Minnesota Statutes 2000, section 256.9657, 120.33 subdivision 2, is amended to read: 120.34 Subd. 2. [HOSPITAL SURCHARGE.] (a) Effective October 1, 120.35 1992, each Minnesota hospital except facilities of the federal 120.36 Indian Health Service and regional treatment centers shall pay 121.1 to the medical assistance account a surcharge equal to 1.4 121.2 percent of net patient revenues excluding net Medicare revenues 121.3 reported by that provider to the health care cost information 121.4 system according to the schedule in subdivision 4. 121.5 (b) Effective July 1, 1994, the surcharge under paragraph 121.6 (a) is increased to 1.56 percent. 121.7 (c) Notwithstanding the Medicare cost finding and allowable 121.8 cost principles, the hospital surcharge is not an allowable cost 121.9 for purposes of rate setting under sections 256.9685 to 256.9695. 121.10 Sec. 18. Minnesota Statutes 2000, section 256.969, is 121.11 amended by adding a subdivision to read: 121.12 Subd. 26. [GREATER MINNESOTA PAYMENT ADJUSTMENT AFTER JUNE 121.13 30, 2001.] (a) For admissions occurring after June 30, 2001, the 121.14 commissioner shall pay fee-for-service inpatient admissions for 121.15 the diagnosis-related groups specified in paragraph (b) at 121.16 hospitals located outside of the seven-county metropolitan area 121.17 at the higher of: 121.18 (1) the hospital's current payment rate for the diagnostic 121.19 category to which the diagnosis-related group belongs, exclusive 121.20 of disproportionate population adjustments received under 121.21 subdivision 9 and hospital payment adjustments received under 121.22 subdivision 23; or 121.23 (2) 90 percent of the average payment rate for that 121.24 diagnostic category for hospitals located within the 121.25 seven-county metropolitan area, exclusive of disproportionate 121.26 population adjustments received under subdivision 9 and hospital 121.27 payment adjustments received under subdivisions 20 and 23. 121.28 (b) The payment increases provided in paragraph (a) apply 121.29 to the following diagnosis-related groups, as they fall within 121.30 the diagnostic categories: 121.31 (1) 370 cesarean section with complicating diagnosis; 121.32 (2) 371 cesarean section without complicating diagnosis; 121.33 (3) 372 vaginal delivery with complicating diagnosis; 121.34 (4) 373 vaginal delivery without complicating diagnosis; 121.35 (5) 386 extreme immaturity and respiratory distress 121.36 syndrome, neonate; 122.1 (6) 388 full-term neonates with other problems; 122.2 (7) 390 prematurity without major problems; 122.3 (8) 391 normal newborn; 122.4 (9) 385 neonate, died or transferred to another acute care 122.5 facility; 122.6 (10) 425 acute adjustment reaction and psychosocial 122.7 dysfunction; 122.8 (11) 430 psychoses; 122.9 (12) 431 childhood mental disorders; and 122.10 (13) 164-167 appendectomy. 122.11 Sec. 19. Minnesota Statutes 2000, section 256B.04, is 122.12 amended by adding a subdivision to read: 122.13 Subd. 1b. [ADMINISTRATIVE SERVICES.] Notwithstanding 122.14 subdivision 1, the commissioner may contract with federally 122.15 recognized Indian tribes with a reservation in Minnesota for the 122.16 provision of early and periodic screening, diagnosis, and 122.17 treatment administrative services for American Indian children, 122.18 in accordance with the Code of Federal Regulations, title 42, 122.19 section 441, subpart B, and Minnesota Rules, part 9505.1693, 122.20 when the tribe chooses to provide such services. For purposes 122.21 of this subdivision, "American Indian" has the meaning given to 122.22 persons to whom services will be provided in the Code of Federal 122.23 Regulations, title 42, section 36.12. Notwithstanding Minnesota 122.24 Rules, part 9505.1748, subpart 1, the commissioner, the local 122.25 agency, and the tribe may contract with any entity for the 122.26 provision of early and periodic screening, diagnosis, and 122.27 treatment administrative services. 122.28 Sec. 20. Minnesota Statutes 2000, section 256B.055, 122.29 subdivision 3a, is amended to read: 122.30 Subd. 3a. [MFIP-S FAMILIES;FAMILIES ELIGIBLE UNDER PRIOR 122.31 AFDC RULES.] (a)Beginning January 1, 1998, or on the date that122.32MFIP-S is implemented in counties, medical assistance may be122.33paid for a person receiving public assistance under the MFIP-S122.34program.Beginning July 1, 2002, medical assistance may be paid 122.35 for a person who would have been eligible, but for excess income 122.36 or assets, under the state's AFDC plan in effect as of July 16, 123.1 1996, with the base AFDC standard increased according to section 123.2 256B.056, subdivision 4. 123.3 (b) BeginningJanuary 1, 1998,July 1, 2002, medical 123.4 assistance may be paid for a person who would have been eligible 123.5 for public assistance under the income andresourceassets 123.6 standards, or who would have been eligible but for excess income123.7or assets,under the state's AFDC plan in effect as of July 16, 123.8 1996,as required by the Personal Responsibility and Work123.9Opportunity Reconciliation Act of 1996 (PRWORA), Public Law123.10Number 104-193with the base AFDC rate increased according to 123.11 section 256B.056, subdivision 4. 123.12 [EFFECTIVE DATE.] This section is effective July 1, 2002. 123.13 Sec. 21. Minnesota Statutes 2000, section 256B.056, 123.14 subdivision 1a, is amended to read: 123.15 Subd. 1a. [INCOME AND ASSETS GENERALLY.] Unless 123.16 specifically required by state law or rule or federal law or 123.17 regulation, the methodologies used in counting income and assets 123.18 to determine eligibility for medical assistance for persons 123.19 whose eligibility category is based on blindness, disability, or 123.20 age of 65 or more years, the methodologies for the supplemental 123.21 security income program shall be used. For children eligible 123.22 for home and community-based waiver services whose eligibility 123.23 for medical assistance is determined without regard to parental 123.24 income, or for children eligible under section 256B.055, 123.25 subdivision 12, child support payments, including any payments 123.26 made by an obligor in satisfaction of or in addition to a 123.27 temporary or permanent order for child support, and social 123.28 security payments, are not counted as income. For families and 123.29 children, which includes all other eligibility categories, the 123.30 methodologies under the state's AFDC plan in effect as of July 123.31 16, 1996, as required by the Personal Responsibility and Work 123.32 Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 123.33 Number 104-193, shall be used. Effective upon federal approval, 123.34 in-kind contributions to, and payments made on behalf of, a 123.35 recipient, by an obligor, in satisfaction of or in addition to a 123.36 temporary or permanent order for child support or maintenance, 124.1 shall be considered income to the recipient. For these 124.2 purposes, a "methodology" does not include an asset or income 124.3 standard, or accounting method, or method of determining 124.4 effective dates. 124.5 [EFFECTIVE DATE.] This section is effective July 1, 2001, 124.6 or the date upon which federal rules published in the Federal 124.7 Register at 66FR2316 become effective, whichever is later. 124.8 Sec. 22. Minnesota Statutes 2000, section 256B.056, 124.9 subdivision 4b, is amended to read: 124.10 Subd. 4b. [INCOME VERIFICATION.] The local agency shall 124.11 not require a monthly income verification form for a recipient 124.12 who is a resident of a long-term care facility and who has 124.13 monthly earned income of $80 or less. The commissioner or 124.14 county agency shall use electronic verification as the primary 124.15 method of income verification. If there is a discrepancy in the 124.16 electronic verification, an individual may be required to submit 124.17 additional verification. 124.18 Sec. 23. Minnesota Statutes 2000, section 256B.057, 124.19 subdivision 2, is amended to read: 124.20 Subd. 2. [CHILDREN.] A childonetwo throughfive18 years 124.21 of age in a family whose countable income islessno greater 124.22 than133185 percent of the federal poverty guidelines for the 124.23 same family size, is eligible for medical assistance.A child124.24six through 18 years of age, who was born after September 30,124.251983, in a family whose countable income is less than 100124.26percent of the federal poverty guidelines for the same family124.27size is eligible for medical assistance.Countable income means 124.28 gross income minus child support paid according to a court order 124.29 and dependent care costs deducted from income under the state's 124.30 AFDC plan in effect as of July 16, 1996. 124.31 [EFFECTIVE DATE.] This section is effective July 1, 2002. 124.32 Sec. 24. Minnesota Statutes 2000, section 256B.057, 124.33 subdivision 9, is amended to read: 124.34 Subd. 9. [EMPLOYED PERSONS WITH DISABILITIES.] (a) Medical 124.35 assistance may be paid for a person who is employed and who: 124.36 (1) meets the definition of disabled under the supplemental 125.1 security income program; 125.2 (2) is at least 16 but less than 65 years of age; 125.3 (3) meets the asset limits in paragraph (b); and 125.4 (4) pays a premium, if required, under paragraph (c). 125.5 Any spousal income or assets shall be disregarded for purposes 125.6 of eligibility and premium determinations. 125.7 After the month of enrollment, a person enrolled in medical 125.8 assistance under this subdivision who is temporarily unable to 125.9 work and without receipt of earned income due to a medical 125.10 condition, as verified by a physician, or who has involuntarily 125.11 left employment may retain eligibility for up to four calendar 125.12 months. 125.13 (b) For purposes of determining eligibility under this 125.14 subdivision, a person's assets must not exceed $20,000, 125.15 excluding: 125.16 (1) all assets excluded under section 256B.056; 125.17 (2) retirement accounts, including individual accounts, 125.18 401(k) plans, 403(b) plans, Keogh plans, and pension plans; and 125.19 (3) medical expense accounts set up through the person's 125.20 employer. 125.21 (c) A person whose earned and unearned income is equal to 125.22 or greaterthan 200than 100 percent of federal poverty 125.23 guidelines for the applicable family size must pay a premium to 125.24 be eligible for medical assistance under this subdivision. The 125.25 premium shall beequal to ten percent of the person's gross125.26earned and unearned income above 200 percent of federal poverty125.27guidelines for the applicable family size up to the cost of125.28coveragebased on the person's gross earned and unearned income 125.29 and the applicable family size using a sliding fee scale 125.30 established by the commissioner, which begins at one percent of 125.31 income at 100 percent of the federal poverty guidelines and 125.32 increases to 7.5 percent of income for those with incomes at or 125.33 above 300 percent of the federal poverty guidelines. Annual 125.34 adjustments in the premium schedule based upon changes in the 125.35 federal poverty guidelines shall be effective for premiums due 125.36 in June of each year. 126.1 (d) A person's eligibility and premium shall be determined 126.2 by the local county agency. Premiums must be paid to the 126.3 commissioner. All premiums are dedicated to the commissioner. 126.4 (e) Any required premium shall be determined at application 126.5 and redetermined annually at recertification or when a change in 126.6 income or family size occurs. 126.7 (f) Premium payment is due upon notification from the 126.8 commissioner of the premium amount required. Premiums may be 126.9 paid in installments at the discretion of the commissioner. 126.10 (g) Nonpayment of the premium shall result in denial or 126.11 termination of medical assistance unless the person demonstrates 126.12 good cause for nonpayment. Good cause exists if the 126.13 requirements specified in Minnesota Rules, part 9506.0040, 126.14 subpart 7, items B to D, are met. Nonpayment shall include 126.15 payment with a returned, refused, or dishonored instrument. The 126.16 commissioner may require a guaranteed form of payment as the 126.17 only means to replace a returned, refused, or dishonored 126.18 instrument. 126.19 [EFFECTIVE DATE.] This section is effective September 1, 126.20 2001. 126.21 Sec. 25. Minnesota Statutes 2000, section 256B.057, is 126.22 amended by adding a subdivision to read: 126.23 Subd. 10. [CERTAIN PERSONS NEEDING TREATMENT FOR BREAST OR 126.24 CERVICAL CANCER.] (a) Medical assistance may be paid for a 126.25 person who: 126.26 (1) has been screened for breast or cervical cancer under 126.27 the centers for disease control and prevention's national breast 126.28 and cervical cancer early detection program established under 126.29 United States Code, title 42, sections 300k et seq.; 126.30 (2) according to the person's treating health professional, 126.31 needs treatment, including diagnostic services necessary to 126.32 determine the extent and proper course of treatment, for breast 126.33 or cervical cancer, including precancerous conditions and early 126.34 stage cancer; 126.35 (3) is under age 65; 126.36 (4) is not otherwise eligible for medical assistance under 127.1 United States Code, title 42, section 1396(a)(10)(A)(i); and 127.2 (5) is not otherwise covered under creditable coverage, as 127.3 defined under United States Code, title 42, section 300gg(c). 127.4 (b) Medical assistance provided for an eligible person 127.5 under this subdivision shall be limited to services provided 127.6 during the period that the person receives treatment for breast 127.7 or cervical cancer. 127.8 (c) A person meeting the criteria in paragraph (a) is 127.9 eligible for medical assistance without meeting the eligibility 127.10 criteria relating to income and assets in section 256B.056, 127.11 subdivisions 1a to 5b. 127.12 Sec. 26. Minnesota Statutes 2000, section 256B.057, is 127.13 amended by adding a subdivision to read: 127.14 Subd. 11. [AGED, BLIND, OR DISABLED.] (a) To be eligible 127.15 for medical assistance, a person eligible under sections 127.16 256B.055, subdivision 7, 7a, or 12, and 256B.056, subdivision 127.17 1a, may have an income up to 100 percent of the federal poverty 127.18 guidelines. 127.19 (b) A person who would be eligible under this subdivision 127.20 but for excess income, may be eligible if the person has 127.21 expenses for medical care above the 133-1/3 percent of the AFDC 127.22 income standard in effect under the July 16, 1996, AFDC state 127.23 plan. Effective July 1, 2001, the base AFDC standard in effect 127.24 shall be increased by the amount allowed under federal law in 127.25 effect January 1, 2001. The base AFDC standard in effect shall 127.26 increase on April 1, 2002, and again on April 1, 2003, by a 127.27 percentage equal to the percent change in the Consumer Price 127.28 Index for all urban consumers for the previous October compared 127.29 to one year earlier. 127.30 (c) In computing income to determine eligibility of persons 127.31 who are not residents of long-term care facilities, the 127.32 commissioner shall disregard increases in income as required by 127.33 Public Law Numbers 94-566, section 503; 99-272; and 99-509. 127.34 Veterans aid and attendance benefits and Veterans Administration 127.35 unusual medical expense payments are considered income to the 127.36 recipient. 128.1 Sec. 27. Minnesota Statutes 2000, section 256B.061, is 128.2 amended to read: 128.3 256B.061 [ELIGIBILITY; RETROACTIVE EFFECT; RESTRICTIONS.] 128.4 (a) If any individual has been determined to be eligible 128.5 for medical assistance, it will be made available for care and 128.6 services included under the plan and furnished in or after the 128.7 third month before the month in which the individual made 128.8 application for such assistance, if such individual was, or upon 128.9 application would have been, eligible for medical assistance at 128.10 the time the care and services were furnished. The commissioner 128.11 may limit, restrict, or suspend the eligibility of an individual 128.12 for up to one year upon that individual's conviction of a 128.13 criminal offense related to application for or receipt of 128.14 medical assistance benefits. 128.15 (b) On the basis of information provided on the completed 128.16 application, an applicant who meets the following criteria shall 128.17 be determined eligible beginning in the month of application: 128.18 (1)whose gross income is less than 90 percent of the128.19applicable income standard;128.20(2)whose total liquid assets are less than 90 percent of 128.21 the asset limit; 128.22(3)(2) does not reside in a long-term care facility; and 128.23(4)(3) meets all other eligibility requirements. 128.24 The applicant must provide all required verifications within 30 128.25 days' notice of the eligibility determination or eligibility 128.26 shall be terminated. 128.27 (c) Under this chapter and chapter 256D within the limits 128.28 of the appropriation made available for this purpose, the 128.29 commissioner shall develop and implement a pilot project 128.30 establishing presumptive eligibility for children under age 19 128.31 with family income at or below the medical assistance 128.32 guidelines. The commissioner shall select locations such as 128.33 provider offices, hospitals, clinics, and schools where 128.34 presumptive eligibility for medical assistance shall be 128.35 determined on site by a trained staff person. The commissioner 128.36 shall expand presumptive eligibility effective July 1, 2002, by 129.1 selecting additional locations. The entity determining 129.2 presumptive eligibility for a child must notify the parent or 129.3 caretaker at the time of the determination and provide the 129.4 parent or caretaker with an application form, and within five 129.5 working days after the date of the presumptive eligibility 129.6 determination must notify the commissioner. The presumptive 129.7 eligibility period ends on the earlier of the date a child is 129.8 found to be eligible for medical assistance, or the last day of 129.9 the month after the month of the presumptive eligibility 129.10 determination if no application for medical assistance has been 129.11 filed for that child. 129.12 Sec. 28. Minnesota Statutes 2000, section 256B.0625, is 129.13 amended by adding a subdivision to read: 129.14 Subd. 5a. [AUTISM BEHAVIOR THERAPY CLINICAL SUPERVISION 129.15 SERVICES.] (a) Medical assistance covers autism behavior therapy 129.16 clinical supervision services. Autism behavior therapy clinical 129.17 supervision services shall be reimbursed at the same rate as 129.18 services provided by a mental health professional. 129.19 (b) Providers enrolled in medical assistance to provide 129.20 this service or related autism behavior therapy services are not 129.21 required to hold a contract with a county board, as specified in 129.22 Minnesota Rules, part 9505.0324, subpart 2. 129.23 Sec. 29. Minnesota Statutes 2000, section 256B.0625, 129.24 subdivision 13, is amended to read: 129.25 Subd. 13. [DRUGS.] (a) Medical assistance covers drugs, 129.26 except for fertility drugs when specifically used to enhance 129.27 fertility, if prescribed by a licensed practitioner and 129.28 dispensed by a licensed pharmacist, by a physician enrolled in 129.29 the medical assistance program as a dispensing physician, or by 129.30 a physician or a nurse practitioner employed by or under 129.31 contract with a community health board as defined in section 129.32 145A.02, subdivision 5, for the purposes of communicable disease 129.33 control. The commissioner, after receiving recommendations from 129.34 professional medical associations and professional pharmacist 129.35 associations, shall designate a formulary committee to advise 129.36 the commissioner on the names of drugs for which payment is 130.1 made, recommend a system for reimbursing providers on a set fee 130.2 or charge basis rather than the present system, and develop 130.3 methods encouraging use of generic drugs when they are less 130.4 expensive and equally effective as trademark drugs. The 130.5 formulary committee shall consist of nine members, four of whom 130.6 shall be physicians who are not employed by the department of 130.7 human services, and a majority of whose practice is for persons 130.8 paying privately or through health insurance, three of whom 130.9 shall be pharmacists who are not employed by the department of 130.10 human services, and a majority of whose practice is for persons 130.11 paying privately or through health insurance, a consumer 130.12 representative, and a nursing home representative. Committee 130.13 members shall serve three-year terms and shall serve without 130.14 compensation. Members may be reappointed once. 130.15 (b) The commissioner shall establish a drug formulary. Its 130.16 establishment and publication shall not be subject to the 130.17 requirements of the Administrative Procedure Act, but the 130.18 formulary committee shall review and comment on the formulary 130.19 contents. The formulary committee shall review and recommend 130.20 drugs which require prior authorization. The formulary 130.21 committee may recommend drugs for prior authorization directly 130.22 to the commissioner, as long as opportunity for public input is 130.23 provided. Prior authorization may be requested by the 130.24 commissioner based on medical and clinical criteria before 130.25 certain drugs are eligible for payment. Before a drug may be 130.26 considered for prior authorization at the request of the 130.27 commissioner: 130.28 (1) the drug formulary committee must develop criteria to 130.29 be used for identifying drugs; the development of these criteria 130.30 is not subject to the requirements of chapter 14, but the 130.31 formulary committee shall provide opportunity for public input 130.32 in developing criteria; 130.33 (2) the drug formulary committee must hold a public forum 130.34 and receive public comment for an additional 15 days; and 130.35 (3) the commissioner must provide information to the 130.36 formulary committee on the impact that placing the drug on prior 131.1 authorization will have on the quality of patient care and 131.2 information regarding whether the drug is subject to clinical 131.3 abuse or misuse. Prior authorization may be required by the 131.4 commissioner before certain formulary drugs are eligible for 131.5 payment. The formulary shall not include: 131.6 (i) drugs or products for which there is no federal 131.7 funding; 131.8 (ii) over-the-counter drugs, except for antacids, 131.9 acetaminophen, family planning products, aspirin, insulin, 131.10 products for the treatment of lice, vitamins for adults with 131.11 documented vitamin deficiencies, vitamins for children under the 131.12 age of seven and pregnant or nursing women, and any other 131.13 over-the-counter drug identified by the commissioner, in 131.14 consultation with the drug formulary committee, as necessary, 131.15 appropriate, and cost-effective for the treatment of certain 131.16 specified chronic diseases, conditions or disorders, and this 131.17 determination shall not be subject to the requirements of 131.18 chapter 14; 131.19 (iii) anorectics, except that medically necessary 131.20 anorectics shall be covered for a recipient previously diagnosed 131.21 as having pickwickian syndrome and currently diagnosed as having 131.22 diabetes and being morbidly obese; 131.23 (iv) drugs for which medical value has not been 131.24 established; and 131.25 (v) drugs from manufacturers who have not signed a rebate 131.26 agreement with the Department of Health and Human Services 131.27 pursuant to section 1927 of title XIX of the Social Security Act. 131.28 The commissioner shall publish conditions for prohibiting 131.29 payment for specific drugs after considering the formulary 131.30 committee's recommendations. An honorarium of $100 per meeting 131.31 and reimbursement for mileage shall be paid to each committee 131.32 member in attendance. 131.33 (c) The basis for determining the amount of payment shall 131.34 be the lower of the actual acquisition costs of the drugs plus a 131.35 fixed dispensing fee; the maximum allowable cost set by the 131.36 federal government or by the commissioner plus the fixed 132.1 dispensing fee; or the usual and customary price charged to the 132.2 public. The pharmacy dispensing fee shall be $3.65, except that 132.3 the dispensing fee for intravenous solutions which must be 132.4 compounded by the pharmacist shall be $8 per bag, $14 per bag 132.5 for cancer chemotherapy products, and $30 per bag for total 132.6 parenteral nutritional products dispensed in one liter 132.7 quantities, or $44 per bag for total parenteral nutritional 132.8 products dispensed in quantities greater than one liter. Actual 132.9 acquisition cost includes quantity and other special discounts 132.10 except time and cash discounts. The actual acquisition cost of 132.11 a drug shall be estimated by the commissioner, at average 132.12 wholesale price minus nine percent, except that where a drug has 132.13 had its wholesale price reduced as a result of the actions of 132.14 the National Association of Medicaid Fraud Control Units, the 132.15 estimated actual acquisition cost shall be the reduced average 132.16 wholesale price, without the nine percent deduction. The 132.17 maximum allowable cost of a multisource drug may be set by the 132.18 commissioner and it shall be comparable to, but no higher than, 132.19 the maximum amount paid by other third-party payors in this 132.20 state who have maximum allowable cost programs. The 132.21 commissioner shall set maximum allowable costs for multisource 132.22 drugs that are not on the federal upper limit list as described 132.23 in United States Code, title 42, chapter 7, section 1396r-8(e), 132.24 the Social Security Act, and Code of Federal Regulations, title 132.25 42, part 447, section 447.332. Establishment of the amount of 132.26 payment for drugs shall not be subject to the requirements of 132.27 the Administrative Procedure Act. An additional dispensing fee 132.28 of $.30 may be added to the dispensing fee paid to pharmacists 132.29 for legend drug prescriptions dispensed to residents of 132.30 long-term care facilities when a unit dose blister card system, 132.31 approved by the department, is used. Under this type of 132.32 dispensing system, the pharmacist must dispense a 30-day supply 132.33 of drug. The National Drug Code (NDC) from the drug container 132.34 used to fill the blister card must be identified on the claim to 132.35 the department. The unit dose blister card containing the drug 132.36 must meet the packaging standards set forth in Minnesota Rules, 133.1 part 6800.2700, that govern the return of unused drugs to the 133.2 pharmacy for reuse. The pharmacy provider will be required to 133.3 credit the department for the actual acquisition cost of all 133.4 unused drugs that are eligible for reuse. Over-the-counter 133.5 medications must be dispensed in the manufacturer's unopened 133.6 package. The commissioner may permit the drug clozapine to be 133.7 dispensed in a quantity that is less than a 30-day supply. 133.8 Whenever a generically equivalent product is available, payment 133.9 shall be on the basis of the actual acquisition cost of the 133.10 generic drug, unless the prescriber specifically indicates 133.11 "dispense as written - brand necessary" on the prescription as 133.12 required by section 151.21, subdivision 2. 133.13 (d) For purposes of this subdivision, "multisource drugs" 133.14 means covered outpatient drugs, excluding innovator multisource 133.15 drugs for which there are two or more drug products, which: 133.16 (1) are related as therapeutically equivalent under the 133.17 Food and Drug Administration's most recent publication of 133.18 "Approved Drug Products with Therapeutic Equivalence 133.19 Evaluations"; 133.20 (2) are pharmaceutically equivalent and bioequivalent as 133.21 determined by the Food and Drug Administration; and 133.22 (3) are sold or marketed in Minnesota. 133.23 "Innovator multisource drug" means a multisource drug that was 133.24 originally marketed under an original new drug application 133.25 approved by the Food and Drug Administration. 133.26 (e) The basis for determining the amount of payment for 133.27 drugs administered in an outpatient setting shall be the lower 133.28 of the usual and customary cost submitted by the provider; the 133.29 average wholesale price minus five percent; or the maximum 133.30 allowable cost set by the federal government under United States 133.31 Code, title 42, chapter 7, section 1396r-8(e) and Code of 133.32 Federal Regulations, title 42, section 447.332, or by the 133.33 commissioner under paragraph (c). 133.34 Sec. 30. Minnesota Statutes 2000, section 256B.0625, 133.35 subdivision 13a, is amended to read: 133.36 Subd. 13a. [DRUG UTILIZATION REVIEW BOARD.] A nine-member 134.1 drug utilization review board is established. The board is 134.2 comprised of at least three but no more than four licensed 134.3 physicians actively engaged in the practice of medicine in 134.4 Minnesota; at least three licensed pharmacists actively engaged 134.5 in the practice of pharmacy in Minnesota; and one consumer 134.6 representative; the remainder to be made up of health care 134.7 professionals who are licensed in their field and have 134.8 recognized knowledge in the clinically appropriate prescribing, 134.9 dispensing, and monitoring of covered outpatient drugs. The 134.10 board shall be staffed by an employee of the department who 134.11 shall serve as an ex officio nonvoting member of the board. The 134.12 members of the board shall be appointed by the commissioner and 134.13 shall serve three-year terms. The members shall be selected 134.14 from lists submitted by professional associations. The 134.15 commissioner shall appoint the initial members of the board for 134.16 terms expiring as follows: three members for terms expiring 134.17 June 30, 1996; three members for terms expiring June 30, 1997; 134.18 and three members for terms expiring June 30, 1998. Members may 134.19 be reappointed once. The board shall annually elect a chair 134.20 from among the members. 134.21 The commissioner shall, with the advice of the board: 134.22 (1) implement a medical assistance retrospective and 134.23 prospective drug utilization review program as required by 134.24 United States Code, title 42, section 1396r-8(g)(3); 134.25 (2) develop and implement the predetermined criteria and 134.26 practice parameters for appropriate prescribing to be used in 134.27 retrospective and prospective drug utilization review; 134.28 (3) develop, select, implement, and assess interventions 134.29 for physicians, pharmacists, and patients that are educational 134.30 and not punitive in nature; 134.31 (4) establish a grievance and appeals process for 134.32 physicians and pharmacists under this section; 134.33 (5) publish and disseminate educational information to 134.34 physicians and pharmacists regarding the board and the review 134.35 program; 134.36 (6) adopt and implement procedures designed to ensure the 135.1 confidentiality of any information collected, stored, retrieved, 135.2 assessed, or analyzed by the board, staff to the board, or 135.3 contractors to the review program that identifies individual 135.4 physicians, pharmacists, or recipients; 135.5 (7) establish and implement an ongoing process to (i) 135.6 receive public comment regarding drug utilization review 135.7 criteria and standards, and (ii) consider the comments along 135.8 with other scientific and clinical information in order to 135.9 revise criteria and standards on a timely basis; and 135.10 (8) adopt any rules necessary to carry out this section. 135.11 The board may establish advisory committees. The 135.12 commissioner may contract with appropriate organizations to 135.13 assist the board in carrying out the board's duties. The 135.14 commissioner may enter into contracts for services to develop 135.15 and implement a retrospective and prospective review program. 135.16 The board shall report to the commissioner annually on the 135.17 date the Drug Utilization Review Annual Report is due to the 135.18 Health Care Financing Administration. This report is to cover 135.19 the preceding federal fiscal year. The commissioner shall make 135.20 the report available to the public upon request. The report 135.21 must include information on the activities of the board and the 135.22 program; the effectiveness of implemented interventions; 135.23 administrative costs; and any fiscal impact resulting from the 135.24 program. An honorarium of$50$100 per meeting and 135.25 reimbursement for mileage shall be paid to each board member in 135.26 attendance. 135.27 Sec. 31. Minnesota Statutes 2000, section 256B.0625, 135.28 subdivision 17, is amended to read: 135.29 Subd. 17. [TRANSPORTATION COSTS.] (a) Medical assistance 135.30 covers transportation costs incurred solely for obtaining 135.31 emergency medical care or transportation costs incurred by 135.32 nonambulatory persons in obtaining emergency or nonemergency 135.33 medical care when paid directly to an ambulance company, common 135.34 carrier, or other recognized providers of transportation 135.35 services. For the purpose of this subdivision, a person who is 135.36 incapable of transport by taxicab or bus shall be considered to 136.1 be nonambulatory. 136.2 (b) Medical assistance covers special transportation, as 136.3 defined in Minnesota Rules, part 9505.0315, subpart 1, item F, 136.4 if the provider receives and maintains a current physician's 136.5 order by the recipient's attending physician certifying that the 136.6 recipient has a physical or mental impairment that would 136.7 prohibit the recipient from safely accessing and using a bus, 136.8 taxi, other commercial transportation, or private automobile. 136.9 Special transportation includes driver-assisted service to 136.10 eligible individuals. Driver-assisted service includes 136.11 passenger pickup at and return to the individual's residence or 136.12 place of business, assistance with admittance of the individual 136.13 to the medical facility, and assistance in passenger securement 136.14 or in securing of wheelchairs or stretchers in the vehicle. The 136.15 commissioner shall establish maximum medical assistance 136.16 reimbursement rates for special transportation services for 136.17 persons who need a wheelchairliftaccessible van or 136.18stretcher-equippedstretcher-accessible vehicle and for those 136.19 who do not need a wheelchairliftaccessible van or 136.20stretcher-equippedstretcher-accessible vehicle. The average of 136.21 these two rates per trip must not exceed $15 for the base rate 136.22 and$1.20$1.30 per mile. Special transportation provided to 136.23 nonambulatory persons who do not need a wheelchairlift136.24 accessible van orstretcher-equippedstretcher-accessible 136.25 vehicle, may be reimbursed at a lower rate than special 136.26 transportation provided to persons who need a wheelchairlift136.27 accessible van orstretcher-equippedstretcher-accessible 136.28 vehicle. 136.29 [EFFECTIVE DATE.] This section is effective July 1, 2001. 136.30 Sec. 32. Minnesota Statutes 2000, section 256B.0625, 136.31 subdivision 17a, is amended to read: 136.32 Subd. 17a. [PAYMENT FOR AMBULANCE SERVICES.] Effective for 136.33 services rendered on or after July 1,19992001, medical 136.34 assistance payments for ambulance services shall beincreased by136.35five percentpaid at the Medicare reimbursement rate or at the 136.36 medical assistance payment rate in effect on July 1, 2000, 137.1 whichever is greater. 137.2 Sec. 33. Minnesota Statutes 2000, section 256B.0625, 137.3 subdivision 18a, is amended to read: 137.4 Subd. 18a. [PAYMENT FOR MEALS AND LODGINGACCESS TO 137.5 MEDICAL SERVICES.] (a) Medical assistance reimbursement for 137.6 meals for persons traveling to receive medical care may not 137.7 exceed $5.50 for breakfast, $6.50 for lunch, or $8 for dinner. 137.8 (b) Medical assistance reimbursement for lodging for 137.9 persons traveling to receive medical care may not exceed $50 per 137.10 day unless prior authorized by the local agency. 137.11 (c) Medical assistance direct mileage reimbursement to the 137.12 eligible person or the eligible person's driver may not exceed 137.13 20 cents per mile. 137.14 (d) Medical assistance covers oral language interpreter 137.15 services when provided by an enrolled health care provider 137.16 during the course of providing a direct, person-to-person 137.17 covered health care service to an enrolled recipient with 137.18 limited English proficiency. 137.19 Sec. 34. Minnesota Statutes 2000, section 256B.0625, 137.20 subdivision 30, is amended to read: 137.21 Subd. 30. [OTHER CLINIC SERVICES.] (a) Medical assistance 137.22 covers rural health clinic services, federally qualified health 137.23 center services, nonprofit community health clinic services, 137.24 public health clinic services, and the services of a clinic 137.25 meeting the criteria established in rule by the commissioner. 137.26 Rural health clinic services and federally qualified health 137.27 center services mean services defined in United States Code, 137.28 title 42, section 1396d(a)(2)(B) and (C). Payment for rural 137.29 health clinic and federally qualified health center services 137.30 shall be made according to applicable federal law and regulation. 137.31 (b) A federally qualified health center that is beginning 137.32 initial operation shall submit an estimate of budgeted costs and 137.33 visits for the initial reporting period in the form and detail 137.34 required by the commissioner. A federally qualified health 137.35 center that is already in operation shall submit an initial 137.36 report using actual costs and visits for the initial reporting 138.1 period. Within 90 days of the end of its reporting period, a 138.2 federally qualified health center shall submit, in the form and 138.3 detail required by the commissioner, a report of its operations, 138.4 including allowable costs actually incurred for the period and 138.5 the actual number of visits for services furnished during the 138.6 period, and other information required by the commissioner. 138.7 Federally qualified health centers that file Medicare cost 138.8 reports shall provide the commissioner with a copy of the most 138.9 recent Medicare cost report filed with the Medicare program 138.10 intermediary for the reporting year which support the costs 138.11 claimed on their cost report to the state. 138.12 (c) In order to continue cost-based payment under the 138.13 medical assistance program according to paragraphs (a) and (b), 138.14 a federally qualified health center or rural health clinic must 138.15 apply for designation as an essential community provider within 138.16 six months of final adoption of rules by the department of 138.17 health according to section 62Q.19, subdivision 7. For those 138.18 federally qualified health centers and rural health clinics that 138.19 have applied for essential community provider status within the 138.20 six-month time prescribed, medical assistance payments will 138.21 continue to be made according to paragraphs (a) and (b) for the 138.22 first three years after application. For federally qualified 138.23 health centers and rural health clinics that either do not apply 138.24 within the time specified above or who have had essential 138.25 community provider status for three years, medical assistance 138.26 payments for health services provided by these entities shall be 138.27 according to the same rates and conditions applicable to the 138.28 same service provided by health care providers that are not 138.29 federally qualified health centers or rural health clinics. 138.30 (d) Effective July 1, 1999, the provisions of paragraph (c) 138.31 requiring a federally qualified health center or a rural health 138.32 clinic to make application for an essential community provider 138.33 designation in order to have cost-based payments made according 138.34 to paragraphs (a) and (b) no longer apply. 138.35 (e) Effective January 1, 2000, payments made according to 138.36 paragraphs (a) and (b) shall be limited to the cost phase-out 139.1 schedule of the Balanced Budget Act of 1997. 139.2 (f) Effective January 1, 2001, each federally qualified 139.3 health center and rural health clinic may elect to be paid 139.4 either under the prospective payment system established in 139.5 United States Code, title 42, section 1396a, (a) or under an 139.6 alternative payment methodology consistent with the requirements 139.7 of United States Code, title 42, section 1392a, (a) and approved 139.8 by the Health Care Financing Administration. The alternative 139.9 payment methodology shall be 100 percent of cost as determined 139.10 according to Medicare cost principles. 139.11 Sec. 35. Minnesota Statutes 2000, section 256B.0625, 139.12 subdivision 34, is amended to read: 139.13 Subd. 34. [INDIAN HEALTH SERVICES FACILITIES.] Medical 139.14 assistance payments to facilities of the Indian health service 139.15 and facilities operated by a tribe or tribal organization under 139.16 funding authorized by United States Code, title 25, sections 139.17 450f to 450n, or title III of the Indian Self-Determination and 139.18 Education Assistance Act, Public Law Number 93-638, for 139.19 enrollees who are eligible for federal financial participation, 139.20 shall be at the option of the facility in accordance with the 139.21 rate published by the United States Assistant Secretary for 139.22 Health under the authority of United States Code, title 42, 139.23 sections 248(a) and 249(b). General assistance medical care 139.24 payments to facilities of the Indian health services and 139.25 facilities operated by a tribe or tribal organization for the 139.26 provision of outpatient medical care services billed after June 139.27 30, 1990, must be in accordance with the general assistance 139.28 medical care rates paid for the same services when provided in a 139.29 facility other than a facility of the Indian health service or a 139.30 facility operated by a tribe or tribal 139.31 organization. MinnesotaCare payments for enrollees who are not 139.32 eligible for federal financial participation at facilities of 139.33 the Indian health service and facilities operated by a tribe or 139.34 tribal organization for the provision of outpatient medical 139.35 services must be in accordance with the medical assistance rates 139.36 paid for the same services when provided in a facility other 140.1 than a facility of the Indian health service or a facility 140.2 operated by a tribe or tribal organization. 140.3 [EFFECTIVE DATE.] This section shall be effective the day 140.4 following final enactment. 140.5 Sec. 36. Minnesota Statutes 2000, section 256B.0625, is 140.6 amended by adding a subdivision to read: 140.7 Subd. 43. [TARGETED CASE MANAGEMENT SERVICES.] Medical 140.8 assistance covers case management services for vulnerable adults 140.9 and persons with developmental disabilities not receiving home 140.10 and community-based waiver services. 140.11 Sec. 37. Minnesota Statutes 2000, section 256B.0625, is 140.12 amended by adding a subdivision to read: 140.13 Subd. 44. [TARGETED CASE MANAGEMENT SERVICE FOR CHILDREN 140.14 UNDER THE AGE OF 19.] Medical assistance, subject to federal 140.15 approval, covers targeted case management services in accordance 140.16 with section 256B.0948 for children under the age of 19 who have 140.17 had at least one previous birth. 140.18 Sec. 38. Minnesota Statutes 2000, section 256B.0635, 140.19 subdivision 1, is amended to read: 140.20 Subdivision 1. [INCREASED EMPLOYMENT.]Beginning January140.211, 1998(a) Until June 30, 2002, medical assistance may be paid 140.22 for persons who received MFIP-S or medical assistance for 140.23 families and children in at least three of six months preceding 140.24 the month in which the person became ineligible for MFIP-S or 140.25 medical assistance, if the ineligibility was due to an increase 140.26 in hours of employment or employment income or due to the loss 140.27 of an earned income disregard. In addition, to receive 140.28 continued assistance under this section, persons who received 140.29 medical assistance for families and children but did not receive 140.30 MFIP-S must have had income less than or equal to the assistance 140.31 standard for their family size under the state's AFDC plan in 140.32 effect as of July 16, 1996,as required by the Personal140.33Responsibility and Work Opportunity Reconciliation Act of 1996140.34(PRWORA), Public Law Number 104-193,increased according to 140.35 section 256B.056, subdivision 4, at the time medical assistance 140.36 eligibility began. A person who is eligible for extended 141.1 medical assistance is entitled tosix12 months of assistance 141.2 without reapplication, unless the assistance unit ceases to 141.3 include a dependent child. For a person under 21 years of141.4age, except medical assistance may not be discontinued for that 141.5 dependent child under 21 years of age within thesix-month141.6 12-month period of extended eligibility until it has been 141.7 determined that the person is not otherwise eligible for medical 141.8 assistance.Medical assistance may be continued for an141.9additional six months if the person meets all requirements for141.10the additional six months, according to title XIX of the Social141.11Security Act, as amended by section 303 of the Family Support141.12Act of 1988, Public Law Number 100-485.141.13 (b) Beginning July 1, 2002, medical assistance for families 141.14 and children may be paid for persons who were eligible under 141.15 section 256B.055, subdivision 3a, paragraph (b), in at least 141.16 three of six months preceding the month in which the person 141.17 became ineligible under that section if the ineligibility was 141.18 due to an increase in hours of employment or employment income 141.19 or due to the loss of an earned income disregard. A person who 141.20 is eligible for extended medical assistance is entitled to 12 141.21 months of assistance without reapplication, unless the 141.22 assistance unit ceases to include a dependent child, except 141.23 medical assistance may not be discontinued for that dependent 141.24 child under 21 years of age within the 12-month period of 141.25 extended eligibility until it has been determined that the 141.26 person is not otherwise eligible for medical assistance. 141.27 [EFFECTIVE DATE.] This section is effective July 1, 2001. 141.28 Sec. 39. Minnesota Statutes 2000, section 256B.0635, 141.29 subdivision 2, is amended to read: 141.30 Subd. 2. [INCREASED CHILD OR SPOUSAL SUPPORT.]Beginning141.31January 1, 1998(a) Until June 30, 2002, medical assistance may 141.32 be paid for persons who received MFIP-S or medical assistance 141.33 for families and children in at least three of the six months 141.34 preceding the month in which the person became ineligible for 141.35 MFIP-S or medical assistance, if the ineligibility was the 141.36 result of the collection of child or spousal support under part 142.1 D of title IV of the Social Security Act. In addition, to 142.2 receive continued assistance under this section, persons who 142.3 received medical assistance for families and children but did 142.4 not receive MFIP-S must have had income less than or equal to 142.5 the assistance standard for their family size under the state's 142.6 AFDC plan in effect as of July 16, 1996,as required by the142.7Personal Responsibility and Work Opportunity Reconciliation Act142.8of 1996 (PRWORA), Public Law Number 104-193increased according 142.9 to section 256B.056, subdivision 4, at the time medical 142.10 assistance eligibility began. A person who is eligible for 142.11 extended medical assistance under this subdivision is entitled 142.12 to four months of assistance without reapplication, unless the 142.13 assistance unit ceases to include a dependent child. For a142.14person under 21 years of age, except medical assistance may not 142.15 be discontinued for that dependent child under 21 years of age 142.16 within the four-month period of extended eligibility until it 142.17 has been determined that the person is not otherwise eligible 142.18 for medical assistance. 142.19 (b) Beginning July 1, 2002, medical assistance for families 142.20 and children may be paid for persons who were eligible under 142.21 section 256B.055, subdivision 3a, paragraph (b), in at least 142.22 three of the six months preceding the month in which the person 142.23 became ineligible under that section if the ineligibility was 142.24 the result of the collection of child or spousal support under 142.25 part D of title IV of the Social Security Act. A person who is 142.26 eligible for extended medical assistance under this subdivision 142.27 is entitled to four months of assistance without reapplication, 142.28 unless the assistance unit ceases to include a dependent child, 142.29 except medical assistance may not be discontinued for that 142.30 dependent child under 21 years of age within the four-month 142.31 period of extended eligibility until it has been determined that 142.32 the person is not otherwise eligible for medical assistance. 142.33 [EFFECTIVE DATE.] This section is effective July 1, 2001. 142.34 Sec. 40. [256B.0637] [PRESUMPTIVE ELIGIBILITY FOR CERTAIN 142.35 PERSONS NEEDING TREATMENT FOR BREAST OR CERVICAL CANCER.] 142.36 Medical assistance is available during a presumptive 143.1 eligibility period for persons who meet the criteria in section 143.2 256B.057, subdivision 10. For purposes of this section, the 143.3 presumptive eligibility period begins on the date on which an 143.4 entity designated by the commissioner determines based on 143.5 preliminary information that the person meets the criteria in 143.6 section 256B.057, subdivision 10. The presumptive eligibility 143.7 period ends on the day on which a determination is made as to 143.8 the person's eligibility, except that if an application is not 143.9 submitted by the last day of the month following the month 143.10 during which the determination based on preliminary information 143.11 is made, the presumptive eligibility period ends on that last 143.12 day of the month. 143.13 Sec. 41. Minnesota Statutes 2000, section 256B.0644, is 143.14 amended to read: 143.15 256B.0644 [PARTICIPATION REQUIRED FOR REIMBURSEMENT UNDER 143.16 OTHER STATE HEALTH CARE PROGRAMS.] 143.17 A vendor of medical care, as defined in section 256B.02, 143.18 subdivision 7, and a health maintenance organization, as defined 143.19 in chapter 62D, must participate as a provider or contractor in 143.20 the medical assistance program, general assistance medical care 143.21 program, and MinnesotaCare as a condition of participating as a 143.22 provider in health insurance plans and programs or contractor 143.23 for state employees established under section 43A.18, the public 143.24 employees insurance program under section 43A.316, for health 143.25 insurance plans offered to local statutory or home rule charter 143.26 city, county, and school district employees, the workers' 143.27 compensation system under section 176.135, and insurance plans 143.28 provided through the Minnesota comprehensive health association 143.29 under sections 62E.01 to 62E.19. The limitations on insurance 143.30 plans offered to local government employees shall not be 143.31 applicable in geographic areas where provider participation is 143.32 limited by managed care contracts with the department of human 143.33 services. For providers other than health maintenance 143.34 organizations, participation in the medical assistance program 143.35 means that (1) the provider accepts new medical assistance, 143.36 general assistance medical care, and MinnesotaCare patients or 144.1 (2) at least 20 percent of the provider's patients are covered 144.2 by medical assistance, general assistance medical care, and 144.3 MinnesotaCare as their primary source of coverage. Patients 144.4 seen on a volunteer basis by the provider at a location other 144.5 than the provider's usual place of practice may be considered in 144.6 meeting this participation requirement. The commissioner shall 144.7 establish participation requirements for health maintenance 144.8 organizations. The commissioner shall provide lists of 144.9 participating medical assistance providers on a quarterly basis 144.10 to the commissioner of employee relations, the commissioner of 144.11 labor and industry, and the commissioner of commerce. Each of 144.12 the commissioners shall develop and implement procedures to 144.13 exclude as participating providers in the program or programs 144.14 under their jurisdiction those providers who do not participate 144.15 in the medical assistance program. The commissioner of employee 144.16 relations shall implement this section through contracts with 144.17 participating health and dental carriers. 144.18 Sec. 42. Minnesota Statutes 2000, section 256B.0913, 144.19 subdivision 12, is amended to read: 144.20 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 144.21 all 180-day eligible clients to help pay for the cost of 144.22 participating in the program. The amount of the premium for the 144.23 alternative care client shall be determined as follows: 144.24 (1) when the alternative care client's income less 144.25 recurring and predictable medical expenses is greater than the 144.26 medical assistance income standard but less than 150 percent of 144.27 the federal poverty guideline, and total assets are less than 144.28 $10,000, the fee is zero; 144.29 (2) when the alternative care client's income less 144.30 recurring and predictable medical expenses is greater than 150 144.31 percent of the federal poverty guideline, and total assets are 144.32 less than $10,000, the fee is 25 percent of the cost of 144.33 alternative care services or the difference between 150 percent 144.34 of the federal poverty guideline and the client's income less 144.35 recurring and predictable medical expenses, whichever is less; 144.36 and 145.1 (3) when the alternative care client's total assets are 145.2 greater than $10,000, the fee is 25 percent of the cost of 145.3 alternative care services. 145.4 For married persons, total assets are defined as the total 145.5 marital assets less the estimated community spouse asset 145.6 allowance, under section 256B.059, if applicable. For married 145.7 persons, total income is defined as the client's income less the 145.8 monthly spousal allotment, under section 256B.058. 145.9 All alternative care services except case management shall 145.10 be included in the estimated costs for the purpose of 145.11 determining 25 percent of the costs. 145.12 The monthly premium shall be calculated based on the cost 145.13 of the first full month of alternative care services and shall 145.14 continue unaltered until the next reassessment is completed or 145.15 at the end of 12 months, whichever comes first. Premiums are 145.16 due and payable each month alternative care services are 145.17 received unless the actual cost of the services is less than the 145.18 premium. 145.19 (b) The fee shall be waived by the commissioner when: 145.20 (1) a person who is residing in a nursing facility is 145.21 receiving case management only; 145.22 (2) a person is applying for medical assistance; 145.23 (3) a married couple is requesting an asset assessment 145.24 under the spousal impoverishment provisions; 145.25 (4) a person is a medical assistance recipient, but has 145.26 been approved for alternative care-funded assisted living 145.27 services; 145.28 (5) a person is found eligible for alternative care, but is 145.29 not yet receiving alternative care services; or 145.30 (6) a person's fee under paragraph (a) is less than $25. 145.31 (c) The county agency must record in the state's receivable 145.32 system the client's assessed premium amount or the reason the 145.33 premium has been waived. The commissioner will bill and collect 145.34 the premium from the clientand forward the amounts collected to145.35the commissioner in the manner and at the times prescribed by145.36the commissioner. Money collected must be deposited in the 146.1 general fund and is appropriated to the commissioner for the 146.2 alternative care program. The client must supply the county 146.3 with the client's social security number at the time of 146.4 application.If a client fails or refuses to pay the premium146.5due,The county shall supply the commissioner with the client's 146.6 social security number and other information the commissioner 146.7 requires to collect the premium from the client. The 146.8 commissioner shall collect unpaid premiums using the Revenue 146.9 Recapture Act in chapter 270A and other methods available to the 146.10 commissioner. The commissioner may require counties to inform 146.11 clients of the collection procedures that may be used by the 146.12 state if a premium is not paid. This paragraph does not apply 146.13 to alternative care pilot projects authorized in Laws 1993, 146.14 First Special Session chapter 1, article 5, section 133, if a 146.15 county operating under the pilot project reports the following 146.16 dollar amounts to the commissioner quarterly: 146.17 (1) total premiums billed to clients; 146.18 (2) total collections of premiums billed; and 146.19 (3) balance of premiums owed by clients. 146.20 If a county does not adhere to these reporting requirements, the 146.21 commissioner may terminate the billing, collecting, and 146.22 remitting portions of the pilot project and require the county 146.23 involved to operate under the procedures set forth in this 146.24 paragraph. 146.25 (d) The commissioner shall begin to adopt emergency or 146.26 permanent rules governing client premiums within 30 days after 146.27 July 1, 1991, including criteria for determining when services 146.28 to a client must be terminated due to failure to pay a premium. 146.29 Sec. 43. Minnesota Statutes 2000, section 256B.0913, 146.30 subdivision 14, is amended to read: 146.31 Subd. 14. [REIMBURSEMENT AND RATE ADJUSTMENTS.] (a) 146.32 Reimbursement for expenditures for the alternative care services 146.33 as approved by the client's case manager shall be through the 146.34 invoice processing procedures of the department's Medicaid 146.35 Management Information System (MMIS). To receive reimbursement, 146.36 the county or vendor must submit invoices within 12 months 147.1 following the date of service. The county agency and its 147.2 vendors under contract shall not be reimbursed for services 147.3 which exceed the county allocation. 147.4 (b)If a county collects less than 50 percent of the client147.5premiums due under subdivision 12, the commissioner may withhold147.6up to three percent of the county's final alternative care147.7program allocation determined under subdivisions 10 and 11.147.8(c)The county shall negotiate individual rates with 147.9 vendors and may be reimbursed for actual costs up to the greater 147.10 of the county's current approved rate or 60 percent of the 147.11 maximum rate in fiscal year 1994 and 65 percent of the maximum 147.12 rate in fiscal year 1995 for each alternative care service. 147.13 Notwithstanding any other rule or statutory provision to the 147.14 contrary, the commissioner shall not be authorized to increase 147.15 rates by an annual inflation factor, unless so authorized by the 147.16 legislature. 147.17(d)(c) On July 1, 1993, the commissioner shall increase 147.18 the maximum rate for home delivered meals to $4.50 per meal. 147.19 Sec. 44. [256B.0924] [TARGETED CASE MANAGEMENT SERVICES 147.20 FOR VULNERABLE ADULTS AND PERSONS WITH DEVELOPMENTAL 147.21 DISABILITIES.] 147.22 Subdivision 1. [PURPOSE.] The state recognizes that 147.23 targeted case management services can decrease the need for more 147.24 costly services such as multiple emergency room visits or 147.25 hospitalizations by linking eligible individuals with less 147.26 costly services available in the community. 147.27 Subd. 2. [DEFINITIONS.] For purposes of this section, the 147.28 following terms have the meanings given: 147.29 (a) "Targeted case management" means services which will 147.30 assist medical assistance eligible persons to gain access to 147.31 needed medical, social, educational, and other services. 147.32 Targeted case management does not include therapy, treatment, 147.33 legal, or outreach services. 147.34 (b) "Targeted case management for adults" means activities 147.35 that coordinate and link social and other services designed to 147.36 help eligible persons gain access to needed protective services, 148.1 social, health care, mental health, habilitative, educational, 148.2 vocational, recreational, advocacy, legal, chemical, health, and 148.3 other related services. 148.4 Subd. 3. [ELIGIBILITY.] Persons are eligible to receive 148.5 targeted case management services under this section if the 148.6 requirements in paragraphs (a) and (b) are met. 148.7 (a) The person must be assessed and determined by the local 148.8 county agency to: 148.9 (1) be age 18 or older; 148.10 (2) be receiving medical assistance; 148.11 (3) have significant functional limitations; and 148.12 (4) be in need of service coordination to attain or 148.13 maintain living in an integrated community setting. 148.14 (b) The person must be a vulnerable adult in need of adult 148.15 protection as defined in section 626.5572, or is an adult with 148.16 mental retardation as defined in section 252A.02, subdivision 2, 148.17 or a related condition as defined in section 252.27, subdivision 148.18 1a, and is not receiving home and community-based waiver 148.19 services. 148.20 Subd. 4. [TARGETED CASE MANAGEMENT SERVICE 148.21 ACTIVITIES.] (a) For persons with mental retardation or a 148.22 related condition, targeted case management services must meet 148.23 the provisions of section 256B.092. 148.24 (b) For persons not eligible as a person with mental 148.25 retardation or a related condition, targeted case management 148.26 service activities include: 148.27 (1) an assessment of the person's need for targeted case 148.28 management services; 148.29 (2) the development of a written personal service plan; 148.30 (3) a regular review and revision of the written personal 148.31 service plan with the recipient and the recipient's legal 148.32 representative, and others as identified by the recipient, to 148.33 ensure access to necessary services and supports identified in 148.34 the plan; 148.35 (4) effective communication with the recipient and the 148.36 recipient's legal representative and others identified by the 149.1 recipient; 149.2 (5) coordination of referrals for needed services with 149.3 qualified providers; 149.4 (6) coordination and monitoring of the overall service 149.5 delivery to ensure the quality and effectiveness of services; 149.6 (7) assistance to the recipient and the recipient's legal 149.7 representative to help make an informed choice of services; 149.8 (8) advocating on behalf of the recipient when service 149.9 barriers are encountered or referring the recipient and the 149.10 recipient's legal representative to an independent advocate; 149.11 (9) monitoring and evaluating services identified in the 149.12 personal service plan to ensure personal outcomes are met and to 149.13 ensure satisfaction with services and service delivery; 149.14 (10) conducting face-to-face monitoring with the recipient 149.15 at least twice a year; 149.16 (11) completing and maintain necessary documentation that 149.17 supports verifies the activities in this section; 149.18 (12) coordinating with the medical assistance facility 149.19 discharge planner in the 180-day period prior to the recipient's 149.20 discharge into the community; and 149.21 (13) a personal service plan developed and reviewed at 149.22 least annually with the recipient and the recipient's legal 149.23 representative. The personal service plan must be revised when 149.24 there is a change in the recipient's status. The personal 149.25 service plan must identify: 149.26 (i) the desired personal short and long-term outcomes; 149.27 (ii) the recipient's preferences for services and supports, 149.28 including development of a person-centered plan if requested; 149.29 and 149.30 (iii) formal and informal services and supports based on 149.31 areas of assessment, such as: social, health, mental health, 149.32 residence, family, educational and vocational, safety, legal, 149.33 self-determination, financial, and chemical health as determined 149.34 by the recipient and the recipient's legal representative and 149.35 the recipient's support network. 149.36 Subd. 5. [PROVIDER STANDARDS.] County boards or providers 150.1 who contract with the county are eligible to receive medical 150.2 assistance reimbursement for adult targeted case management 150.3 services. To qualify as a provider of targeted case management 150.4 services the vendor must: 150.5 (1) have demonstrated the capacity and experience to 150.6 provide the activities of case management services defined in 150.7 subdivision 4; 150.8 (2) be able to coordinate and link community resources 150.9 needed by the recipient; 150.10 (3) have the administrative capacity and experience to 150.11 serve the eligible population in providing services and to 150.12 ensure quality of services under state and federal requirements; 150.13 (4) have a financial management system that provides 150.14 accurate documentation of services and costs under state and 150.15 federal requirements; 150.16 (5) have the capacity to document and maintain individual 150.17 case records complying with state and federal requirements; 150.18 (6) coordinate with county social service agencies 150.19 responsible for planning for community social services under 150.20 chapters 256E and 256F; conducting adult protective 150.21 investigations under section 626.557, and conducting prepetition 150.22 screenings for commitments under section 253B.07; 150.23 (7) coordinate with health care providers to ensure access 150.24 to necessary health care services; 150.25 (8) have a procedure in place that notifies the recipient 150.26 and the recipient's legal representative of any conflict of 150.27 interest if the contracted targeted case management service 150.28 provider also provides the recipient's services and supports and 150.29 provides information on all potential conflicts of interest and 150.30 obtains the recipient's informed consent and provides the 150.31 recipient with alternatives; and 150.32 (9) have demonstrated the capacity to achieve the following 150.33 performance outcomes: access, quality, and consumer 150.34 satisfaction. 150.35 Subd. 6. [PAYMENT FOR TARGETED CASE MANAGEMENT.] (a) 150.36 Medical assistance and MinnesotaCare payment for targeted case 151.1 management shall be made on a monthly basis. In order to 151.2 receive payment for an eligible adult, the provider must 151.3 document at least one contact per month and not more than two 151.4 consecutive months without a face-to-face contact with the adult 151.5 or the adult's legal representative. 151.6 (b) Payment for targeted case management provided by county 151.7 staff under this subdivision shall be based on the monthly rate 151.8 methodology under section 256B.094, subdivision 6, paragraph 151.9 (b), calculated as one combined average rate together with adult 151.10 mental health case management under section 256B.0625, 151.11 subdivision 20. Billing and payment must identify the 151.12 recipient's primary population group to allow tracking of 151.13 revenues. 151.14 (c) Payment for targeted case management provided by 151.15 county-contracted vendors shall be based on a monthly rate 151.16 negotiated by the host county. The negotiated rate must not 151.17 exceed the rate charged by the vendor for the same service to 151.18 other payers. If the service is provided by a team of 151.19 contracted vendors, the county may negotiate a team rate with a 151.20 vendor who is a member of the team. The team shall determine 151.21 how to distribute the rate among its members. No reimbursement 151.22 received by contracted vendors shall be returned to the county, 151.23 except to reimburse the county for advance funding provided by 151.24 the county to the vendor. 151.25 (d) If the service is provided by a team that includes 151.26 contracted vendors and county staff, the costs for county staff 151.27 participation on the team shall be included in the rate for 151.28 county-provided services. In this case, the contracted vendor 151.29 and the county may each receive separate payment for services 151.30 provided by each entity in the same month. In order to prevent 151.31 duplication of services, the county must document, in the 151.32 recipient's file, the need for team targeted case management and 151.33 a description of the different roles of the team members. 151.34 (e) Notwithstanding section 256B.19, subdivision 1, the 151.35 nonfederal share of costs for targeted case management shall be 151.36 provided by the recipient's county of responsibility, as defined 152.1 in sections 256G.01 to 256G.12, from sources other than federal 152.2 funds or funds used to match other federal funds. 152.3 (f) The commissioner may suspend, reduce, or terminate 152.4 reimbursement to a provider that does not meet the reporting or 152.5 other requirements of this section. The county of 152.6 responsibility, as defined in sections 256G.01 to 256G.12, is 152.7 responsible for any federal disallowances. The county may share 152.8 this responsibility with its contracted vendors. 152.9 (g) The commissioner shall set aside five percent of the 152.10 federal funds received under this section for use in reimbursing 152.11 the state for costs of developing and implementing this section. 152.12 (h) Notwithstanding section 256.025, subdivision 2, 152.13 payments to counties for targeted case management expenditures 152.14 under this section shall only be made from federal earnings from 152.15 services provided under this section. Payments to contracted 152.16 vendors shall include both the federal earnings and the county 152.17 share. 152.18 (i) Notwithstanding section 256B.041, county payments for 152.19 the cost of case management services provided by county staff 152.20 shall not be made to the state treasurer. For the purposes of 152.21 targeted case management services provided by county staff under 152.22 this section, the centralized disbursement of payments to 152.23 counties under section 256B.041 consists only of federal 152.24 earnings from services provided under this section. 152.25 (j) If the recipient is a resident of a nursing facility, 152.26 intermediate care facility, or hospital, and the recipient's 152.27 institutional care is paid by medical assistance, payment for 152.28 targeted case management services under this subdivision is 152.29 limited to the last 180 days of the recipient's residency in 152.30 that facility and may not exceed more than six months in a 152.31 calendar year. 152.32 (k) Payment for targeted case management services under 152.33 this subdivision shall not duplicate payments made under other 152.34 program authorities for the same purpose. 152.35 (l) Any growth in targeted case management services and 152.36 cost increases under this section shall be the responsibility of 153.1 the counties. 153.2 Subd. 7. [IMPLEMENTATION AND EVALUATION.] The commissioner 153.3 of human services in consultation with county boards shall 153.4 establish a program to accomplish the provisions of subdivisions 153.5 1 to 6. The commissioner in consultation with county boards 153.6 shall establish performance measures to evaluate the 153.7 effectiveness of the targeted case management services. If a 153.8 county fails to meet agreed upon performance measures, the 153.9 commissioner may authorize contracted providers other than the 153.10 county. Providers contracted by the commissioner shall also be 153.11 subject to the standards in subdivision 6. 153.12 Sec. 45. [256B.0948] [TARGETED CASE MANAGEMENT SERVICES 153.13 FOR CHILDREN UNDER THE AGE OF 19.] 153.14 Subdivision 1. [ELIGIBILITY.] An eligible recipient must: 153.15 (1) be under the age of 19; 153.16 (2) be enrolled in medical assistance or MinnesotaCare; 153.17 (3) have had at least one previous birth; and 153.18 (4) not receiving any other form of targeted case 153.19 management or case management through home and community-based 153.20 waiver services. 153.21 Subd. 2. [SCOPE.] "Targeted case management services" 153.22 means the coordination or implementation of social, health, 153.23 educational, counseling, or other services designed to ensure 153.24 continued social support to the recipient to prevent or delay a 153.25 subsequent pregnancy. 153.26 Subd. 3. [ELIGIBLE SERVICES.] (a) Case management services 153.27 include: 153.28 (1) assessing the recipient's need for medical, social, 153.29 educational, and other related services; 153.30 (2) coordinating health, social, educational, and 153.31 vocational needs with community-based services and programs; 153.32 (3) providing counseling services, including mentoring, 153.33 academic support, after-school enrichment, and healthy lifestyle 153.34 practices; 153.35 (4) monitoring the needs of the recipient on a regular 153.36 basis to ensure continued support; and 154.1 (5) promoting positive parenting. 154.2 (b) These services shall be provided to the recipient on a 154.3 one-to-one basis, in the recipient's home, community setting, or 154.4 in groups. 154.5 (c) Payment shall be made on a monthly basis. In order to 154.6 receive payment, a provider must document at least a 154.7 face-to-face contact with the recipient. 154.8 Subd. 4. [INDIVIDUAL SUPPORT PLAN.] Providers must develop 154.9 and implement an individual support plan for each recipient. 154.10 The plan must include concrete, measurable goals to be achieved 154.11 and specific objectives directed toward the achievement of each 154.12 goal. The plan must indicate how collaboration with other 154.13 services will occur. 154.14 Subd. 5. [TARGET POPULATION.] The commissioner shall 154.15 contract with qualified case managers to provide targeted case 154.16 management services. The contract will further define the 154.17 target population, covered case management services, payment 154.18 rates, and provider qualifications to ensure that annual 154.19 spending, including related administrative costs for the 154.20 nonfedral share of the cost is within the amount appropriated 154.21 for this purpose. 154.22 [EFFECTIVE DATE.] This section is effective on January 1, 154.23 2002, or upon federal approval, whichever is later. 154.24 Sec. 46. [256B.195] [ADDITIONAL INTERGOVERNMENTAL 154.25 TRANSFERS; HOSPITAL PAYMENTS.] 154.26 Subdivision 1. [FEDERAL APPROVAL REQUIRED.] Section 154.27 256.969, subdivision 26, and this section are contingent on 154.28 federal approval of the intergovernmental transfers and payments 154.29 to safety net hospitals authorized under this section. 154.30 Subd. 2. [PAYMENTS FROM GOVERNMENTAL HOSPITALS.] In 154.31 addition to any payment required under section 256B.19, 154.32 effective July 15, 2001, the following government entities shall 154.33 make the payments indicated before noon on the 15th of each 154.34 month: 154.35 (1) Hennepin county, $1,883,000; and 154.36 (2) Ramsey county, $696,450. 155.1 These sums shall be part of the designated governmental unit's 155.2 portion of the nonfederal share of medical assistance costs. 155.3 Subd. 3. [PAYMENTS TO CERTAIN SAFETY NET HOSPITALS.] (a) 155.4 Effective July 15, 2001, the commissioner shall make the 155.5 following payments to the hospitals indicated after noon on the 155.6 15th of each month: 155.7 (1) to Hennepin county medical center, $3,218,000, of which 155.8 $1,883,000 is to offset the amount of the transfer under 155.9 subdivision 2 and $1,335,000 is to increase payments for medical 155.10 assistance admissions; and 155.11 (2) to Regions hospital, $1,190,250, of which $696,450 is 155.12 to offset the amount of the transfer under subdivision 2 and 155.13 $493,800 is to increase payments for medical assistance 155.14 admissions. 155.15 (b) This section and section 256.969, subdivision 26, shall 155.16 apply to fee-for-service payments only and shall not increase 155.17 capitation payments or payments made based on average rates. 155.18 (c) Medical assistance rate or payment changes required to 155.19 obtain federal financial participation under section 62J.692, 155.20 subdivision 8, shall precede the determination of 155.21 intergovernmental transfer amounts determined in this 155.22 subdivision. Participation in the intergovernmental transfer 155.23 program shall not result in the offset of any health care 155.24 provider's receipt of medical assistance payment increases other 155.25 than limits on rates and payments. 155.26 Subd. 4. [ADJUSTMENTS PERMITTED.] (a) The commissioner may 155.27 adjust the intergovernmental transfers under subdivision 2 and 155.28 the hospital payments under subdivision 3, after consultation 155.29 with the nonstate government entities named in this section, 155.30 based on the commissioner's determination of Medicare upper 155.31 payment limits and hospital-specific limitations on 155.32 disproportionate share payments. 155.33 (b) The ratio of medical assistance payments specified in 155.34 subdivision 3 to the intergovernmental transfers specified in 155.35 subdivision 2 shall not be reduced below 170 percent unless a 155.36 further reduction is required to preserve state budget 156.1 neutrality. 156.2 (c) If the federal rules regarding the establishment of the 156.3 150 percent upper payment limit for certain nonstate public 156.4 hospitals are rescinded, or if the upper payment limit is 156.5 otherwise reduced to 100 percent, the ratio of intergovernmental 156.6 transfers and medical assistance payments among the 156.7 participating entities named in this section shall be adjusted 156.8 based on the proportion of medical assistance inpatient hospital 156.9 admissions from the third previous rate year provided by each 156.10 participating hospital, and paragraph (b) shall not apply. 156.11 Subd. 5. [INCLUSION OF FAIRVIEW UNIVERSITY MEDICAL 156.12 CENTER.] Upon federal approval of the inclusion of Fairview 156.13 university medical center in the nonstate government category, 156.14 the commissioner shall establish an intergovernmental transfer 156.15 with the University of Minnesota in an amount determined by the 156.16 commissioner based on the increase in the Medicare upper payment 156.17 limit due solely to the inclusion of Fairview university medical 156.18 center as a nonstate government hospital and the amount 156.19 available under the hospital specific disproportionate share 156.20 limit. All of the proceeds of the transfer shall be used to 156.21 increase payments to Fairview university medical center for 156.22 medical assistance admissions. From this payment, Fairview 156.23 university medical center shall pay to the University of 156.24 Minnesota the cost of the transfer on the same day the payment 156.25 is received. 156.26 Sec. 47. [256B.53] [DENTAL ACCESS GRANTS.] 156.27 (a) The commissioner shall award grants to community 156.28 clinics or other nonprofit community organizations, political 156.29 subdivisions, professional associations, or other organizations 156.30 that demonstrate the ability to provide dental services 156.31 effectively to public program recipients. Grants may be used to 156.32 fund the costs related to coordinating access for recipients, 156.33 developing and implementing patient care criteria, upgrading or 156.34 establishing new facilities, acquiring furnishings or equipment, 156.35 recruiting new providers, or other development costs that will 156.36 improve access to dental care in a region. 157.1 (b) In awarding grants, the commissioner shall give 157.2 priority to applicants that plan to serve areas of the state in 157.3 which the number of dental providers is not currently sufficient 157.4 to meet the needs of recipients of public programs or uninsured 157.5 individuals. The commissioner shall consider the following in 157.6 awarding the grants: 157.7 (1) potential to successfully increase access to an 157.8 underserved population; 157.9 (2) the long-term viability of the project to improve 157.10 access beyond the period of initial funding; 157.11 (3) the efficiency in the use of the funding; and 157.12 (4) the experience of the applicants in providing services 157.13 to the target population. 157.14 (c) The commissioner shall consider grants for the 157.15 following: 157.16 (1) implementation of new programs or continued expansion 157.17 of current access programs that have demonstrated success in 157.18 providing dental services in underserved areas; 157.19 (2) a program for mobile or other types of outreach dental 157.20 clinics in underserved geographic areas; 157.21 (3) a program for school-based dental clinics in schools 157.22 with high numbers of children receiving medical assistance; 157.23 (4) a program testing new models of care that are sensitive 157.24 to the cultural needs of the recipients; 157.25 (5) a program creating new educational campaigns that 157.26 inform individuals of the importance of good oral health and the 157.27 link between dental disease and overall health status; 157.28 (6) a program that organizes a network of volunteer 157.29 dentists to provide dental services to public program recipients 157.30 or uninsured individuals; and 157.31 (7) a program that tests new delivery models by creating 157.32 partnerships between local providers and county public health 157.33 agencies. 157.34 (d) The commissioner shall evaluate the effects of the 157.35 dental access initiatives funded through the dental access 157.36 grants and submit a report to the legislature by January 15, 158.1 2003. 158.2 Sec. 48. [256B.55] [DENTAL ACCESS ADVISORY COMMITTEE.] 158.3 Subdivision 1. [ESTABLISHMENT.] The commissioner shall 158.4 establish a dental access advisory committee to monitor the 158.5 purchasing, administration, and coverage of dental care services 158.6 for the public health care programs to ensure dental care access 158.7 and quality for public program recipients. 158.8 Subd. 2. [MEMBERSHIP.] (a) The membership of the advisory 158.9 committee shall include, but is not limited to, representatives 158.10 of dentists, including a dentist practicing in the seven-county 158.11 metropolitan area and a dentist practicing outside the 158.12 seven-county metropolitan area; oral surgeons; pediatric 158.13 dentists; dental hygienists; community clinics; client advocacy 158.14 groups; public health; health service plans; the University of 158.15 Minnesota school of dentistry and the department of pediatrics; 158.16 and the commissioner of health. 158.17 (b) The advisory committee is governed by section 15.059 158.18 for membership terms and removal of members. 158.19 Subd. 3. [DUTIES.] The advisory committee shall provide 158.20 recommendations on the following: 158.21 (1) how to reduce the administrative burden governing 158.22 dental care coverage policies in order to promote administrative 158.23 simplification, including prior authorization, coverage limits, 158.24 and co-payment collections; 158.25 (2) developing and implementing an action plan to improve 158.26 the oral health of children and persons with special needs in 158.27 the state; 158.28 (3) exploring alternative ways of purchasing and improving 158.29 access to dental services; 158.30 (4) developing ways to foster greater responsibility among 158.31 health care program recipients in seeking and obtaining dental 158.32 care, including initiatives to keep dental appointments and 158.33 comply with dental care plans; 158.34 (5) exploring innovative ways for dental providers to 158.35 schedule public program patients in order to reduce or minimize 158.36 the effect of appointment no shows; 159.1 (6) exploring ways to meet the barriers that may be present 159.2 in providing dental services to health care program recipients 159.3 such as language, culture, disability, and lack of 159.4 transportation; and 159.5 (7) exploring the possibility of pediatricians, family 159.6 physicians, and nurse practitioners providing basic oral health 159.7 screenings and basic preventive dental services. 159.8 Subd. 4. [REPORT.] The commissioner shall submit a report 159.9 by February 1, 2002, and by February 1, 2003, summarizing the 159.10 activities and recommendations of the advisory committee. 159.11 Subd. 5. [SUNSET.] Notwithstanding section 15.059, 159.12 subdivision 5, this section expires June 30, 2003. 159.13 Sec. 49. Minnesota Statutes 2000, section 256B.69, 159.14 subdivision 4, is amended to read: 159.15 Subd. 4. [LIMITATION OF CHOICE.] (a) The commissioner 159.16 shall develop criteria to determine when limitation of choice 159.17 may be implemented in the experimental counties. The criteria 159.18 shall ensure that all eligible individuals in the county have 159.19 continuing access to the full range of medical assistance 159.20 services as specified in subdivision 6. 159.21 (b) The commissioner shall exempt the following persons 159.22 from participation in the project, in addition to those who do 159.23 not meet the criteria for limitation of choice: 159.24 (1) persons eligible for medical assistance according to 159.25 section 256B.055, subdivision 1; 159.26 (2) persons eligible for medical assistance due to 159.27 blindness or disability as determined by the social security 159.28 administration or the state medical review team, unless: 159.29 (i) they are 65 years of age or older,; or 159.30 (ii) they reside in Itasca county or they reside in a 159.31 county in which the commissioner conducts a pilot project under 159.32 a waiver granted pursuant to section 1115 of the Social Security 159.33 Act; 159.34 (3) recipients who currently have private coverage through 159.35 a health maintenance organization; 159.36 (4) recipients who are eligible for medical assistance by 160.1 spending down excess income for medical expenses other than the 160.2 nursing facility per diem expense; 160.3 (5) recipients who receive benefits under the Refugee 160.4 Assistance Program, established under United States Code, title 160.5 8, section 1522(e); 160.6 (6) children who are both determined to be severely 160.7 emotionally disturbed and receiving case management services 160.8 according to section 256B.0625, subdivision 20;and160.9 (7) adults who are both determined to be seriously and 160.10 persistently mentally ill and received case management services 160.11 according to section 256B.0625, subdivision 20; and 160.12 (8) persons eligible for medical assistance according to 160.13 section 256B.057, subdivision 10. 160.14 Children under age 21 who are in foster placement may enroll in 160.15 the project on an elective basis. Individuals excluded under 160.16 clauses (6) and (7) may choose to enroll on an elective basis. 160.17 (c) When a child enrolled with a demonstration provider has 160.18 been identified as receiving mental health services in an 160.19 alternative school, the alternative school shall notify the 160.20 commissioner and the child's county of financial 160.21 responsibility. The commissioner, in coordination with the 160.22 county, shall determine whether the child qualifies under 160.23 paragraph (b) for exclusion from participation in the 160.24 demonstration project. If the child qualifies, the county shall 160.25 contact the child's parent or guardian and offer the option for 160.26 the child to be excluded from the demonstration project. 160.27 (d) The commissioner may allow persons with a one-month 160.28 spenddown who are otherwise eligible to enroll to voluntarily 160.29 enroll or remain enrolled, if they elect to prepay their monthly 160.30 spenddown to the state. 160.31 (e)Beginning on or after July 1, 1997,The commissioner 160.32 may require those individuals to enroll in the prepaid medical 160.33 assistance program who otherwise would have been excluded 160.34 under paragraph (b), clauses (1)and, (3), and (8), and under 160.35 Minnesota Rules, part 9500.1452, subpart 2, items H, K, and L. 160.36 (f) Before limitation of choice is implemented, eligible 161.1 individuals shall be notified and after notification, shall be 161.2 allowed to choose only among demonstration providers. The 161.3 commissioner may assign an individual with private coverage 161.4 through a health maintenance organization, to the same health 161.5 maintenance organization for medical assistance coverage, if the 161.6 health maintenance organization is under contract for medical 161.7 assistance in the individual's county of residence. After 161.8 initially choosing a provider, the recipient is allowed to 161.9 change that choice only at specified times as allowed by the 161.10 commissioner. If a demonstration provider ends participation in 161.11 the project for any reason, a recipient enrolled with that 161.12 provider must select a new provider but may change providers 161.13 without cause once more within the first 60 days after 161.14 enrollment with the second provider. 161.15 [EFFECTIVE DATE.] Paragraph (c) of this section is 161.16 effective the day following final enactment. 161.17 Sec. 50. Minnesota Statutes 2000, section 256B.69, 161.18 subdivision 5c, is amended to read: 161.19 Subd. 5c. [MEDICAL EDUCATION AND RESEARCH FUND.] (a) 161.20 Beginning in January 1999 and each year thereafter: 161.21 (1) the commissioner of human services shall transfer an 161.22 amount equal to the reduction in the prepaid medical assistance 161.23 and prepaid general assistance medical care payments resulting 161.24 from clause (2), excluding nursing facility and elderly waiver 161.25 payments and demonstration projects operating under subdivision 161.26 23, and an amount totaling the amount identified in clauses (3) 161.27 and (4) to the medical education and research fund established 161.28 under section 62J.692; 161.29 (2) until January 1, 2002, the county medical assistance 161.30 and general assistance medical care capitation base rate prior 161.31 to plan specific adjustments and after the regional rate 161.32 adjustments under section 256B.69, subdivision 5b, shall be 161.33 reduced 6.3 percent for Hennepin county, two percent for the 161.34 remaining metropolitan counties, and no reduction for 161.35 nonmetropolitan Minnesota counties; and after January 1, 2002, 161.36 the county medical assistance and general assistance medical 162.1 care capitation base rate prior to plan specific adjustments 162.2 shall be reduced 6.3 percent for Hennepin county, two percent 162.3 for the remaining metropolitan counties, and 1.6 percent for 162.4 nonmetropolitan Minnesota counties;and162.5 (3) effective July 1, 2001, the amount transferred under 162.6 section 62J.694, subdivision 2, paragraph (d), to increase the 162.7 capitation rates plus any federal matching funds; 162.8 (4) effective July 1, 2001, $600,000 from the capitation 162.9 rates paid under this section plus any federal matching funds on 162.10 this amount; and 162.11 (5) the amount calculated under clause (1) shall not be 162.12 adjusted for subsequent changes to the capitation payments for 162.13 periods already paid. 162.14 (b) This subdivision shall be effective upon approval of a 162.15 federal waiver which allows federal financial participation in 162.16 the medical education and research fund. 162.17 Sec. 51. Minnesota Statutes 2000, section 256B.69, is 162.18 amended by adding a subdivision to read: 162.19 Subd. 6c. [DENTAL SERVICES DEMONSTRATION PROJECT.] The 162.20 commissioner shall establish a dental services demonstration 162.21 project in Crow Wing, Todd, Morrison, Wadena, and Cass counties 162.22 for provision of dental services to medical assistance, general 162.23 assistance medical care, and MinnesotaCare recipients. The 162.24 commissioner may contract on a prospective per capita payment 162.25 basis for these dental services with an organization licensed 162.26 under chapter 62C, 62D, or 62N in accordance with section 162.27 256B.037 or may establish and administer a fee-for-service 162.28 system for the reimbursement of dental services. 162.29 Sec. 52. Minnesota Statutes 2000, section 256B.69, 162.30 subdivision 23, is amended to read: 162.31 Subd. 23. [ALTERNATIVE INTEGRATED LONG-TERM CARE SERVICES; 162.32 ELDERLY AND DISABLED PERSONS.] (a) The commissioner may 162.33 implement demonstration projects to create alternative 162.34 integrated delivery systems for acute and long-term care 162.35 services to elderly persons and persons with disabilities as 162.36 defined in section 256B.77, subdivision 7a, that provide 163.1 increased coordination, improve access to quality services, and 163.2 mitigate future cost increases. The commissioner may seek 163.3 federal authority to combine Medicare and Medicaid capitation 163.4 payments for the purpose of such demonstrations. Medicare funds 163.5 and services shall be administered according to the terms and 163.6 conditions of the federal waiver and demonstration provisions. 163.7 For the purpose of administering medical assistance funds, 163.8 demonstrations under this subdivision are subject to 163.9 subdivisions 1 to 22. The provisions of Minnesota Rules, parts 163.10 9500.1450 to 9500.1464, apply to these demonstrations, with the 163.11 exceptions of parts 9500.1452, subpart 2, item B; and 9500.1457, 163.12 subpart 1, items B and C, which do not apply to persons 163.13 enrolling in demonstrations under this section. An initial open 163.14 enrollment period may be provided. Persons who disenroll from 163.15 demonstrations under this subdivision remain subject to 163.16 Minnesota Rules, parts 9500.1450 to 9500.1464. When a person is 163.17 enrolled in a health plan under these demonstrations and the 163.18 health plan's participation is subsequently terminated for any 163.19 reason, the person shall be provided an opportunity to select a 163.20 new health plan and shall have the right to change health plans 163.21 within the first 60 days of enrollment in the second health 163.22 plan. Persons required to participate in health plans under 163.23 this section who fail to make a choice of health plan shall not 163.24 be randomly assigned to health plans under these demonstrations. 163.25 Notwithstanding section 256L.12, subdivision 5, and Minnesota 163.26 Rules, part 9505.5220, subpart 1, item A, if adopted, for the 163.27 purpose of demonstrations under this subdivision, the 163.28 commissioner may contract with managed care organizations, 163.29 including counties, to serve only elderly persons eligible for 163.30 medical assistance, elderly and disabled persons, or disabled 163.31 persons only. For persons with primary diagnoses of mental 163.32 retardation or a related condition, serious and persistent 163.33 mental illness, or serious emotional disturbance, the 163.34 commissioner must ensure that the county authority has approved 163.35 the demonstration and contracting design. Enrollment in these 163.36 projects for persons with disabilities shall be voluntaryuntil164.1July 1, 2001. The commissioner shall not implement any 164.2 demonstration project under this subdivision for persons with 164.3 primary diagnoses of mental retardation or a related condition, 164.4 serious and persistent mental illness, or serious emotional 164.5 disturbance, without approval of the county board of the county 164.6 in which the demonstration is being implemented. 164.7 Before implementation of a demonstration project for 164.8 disabled persons, the commissioner must provide information to 164.9 appropriate committees of the house of representatives and 164.10 senate and must involve representatives of affected disability 164.11 groups in the design of the demonstration projects. 164.12 (b) A nursing facility reimbursed under the alternative 164.13 reimbursement methodology in section 256B.434 may, in 164.14 collaboration with a hospital, clinic, or other health care 164.15 entity provide services under paragraph (a). The commissioner 164.16 shall amend the state plan and seek any federal waivers 164.17 necessary to implement this paragraph. 164.18 Sec. 53. Minnesota Statutes 2000, section 256B.75, is 164.19 amended to read: 164.20 256B.75 [HOSPITAL OUTPATIENT REIMBURSEMENT.] 164.21 (a) For outpatient hospital facility fee payments for 164.22 services rendered on or after October 1, 1992, the commissioner 164.23 of human services shall pay the lower of (1) submitted charge, 164.24 or (2) 32 percent above the rate in effect on June 30, 1992, 164.25 except for those services for which there is a federal maximum 164.26 allowable payment. Effective for services rendered on or after 164.27 January 1, 2000, payment rates for nonsurgical outpatient 164.28 hospital facility fees and emergency room facility fees shall be 164.29 increased by eight percent over the rates in effect on December 164.30 31, 1999, except for those services for which there is a federal 164.31 maximum allowable payment. Services for which there is a 164.32 federal maximum allowable payment shall be paid at the lower of 164.33 (1) submitted charge, or (2) the federal maximum allowable 164.34 payment. Total aggregate payment for outpatient hospital 164.35 facility fee services shall not exceed the Medicare upper 164.36 limit. If it is determined that a provision of this section 165.1 conflicts with existing or future requirements of the United 165.2 States government with respect to federal financial 165.3 participation in medical assistance, the federal requirements 165.4 prevail. The commissioner may, in the aggregate, prospectively 165.5 reduce payment rates to avoid reduced federal financial 165.6 participation resulting from rates that are in excess of the 165.7 Medicare upper limitations. 165.8 (b) Notwithstanding paragraph (a), payment for outpatient, 165.9 emergency, and ambulatory surgery hospital facility fee services 165.10 for critical access hospitals designated under section 144.1483, 165.11 clause (11), shall be paid on a cost-based payment system that 165.12 is based on the cost-finding methods and allowable costs of the 165.13 Medicare program. 165.14 (c) Effective for services provided on or after July 1, 165.15 2002, rates that are based on the Medicare outpatient 165.16 prospective payment system shall be replaced by a budget neutral 165.17 prospective payment system that is derived using medical 165.18 assistance data. The commissioner shall provide a proposal to 165.19 the 2002 legislature to define and implement this provision. 165.20 Sec. 54. Minnesota Statutes 2000, section 256B.76, is 165.21 amended to read: 165.22 256B.76 [PHYSICIAN AND DENTAL REIMBURSEMENT.] 165.23 (a) Effective for services rendered on or after October 1, 165.24 1992, the commissioner shall make payments for physician 165.25 services as follows: 165.26 (1) payment for level one Health Care Finance 165.27 Administration's common procedural coding system (HCPCS) codes 165.28 titled "office and other outpatient services," "preventive 165.29 medicine new and established patient," "delivery, antepartum, 165.30 and postpartum care," "critical care,"Caesareancesarean 165.31 delivery and pharmacologic management provided to psychiatric 165.32 patients, and HCPCS level three codes for enhanced services for 165.33 prenatal high risk, shall be paid at the lower of (i) submitted 165.34 charges, or (ii) 25 percent above the rate in effect on June 30, 165.35 1992. If the rate on any procedure code within these categories 165.36 is different than the rate that would have been paid under the 166.1 methodology in section 256B.74, subdivision 2, then the larger 166.2 rate shall be paid; 166.3 (2) payments for all other services shall be paid at the 166.4 lower of (i) submitted charges, or (ii) 15.4 percent above the 166.5 rate in effect on June 30, 1992; 166.6 (3) all physician rates shall be converted from the 50th 166.7 percentile of 1982 to the 50th percentile of 1989, less the 166.8 percent in aggregate necessary to equal the above increases 166.9 except that payment rates for home health agency services shall 166.10 be the rates in effect on September 30, 1992; 166.11 (4) effective for services rendered on or after January 1, 166.12 2000, payment rates for physician and professional services 166.13 shall be increased by three percent over the rates in effect on 166.14 December 31, 1999, except for home health agency and family 166.15 planning agency services; and 166.16 (5) the increases in clause (4) shall be implemented 166.17 January 1, 2000, for managed care. 166.18 (b) Effective for services rendered on or after October 1, 166.19 1992, the commissioner shall make payments for dental services 166.20 as follows: 166.21 (1) dental services shall be paid at the lower of (i) 166.22 submitted charges, or (ii) 25 percent above the rate in effect 166.23 on June 30, 1992; 166.24 (2) dental rates shall be converted from the 50th 166.25 percentile of 1982 to the 50th percentile of 1989, less the 166.26 percent in aggregate necessary to equal the above increases; 166.27 (3) effective for services rendered on or after January 1, 166.28 2000, payment rates for dental services shall be increased by 166.29 three percent over the rates in effect on December 31, 1999; 166.30 (4)the commissioner shall award grants to community166.31clinics or other nonprofit community organizations, political166.32subdivisions, professional associations, or other organizations166.33that demonstrate the ability to provide dental services166.34effectively to public program recipients. Grants may be used to166.35fund the costs related to coordinating access for recipients,166.36developing and implementing patient care criteria, upgrading or167.1establishing new facilities, acquiring furnishings or equipment,167.2recruiting new providers, or other development costs that will167.3improve access to dental care in a region. In awarding grants,167.4the commissioner shall give priority to applicants that plan to167.5serve areas of the state in which the number of dental providers167.6is not currently sufficient to meet the needs of recipients of167.7public programs or uninsured individuals. The commissioner167.8shall consider the following in awarding the grants: (i)167.9potential to successfully increase access to an underserved167.10population; (ii) the ability to raise matching funds; (iii) the167.11long-term viability of the project to improve access beyond the167.12period of initial funding; (iv) the efficiency in the use of the167.13funding; and (v) the experience of the proposers in providing167.14services to the target population.167.15The commissioner shall monitor the grants and may terminate167.16a grant if the grantee does not increase dental access for167.17public program recipients. The commissioner shall consider167.18grants for the following:167.19(i) implementation of new programs or continued expansion167.20of current access programs that have demonstrated success in167.21providing dental services in underserved areas;167.22(ii) a pilot program for utilizing hygienists outside of a167.23traditional dental office to provide dental hygiene services;167.24and167.25(iii) a program that organizes a network of volunteer167.26dentists, establishes a system to refer eligible individuals to167.27volunteer dentists, and through that network provides donated167.28dental care services to public program recipients or uninsured167.29individuals.167.30(5)beginning October 1, 1999, the payment for tooth 167.31 sealants and fluoride treatments shall be the lower of (i) 167.32 submitted charge, or (ii) 80 percent of median 1997 charges;and167.33(6)(5) the increases listed in clauses (3) and(5)(4) 167.34 shall be implemented January 1, 2000, for managed care; 167.35 (6) effective for services provided on or after January 1, 167.36 2002, payment for diagnostic examinations and dental x-rays 168.1 provided to children under age 21 shall be the lower of: 168.2 (i) the submitted charge; or 168.3 (ii) 70 percent of median 1999 charges; and 168.4 (7) a dental provider shall be reimbursed for the dental 168.5 services actually provided to a patient when the dental work 168.6 scheduled requires more than one appointment and the patient 168.7 fails to keep the subsequent appointment or appointments. 168.8 (c) Effective for dental services provided on or after 168.9 January 1, 2002, the commissioner may increase reimbursement to 168.10 dentists or dental clinics designated by the commissioner as 168.11 critical access providers. The commissioner may increase 168.12 reimbursement to a critical access provider by up to 30 percent 168.13 more than would otherwise be paid to that provider. In 168.14 determining critical access provider status, the commissioner 168.15 shall review: 168.16 (1) the utilization rate for dental services by Minnesota 168.17 health care program patients in the service area; 168.18 (2) the level of service provided to Minnesota health care 168.19 program patients by the dentist or dental clinic; and 168.20 (3) whether the level of services provided by the dentist 168.21 or clinic is critical to maintaining an adequate level of access 168.22 for patients in the service area. 168.23 If no provider in a service area is designated a critical access 168.24 provider upon review, the commissioner may designate a dentist 168.25 or dental clinic as a critical access provider if the dentist or 168.26 clinic is willing to provide care to Minnesota health care 168.27 program patients at a level that significantly increases access 168.28 to dental care within the service area. The commissioner shall 168.29 adjust payments to prepaid health plans to reflect increased 168.30 reimbursement to critical access providers under this paragraph 168.31 effective January 1, 2002. 168.32 (d) An entity that operates both a Medicare certified 168.33 comprehensive outpatient rehabilitation facility and a facility 168.34 which was certified prior to January 1, 1993, that is licensed 168.35 under Minnesota Rules, parts 9570.2000 to 9570.3600, and for 168.36 whom at least 33 percent of the clients receiving rehabilitation 169.1 services and mental health services in the most recent calendar 169.2 year are medical assistance recipients, shall be reimbursed by 169.3 the commissioner for rehabilitation services and mental health 169.4 services at rates that are 38 percent greater than the maximum 169.5 reimbursement rate allowed under paragraph (a), clause (2), when 169.6 those services are (1) provided within the comprehensive 169.7 outpatient rehabilitation facility and (2) provided to residents 169.8 of nursing facilities owned by the entity. 169.9 Sec. 55. [256B.78] [MEDICAL ASSISTANCE DEMONSTRATION 169.10 PROJECT FOR FAMILY PLANNING SERVICES.] 169.11 (a) The commissioner of human services shall establish a 169.12 medical assistance demonstration project to determine whether 169.13 improved access to coverage of prepregnancy family planning 169.14 services reduces medical assistance and MFIP costs. 169.15 (b) This section is effective upon federal approval of the 169.16 demonstration project. 169.17 Sec. 56. [256B.79] [HEALTH CARE PREVENTIVE SERVICES POOL.] 169.18 The commissioner of human services shall create an 169.19 uncompensated care pool to reimburse community clinics and other 169.20 health care providers that provide initial health care 169.21 screenings and preventive care services to children who are 169.22 uninsured. The commissioner shall establish a process for 169.23 clinics to apply for reimbursement. As a condition of receiving 169.24 payment from this pool, the clinic or provider must offer 169.25 services ranging from providing information up to on-site 169.26 enrollment. 169.27 Sec. 57. Minnesota Statutes 2000, section 256J.31, 169.28 subdivision 12, is amended to read: 169.29 Subd. 12. [RIGHT TO DISCONTINUE CASH ASSISTANCE.] A 169.30 participant who is not in vendor payment status may discontinue 169.31 receipt of the cash assistance portion of the MFIP assistance 169.32 grant and retain eligibility for child care assistance under 169.33 section 119B.05and for medical assistance under sections169.34256B.055, subdivision 3a, and 256B.0635. For the months a 169.35 participant chooses to discontinue the receipt of the cash 169.36 portion of the MFIP grant, the assistance unit accrues months of 170.1 eligibility to be applied toward eligibility for child care 170.2 under section 119B.05and for medical assistance under sections170.3256B.055, subdivision 3a, and 256B.0635. 170.4 [EFFECTIVE DATE.] This section is effective July 1, 2002. 170.5 Sec. 58. Minnesota Statutes 2000, section 256K.03, 170.6 subdivision 1, is amended to read: 170.7 Subdivision 1. [NOTIFICATION OF PROGRAM.] Except for the 170.8 provisions in this section, the provisions for the MFIP 170.9 application process shall be followed. Within two days after 170.10 receipt of a completed combined application form, the county 170.11 agency must refer to the provider the applicant who meets the 170.12 conditions under section 256K.02, and notify the applicant in 170.13 writing of the program including the following provisions: 170.14 (1) notification that, as part of the application process, 170.15 applicants are required to attend orientation, to be followed 170.16 immediately by a job search; 170.17 (2) the program provider, the date, time, and location of 170.18 the scheduled program orientation; 170.19 (3) the procedures for qualifying for and receiving 170.20 benefits under the program; 170.21 (4) the immediate availability of supportive services, 170.22 including, but not limited to, child care, transportation, 170.23medical assistance,and other work-related aid; and 170.24 (5) the rights, responsibilities, and obligations of 170.25 participants in the program, including, but not limited to, the 170.26 grounds for exemptions and deferrals, the consequences for 170.27 refusing or failing to participate fully, and the appeal process. 170.28 [EFFECTIVE DATE.] This section is effective July 1, 2002. 170.29 Sec. 59. Minnesota Statutes 2000, section 256K.07, is 170.30 amended to read: 170.31 256K.07 [ELIGIBILITY FOR FOOD STAMPS, MEDICAL ASSISTANCE,170.32 AND CHILD CARE.] 170.33 The participant shall be treated as an MFIP recipient for 170.34 food stamps, medical assistance,and child care eligibility 170.35 purposes. The participant who leaves the program as a result of 170.36 increased earnings from employment shall be eligible for 171.1transitional medical assistance andchild care without regard to 171.2 MFIP receipt in three of the six months preceding ineligibility. 171.3 [EFFECTIVE DATE.] This section is effective July 1, 2002. 171.4 Sec. 60. Minnesota Statutes 2000, section 256L.01, 171.5 subdivision 4, is amended to read: 171.6 Subd. 4. [GROSS INDIVIDUAL OR GROSS FAMILY INCOME.] (a) 171.7 "Gross individual or gross family income" forfarm andnonfarm 171.8 self-employed means income calculated using as the baseline the 171.9 adjusted gross income reported on the applicant's federal income 171.10 tax form for the previous year and adding back in reported 171.11 depreciation, carryover loss, and net operating loss amounts 171.12 that apply to the business in which the family is currently 171.13 engaged. 171.14 (b) "Gross individual or gross family income" for farm 171.15 self-employed means income calculated using as the baseline the 171.16 adjusted gross income reported on the applicant's federal income 171.17 tax form for the previous year and adding back in reported 171.18 depreciation amounts that apply to the business in which the 171.19 family is currently engaged. 171.20 (c) Applicants shall report the most recent financial 171.21 situation of the family if it has changed from the period of 171.22 time covered by the federal income tax form. The report may be 171.23 in the form of percentage increase or decrease. 171.24 [EFFECTIVE DATE.] This section is effective July 1, 2001, 171.25 or upon receipt of federal approval, whichever is later. 171.26 Sec. 61. Minnesota Statutes 2000, section 256L.02, 171.27 subdivision 4, is amended to read: 171.28 Subd. 4. [FUNDING FOR PREGNANT WOMEN AND CHILDRENUNDER171.29AGE TWO.] (a) For fiscal years beginning on or after July 1, 171.30 1999, the state cost of health care services provided to 171.31 MinnesotaCare enrollees who are pregnant women or children under 171.32 age two shall be paid out of the general fund rather than the 171.33 health care access fund. If the commissioner of finance decides 171.34 to pay for these costs using a source other than the general 171.35 fund, the commissioner shall include the change as a budget 171.36 initiative in the biennial or supplemental budget, and shall not 172.1 change the funding source through a forecast modification. 172.2 (b) For fiscal years beginning on or after July 1, 2002, 172.3 the state cost of health care services provided to MinnesotaCare 172.4 enrollees who are children under age 19 whose gross family 172.5 income is equal to or less than 185 percent of the federal 172.6 poverty guidelines shall be paid out of the general fund rather 172.7 than the health care access fund. 172.8 [EFFECTIVE DATE.] This section is effective July 1, 2001. 172.9 Sec. 62. Minnesota Statutes 2000, section 256L.04, 172.10 subdivision 2, is amended to read: 172.11 Subd. 2. [COOPERATION IN ESTABLISHING THIRD-PARTY 172.12 LIABILITY, PATERNITY, AND OTHER MEDICAL SUPPORT.] (a) To be 172.13 eligible for MinnesotaCare, individuals and families must 172.14 cooperate with the state agency to identify potentially liable 172.15 third-party payers and assist the state in obtaining third-party 172.16 payments. "Cooperation" includes, but is not limited to, 172.17 identifying any third party who may be liable for care and 172.18 services provided under MinnesotaCare to the enrollee, providing 172.19 relevant information to assist the state in pursuing a 172.20 potentially liable third party, and completing forms necessary 172.21 to recover third-party payments. For a child through age 18 172.22 whose gross family income is equal to or less than 225 percent 172.23 of the federal poverty guidelines, cooperation also includes 172.24 providing information about a group health plan in which the 172.25 child is enrolled or eligible to enroll. If the health plan is 172.26 determined cost-effective by the state agency and premiums are 172.27 paid by the state or local agency or there is no cost to the 172.28 enrollee, the MinnesotaCare enrollee must enroll or remain 172.29 enrolled in the group health plan, and the commissioner may 172.30 exempt the enrollee from the requirements of section 256L.12. 172.31 For purposes of this subdivision, coverage provided by the 172.32 Minnesota comprehensive health association under chapter 62E 172.33 shall not be considered group health plan coverage or 172.34 cost-effective by the state and local agency. 172.35 (b) A parent, guardian, relative caretaker, or child 172.36 enrolled in the MinnesotaCare program must cooperate with the 173.1 department of human services and the local agency in 173.2 establishing the paternity of an enrolled child and in obtaining 173.3 medical care support and payments for the child and any other 173.4 person for whom the person can legally assign rights, in 173.5 accordance with applicable laws and rules governing the medical 173.6 assistance program. A child shall not be ineligible for or 173.7 disenrolled from the MinnesotaCare program solely because the 173.8 child's parent, relative caretaker, or guardian fails to 173.9 cooperate in establishing paternity or obtaining medical support. 173.10 [EFFECTIVE DATE.] This section is effective July 1, 2002. 173.11 Sec. 63. Minnesota Statutes 2000, section 256L.05, 173.12 subdivision 2, is amended to read: 173.13 Subd. 2. [COMMISSIONER'S DUTIES.] The commissionershall173.14use individuals' social security numbers as identifiers for173.15purposes of administering the plan and conduct data matches to173.16verify income. Applicants shall submit evidence of individual173.17and family income, earned and unearned, such as the most recent173.18income tax return, wage slips, or other documentation that is173.19determined by the commissioner as necessary to verify income173.20eligibilityor county agency shall use electronic verification 173.21 as the primary method of income verification. If there is a 173.22 discrepancy in the electronic verification, an individual may be 173.23 required to submit additional verification. In addition, the 173.24 commissioner shall perform random audits to verify reported 173.25 income and eligibility. The commissioner may execute data 173.26 sharing arrangements with the department of revenue and any 173.27 other governmental agency in order to perform income 173.28 verification related to eligibility and premium payment under 173.29 the MinnesotaCare program. 173.30 Sec. 64. Minnesota Statutes 2000, section 256L.06, 173.31 subdivision 3, is amended to read: 173.32 Subd. 3. [ADMINISTRATION AND COMMISSIONER'S DUTIES.] (a) 173.33 Premiums are dedicated to the commissioner for MinnesotaCare. 173.34 (b) The commissioner shall develop and implement procedures 173.35 to: (1) require enrollees to report changes in income; (2) 173.36 adjust sliding scale premium payments, based upon changes in 174.1 enrollee income; and (3) disenroll enrollees from MinnesotaCare 174.2 for failure to pay required premiums. Failure to pay includes 174.3 payment with a dishonored check, a returned automatic bank 174.4 withdrawal, or a refused credit card or debit card payment. The 174.5 commissioner may demand a guaranteed form of payment, including 174.6 a cashier's check or a money order, as the only means to replace 174.7 a dishonored, returned, or refused payment. 174.8 (c) Premiums are calculated on a calendar month basis and 174.9 may be paid on a monthly, quarterly, or annual basis, with the 174.10 first payment due upon notice from the commissioner of the 174.11 premium amount required. The commissioner shall inform 174.12 applicants and enrollees of these premium payment options. 174.13 Premium payment is required before enrollment is complete and to 174.14 maintain eligibility in MinnesotaCare. 174.15 (d) Nonpayment of the premium will result in disenrollment 174.16 from the planwithin one calendar month after the due date174.17 effective for the calendar month for which the premium was due. 174.18 Persons disenrolled for nonpayment or who voluntarily terminate 174.19 coverage from the program may not reenroll until four calendar 174.20 months have elapsed. Persons disenrolled for nonpayment who pay 174.21 all past due premiums as well as current premiums due, including 174.22 premiums due for the period of disenrollment, within 20 days of 174.23 disenrollment, shall be reenrolled retroactively to the first 174.24 day of disenrollment. Persons disenrolled for nonpayment or who 174.25 voluntarily terminate coverage from the program may not reenroll 174.26 for four calendar months unless the person demonstrates good 174.27 cause for nonpayment. Good cause does not exist if a person 174.28 chooses to pay other family expenses instead of the premium. 174.29 The commissioner shall define good cause in rule. 174.30 [EFFECTIVE DATE.] This section is effective July 1, 2002. 174.31 Sec. 65. Minnesota Statutes 2000, section 256L.07, 174.32 subdivision 1, is amended to read: 174.33 Subdivision 1. [GENERAL REQUIREMENTS.] (a) Children 174.34 enrolled in the original children's health plan as of September 174.35 30, 1992, and children who enrolled in the MinnesotaCare program 174.36 after September 30, 1992, pursuant to Laws 1992, chapter 549, 175.1 article 4, section 17, who have maintained continuous coverage 175.2 in the MinnesotaCare program or medical assistance; and children 175.3 under two; pregnant women; and children through age 18 who have 175.4 family gross incomes that are equal to or less than150225 175.5 percent of the federal poverty guidelines are eligible without 175.6 meeting the requirements ofsubdivision 2, as long as they175.7maintain continuous coverage in the MinnesotaCare program or175.8medical assistance. Children who apply for MinnesotaCare on or175.9after the implementation date of the employer-subsidized health175.10coverage program as described in Laws 1998, chapter 407, article175.115, section 45, who have family gross incomes that are equal to175.12or less than 150 percent of the federal poverty guidelines, must175.13meet the requirements of subdivision 2 to be eligible for175.14MinnesotaCaresubdivisions 2 and 3. 175.15 (b) Families enrolled in MinnesotaCare under section 175.16 256L.04, subdivision 1, whose income increases above 275 percent 175.17 of the federal poverty guidelines, are no longer eligible for 175.18 the program and shall be disenrolled by the commissioner. 175.19 Individuals enrolled in MinnesotaCare under section 256L.04, 175.20 subdivision 7, whose income increases above 175 percent of the 175.21 federal poverty guidelines are no longer eligible for the 175.22 program and shall be disenrolled by the commissioner. For 175.23 persons disenrolled under this subdivision, MinnesotaCare 175.24 coverage terminates the last day of the calendar month following 175.25 the month in which the commissioner determines that the income 175.26 of a family or individual exceeds program income limits. 175.27 (c) Notwithstanding paragraph (b), individuals and families 175.28 may remain enrolled in MinnesotaCare if ten percent of their 175.29 annual income is less than the annual premium for a policy with 175.30 a $500 deductible available through the Minnesota comprehensive 175.31 health association. Individuals and families who are no longer 175.32 eligible for MinnesotaCare under this subdivision shall be given 175.33 an 18-month notice period from the date that ineligibility is 175.34 determined before disenrollment. 175.35 [EFFECTIVE DATE.] This section is effective July 1, 2002. 175.36 Sec. 66. Minnesota Statutes 2000, section 256L.07, 176.1 subdivision 2, is amended to read: 176.2 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 176.3 COVERAGE.] (a) To be eligible, a family or individual must not 176.4 have access to subsidized health coverage through an employer 176.5 and must not have had access to employer-subsidized coverage 176.6 through a current employer for 18 months prior to application or 176.7 reapplication. A family or individual whose employer-subsidized 176.8 coverage is lost due to an employer terminating health care 176.9 coverage as an employee benefit during the previous 18 months is 176.10 not eligible. 176.11 (b) This subdivision does not apply to a family or 176.12 individual who was enrolled in MinnesotaCare within six months 176.13 or less of reapplication and who no longer has 176.14 employer-subsidized coverage due to the employer terminating 176.15 health care coverage as an employee benefit. 176.16 (c) For purposes of thisrequirementsubdivision, 176.17 subsidized health coverage means health coverage for which the 176.18 employer pays at least5060 percent of the cost of coverage for 176.19 the employee or dependent, or a higher percentage as specified 176.20 by the commissioner. Children are eligible for 176.21 employer-subsidized coverage through either parent, including 176.22 the noncustodial parent. The commissioner must treat employer 176.23 contributions to Internal Revenue Code Section 125 plans and any 176.24 other employer benefits intended to pay health care costs as 176.25 qualified employer subsidies toward the cost of health coverage 176.26 for employees for purposes of this subdivision. 176.27 Sec. 67. Minnesota Statutes 2000, section 256L.07, 176.28 subdivision 3, is amended to read: 176.29 Subd. 3. [OTHER HEALTH COVERAGE.] (a) Families and 176.30 individuals enrolled in the MinnesotaCare program must have no 176.31 health coverage while enrolled or for at least four months prior 176.32 to application and renewal.Children enrolled in the original176.33children's health plan and children in families with income176.34equal to or less than 150 percent of the federal poverty176.35guidelines, who have other health insurance, are eligible if the176.36coverage:177.1(1) lacks two or more of the following:177.2(i) basic hospital insurance;177.3(ii) medical-surgical insurance;177.4(iii) prescription drug coverage;177.5(iv) dental coverage; or177.6(v) vision coverage;177.7(2) requires a deductible of $100 or more per person per177.8year; or177.9(3) lacks coverage because the child has exceeded the177.10maximum coverage for a particular diagnosis or the policy177.11excludes a particular diagnosis.177.12 The commissioner may change this eligibility criterion for 177.13 sliding scale premiums in order to remain within the limits of 177.14 available appropriations. The requirement of no health coverage 177.15 does not apply to newborns. 177.16 (b) Medical assistance, general assistance medical care, 177.17 and civilian health and medical program of the uniformed 177.18 service, CHAMPUS, are not considered insurance or health 177.19 coverage for purposes of the four-month requirement described in 177.20 this subdivision. 177.21 (c) For purposes of this subdivision, Medicare Part A or B 177.22 coverage under title XVIII of the Social Security Act, United 177.23 States Code, title 42, sections 1395c to 1395w-4, is considered 177.24 health coverage. An applicant or enrollee may not refuse 177.25 Medicare coverage to establish eligibility for MinnesotaCare. 177.26 (d) Applicants who were recipients of medical assistance or 177.27 general assistance medical care within one month of application 177.28 must meet the provisions of this subdivision and subdivision 2. 177.29 [EFFECTIVE DATE.] This section is effective July 1, 2002. 177.30 Sec. 68. Minnesota Statutes 2000, section 256L.07, is 177.31 amended by adding a subdivision to read: 177.32 Subd. 5. [EXEMPTION FOR PERSONS WITH CONTINUATION 177.33 COVERAGE.] (a) Families with children and individuals who apply 177.34 for the MinnesotaCare program upon termination from continuation 177.35 coverage required under federal or state law are exempt from the 177.36 requirements of subdivision 3. 178.1 (b) For purposes of paragraph (a), "termination from 178.2 continuation coverage" means involuntary termination for any 178.3 reason, other than premium nonpayment by the family or 178.4 individual, including termination due to reaching the end of the 178.5 maximum period for continuation coverage required under federal 178.6 or state law. 178.7 Sec. 69. Minnesota Statutes 2000, section 256L.07, is 178.8 amended by adding a subdivision to read: 178.9 Subd. 6. [EXEMPTION FOR PERSONS LOSING COVERAGE AS A 178.10 DEPENDENT.] Individuals who apply for the MinnesotaCare program 178.11 upon termination of other health coverage due to loss of status 178.12 as a dependent are exempt from the requirements of subdivision 3. 178.13 Sec. 70. Minnesota Statutes 2000, section 256L.12, is 178.14 amended by adding a subdivision to read: 178.15 Subd. 11. [AMERICAN INDIAN ENROLLEES.] For American Indian 178.16 enrollees, MinnesotaCare shall cover health care services 178.17 provided at Indian Health Service facilities and facilities 178.18 operated by a tribe or tribal organization under funding 178.19 authorized by United States Code, title 25, sections 450f to 178.20 450n, or title III of the Indian Self-Determination and 178.21 Education Assistance Act, Public Law Number 93-638, if those 178.22 services would otherwise be covered under section 256L.03. 178.23 Payments for services provided under this subdivision shall be 178.24 made on a fee-for-service basis, and may, at the option of the 178.25 tribe or tribal organization, be made at the rates authorized 178.26 under sections 256.969, subdivision 16, and 256B.0625, 178.27 subdivision 34, for those MinnesotaCare enrollees eligible for 178.28 coverage at medical assistance rates. For purposes of this 178.29 subdivision, "American Indian" has the meaning given to persons 178.30 to whom services will be provided in the Code of Federal 178.31 Regulations, title 42, section 36.12. 178.32 Sec. 71. Minnesota Statutes 2000, section 256L.15, 178.33 subdivision 1, is amended to read: 178.34 Subdivision 1. [PREMIUM DETERMINATION.] (a) Except as 178.35 provided in paragraph (b), families with children and 178.36 individuals shall pay a premium determined according to a 179.1 sliding fee based on a percentage of the family's gross family 179.2 income. 179.3 (b) Children in households with family income equal to or 179.4 less than 225 percent of the federal poverty guidelines and the 179.5 parents and relative caretakers of children under the age of 21 179.6 in households with family income equal to or less than 120 179.7 percent of the federal poverty guidelines are exempt from paying 179.8 a premium. Pregnant women and children under age two are exempt 179.9 from the provisions of section 256L.06, subdivision 3, paragraph 179.10 (b), clause (3), requiring disenrollment for failure to pay 179.11 premiums. For pregnant women, this exemption continues until 179.12 the first day of the month following the 60th day postpartum. 179.13 Women who remain enrolled during pregnancy or the postpartum 179.14 period, despite nonpayment of premiums, shall be disenrolled on 179.15 the first of the month following the 60th day postpartum for the 179.16 penalty period that otherwise applies under section 256L.06, 179.17 unless they begin paying premiums. 179.18 Sec. 72. Minnesota Statutes 2000, section 256L.15, 179.19 subdivision 2, is amended to read: 179.20 Subd. 2. [SLIDING FEE SCALE TO DETERMINE PERCENTAGE OF 179.21 GROSS INDIVIDUAL OR FAMILY INCOME.] (a) The commissioner shall 179.22 establish a sliding fee scale to determine the percentage of 179.23 gross individual or family income that households at different 179.24 income levels must pay to obtain coverage through the 179.25 MinnesotaCare program. The sliding fee scale must be based on 179.26 the enrollee's gross individual or family income. The sliding 179.27 fee scale must contain separate tables based on enrollment of 179.28 one, two, or three or more persons. For single adults and 179.29 families without children, the sliding fee scale begins with a 179.30 premium of 1.5 percent of grossindividual orfamily incomefor179.31individuals or families with incomes below the limits for the179.32medical assistance program for families and children in effect179.33on January 1, 1999,and proceeds through the following evenly 179.34 spaced steps: 1.8, 2.3, 3.1, 3.8, 4.8, 5.9, 7.4, and 8.8 179.35 percent. For families with children, the sliding fee scale 179.36 begins with a premium of 1.5 percent of gross family income with 180.1 incomes below the children in effect on January 1, 1999, and 180.2 proceeds through following evenly spaced steps: 1.8, 2.3, 3.1, 180.3 and 5.0 percent. These percentages are matched to evenly spaced 180.4 income steps ranging from the medical assistance income limit 180.5 for families and children in effect on January 1, 1999, to 275 180.6 percent of the federal poverty guidelines for the applicable 180.7 family size, up to a family size of five. The sliding fee scale 180.8 for a family of five must be used for families of more than five. 180.9 The sliding fee scale and percentages are not subject to the 180.10 provisions of chapter 14. If a family or individual reports 180.11 increased income after enrollment, premiums shall not be 180.12 adjusted until eligibility renewal. 180.13 (b) Enrolled individuals and families whose gross annual 180.14 income increases above 275 percent of the federal poverty 180.15 guideline shall pay the maximum premium. The maximum premium is 180.16 defined as a base charge for one, two, or three or more 180.17 enrollees so that if all MinnesotaCare cases paid the maximum 180.18 premium, the total revenue would equal the total cost of 180.19 MinnesotaCare medical coverage and administration. In this 180.20 calculation, administrative costs shall be assumed to equal ten 180.21 percent of the total. The costs of medical coverage for 180.22 pregnant women and children under age two and the enrollees in 180.23 these groups shall be excluded from the total. The maximum 180.24 premium for two enrollees shall be twice the maximum premium for 180.25 one, and the maximum premium for three or more enrollees shall 180.26 be three times the maximum premium for one. 180.27 Sec. 73. Minnesota Statutes 2000, section 256L.16, is 180.28 amended to read: 180.29 256L.16 [PAYMENT RATES; SERVICES FOR FAMILIES AND CHILDREN 180.30 UNDER THE MINNESOTACARE HEALTH CARE REFORM WAIVER.] 180.31 Section 256L.11, subdivision 2, shall not apply to services 180.32 provided tochildrenfamilies with children who are eligibleto180.33receive expanded servicesaccording to section256L.03,180.34subdivision 1a256L.04, subdivision 1a. 180.35 Sec. 74. Laws 1999, chapter 245, article 4, section 110, 180.36 is amended to read: 181.1 Sec. 110. [PROGRAMS FOR SENIOR CITIZENS.] 181.2 The commissioner of human services shall study the 181.3 eligibility criteria of and benefits provided to persons age 65 181.4 and over through the array of cash assistance and health care 181.5 programs administered by the department, and the extent to which 181.6 these programs can be combined, simplified, or coordinated to 181.7 reduce administrative costs and improve access. The 181.8 commissioner shall also study potential barriers to enrollment 181.9 for low-income seniors who would otherwise deplete resources 181.10 necessary to maintain independent community living. At a 181.11 minimum, the study must include an evaluation of asset 181.12 requirements and enrollment sites. The commissioner shall 181.13 report study findings and recommendations to the legislature by 181.14June 30, 2001January 15, 2002. 181.15 Sec. 75. [EXPAND DENTAL AUXILIARY PERSONNEL; 181.16 FOREIGN-TRAINED DENTISTS; DENTAL CLINICS.] 181.17 Subdivision 1. [DEVELOPMENT.] (a) The board of dentistry, 181.18 in consultation with the University of Minnesota school of 181.19 dentistry, the Minnesota state colleges and universities that 181.20 offer a dental auxiliary training program, the commissioner of 181.21 health, and licensed dentists and dental auxiliaries practicing 181.22 in private practice and at community clinics, shall develop new 181.23 expanded duties for registered dental assistants and dental 181.24 hygienists. The new duties must be performed under direct or 181.25 indirect supervision of a licensed dentist and must include 181.26 selected technical dental services. These expanded duties must 181.27 be limited to reversible procedures, including, but not be 181.28 limited to, placement, contouring, and adjustment of amalgam, 181.29 composite, glass ionomer, and temporary restoration; pit and 181.30 fissure sealants; and the adaptation and cementation of 181.31 stainless steel crowns for primary teeth. These expanded duties 181.32 shall not include or imply a diagnosis or treatment plan, nor 181.33 include prescribing medications, cutting hard or soft tissue, or 181.34 any direct patient care in which formal training has not been 181.35 completed. The board shall establish a standard of practice and 181.36 necessary educational qualifications for certification to 182.1 perform the new duties. 182.2 (b) The board shall make recommendations to amend Minnesota 182.3 Statutes, chapter 150A, to permit a foreign-trained dentist to 182.4 practice as a dental hygienist or as a registered dental 182.5 assistant. 182.6 (c) The board shall submit the proposed changes to 182.7 Minnesota Statutes, chapter 150A, to the legislature by January 182.8 15, 2002. 182.9 Subd. 2. [DENTAL CLINICS.] The commissioner of health, in 182.10 consultation with the Minnesota state colleges and universities, 182.11 shall determine the capital improvements needed to establish 182.12 community-based dental clinics at state colleges and 182.13 universities to be used as training sites and as public 182.14 community-based dental clinics for public program recipients 182.15 during times when the school is not in session and the clinic is 182.16 not in use. The commissioner shall submit the necessary capital 182.17 improvement costs for start-up equipment and necessary 182.18 infrastructure as part of the 2002 legislative capital budget 182.19 requests. 182.20 Sec. 76. [FEDERAL WAIVER REQUEST.] 182.21 The commissioner of human services shall seek federal 182.22 approval to expand the medical assistance program to provide 182.23 access to discounted prices for prescription drugs to Medicare 182.24 beneficiaries with no prescription drug coverage. Individuals 182.25 in this expanded coverage group shall receive a discount for 182.26 prescription drugs equal to the average rebate paid to the 182.27 medical assistance program by pharmaceutical manufacturers. 182.28 Upon receipt of the waiver, the commissioner shall submit a 182.29 proposal to the legislature for implementation of this expansion 182.30 to individuals with income at or below 200 percent of the 182.31 federal poverty guidelines. 182.32 Sec. 77. [HEALTH STATUS IMPROVEMENT GRANTS.] 182.33 The commissioner of human services shall award grants to 182.34 improve the quality of health care services provided to 182.35 children. Priority shall be given to grant applications that: 182.36 (1) develop "best practices guidelines" for primary and 183.1 preventative health care services to all children in Minnesota, 183.2 regardless of payor; 183.3 (2) design and implement community-based education and 183.4 evaluation programs for physicians and other direct care 183.5 providers to implement best practice guidelines; and 183.6 (3) reduce disparities in access to health care services 183.7 and in health status of Minnesota children. 183.8 Sec. 78. [NOTICE OF PREMIUM CHANGES IN THE EMPLOYED 183.9 PERSONS WITH DISABILITIES PROGRAM.] 183.10 The commissioner of human services shall provide notice to 183.11 all medical assistance recipients receiving coverage through the 183.12 employed persons with disabilities program under Minnesota 183.13 Statutes, section 256B.057, subdivision 9, of the first new 183.14 premium schedule in effect on September 1, 2001, at least two 183.15 months before the month in which the first new premium is due. 183.16 Sec. 79. [REPEALER.] 183.17 (a) Minnesota Statutes 2000, section 256.955, subdivision 183.18 2b, is repealed effective January 1, 2002. 183.19 (b) Minnesota Statutes 2000, sections 256B.0635, 183.20 subdivision 3; and 256L.15, subdivision 3, are repealed 183.21 effective July 1, 2002. 183.22 ARTICLE 4 183.23 CONTINUING CARE 183.24 Section 1. Minnesota Statutes 2000, section 245A.13, 183.25 subdivision 7, is amended to read: 183.26 Subd. 7. [RATE RECOMMENDATION.] The commissioner of human 183.27 services may review rates of a residential program participating 183.28 in the medical assistance program which is in receivership and 183.29 that has needs or deficiencies documented by the department of 183.30 health or the department of human services. If the commissioner 183.31 of human services determines that a review of the rate 183.32 established undersection 256B.501sections 256B.5012 and 183.33 256B.5013 is needed, the commissioner shall: 183.34 (1) review the order or determination that cites the 183.35 deficiencies or needs; and 183.36 (2) determine the need for additional staff, additional 184.1 annual hours by type of employee, and additional consultants, 184.2 services, supplies, equipment, repairs, or capital assets 184.3 necessary to satisfy the needs or deficiencies. 184.4 Sec. 2. Minnesota Statutes 2000, section 245A.13, 184.5 subdivision 8, is amended to read: 184.6 Subd. 8. [ADJUSTMENT TO THE RATE.] Upon review of rates 184.7 under subdivision 7, the commissioner may adjust the residential 184.8 program's payment rate. The commissioner shall review the 184.9 circumstances, together with the residentialprogram cost report184.10 program's most recent income and expense report, to determine 184.11 whether or not the deficiencies or needs can be corrected or met 184.12 by reallocating residential program staff, costs, revenues, 184.13 or any other resources includinganyinvestments, efficiency184.14incentives, or allowances. If the commissioner determines that 184.15 any deficiency cannot be corrected or the need cannot be met 184.16 with the payment rate currently being paid, the commissioner 184.17 shall determine the payment rate adjustment by dividing the 184.18 additional annual costs established during the commissioner's 184.19 review by the residential program's actual resident days from 184.20 the most recentdesk-audited costincome and expense report or 184.21 the estimated resident days in the projected receivership 184.22 period. The payment rate adjustmentmust meet the conditions in184.23Minnesota Rules, parts 9553.0010 to 9553.0080, andremains in 184.24 effect during the period of the receivership or until another 184.25 date set by the commissioner. Upon the subsequent sale, 184.26 closure, or transfer of the residential program, the 184.27 commissioner may recover amounts that were paid as payment rate 184.28 adjustments under this subdivision. This recovery shall be 184.29 determined through a review of actual costs and resident days in 184.30 the receivership period. The costs the commissioner finds to be 184.31 allowable shall be divided by the actual resident days for the 184.32 receivership period. This rate shall be compared to the rate 184.33 paid throughout the receivership period, with the difference 184.34 multiplied by resident days, being the amount to be repaid to 184.35 the commissioner. Allowable costs shall be determined by the 184.36 commissioner as those ordinary, necessary, and related to 185.1 resident care by prudent and cost-conscious management. The 185.2 buyer or transferee shall repay this amount to the commissioner 185.3 within 60 days after the commissioner notifies the buyer or 185.4 transferee of the obligation to repay. This provision does not 185.5 limit the liability of the seller to the commissioner pursuant 185.6 to section 256B.0641. 185.7 Sec. 3. Minnesota Statutes 2000, section 252.275, 185.8 subdivision 4b, is amended to read: 185.9 Subd. 4b. [GUARANTEED FLOOR.] Each countywith an original185.10allocation for the preceding year that is equal to or less than185.11the guaranteed floor minimum index shall have a guaranteed floor185.12equal to its original allocation for the preceding year. Each185.13county with an original allocation for the preceding year that185.14is greater than the guaranteed floor minimum indexshall have a 185.15 guaranteed floor equal to the lesser of clause (1) or (2): 185.16 (1) the county's original allocation for the preceding 185.17 year; or 185.18 (2) 70 percent of the county's reported expenditures 185.19 eligible for reimbursement during the 12 months ending on June 185.20 30 of the preceding calendar year. 185.21For calendar year 1993, the guaranteed floor minimum index185.22shall be $20,000. For each subsequent year, the index shall be185.23adjusted by the projected change in the average value in the185.24United States Department of Labor Bureau of Labor Statistics185.25consumer price index (all urban) for that year.185.26 Notwithstanding this subdivision, no county shall be 185.27 allocated a guaranteed floor of less than $1,000. 185.28 When the amount of funds available for allocation is less 185.29 than the amount available in the previous year, each county's 185.30 previous year allocation shall be reduced in proportion to the 185.31 reduction in the statewide funding, to establish each county's 185.32 guaranteed floor. 185.33 Sec. 4. Minnesota Statutes 2000, section 254B.03, 185.34 subdivision 1, is amended to read: 185.35 Subdivision 1. [LOCAL AGENCY DUTIES.] (a) Every local 185.36 agency shall provide chemical dependency services to persons 186.1 residing within its jurisdiction who meet criteria established 186.2 by the commissioner for placement in a chemical dependency 186.3 residential or nonresidential treatment service. Chemical 186.4 dependency money must be administered by the local agencies 186.5 according to law and rules adopted by the commissioner under 186.6 sections 14.001 to 14.69. 186.7 (b) In order to contain costs, the county board shall, with 186.8 the approval of the commissioner of human services, select 186.9 eligible vendors of chemical dependency services who can provide 186.10 economical and appropriate treatment. Unless the local agency 186.11 is a social services department directly administered by a 186.12 county or human services board, the local agency shall not be an 186.13 eligible vendor under section 254B.05. The commissioner may 186.14 approve proposals from county boards to provide services in an 186.15 economical manner or to control utilization, with safeguards to 186.16 ensure that necessary services are provided. If a county 186.17 implements a demonstration or experimental medical services 186.18 funding plan, the commissioner shall transfer the money as 186.19 appropriate. If a county selects a vendor located in another 186.20 state, the county shall ensure that the vendor is in compliance 186.21 with the rules governing licensure of programs located in the 186.22 state. 186.23 (c) The calendar year19982002 rate for vendors may not 186.24 increase more thanthree3.5 percent above the rate approved in 186.25 effect on January 1,19972001. The calendar year19992003 186.26 rate for vendors may not increase more thanthree3.5 percent 186.27 above the rate in effect on January 1,19982002. 186.28 (d) A culturally specific vendor that provides assessments 186.29 under a variance under Minnesota Rules, part 9530.6610, shall be 186.30 allowed to provide assessment services to persons not covered by 186.31 the variance. 186.32 Sec. 5. Minnesota Statutes 2000, section 254B.09, is 186.33 amended by adding a subdivision to read: 186.34 Subd. 8. [PAYMENTS TO IMPROVE SERVICES TO AMERICAN 186.35 INDIANS.] The commissioner may set rates for chemical dependency 186.36 services according to the American Indian Health Improvement 187.1 Act, Public Law Number 94-437, for eligible vendors. These 187.2 rates shall supersede rates set in county purchase of service 187.3 agreements when payments are made on behalf of clients eligible 187.4 according to Public Law Number 94-437. 187.5 Sec. 6. Minnesota Statutes 2000, section 256.01, is 187.6 amended by adding a subdivision to read: 187.7 Subd. 19. [GRANTS FOR CASE MANAGEMENT SERVICES TO PERSONS 187.8 WITH HIV OR AIDS.] The commissioner may award grants to eligible 187.9 vendors for the development, implementation, and evaluation of 187.10 case management services for individuals infected with the human 187.11 immunodeficiency virus. HIV/AIDs case management services will 187.12 be provided to increase access to cost effective health care 187.13 services, to reduce the risk of HIV transmission, to ensure that 187.14 basic client needs are met, and to increase client access to 187.15 needed community supports or services. 187.16 Sec. 7. Minnesota Statutes 2000, section 256.476, 187.17 subdivision 1, is amended to read: 187.18 Subdivision 1. [PURPOSE AND GOALS.] The commissioner of 187.19 human services shall establish a consumer support grant 187.20 programto assistfor individuals with functional limitations 187.21 and their familiesin purchasing and securing supports which the187.22individuals need to live as independently and productively in187.23the community as possiblewho wish to purchase and secure their 187.24 own supports. The commissioner and local agencies shall jointly 187.25 develop an implementation plan which must include a way to 187.26 resolve the issues related to county liability. The program 187.27 shall: 187.28 (1) make support grants available to individuals or 187.29 families as an effective alternative to existing programs and 187.30 services, such as the developmental disability family support 187.31 program,the alternative care program,personal care attendant 187.32 services, home health aide services, and private duty nursing 187.33facilityservices; 187.34 (2) provide consumers more control, flexibility, and 187.35 responsibility overthe needed supportstheir services and 187.36 supports; 188.1 (3) promote local program management and decision making; 188.2 and 188.3 (4) encourage the use of informal and typical community 188.4 supports. 188.5 Sec. 8. Minnesota Statutes 2000, section 256.476, 188.6 subdivision 2, is amended to read: 188.7 Subd. 2. [DEFINITIONS.] For purposes of this section, the 188.8 following terms have the meanings given them: 188.9 (a) "County board" means the county board of commissioners 188.10 for the county of financial responsibility as defined in section 188.11 256G.02, subdivision 4, or its designated representative. When 188.12 a human services board has been established under sections 188.13 402.01 to 402.10, it shall be considered the county board for 188.14 the purposes of this section. 188.15 (b) "Family" means the person's birth parents, adoptive 188.16 parents or stepparents, siblings or stepsiblings, children or 188.17 stepchildren, grandparents, grandchildren, niece, nephew, aunt, 188.18 uncle, or spouse. For the purposes of this section, a family 188.19 member is at least 18 years of age. 188.20 (c) "Functional limitations" means the long-term inability 188.21 to perform an activity or task in one or more areas of major 188.22 life activity, including self-care, understanding and use of 188.23 language, learning, mobility, self-direction, and capacity for 188.24 independent living. For the purpose of this section, the 188.25 inability to perform an activity or task results from a mental, 188.26 emotional, psychological, sensory, or physical disability, 188.27 condition, or illness. 188.28 (d) "Informed choice" means a voluntary decision made by 188.29 the person or the person's legal representative, after becoming 188.30 familiarized with the alternatives to: 188.31 (1) select a preferred alternative from a number of 188.32 feasible alternatives; 188.33 (2) select an alternative which may be developed in the 188.34 future; and 188.35 (3) refuse any or all alternatives. 188.36 (e) "Local agency" means the local agency authorized by the 189.1 county board to carry out the provisions of this section. 189.2 (f) "Person" or "persons" means a person or persons meeting 189.3 the eligibility criteria in subdivision 3. 189.4 (g) "Authorized representative" means an individual 189.5 designated by the person or their legal representative to act on 189.6 their behalf. This individual may be a family member, guardian, 189.7 representative payee, or other individual designated by the 189.8 person or their legal representative, if any, to assist in 189.9 purchasing and arranging for supports. For the purposes of this 189.10 section, an authorized representative is at least 18 years of 189.11 age. 189.12 (h) "Screening" means the screening of a person's service 189.13 needs under sections 256B.0911 and 256B.092. 189.14 (i) "Supports" means services, care, aids,home189.15 environmental modifications, or assistance purchased by the 189.16 person or the person's family. Examples of supports include 189.17 respite care, assistance with daily living, andadaptive aids189.18 assistive technology. For the purpose of this section, 189.19 notwithstanding the provisions of section 144A.43, supports 189.20 purchased under the consumer support program are not considered 189.21 home care services. 189.22 (j) "Program of origination" means the program the 189.23 individual transferred from when approved for the consumer 189.24 support grant program. 189.25 Sec. 9. Minnesota Statutes 2000, section 256.476, 189.26 subdivision 3, is amended to read: 189.27 Subd. 3. [ELIGIBILITY TO APPLY FOR GRANTS.] (a) A person 189.28 is eligible to apply for a consumer support grant if the person 189.29 meets all of the following criteria: 189.30 (1) the person is eligible for and has been approved to 189.31 receive services under medical assistance as determined under 189.32 sections 256B.055 and 256B.056or the person is eligible for and189.33has been approved to receive services under alternative care189.34services as determined under section 256B.0913or the person has 189.35 been approved to receive a grant under the developmental 189.36 disability family support program under section 252.32; 190.1 (2) the person is able to direct and purchase the person's 190.2 own care and supports, or the person has a family member, legal 190.3 representative, or other authorized representative who can 190.4 purchase and arrange supports on the person's behalf; 190.5 (3) the person has functional limitations, requires ongoing 190.6 supports to live in the community, and is at risk of or would 190.7 continue institutionalization without such supports; and 190.8 (4) the person will live in a home. For the purpose of 190.9 this section, "home" means the person's own home or home of a 190.10 person's family member. These homes are natural home settings 190.11 and are not licensed by the department of health or human 190.12 services. 190.13 (b) Persons may not concurrently receive a consumer support 190.14 grant if they are: 190.15 (1) receiving home and community-based services under 190.16 United States Code, title 42, section 1396h(c); personal care 190.17 attendant and home health aide services under section 256B.0625; 190.18 a developmental disability family support grant; or alternative 190.19 care services under section 256B.0913; or 190.20 (2) residing in an institutional or congregate care setting. 190.21 (c) A person or person's family receiving a consumer 190.22 support grant shall not be charged a fee or premium by a local 190.23 agency for participating in the program. 190.24 (d) The commissioner may limit the participation ofnursing190.25facility residents, residents of intermediate care facilities190.26for persons with mental retardation, and therecipients of 190.27 services from federal waiver programs in the consumer support 190.28 grant program if the participation of these individuals will 190.29 result in an increase in the cost to the state. 190.30 (e) The commissioner shall establish a budgeted 190.31 appropriation each fiscal year for the consumer support grant 190.32 program. The number of individuals participating in the program 190.33 will be adjusted so the total amount allocated to counties does 190.34 not exceed the amount of the budgeted appropriation. The 190.35 budgeted appropriation will be adjusted annually to accommodate 190.36 changes in demand for the consumer support grants. 191.1 Sec. 10. Minnesota Statutes 2000, section 256.476, 191.2 subdivision 4, is amended to read: 191.3 Subd. 4. [SUPPORT GRANTS; CRITERIA AND LIMITATIONS.] (a) A 191.4 county board may choose to participate in the consumer support 191.5 grant program. If a county board chooses to participate in the 191.6 program, the local agency shall establish written procedures and 191.7 criteria to determine the amount and use of support grants. 191.8 These procedures must include, at least, the availability of 191.9 respite care, assistance with daily living, and adaptive aids. 191.10 The local agency may establish monthly or annual maximum amounts 191.11 for grants and procedures where exceptional resources may be 191.12 required to meet the health and safety needs of the person on a 191.13 time-limited basis, however, the total amount awarded to each 191.14 individual may not exceed the limits established in subdivision 191.15 5, paragraph (f). 191.16 (b) Support grants to a person or a person's family will be 191.17 provided through a monthly subsidy payment and be in the form of 191.18 cash, voucher, or direct county payment to vendor. Support 191.19 grant amounts must be determined by the local agency. Each 191.20 service and item purchased with a support grant must meet all of 191.21 the following criteria: 191.22 (1) it must be over and above the normal cost of caring for 191.23 the person if the person did not have functional limitations; 191.24 (2) it must be directly attributable to the person's 191.25 functional limitations; 191.26 (3) it must enable the person or the person's family to 191.27 delay or prevent out-of-home placement of the person; and 191.28 (4) it must be consistent with the needs identified in the 191.29 service plan, when applicable. 191.30 (c) Items and services purchased with support grants must 191.31 be those for which there are no other public or private funds 191.32 available to the person or the person's family. Fees assessed 191.33 to the person or the person's family for health and human 191.34 services are not reimbursable through the grant. 191.35 (d) In approving or denying applications, the local agency 191.36 shall consider the following factors: 192.1 (1) the extent and areas of the person's functional 192.2 limitations; 192.3 (2) the degree of need in the home environment for 192.4 additional support; and 192.5 (3) the potential effectiveness of the grant to maintain 192.6 and support the person in the family environment or the person's 192.7 own home. 192.8 (e) At the time of application to the program or screening 192.9 for other services, the person or the person's family shall be 192.10 provided sufficient information to ensure an informed choice of 192.11 alternatives by the person, the person's legal representative, 192.12 if any, or the person's family. The application shall be made 192.13 to the local agency and shall specify the needs of the person 192.14 and family, the form and amount of grant requested, the items 192.15 and services to be reimbursed, and evidence of eligibility for 192.16 medical assistanceor alternative care program. 192.17 (f) Upon approval of an application by the local agency and 192.18 agreement on a support plan for the person or person's family, 192.19 the local agency shall make grants to the person or the person's 192.20 family. The grant shall be in an amount for the direct costs of 192.21 the services or supports outlined in the service agreement. 192.22 (g) Reimbursable costs shall not include costs for 192.23 resources already available, such as special education classes, 192.24 day training and habilitation, case management, other services 192.25 to which the person is entitled, medical costs covered by 192.26 insurance or other health programs, or other resources usually 192.27 available at no cost to the person or the person's family. 192.28 (h) The state of Minnesota, the county boards participating 192.29 in the consumer support grant program, or the agencies acting on 192.30 behalf of the county boards in the implementation and 192.31 administration of the consumer support grant program shall not 192.32 be liable for damages, injuries, or liabilities sustained 192.33 through the purchase of support by the individual, the 192.34 individual's family, or the authorized representative under this 192.35 section with funds received through the consumer support grant 192.36 program. Liabilities include but are not limited to: workers' 193.1 compensation liability, the Federal Insurance Contributions Act 193.2 (FICA), or the Federal Unemployment Tax Act (FUTA). For 193.3 purposes of this section, participating county boards and 193.4 agencies acting on behalf of county boards are exempt from the 193.5 provisions of section 268.04. 193.6 Sec. 11. Minnesota Statutes 2000, section 256.476, 193.7 subdivision 5, is amended to read: 193.8 Subd. 5. [REIMBURSEMENT, ALLOCATIONS, AND REPORTING.] (a) 193.9 For the purpose of transferring persons to the consumer support 193.10 grant program from specific programs or services, such as the 193.11 developmental disability family support program andalternative193.12care program,personal careattendantassistant services, home 193.13 health aide services, ornursing facilityprivate duty nursing 193.14 services, the amount of funds transferred by the commissioner 193.15 between the developmental disability family support program 193.16 account,the alternative care account,the medical assistance 193.17 account, or the consumer support grant account shall be based on 193.18 each county's participation in transferring persons to the 193.19 consumer support grant program from those programs and services. 193.20 (b) At the beginning of each fiscal year, county 193.21 allocations for consumer support grants shall be based on: 193.22 (1) the number of persons to whom the county board expects 193.23 to provide consumer supports grants; 193.24 (2) their eligibility for current program and services; 193.25 (3) the amount of nonfederal dollars expended on those 193.26 individuals for those programs and servicesor, in situations193.27where an individual is unable to obtain the support needed from193.28the program of origination due to the unavailability of service193.29providers at the time or the location where the supports are193.30needed, the allocation will be based on the county's best193.31estimate of the nonfederal dollars that would have been expended193.32if the services had been available; and 193.33 (4) projected dates when persons will start receiving 193.34 grants. County allocations shall be adjusted periodically by 193.35 the commissioner based on the actual transfer of persons or 193.36 service openings, and the nonfederal dollars associated with 194.1 those persons or service openings, to the consumer support grant 194.2 program. 194.3 (c) The amount of funds transferred by the commissioner 194.4 fromthe alternative care account andthe medical assistance 194.5 account for an individual may be changed if it is determined by 194.6 the county or its agent that the individual's need for support 194.7 has changed. 194.8 (d) The authority to utilize funds transferred to the 194.9 consumer support grant account for the purposes of implementing 194.10 and administering the consumer support grant program will not be 194.11 limited or constrained by the spending authority provided to the 194.12 program of origination. 194.13 (e) The commissionershallmay use up to five percent of 194.14 each county's allocation, as adjusted, for payments to that 194.15 county for administrative expenses, to be paid as a 194.16 proportionate addition to reported direct service expenditures. 194.17 (f)Except as provided in this paragraph,The county 194.18 allocation for each individual or individual's family cannot 194.19 exceed80 percent ofthe total nonfederal dollars expended on 194.20 the individual by the program of originationexcept for the194.21developmental disabilities family support grant program which194.22can be approved up to 100 percent of the nonfederal dollars and194.23in situations as described in paragraph (b), clause (3). In194.24situations where exceptional need exists or the individual's194.25need for support increases, up to 100 percent of the nonfederal194.26dollars expended may be allocated to the county. Allocations194.27that exceed 80 percent of the nonfederal dollars expended on the194.28individual by the program of origination must be approved by the194.29commissioner. The remainder of the amount expended on the194.30individual by the program of origination will be used in the194.31following proportions: half will be made available to the194.32consumer support grant program and participating counties for194.33consumer training, resource development, and other costs, and194.34half will be returned to the state general fund. 194.35 (g) The commissioner may recover, suspend, or withhold 194.36 payments if the county board, local agency, or grantee does not 195.1 comply with the requirements of this section. 195.2 (h) Grant funds unexpended by consumers shall return to the 195.3 state once a year. The annual return of unexpended grant funds 195.4 shall occur in the quarter following the end of the state fiscal 195.5 year. 195.6 Sec. 12. Minnesota Statutes 2000, section 256.476, 195.7 subdivision 8, is amended to read: 195.8 Subd. 8. [COMMISSIONER RESPONSIBILITIES.] The commissioner 195.9 shall: 195.10 (1) transfer and allocate funds pursuant to this section; 195.11 (2) determine allocations based on projected and actual 195.12 local agency use; 195.13 (3) monitor and oversee overall program spending; 195.14 (4) evaluate the effectiveness of the program; 195.15 (5) provide training and technical assistance for local 195.16 agencies and consumers to help identify potential applicants to 195.17 the program; and 195.18 (6) develop guidelines for local agency program 195.19 administration and consumer information; and195.20(7) apply for a federal waiver or take any other action195.21necessary to maximize federal funding for the program by195.22September 1, 1999. 195.23 Sec. 13. Minnesota Statutes 2000, section 256.476, is 195.24 amended by adding a subdivision to read: 195.25 Subd. 11. [CONSUMER SUPPORT GRANT PROGRAM AFTER JULY 1, 195.26 2001.] (a) Effective July 1, 2001, upon approval of the 1115 195.27 federal waiver for consumer-directed home care in section 195.28 256B.0627, subdivision 13, the consumer support grant program 195.29 shall be limited to 200 persons. 195.30 (b) If federal approval delays implementation of the 1115 195.31 waiver or it is denied, additional individuals may receive 195.32 consumer support grants according to subdivision 5. The 195.33 statewide average of medical assistance expenditures for 195.34 recipients receiving those services during the most recent 195.35 fiscal year will be used to determine the maximum allowable 195.36 grant award. 196.1 (c) Persons receiving consumer support grants prior to July 196.2 1, 2001, may continue to receive a grant amount established 196.3 prior to July 1, 2001. 196.4 Sec. 14. Minnesota Statutes 2000, section 256B.0625, 196.5 subdivision 7, is amended to read: 196.6 Subd. 7. [PRIVATE DUTY NURSING.] Medical assistance covers 196.7 private duty nursing services in a recipient's home. Recipients 196.8 who are authorized to receive private duty nursing services in 196.9 their home may use approved hours outside of the home during 196.10 hours when normal life activities take them outside of their 196.11 homeand when, without the provision of private duty nursing,196.12their health and safety would be jeopardized. To use private 196.13 duty nursing services at school, the recipient or responsible 196.14 party must provide written authorization in the care plan 196.15 identifying the chosen provider and the daily amount of services 196.16 to be used at school. Medical assistance does not cover private 196.17 duty nursing services for residents of a hospital, nursing 196.18 facility, intermediate care facility, or a health care facility 196.19 licensed by the commissioner of health, except as authorized in 196.20 section 256B.64 for ventilator-dependent recipients in hospitals 196.21 or unless a resident who is otherwise eligible is on leave from 196.22 the facility and the facility either pays for the private duty 196.23 nursing services or forgoes the facility per diem for the leave 196.24 days that private duty nursing services are used. Total hours 196.25 of service and payment allowed for services outside the home 196.26 cannot exceed that which is otherwise allowed in an in-home 196.27 setting according to section 256B.0627. All private duty 196.28 nursing services must be provided according to the limits 196.29 established under section 256B.0627. Private duty nursing 196.30 services may not be reimbursed if the nurse is thespouse of the196.31recipient or the parent orfoster care provider of a recipient 196.32 who is under age 18, or the recipient's legal guardian. 196.33 Sec. 15. Minnesota Statutes 2000, section 256B.0625, 196.34 subdivision 19a, is amended to read: 196.35 Subd. 19a. [PERSONAL CARE ASSISTANT SERVICES.] Medical 196.36 assistance covers personal care assistant services in a 197.1 recipient's home. To qualify for personal care assistant 197.2 services, recipients or responsible parties must be able to 197.3 identify the recipient's needs, direct and evaluate task 197.4 accomplishment, and provide for health and safety. Approved 197.5 hours may be used outside the home when normal life activities 197.6 take them outside the homeand when, without the provision of197.7personal care, their health and safety would be jeopardized. To 197.8 use personal care assistant services at school, the recipient or 197.9 responsible party must provide written authorization in the care 197.10 plan identifying the chosen provider and the daily amount of 197.11 services to be used at school. Total hours for services, 197.12 whether actually performed inside or outside the recipient's 197.13 home, cannot exceed that which is otherwise allowed for personal 197.14 care assistant services in an in-home setting according to 197.15 section 256B.0627. Medical assistance does not cover personal 197.16 care assistant services for residents of a hospital, nursing 197.17 facility, intermediate care facility, health care facility 197.18 licensed by the commissioner of health, or unless a resident who 197.19 is otherwise eligible is on leave from the facility and the 197.20 facility either pays for the personal care assistant services or 197.21 forgoes the facility per diem for the leave days that personal 197.22 care assistant services are used. All personal care assistant 197.23 services must be provided according to section 256B.0627. 197.24 Personal care assistant services may not be reimbursed if the 197.25 personal care assistant is the spouse or legal guardian of the 197.26 recipient or the parent of a recipient under age 18, or the 197.27 responsible party or the foster care provider of a recipient who 197.28 cannot direct the recipient's own care unless, in the case of a 197.29 foster care provider, a county or state case manager visits the 197.30 recipient as needed, but not less than every six months, to 197.31 monitor the health and safety of the recipient and to ensure the 197.32 goals of the care plan are met. Parents of adult recipients, 197.33 adult children of the recipient or adult siblings of the 197.34 recipient may be reimbursed for personal care assistant services 197.35if they are not the recipient's legal guardian and, if they are 197.36 granted a waiver under section 256B.0627.Until July 1, 2001,198.1andNotwithstanding the provisions of section 256B.0627, 198.2 subdivision 4, paragraph (b), clause (4), the noncorporate legal 198.3 guardian or conservator of an adult, who is not the responsible 198.4 party and not the personal care provider organization, may be 198.5 granted a hardship waiver under section 256B.0627, to be 198.6 reimbursed to provide personal care assistant services to the 198.7 recipient, and shall not be considered to have a service 198.8 provider interest for purposes of participation on the screening 198.9 team under section 256B.092, subdivision 7. 198.10 Sec. 16. Minnesota Statutes 2000, section 256B.0625, 198.11 subdivision 19c, is amended to read: 198.12 Subd. 19c. [PERSONAL CARE.] Medical assistance covers 198.13 personal care assistant services provided by an individual who 198.14 is qualified to provide the services according to subdivision 198.15 19a and section 256B.0627, where the services are prescribed by 198.16 a physician in accordance with a plan of treatment and are 198.17 supervised by the recipientunder the fiscal agent option198.18according to section 256B.0627, subdivision 10,or a qualified 198.19 professional. "Qualified professional" means a mental health 198.20 professional as defined in section 245.462, subdivision 18, or 198.21 245.4871, subdivision 27; or a registered nurse as defined in 198.22 sections 148.171 to 148.285. As part of the assessment, the 198.23 county public health nurse willconsult withassist the 198.24 recipient or responsible partyandto identify the most 198.25 appropriate person to provide supervision of the personal care 198.26 assistant. The qualified professional shall perform the duties 198.27 described in Minnesota Rules, part 9505.0335, subpart 4. 198.28 Sec. 17. Minnesota Statutes 2000, section 256B.0625, 198.29 subdivision 20, is amended to read: 198.30 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 198.31 extent authorized by rule of the state agency, medical 198.32 assistance covers case management services to persons with 198.33 serious and persistent mental illness and children with severe 198.34 emotional disturbance. Services provided under this section 198.35 must meet the relevant standards in sections 245.461 to 198.36 245.4888, the Comprehensive Adult and Children's Mental Health 199.1 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 199.2 9505.0322, excluding subpart 10. 199.3 (b) Entities meeting program standards set out in rules 199.4 governing family community support services as defined in 199.5 section 245.4871, subdivision 17, are eligible for medical 199.6 assistance reimbursement for case management services for 199.7 children with severe emotional disturbance when these services 199.8 meet the program standards in Minnesota Rules, parts 9520.0900 199.9 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 199.10 (c) Medical assistance and MinnesotaCare payment for mental 199.11 health case management shall be made on a monthly basis. In 199.12 order to receive payment for an eligible child, the provider 199.13 must document at least a face-to-face contact with the child, 199.14 the child's parents, or the child's legal representative. To 199.15 receive payment for an eligible adult, the provider must 199.16 document: 199.17 (1) at least a face-to-face contact with the adult or the 199.18 adult's legal representative; or 199.19 (2) at least a telephone contact with the adult or the 199.20 adult's legal representative and document a face-to-face contact 199.21 with the adult or the adult's legal representative within the 199.22 preceding two months. 199.23 (d) Payment for mental health case management provided by 199.24 county or state staff shall be based on the monthly rate 199.25 methodology under section 256B.094, subdivision 6, paragraph 199.26 (b), with separate rates calculated for child welfare and mental 199.27 health, and within mental health, separate rates for children 199.28 and adults. 199.29 (e) Payment for mental health case management provided by 199.30 county-contracted vendors shall be based on a monthly rate 199.31 negotiated by the host county. The negotiated rate must not 199.32 exceed the rate charged by the vendor for the same service to 199.33 other payers. If the service is provided by a team of 199.34 contracted vendors, the county may negotiate a team rate with a 199.35 vendor who is a member of the team. The team shall determine 199.36 how to distribute the rate among its members. No reimbursement 200.1 received by contracted vendors shall be returned to the county, 200.2 except to reimburse the county for advance funding provided by 200.3 the county to the vendor. 200.4 (f) If the service is provided by a team which includes 200.5 contracted vendors and county or state staff, the costs for 200.6 county or state staff participation in the team shall be 200.7 included in the rate for county-provided services. In this 200.8 case, the contracted vendor and the county may each receive 200.9 separate payment for services provided by each entity in the 200.10 same month. In order to prevent duplication of services, the 200.11 county must document, in the recipient's file, the need for team 200.12 case management and a description of the roles of the team 200.13 members. 200.14 (g) The commissioner shall calculate the nonfederal share 200.15 of actual medical assistance and general assistance medical care 200.16 payments for each county, based on the higher of calendar year 200.17 1995 or 1996, by service date, project that amount forward to 200.18 1999, and transfer one-half of the result from medical 200.19 assistance and general assistance medical care to each county's 200.20 mental health grants under sections 245.4886 and 256E.12 for 200.21 calendar year 1999. The annualized minimum amount added to each 200.22 county's mental health grant shall be $3,000 per year for 200.23 children and $5,000 per year for adults. The commissioner may 200.24 reduce the statewide growth factor in order to fund these 200.25 minimums. The annualized total amount transferred shall become 200.26 part of the base for future mental health grants for each county. 200.27 (h) Any net increase in revenue to the county as a result 200.28 of the change in this section must be used to provide expanded 200.29 mental health services as defined in sections 245.461 to 200.30 245.4888, the Comprehensive Adult and Children's Mental Health 200.31 Acts, excluding inpatient and residential treatment. For 200.32 adults, increased revenue may also be used for services and 200.33 consumer supports which are part of adult mental health projects 200.34 approved under Laws 1997, chapter 203, article 7, section 25. 200.35 For children, increased revenue may also be used for respite 200.36 care and nonresidential individualized rehabilitation services 201.1 as defined in section 245.492, subdivisions 17 and 23. 201.2 "Increased revenue" has the meaning given in Minnesota Rules, 201.3 part 9520.0903, subpart 3. 201.4 (i) Notwithstanding section 256B.19, subdivision 1, the 201.5 nonfederal share of costs for mental health case management 201.6 shall be provided by the recipient's county of responsibility, 201.7 as defined in sections 256G.01 to 256G.12, from sources other 201.8 than federal funds or funds used to match other federal funds. 201.9 (j) The commissioner may suspend, reduce, or terminate the 201.10 reimbursement to a provider that does not meet the reporting or 201.11 other requirements of this section. The county of 201.12 responsibility, as defined in sections 256G.01 to 256G.12, is 201.13 responsible for any federal disallowances. The county may share 201.14 this responsibility with its contracted vendors. 201.15 (k) The commissioner shall set aside a portion of the 201.16 federal funds earned under this section to repay the special 201.17 revenue maximization account under section 256.01, subdivision 201.18 2, clause (15). The repayment is limited to: 201.19 (1) the costs of developing and implementing this section; 201.20 and 201.21 (2) programming the information systems. 201.22 (l) Notwithstanding section 256.025, subdivision 2, 201.23 payments to counties for case management expenditures under this 201.24 section shall only be made from federal earnings from services 201.25 provided under this section. Payments to contracted vendors 201.26 shall include both the federal earnings and the county share. 201.27 (m) Notwithstanding section 256B.041, county payments for 201.28 the cost of mental health case management services provided by 201.29 county or state staff shall not be made to the state treasurer. 201.30 For the purposes of mental health case management services 201.31 provided by county or state staff under this section, the 201.32 centralized disbursement of payments to counties under section 201.33 256B.041 consists only of federal earnings from services 201.34 provided under this section. 201.35 (n) Case management services under this subdivision do not 201.36 include therapy, treatment, legal, or outreach services. 202.1 (o) If the recipient is a resident of a nursing facility, 202.2 intermediate care facility, or hospital, and the recipient's 202.3 institutional care is paid by medical assistance, payment for 202.4 case management services under this subdivision is limited to 202.5 the last30180 days of the recipient's residency in that 202.6 facility and may not exceed more thantwosix months in a 202.7 calendar year. 202.8 (p) Payment for case management services under this 202.9 subdivision shall not duplicate payments made under other 202.10 program authorities for the same purpose. 202.11 (q) By July 1, 2000, the commissioner shall evaluate the 202.12 effectiveness of the changes required by this section, including 202.13 changes in number of persons receiving mental health case 202.14 management, changes in hours of service per person, and changes 202.15 in caseload size. 202.16 (r) For each calendar year beginning with the calendar year 202.17 2001, the annualized amount of state funds for each county 202.18 determined under paragraph (g) shall be adjusted by the county's 202.19 percentage change in the average number of clients per month who 202.20 received case management under this section during the fiscal 202.21 year that ended six months prior to the calendar year in 202.22 question, in comparison to the prior fiscal year. 202.23 (s) For counties receiving the minimum allocation of $3,000 202.24 or $5,000 described in paragraph (g), the adjustment in 202.25 paragraph (r) shall be determined so that the county receives 202.26 the higher of the following amounts: 202.27 (1) a continuation of the minimum allocation in paragraph 202.28 (g); or 202.29 (2) an amount based on that county's average number of 202.30 clients per month who received case management under this 202.31 section during the fiscal year that ended six months prior to 202.32 the calendar year in question, in comparison to the prior fiscal 202.33 year, times the average statewide grant per person per month for 202.34 counties not receiving the minimum allocation. 202.35 (t) The adjustments in paragraphs (r) and (s) shall be 202.36 calculated separately for children and adults. 203.1 Sec. 18. Minnesota Statutes 2000, section 256B.0625, is 203.2 amended by adding a subdivision to read: 203.3 Subd. 43. [TARGETED CASE MANAGEMENT.] For purposes of 203.4 subdivisions 43a to 43h, the following terms have the meanings 203.5 given them: 203.6 (1) "home care service recipients" means those individuals 203.7 receiving the following services under section 256B.0627: 203.8 skilled nursing visits, home health aide visits, private duty 203.9 nursing, personal care assistants, or therapies provided through 203.10 a home health agency; 203.11 (2) "home care targeted case management" means the 203.12 provision of targeted case management services for the purpose 203.13 of assisting home care service recipients to gain access to 203.14 needed services and supports so that they may remain in the 203.15 community; 203.16 (3) "institutions" means hospitals, consistent with Code of 203.17 Federal Regulations, title 42, section 440.10; regional 203.18 treatment center inpatient services, consistent with section 203.19 245.474; nursing facilities; and intermediate care facilities 203.20 for persons with mental retardation; 203.21 (4) "relocation targeted case management" means the 203.22 provision of targeted case management services for the purpose 203.23 of assisting recipients to gain access to needed services and 203.24 supports if they choose to move from an institution to the 203.25 community. Relocation targeted case management may be provided 203.26 during the last 180 consecutive days of an eligible recipient's 203.27 institutional stay; and 203.28 (5) "targeted case management" means case management 203.29 services provided to help recipients gain access to needed 203.30 medical, social, educational, and other services and supports. 203.31 Sec. 19. Minnesota Statutes 2000, section 256B.0625, is 203.32 amended by adding a subdivision to read: 203.33 Subd. 43a. [ELIGIBILITY.] The following persons are 203.34 eligible for relocation targeted case management or home care- 203.35 targeted case management: 203.36 (1) medical assistance eligible persons residing in 204.1 institutions who choose to move into the community are eligible 204.2 for relocation targeted case management services; and 204.3 (2) medical assistance eligible persons receiving home care 204.4 services, who are not eligible for any other medical assistance 204.5 reimbursable case management service, are eligible for home care- 204.6 targeted case management services beginning January 1, 2003. 204.7 Sec. 20. Minnesota Statutes 2000, section 256B.0625, is 204.8 amended by adding a subdivision to read: 204.9 Subd. 43b. [RELOCATION TARGETED CASE MANAGEMENT PROVIDER 204.10 QUALIFICATIONS.] The following qualifications and certification 204.11 standards must be met by providers of relocation targeted case 204.12 management: 204.13 (a) The commissioner must certify each provider or 204.14 relocation targeted case management before enrollment. The 204.15 certification process shall examine the provider's ability to 204.16 meet the requirements in this subdivision and other federal and 204.17 state requirements of this service. A certified relocation 204.18 targeted case management provider may subcontract with another 204.19 provider to deliver relocation targeted case management 204.20 services. Subcontracted providers must demonstrate the ability 204.21 to provide the services outlined in subdivision 43d. 204.22 (b) A relocation targeted case management provider is an 204.23 enrolled medical assistance provider who is determined by the 204.24 commissioner to have all of the following characteristics: 204.25 (1) the legal authority to provide public welfare under 204.26 sections 393.01, subdivision 7; and 393.07; or a federally 204.27 recognized Indian tribe; 204.28 (2) the demonstrated capacity and experience to provide the 204.29 components of case management to coordinate and link community 204.30 resources needed by the eligible population; 204.31 (3) the administrative capacity and experience to serve the 204.32 target population for whom it will provide services and ensure 204.33 quality of services under state and federal requirements; 204.34 (4) the legal authority to provide complete investigative 204.35 and protective services under section 626.556, subdivision 10; 204.36 and child welfare and foster care services under section 393.07, 205.1 subdivisions 1 and 2; or a federally recognized Indian tribe; 205.2 (5) a financial management system that provides accurate 205.3 documentation of services and costs under state and federal 205.4 requirements; and 205.5 (6) the capacity to document and maintain individual case 205.6 records under state and federal requirements. 205.7 A provider of targeted case management under subdivision 20 may 205.8 be deemed a certified provider of relocation targeted case 205.9 management. 205.10 Sec. 21. Minnesota Statutes 2000, section 256B.0625, is 205.11 amended by adding a subdivision to read: 205.12 Subd. 43c. [HOME CARE TARGETED CASE MANAGEMENT PROVIDER 205.13 QUALIFICATIONS.] The following qualifications and certification 205.14 standards must be met by providers of home care targeted case 205.15 management. 205.16 (a) The commissioner must certify each provider of home 205.17 care targeted case management before enrollment. The 205.18 certification process shall examine the provider's ability to 205.19 meet the requirements in this subdivision and other state and 205.20 federal requirements of this service. 205.21 (b) A home care targeted case management provider is an 205.22 enrolled medical assistance provider who has a minimum of a 205.23 bachelor's degree, a license in a health or human services 205.24 field, and is determined by the commissioner to have all of the 205.25 following characteristics: 205.26 (1) the demonstrated capacity and experience to provide the 205.27 components of case management to coordinate and link community 205.28 resources needed by the eligible population; 205.29 (2) the administrative capacity and experience to serve the 205.30 target population for whom it will provide services and ensure 205.31 quality of services under state and federal requirements; 205.32 (3) a financial management system that provides accurate 205.33 documentation of services and costs under state and federal 205.34 requirements; 205.35 (4) the capacity to document and maintain individual case 205.36 records under state and federal requirements; and 206.1 (5) the capacity to coordinate with county administrative 206.2 functions. 206.3 Sec. 22. Minnesota Statutes 2000, section 256B.0625, is 206.4 amended by adding a subdivision to read: 206.5 Subd. 43d. [ELIGIBLE SERVICES.] Services eligible for 206.6 medical assistance reimbursement as targeted case management 206.7 include: 206.8 (1) assessment of the recipient's need for targeted case 206.9 management services; 206.10 (2) development, completion, and regular review of a 206.11 written individual service plan, which is based upon the 206.12 assessment of the recipient's needs and choices, and which will 206.13 ensure access to medical, social, educational, and other related 206.14 services and supports; 206.15 (3) routine contact or communication with the recipient, 206.16 the recipient's family, primary caregiver, legal representative, 206.17 substitute care provider, service providers, or other relevant 206.18 persons identified as necessary to the development or 206.19 implementation of the goals of the individual service plan; 206.20 (4) coordinating referrals for, and the provision of, case 206.21 management services for the recipient with appropriate service 206.22 providers, consistent with section 1902(a)(23) of the Social 206.23 Security Act; 206.24 (5) coordinating and monitoring the overall service 206.25 delivery to ensure quality of services, appropriateness, and 206.26 continued need; 206.27 (6) completing and maintaining necessary documentation that 206.28 supports and verifies the activities in this subdivision; 206.29 (7) traveling to conduct a visit with the recipient or 206.30 other relevant person necessary to develop or implement the 206.31 goals of the individual service plan; and 206.32 (8) coordinating with the institution discharge planner in 206.33 the 180-day period before the recipient's discharge. 206.34 Sec. 23. Minnesota Statutes 2000, section 256B.0625, is 206.35 amended by adding a subdivision to read: 206.36 Subd. 43e. [TIMELINES.] The following timelines must be 207.1 met for assigning a case manager: 207.2 (1) for relocation targeted case management, an eligible 207.3 recipient must be assigned a case manager who visits the person 207.4 within 20 working days of requesting one from their county of 207.5 financial responsibility as determined under chapter 256G. If a 207.6 county agency does not provide case management services as 207.7 required, the recipient may, after written notice to the county 207.8 agency, obtain targeted-relocation case management services from 207.9 a home care targeted case management provider under this 207.10 subdivision; and 207.11 (2) for home care targeted case management, an eligible 207.12 recipient must be assigned a case manager within 20 working days 207.13 of requesting one from a home care targeted case management 207.14 provider, as defined in subdivision 43c. 207.15 Sec. 24. Minnesota Statutes 2000, section 256B.0625, is 207.16 amended by adding a subdivision to read: 207.17 Subd. 43f. [EVALUATION.] The commissioner shall evaluate 207.18 the delivery of targeted case management, including, but not 207.19 limited to, access to case management services, consumer 207.20 satisfaction with case management services, and quality of case 207.21 management services. 207.22 Sec. 25. Minnesota Statutes 2000, section 256B.0625, is 207.23 amended by adding a subdivision to read: 207.24 Subd. 43g. [CONTACT DOCUMENTATION.] The case manager must 207.25 document each face-to-face and telephone contact with the 207.26 recipient and others involved in the recipient's individual 207.27 service plan. 207.28 Sec. 26. Minnesota Statutes 2000, section 256B.0625, is 207.29 amended by adding a subdivision to read: 207.30 Subd. 43h. [PAYMENT RATES.] The commissioner shall set 207.31 payment rates for targeted case management under this 207.32 subdivision. Case managers may bill according to the following 207.33 criteria: 207.34 (1) for relocation targeted case management, case managers 207.35 may bill for direct case management activities, including 207.36 face-to-face and telephone contacts, in the 180 days preceding 208.1 an eligible recipient's discharge from an institution; 208.2 (2) for home care targeted case management, case managers 208.3 may bill for direct case management activities, including 208.4 face-to-face and telephone contacts; and 208.5 (3) billings for targeted case management services under 208.6 this subdivision shall not duplicate payments made under other 208.7 program authorities for the same purpose. 208.8 Sec. 27. Minnesota Statutes 2000, section 256B.0627, 208.9 subdivision 1, is amended to read: 208.10 Subdivision 1. [DEFINITION.] (a) "Activities of daily 208.11 living" includes eating, toileting, grooming, dressing, bathing, 208.12 transferring, mobility, and positioning. 208.13 (b) "Assessment" means a review and evaluation of a 208.14 recipient's need for home care services conducted in person. 208.15 Assessments for private duty nursing shall be conducted by a 208.16 registered private duty nurse. Assessments for home health 208.17 agency services shall be conducted by a home health agency 208.18 nurse. Assessments for personal care assistant services shall 208.19 be conducted by the county public health nurse or a certified 208.20 public health nurse under contract with the county. A 208.21 face-to-face assessment must include: documentation of health 208.22 status, determination of need, evaluation of service 208.23 effectiveness, identification of appropriate services, service 208.24 plan development or modification, coordination of services, 208.25 referrals and follow-up to appropriate payers and community 208.26 resources, completion of required reports, recommendation of 208.27 service authorization, and consumer education. Once the need 208.28 for personal care assistant services is determined under this 208.29 section, the county public health nurse or certified public 208.30 health nurse under contract with the county is responsible for 208.31 communicating this recommendation to the commissioner and the 208.32 recipient. A face-to-face assessment for personal 208.33 care assistant services is conducted on those recipients who 208.34 have never had a county public health nurse assessment. A 208.35 face-to-face assessment must occur at least annually or when 208.36 there is a significant change in the recipient's condition or 209.1 when there is a change in the need for personal care assistant 209.2 services. A service update may substitute for the annual 209.3 face-to-face assessment when there is not a significant change 209.4 in recipient condition or a change in the need for personal care 209.5 assistant service. A service update or review for temporary 209.6 increase includes a review of initial baseline data, evaluation 209.7 of service effectiveness, redetermination of service need, 209.8 modification of service plan and appropriate referrals, update 209.9 of initial forms, obtaining service authorization, and on going 209.10 consumer education. Assessments for medical assistance home 209.11 care services for mental retardation or related conditions and 209.12 alternative care services for developmentally disabled home and 209.13 community-based waivered recipients may be conducted by the 209.14 county public health nurse to ensure coordination and avoid 209.15 duplication. Assessments must be completed on forms provided by 209.16 the commissioner within 30 days of a request for home care 209.17 services by a recipient or responsible party. 209.18(b)(c) "Care plan" means a written description of personal 209.19 care assistant services developed by the qualified 209.20 professional or the recipient's physician with the recipient or 209.21 responsible party to be used by the personal care assistant with 209.22 a copy provided to the recipient or responsible party. 209.23 (d) "Complex and regular private duty nursing care" means: 209.24 (1) complex care is private duty nursing provided to 209.25 recipients who are ventilator dependent or for whom a physician 209.26 has certified that were it not for private duty nursing the 209.27 recipient would meet the criteria for inpatient hospital 209.28 intensive care unit (ICU) level of care; and 209.29 (2) regular care is private duty nursing provided to all 209.30 other recipients. 209.31 (e) "Health-related functions" means functions that can be 209.32 delegated or assigned by a licensed health care professional 209.33 under state law to be performed by a personal care attendant. 209.34(c)(f) "Home care services" means a health service, 209.35 determined by the commissioner as medically necessary, that is 209.36 ordered by a physician and documented in a service plan that is 210.1 reviewed by the physician at least once every6260 days for the 210.2 provision of home health services, or private duty nursing, or 210.3 at least once every 365 days for personal care. Home care 210.4 services are provided to the recipient at the recipient's 210.5 residence that is a place other than a hospital or long-term 210.6 care facility or as specified in section 256B.0625. 210.7 (g) "Instrumental activities of daily living" includes meal 210.8 planning and preparation, managing finances, shopping for food, 210.9 clothing, and other essential items, performing essential 210.10 household chores, communication by telephone and other media, 210.11 and getting around and participating in the community. 210.12(d)(h) "Medically necessary" has the meaning given in 210.13 Minnesota Rules, parts 9505.0170 to 9505.0475. 210.14(e)(i) "Personal care assistant" means a person who: 210.15 (1) is at least 18 years old, except for persons 16 to 18 210.16 years of age who participated in a related school-based job 210.17 training program or have completed a certified home health aide 210.18 competency evaluation; 210.19 (2) is able to effectively communicate with the recipient 210.20 and personal care provider organization; 210.21 (3) effective July 1, 1996, has completed one of the 210.22 training requirements as specified in Minnesota Rules, part 210.23 9505.0335, subpart 3, items A to D; 210.24 (4) has the ability to, and provides covered personal 210.25 care assistant services according to the recipient's care plan, 210.26 responds appropriately to recipient needs, and reports changes 210.27 in the recipient's condition to the supervising qualified 210.28 professional or physician; 210.29 (5) is not a consumer of personal care assistant services; 210.30 and 210.31 (6) is subject to criminal background checks and procedures 210.32 specified in section 245A.04. 210.33(f)(j) "Personal care provider organization" means an 210.34 organization enrolled to provide personal care assistant 210.35 services under the medical assistance program that complies with 210.36 the following: (1) owners who have a five percent interest or 211.1 more, and managerial officials are subject to a background study 211.2 as provided in section 245A.04. This applies to currently 211.3 enrolled personal care provider organizations and those agencies 211.4 seeking enrollment as a personal care provider organization. An 211.5 organization will be barred from enrollment if an owner or 211.6 managerial official of the organization has been convicted of a 211.7 crime specified in section 245A.04, or a comparable crime in 211.8 another jurisdiction, unless the owner or managerial official 211.9 meets the reconsideration criteria specified in section 245A.04; 211.10 (2) the organization must maintain a surety bond and liability 211.11 insurance throughout the duration of enrollment and provides 211.12 proof thereof. The insurer must notify the department of human 211.13 services of the cancellation or lapse of policy; and (3) the 211.14 organization must maintain documentation of services as 211.15 specified in Minnesota Rules, part 9505.2175, subpart 7, as well 211.16 as evidence of compliance with personal care assistant training 211.17 requirements. 211.18(g)(k) "Responsible party" means an individual residing 211.19 with a recipient of personal care assistant services who is 211.20 capable of providing the supportive care necessary to assist the 211.21 recipient to live in the community, is at least 18 years old, 211.22 and is not a personal care assistant. Responsible parties who 211.23 are parents of minors or guardians of minors or incapacitated 211.24 persons may delegate the responsibility to another adult during 211.25 a temporary absence of at least 24 hours but not more than six 211.26 months. The person delegated as a responsible party must be 211.27 able to meet the definition of responsible party, except that 211.28 the delegated responsible party is required to reside with the 211.29 recipient only while serving as the responsible party. Foster 211.30 care license holders may be designated the responsible party for 211.31 residents of the foster care home if case management is provided 211.32 as required in section 256B.0625, subdivision 19a. For persons 211.33 who, as of April 1, 1992, are sharing personal care assistant 211.34 services in order to obtain the availability of 24-hour 211.35 coverage, an employee of the personal care provider organization 211.36 may be designated as the responsible party if case management is 212.1 provided as required in section 256B.0625, subdivision 19a. 212.2(h)(l) "Service plan" means a written description of the 212.3 services needed based on the assessment developed by the nurse 212.4 who conducts the assessment together with the recipient or 212.5 responsible party. The service plan shall include a description 212.6 of the covered home care services, frequency and duration of 212.7 services, and expected outcomes and goals. The recipient and 212.8 the provider chosen by the recipient or responsible party must 212.9 be given a copy of the completed service plan within 30 calendar 212.10 days of the request for home care services by the recipient or 212.11 responsible party. 212.12(i)(m) "Skilled nurse visits" are provided in a 212.13 recipient's residence under a plan of care or service plan that 212.14 specifies a level of care which the nurse is qualified to 212.15 provide. These services are: 212.16 (1) nursing services according to the written plan of care 212.17 or service plan and accepted standards of medical and nursing 212.18 practice in accordance with chapter 148; 212.19 (2) services which due to the recipient's medical condition 212.20 may only be safely and effectively provided by a registered 212.21 nurse or a licensed practical nurse; 212.22 (3) assessments performed only by a registered nurse; and 212.23 (4) teaching and training the recipient, the recipient's 212.24 family, or other caregivers requiring the skills of a registered 212.25 nurse or licensed practical nurse. 212.26 (n) "Telehomecare" means the use of telecommunications 212.27 technology by a home health care professional to deliver home 212.28 health care services, within the professional's scope of 212.29 practice, to a patient located at a site other than the site 212.30 where the practitioner is located. 212.31 [EFFECTIVE DATE.] Paragraph (d) of this section is 212.32 effective January 1, 2003. 212.33 Sec. 28. Minnesota Statutes 2000, section 256B.0627, 212.34 subdivision 2, is amended to read: 212.35 Subd. 2. [SERVICES COVERED.] Home care services covered 212.36 under this section include: 213.1 (1) nursing services under section 256B.0625, subdivision 213.2 6a; 213.3 (2) private duty nursing services under section 256B.0625, 213.4 subdivision 7; 213.5 (3) home healthaideservices under section 256B.0625, 213.6 subdivision 6a; 213.7 (4) personal care assistant services under section 213.8 256B.0625, subdivision 19a; 213.9 (5) supervision of personal care assistant services 213.10 provided by a qualified professional under section 256B.0625, 213.11 subdivision 19a; 213.12 (6)consultingqualified professional of personal care 213.13 assistant services under the fiscalagentintermediary option as 213.14 specified in subdivision 10; 213.15 (7) face-to-face assessments by county public health nurses 213.16 for services under section 256B.0625, subdivision 19a; and 213.17 (8) service updates and review of temporary increases for 213.18 personal care assistant services by the county public health 213.19 nurse for services under section 256B.0625, subdivision 19a. 213.20 Sec. 29. Minnesota Statutes 2000, section 256B.0627, 213.21 subdivision 4, is amended to read: 213.22 Subd. 4. [PERSONAL CARE ASSISTANT SERVICES.] (a) The 213.23 personal care assistant services that are eligible for payment 213.24 arethe following:services and supports furnished to an 213.25 individual, as needed, to assist in accomplishing activities of 213.26 daily living; instrumental activities of daily living; 213.27 health-related functions through hands-on assistance, 213.28 supervision, and cueing; and redirection and intervention for 213.29 behavior including observation and monitoring. 213.30 (b) Payment for services will be made within the limits 213.31 approved using the prior authorized process established in 213.32 subdivision 5. 213.33 (c) The amount and type of services authorized shall be 213.34 based on an assessment of the recipient's needs in these areas: 213.35 (1) bowel and bladder care; 213.36 (2) skin care to maintain the health of the skin; 214.1 (3) repetitive maintenance range of motion, muscle 214.2 strengthening exercises, and other tasks specific to maintaining 214.3 a recipient's optimal level of function; 214.4 (4) respiratory assistance; 214.5 (5) transfers and ambulation; 214.6 (6) bathing, grooming, and hairwashing necessary for 214.7 personal hygiene; 214.8 (7) turning and positioning; 214.9 (8) assistance with furnishing medication that is 214.10 self-administered; 214.11 (9) application and maintenance of prosthetics and 214.12 orthotics; 214.13 (10) cleaning medical equipment; 214.14 (11) dressing or undressing; 214.15 (12) assistance with eating and meal preparation and 214.16 necessary grocery shopping; 214.17 (13) accompanying a recipient to obtain medical diagnosis 214.18 or treatment; 214.19 (14) assisting, monitoring, or prompting the recipient to 214.20 complete the services in clauses (1) to (13); 214.21 (15) redirection, monitoring, and observation that are 214.22 medically necessary and an integral part of completing the 214.23 personal care assistant services described in clauses (1) to 214.24 (14); 214.25 (16) redirection and intervention for behavior, including 214.26 observation and monitoring; 214.27 (17) interventions for seizure disorders, including 214.28 monitoring and observation if the recipient has had a seizure 214.29 that requires intervention within the past three months; 214.30 (18) tracheostomy suctioning using a clean procedure if the 214.31 procedure is properly delegated by a registered nurse. Before 214.32 this procedure can be delegated to a personal care assistant, a 214.33 registered nurse must determine that the tracheostomy suctioning 214.34 can be accomplished utilizing a clean rather than a sterile 214.35 procedure and must ensure that the personal care assistant has 214.36 been taught the proper procedure; and 215.1 (19) incidental household services that are an integral 215.2 part of a personal care service described in clauses (1) to (18). 215.3 For purposes of this subdivision, monitoring and observation 215.4 means watching for outward visible signs that are likely to 215.5 occur and for which there is a covered personal care service or 215.6 an appropriate personal care intervention. For purposes of this 215.7 subdivision, a clean procedure refers to a procedure that 215.8 reduces the numbers of microorganisms or prevents or reduces the 215.9 transmission of microorganisms from one person or place to 215.10 another. A clean procedure may be used beginning 14 days after 215.11 insertion. 215.12(b)(d) The personal care assistant services that are not 215.13 eligible for payment are the following: 215.14 (1) services not ordered by the physician; 215.15 (2) assessments by personal care assistant provider 215.16 organizations or by independently enrolled registered nurses; 215.17 (3) services that are not in the service plan; 215.18 (4) services provided by the recipient's spouse, legal 215.19 guardian for an adult or child recipient, or parent of a 215.20 recipient under age 18; 215.21 (5) services provided by a foster care provider of a 215.22 recipient who cannot direct the recipient's own care, unless 215.23 monitored by a county or state case manager under section 215.24 256B.0625, subdivision 19a; 215.25 (6) services provided by the residential or program license 215.26 holder in a residence for more than four persons; 215.27 (7) services that are the responsibility of a residential 215.28 or program license holder under the terms of a service agreement 215.29 and administrative rules; 215.30 (8)sterile procedures;215.31(9)injections of fluids into veins, muscles, or skin; 215.32(10)(9) services provided by parents of adult recipients, 215.33 adult children, or siblings of the recipient, unless these 215.34 relatives meet one of the following hardship criteria and the 215.35 commissioner waives this requirement: 215.36 (i) the relative resigns from a part-time or full-time job 216.1 to provide personal care for the recipient; 216.2 (ii) the relative goes from a full-time to a part-time job 216.3 with less compensation to provide personal care for the 216.4 recipient; 216.5 (iii) the relative takes a leave of absence without pay to 216.6 provide personal care for the recipient; 216.7 (iv) the relative incurs substantial expenses by providing 216.8 personal care for the recipient; or 216.9 (v) because of labor conditions, special language needs, or 216.10 intermittent hours of care needed, the relative is needed in 216.11 order to provide an adequate number of qualified personal care 216.12 assistants to meet the medical needs of the recipient; 216.13(11)(10) homemaker services that are not an integral part 216.14 of a personal care assistant services; 216.15(12)(11) home maintenance, or chore services; 216.16(13)(12) services not specified under paragraph (a); and 216.17(14)(13) services not authorized by the commissioner or 216.18 the commissioner's designee. 216.19 (e) The recipient or responsible party may choose to 216.20 supervise the personal care assistant or to have a qualified 216.21 professional, as defined in section 256B.0625, subdivision 19c, 216.22 provide the supervision. As required under section 256B.0625, 216.23 subdivision 19c, the county public health nurse, as a part of 216.24 the assessment, will consult with the recipient or responsible 216.25 party to identify the most appropriate person to provide 216.26 supervision of the personal care assistant. Health-related 216.27 delegated tasks performed by the personal care assistant will be 216.28 under the supervision of a qualified professional or the 216.29 direction of the recipient's physician. If the recipient has a 216.30 qualified professional, Minnesota Rules, part 9505.0335, subpart 216.31 4, applies. 216.32 Sec. 30. Minnesota Statutes 2000, section 256B.0627, 216.33 subdivision 5, is amended to read: 216.34 Subd. 5. [LIMITATION ON PAYMENTS.] Medical assistance 216.35 payments for home care services shall be limited according to 216.36 this subdivision. 217.1 (a) [LIMITS ON SERVICES WITHOUT PRIOR AUTHORIZATION.] A 217.2 recipient may receive the following home care services during a 217.3 calendar year: 217.4 (1) up to two face-to-face assessments to determine a 217.5 recipient's need for personal care assistant services; 217.6 (2) one service update done to determine a recipient's need 217.7 for personal care assistant services; and 217.8 (3) up tofivenine skilled nurse visits. 217.9 (b) [PRIOR AUTHORIZATION; EXCEPTIONS.] All home care 217.10 services above the limits in paragraph (a) must receive the 217.11 commissioner's prior authorization, except when: 217.12 (1) the home care services were required to treat an 217.13 emergency medical condition that if not immediately treated 217.14 could cause a recipient serious physical or mental disability, 217.15 continuation of severe pain, or death. The provider must 217.16 request retroactive authorization no later than five working 217.17 days after giving the initial service. The provider must be 217.18 able to substantiate the emergency by documentation such as 217.19 reports, notes, and admission or discharge histories; 217.20 (2) the home care services were provided on or after the 217.21 date on which the recipient's eligibility began, but before the 217.22 date on which the recipient was notified that the case was 217.23 opened. Authorization will be considered if the request is 217.24 submitted by the provider within 20 working days of the date the 217.25 recipient was notified that the case was opened; 217.26 (3) a third-party payor for home care services has denied 217.27 or adjusted a payment. Authorization requests must be submitted 217.28 by the provider within 20 working days of the notice of denial 217.29 or adjustment. A copy of the notice must be included with the 217.30 request; 217.31 (4) the commissioner has determined that a county or state 217.32 human services agency has made an error; or 217.33 (5) the professional nurse determines an immediate need for 217.34 up to 40 skilled nursing or home health aide visits per calendar 217.35 year and submits a request for authorization within 20 working 217.36 days of the initial service date, and medical assistance is 218.1 determined to be the appropriate payer. 218.2 (c) [RETROACTIVE AUTHORIZATION.] A request for retroactive 218.3 authorization will be evaluated according to the same criteria 218.4 applied to prior authorization requests. 218.5 (d) [ASSESSMENT AND SERVICE PLAN.] Assessments under 218.6 section 256B.0627, subdivision 1, paragraph (a), shall be 218.7 conducted initially, and at least annually thereafter, in person 218.8 with the recipient and result in a completed service plan using 218.9 forms specified by the commissioner. Within 30 days of 218.10 recipient or responsible party request for home care services, 218.11 the assessment, the service plan, and other information 218.12 necessary to determine medical necessity such as diagnostic or 218.13 testing information, social or medical histories, and hospital 218.14 or facility discharge summaries shall be submitted to the 218.15 commissioner. For personal care assistant services: 218.16 (1) The amount and type of service authorized based upon 218.17 the assessment and service plan will follow the recipient if the 218.18 recipient chooses to change providers. 218.19 (2) If the recipient's medical need changes, the 218.20 recipient's provider may assess the need for a change in service 218.21 authorization and request the change from the county public 218.22 health nurse. Within 30 days of the request, the public health 218.23 nurse will determine whether to request the change in services 218.24 based upon the provider assessment, or conduct a home visit to 218.25 assess the need and determine whether the change is appropriate. 218.26 (3) To continue to receive personal care assistant services 218.27 after the first year, the recipient or the responsible party, in 218.28 conjunction with the public health nurse, may complete a service 218.29 update on forms developed by the commissioner according to 218.30 criteria and procedures in subdivision 1. 218.31 (e) [PRIOR AUTHORIZATION.] The commissioner, or the 218.32 commissioner's designee, shall review the assessment, service 218.33 update, request for temporary services, service plan, and any 218.34 additional information that is submitted. The commissioner 218.35 shall, within 30 days after receiving a complete request, 218.36 assessment, and service plan, authorize home care services as 219.1 follows: 219.2 (1) [HOME HEALTH SERVICES.] All home health services 219.3 provided by alicensed nurse or ahome health aide must be prior 219.4 authorized by the commissioner or the commissioner's designee. 219.5 Prior authorization must be based on medical necessity and 219.6 cost-effectiveness when compared with other care options. When 219.7 home health services are used in combination with personal care 219.8 and private duty nursing, the cost of all home care services 219.9 shall be considered for cost-effectiveness. The commissioner 219.10 shall limitnurse andhome health aide visits to no more than 219.11 one visiteachper day. The commissioner, or the commissioner's 219.12 designee, may authorize up to two skilled nurse visits per day. 219.13 (2) [PERSONAL CARE ASSISTANT SERVICES.] (i) All personal 219.14 care assistant services and supervision by a qualified 219.15 professional, if requested by the recipient, must be prior 219.16 authorized by the commissioner or the commissioner's designee 219.17 except for the assessments established in paragraph (a). The 219.18 amount of personal care assistant services authorized must be 219.19 based on the recipient's home care rating. A child may not be 219.20 found to be dependent in an activity of daily living if because 219.21 of the child's age an adult would either perform the activity 219.22 for the child or assist the child with the activity and the 219.23 amount of assistance needed is similar to the assistance 219.24 appropriate for a typical child of the same age. Based on 219.25 medical necessity, the commissioner may authorize: 219.26 (A) up to two times the average number of direct care hours 219.27 provided in nursing facilities for the recipient's comparable 219.28 case mix level; or 219.29 (B) up to three times the average number of direct care 219.30 hours provided in nursing facilities for recipients who have 219.31 complex medical needs or are dependent in at least seven 219.32 activities of daily living and need physical assistance with 219.33 eating or have a neurological diagnosis; or 219.34 (C) up to 60 percent of the average reimbursement rate, as 219.35 of July 1, 1991, for care provided in a regional treatment 219.36 center for recipients who have Level I behavior, plus any 220.1 inflation adjustment as provided by the legislature for personal 220.2 care service; or 220.3 (D) up to the amount the commissioner would pay, as of July 220.4 1, 1991, plus any inflation adjustment provided for home care 220.5 services, for care provided in a regional treatment center for 220.6 recipients referred to the commissioner by a regional treatment 220.7 center preadmission evaluation team. For purposes of this 220.8 clause, home care services means all services provided in the 220.9 home or community that would be included in the payment to a 220.10 regional treatment center; or 220.11 (E) up to the amount medical assistance would reimburse for 220.12 facility care for recipients referred to the commissioner by a 220.13 preadmission screening team established under section 256B.0911 220.14 or 256B.092; and 220.15 (F) a reasonable amount of time for the provision of 220.16 supervision by a qualified professional of personal 220.17 care assistant services, if a qualified professional is 220.18 requested by the recipient or responsible party. 220.19 (ii) The number of direct care hours shall be determined 220.20 according to the annual cost report submitted to the department 220.21 by nursing facilities. The average number of direct care hours, 220.22 as established by May 1, 1992, shall be calculated and 220.23 incorporated into the home care limits on July 1, 1992. These 220.24 limits shall be calculated to the nearest quarter hour. 220.25 (iii) The home care rating shall be determined by the 220.26 commissioner or the commissioner's designee based on information 220.27 submitted to the commissioner by the county public health nurse 220.28 on forms specified by the commissioner. The home care rating 220.29 shall be a combination of current assessment tools developed 220.30 under sections 256B.0911 and 256B.501 with an addition for 220.31 seizure activity that will assess the frequency and severity of 220.32 seizure activity and with adjustments, additions, and 220.33 clarifications that are necessary to reflect the needs and 220.34 conditions of recipients who need home care including children 220.35 and adults under 65 years of age. The commissioner shall 220.36 establish these forms and protocols under this section and shall 221.1 use an advisory group, including representatives of recipients, 221.2 providers, and counties, for consultation in establishing and 221.3 revising the forms and protocols. 221.4 (iv) A recipient shall qualify as having complex medical 221.5 needs if the care required is difficult to perform and because 221.6 of recipient's medical condition requires more time than 221.7 community-based standards allow or requires more skill than 221.8 would ordinarily be required and the recipient needs or has one 221.9 or more of the following: 221.10 (A) daily tube feedings; 221.11 (B) daily parenteral therapy; 221.12 (C) wound or decubiti care; 221.13 (D) postural drainage, percussion, nebulizer treatments, 221.14 suctioning, tracheotomy care, oxygen, mechanical ventilation; 221.15 (E) catheterization; 221.16 (F) ostomy care; 221.17 (G) quadriplegia; or 221.18 (H) other comparable medical conditions or treatments the 221.19 commissioner determines would otherwise require institutional 221.20 care. 221.21 (v) A recipient shall qualify as having Level I behavior if 221.22 there is reasonable supporting evidence that the recipient 221.23 exhibits, or that without supervision, observation, or 221.24 redirection would exhibit, one or more of the following 221.25 behaviors that cause, or have the potential to cause: 221.26 (A) injury to the recipient's own body; 221.27 (B) physical injury to other people; or 221.28 (C) destruction of property. 221.29 (vi) Time authorized for personal care relating to Level I 221.30 behavior in subclause (v), items (A) to (C), shall be based on 221.31 the predictability, frequency, and amount of intervention 221.32 required. 221.33 (vii) A recipient shall qualify as having Level II behavior 221.34 if the recipient exhibits on a daily basis one or more of the 221.35 following behaviors that interfere with the completion of 221.36 personal care assistant services under subdivision 4, paragraph 222.1 (a): 222.2 (A) unusual or repetitive habits; 222.3 (B) withdrawn behavior; or 222.4 (C) offensive behavior. 222.5 (viii) A recipient with a home care rating of Level II 222.6 behavior in subclause (vii), items (A) to (C), shall be rated as 222.7 comparable to a recipient with complex medical needs under 222.8 subclause (iv). If a recipient has both complex medical needs 222.9 and Level II behavior, the home care rating shall be the next 222.10 complex category up to the maximum rating under subclause (i), 222.11 item (B). 222.12 (3) [PRIVATE DUTY NURSING SERVICES.] All private duty 222.13 nursing services shall be prior authorized by the commissioner 222.14 or the commissioner's designee. Prior authorization for private 222.15 duty nursing services shall be based on medical necessity and 222.16 cost-effectiveness when compared with alternative care options. 222.17 The commissioner may authorize medically necessary private duty 222.18 nursing services in quarter-hour units when: 222.19 (i) the recipient requires more individual and continuous 222.20 care than can be provided during a nurse visit; or 222.21 (ii) the cares are outside of the scope of services that 222.22 can be provided by a home health aide or personal care assistant. 222.23 The commissioner may authorize: 222.24 (A) up to two times the average amount of direct care hours 222.25 provided in nursing facilities statewide for case mix 222.26 classification "K" as established by the annual cost report 222.27 submitted to the department by nursing facilities in May 1992; 222.28 (B) private duty nursing in combination with other home 222.29 care services up to the total cost allowed under clause (2); 222.30 (C) up to 16 hours per day if the recipient requires more 222.31 nursing than the maximum number of direct care hours as 222.32 established in item (A) and the recipient meets the hospital 222.33 admission criteria established under Minnesota Rules, parts 222.349505.05009505.0501 to 9505.0540. 222.35 The commissioner may authorize up to 16 hours per day of 222.36 medically necessary private duty nursing services or up to 24 223.1 hours per day of medically necessary private duty nursing 223.2 services until such time as the commissioner is able to make a 223.3 determination of eligibility for recipients who are 223.4 cooperatively applying for home care services under the 223.5 community alternative care program developed under section 223.6 256B.49, or until it is determined by the appropriate regulatory 223.7 agency that a health benefit plan is or is not required to pay 223.8 for appropriate medically necessary health care services. 223.9 Recipients or their representatives must cooperatively assist 223.10 the commissioner in obtaining this determination. Recipients 223.11 who are eligible for the community alternative care program may 223.12 not receive more hours of nursing under this section than would 223.13 otherwise be authorized under section 256B.49. 223.14 Beginning January 1, 2003, private duty nursing services 223.15 shall be authorized for complex and regular care according to 223.16 section 256B.0627. 223.17 (4) [VENTILATOR-DEPENDENT RECIPIENTS.] If the recipient is 223.18 ventilator-dependent, the monthly medical assistance 223.19 authorization for home care services shall not exceed what the 223.20 commissioner would pay for care at the highest cost hospital 223.21 designated as a long-term hospital under the Medicare program. 223.22 For purposes of this clause, home care services means all 223.23 services provided in the home that would be included in the 223.24 payment for care at the long-term hospital. 223.25 "Ventilator-dependent" means an individual who receives 223.26 mechanical ventilation for life support at least six hours per 223.27 day and is expected to be or has been dependent for at least 30 223.28 consecutive days. 223.29 (f) [PRIOR AUTHORIZATION; TIME LIMITS.] The commissioner 223.30 or the commissioner's designee shall determine the time period 223.31 for which a prior authorization shall be effective. If the 223.32 recipient continues to require home care services beyond the 223.33 duration of the prior authorization, the home care provider must 223.34 request a new prior authorization. Under no circumstances, 223.35 other than the exceptions in paragraph (b), shall a prior 223.36 authorization be valid prior to the date the commissioner 224.1 receives the request or for more than 12 months. A recipient 224.2 who appeals a reduction in previously authorized home care 224.3 services may continue previously authorized services, other than 224.4 temporary services under paragraph (h), pending an appeal under 224.5 section 256.045. The commissioner must provide a detailed 224.6 explanation of why the authorized services are reduced in amount 224.7 from those requested by the home care provider. 224.8 (g) [APPROVAL OF HOME CARE SERVICES.] The commissioner or 224.9 the commissioner's designee shall determine the medical 224.10 necessity of home care services, the level of caregiver 224.11 according to subdivision 2, and the institutional comparison 224.12 according to this subdivision, the cost-effectiveness of 224.13 services, and the amount, scope, and duration of home care 224.14 services reimbursable by medical assistance, based on the 224.15 assessment, primary payer coverage determination information as 224.16 required, the service plan, the recipient's age, the cost of 224.17 services, the recipient's medical condition, and diagnosis or 224.18 disability. The commissioner may publish additional criteria 224.19 for determining medical necessity according to section 256B.04. 224.20 (h) [PRIOR AUTHORIZATION REQUESTS; TEMPORARY SERVICES.] 224.21 The agency nurse, the independently enrolled private duty nurse, 224.22 or county public health nurse may request a temporary 224.23 authorization for home care services by telephone. The 224.24 commissioner may approve a temporary level of home care services 224.25 based on the assessment, and service or care plan information, 224.26 and primary payer coverage determination information as required. 224.27 Authorization for a temporary level of home care services 224.28 including nurse supervision is limited to the time specified by 224.29 the commissioner, but shall not exceed 45 days, unless extended 224.30 because the county public health nurse has not completed the 224.31 required assessment and service plan, or the commissioner's 224.32 determination has not been made. The level of services 224.33 authorized under this provision shall have no bearing on a 224.34 future prior authorization. 224.35 (i) [PRIOR AUTHORIZATION REQUIRED IN FOSTER CARE SETTING.] 224.36 Home care services provided in an adult or child foster care 225.1 setting must receive prior authorization by the department 225.2 according to the limits established in paragraph (a). 225.3 The commissioner may not authorize: 225.4 (1) home care services that are the responsibility of the 225.5 foster care provider under the terms of the foster care 225.6 placement agreement and administrative rules; 225.7 (2) personal care assistant services when the foster care 225.8 license holder is also the personal care provider or personal 225.9 care assistant unless the recipient can direct the recipient's 225.10 own care, or case management is provided as required in section 225.11 256B.0625, subdivision 19a; 225.12 (3) personal care assistant services when the responsible 225.13 party is an employee of, or under contract with, or has any 225.14 direct or indirect financial relationship with the personal care 225.15 provider or personal care assistant, unless case management is 225.16 provided as required in section 256B.0625, subdivision 19a; or 225.17 (4) personal care assistant and private duty nursing 225.18 services when the number of foster care residents is greater 225.19 than four unless the county responsible for the recipient's 225.20 foster placement made the placement prior to April 1, 1992, 225.21 requests that personal care assistant and private duty nursing 225.22 services be provided, and case management is provided as 225.23 required in section 256B.0625, subdivision 19a. 225.24 Sec. 31. Minnesota Statutes 2000, section 256B.0627, 225.25 subdivision 7, is amended to read: 225.26 Subd. 7. [NONCOVERED HOME CARE SERVICES.] The following 225.27 home care services are not eligible for payment under medical 225.28 assistance: 225.29 (1) skilled nurse visits for the sole purpose of 225.30 supervision of the home health aide; 225.31 (2) a skilled nursing visit: 225.32 (i) only for the purpose of monitoring medication 225.33 compliance with an established medication program for a 225.34 recipient; or 225.35 (ii) to administer or assist with medication 225.36 administration, including injections, prefilling syringes for 226.1 injections, or oral medication set-up of an adult recipient, 226.2 when as determined and documented by the registered nurse, the 226.3 need can be met by an available pharmacy or the recipient is 226.4 physically and mentally able to self-administer or prefill a 226.5 medication; 226.6 (3) home care services to a recipient who is eligible for 226.7 covered servicesincluding hospice, if elected by the recipient,226.8 under the Medicare program or any other insurance held by the 226.9 recipient; 226.10 (4) services to other members of the recipient's household; 226.11 (5) a visit made by a skilled nurse solely to train other 226.12 home health agency workers; 226.13 (6) any home care service included in the daily rate of the 226.14 community-based residential facility where the recipient is 226.15 residing; 226.16 (7) nursing and rehabilitation therapy services that are 226.17 reasonably accessible to a recipient outside the recipient's 226.18 place of residence, excluding the assessment, counseling and 226.19 education, and personal assistant care; 226.20 (8) any home health agency service, excluding personal care 226.21 assistant services and private duty nursing services, which are 226.22 performed in a place other than the recipient's residence; and 226.23 (9) Medicare evaluation or administrative nursing visits on 226.24 dual-eligible recipients that do not qualify for Medicare visit 226.25 billing. 226.26 Sec. 32. Minnesota Statutes 2000, section 256B.0627, 226.27 subdivision 8, is amended to read: 226.28 Subd. 8. [SHARED PERSONAL CARE ASSISTANT SERVICES.] (a) 226.29 Medical assistance payments for shared personal care assistance 226.30 services shall be limited according to this subdivision. 226.31 (b) Recipients of personal care assistant services may 226.32 share staff and the commissioner shall provide a rate system for 226.33 shared personal care assistant services. For two persons 226.34 sharing services, the rate paid to a provider shall not exceed 226.35 1-1/2 times the rate paid for serving a single individual, and 226.36 for three persons sharing services, the rate paid to a provider 227.1 shall not exceed twice the rate paid for serving a single 227.2 individual. These rates apply only to situations in which all 227.3 recipients were present and received shared services on the date 227.4 for which the service is billed. No more than three persons may 227.5 receive shared services from a personal care assistant in a 227.6 single setting. 227.7 (c) Shared service is the provision of personal 227.8 care assistant services by a personal care assistant to two or 227.9 three recipients at the same time and in the same setting. For 227.10 the purposes of this subdivision, "setting" means: 227.11 (1) the home or foster care home of one of the individual 227.12 recipients; or 227.13 (2) a child care program in which all recipients served by 227.14 one personal care assistant are participating, which is licensed 227.15 under chapter 245A or operated by a local school district or 227.16 private school; or 227.17 (3) outside the home or foster care home of one of the 227.18 recipients when normal life activities take the recipients 227.19 outside the home. 227.20 The provisions of this subdivision do not apply when a 227.21 personal care assistant is caring for multiple recipients in 227.22 more than one setting. 227.23 (d) The recipient or the recipient's responsible party, in 227.24 conjunction with the county public health nurse, shall determine: 227.25 (1) whether shared personal care assistant services is an 227.26 appropriate option based on the individual needs and preferences 227.27 of the recipient; and 227.28 (2) the amount of shared services allocated as part of the 227.29 overall authorization of personal care assistant services. 227.30 The recipient or the responsible party, in conjunction with 227.31 the supervising qualified professional, if a qualified 227.32 professional is requested by any one of the recipients or 227.33 responsible parties, shall arrange the setting and grouping of 227.34 shared services based on the individual needs and preferences of 227.35 the recipients. Decisions on the selection of recipients to 227.36 share services must be based on the ages of the recipients, 228.1 compatibility, and coordination of their care needs. 228.2 (e) The following items must be considered by the recipient 228.3 or the responsible party and the supervising qualified 228.4 professional, if a qualified professional has been requested by 228.5 any one of the recipients or responsible parties, and documented 228.6 in the recipient's health service record: 228.7 (1) the additional qualifications needed by the personal 228.8 care assistant to provide care to several recipients in the same 228.9 setting; 228.10 (2) the additional training and supervision needed by the 228.11 personal care assistant to ensure that the needs of the 228.12 recipient are met appropriately and safely. The provider must 228.13 provide on-site supervision by a qualified professional within 228.14 the first 14 days of shared services, and monthly thereafter, if 228.15 supervision by a qualified provider has been requested by any 228.16 one of the recipients or responsible parties; 228.17 (3) the setting in which the shared services will be 228.18 provided; 228.19 (4) the ongoing monitoring and evaluation of the 228.20 effectiveness and appropriateness of the service and process 228.21 used to make changes in service or setting; and 228.22 (5) a contingency plan which accounts for absence of the 228.23 recipient in a shared services setting due to illness or other 228.24 circumstances and staffing contingencies. 228.25 (f) The provider must offer the recipient or the 228.26 responsible party the option of shared or one-on-one personal 228.27 care assistant services. The recipient or the responsible party 228.28 can withdraw from participating in a shared services arrangement 228.29 at any time. 228.30 (g) In addition to documentation requirements under 228.31 Minnesota Rules, part 9505.2175, a personal care provider must 228.32 meet documentation requirements for shared personal care 228.33 assistant services and must document the following in the health 228.34 service record for each individual recipient sharing services: 228.35 (1) permission by the recipient or the recipient's 228.36 responsible party, if any, for the maximum number of shared 229.1 services hours per week chosen by the recipient; 229.2 (2) permission by the recipient or the recipient's 229.3 responsible party, if any, for personal care assistant services 229.4 provided outside the recipient's residence; 229.5 (3) permission by the recipient or the recipient's 229.6 responsible party, if any, for others to receive shared services 229.7 in the recipient's residence; 229.8 (4) revocation by the recipient or the recipient's 229.9 responsible party, if any, of the shared service authorization, 229.10 or the shared service to be provided to others in the 229.11 recipient's residence, or the shared service to be provided 229.12 outside the recipient's residence; 229.13 (5) supervision of the shared personal care assistant 229.14 services by the qualified professional, if a qualified 229.15 professional is requested by one of the recipients or 229.16 responsible parties, including the date, time of day, number of 229.17 hours spent supervising the provision of shared services, 229.18 whether the supervision was face-to-face or another method of 229.19 supervision, changes in the recipient's condition, shared 229.20 services scheduling issues and recommendations; 229.21 (6) documentation by the qualified professional, if a 229.22 qualified professional is requested by one of the recipients or 229.23 responsible parties, of telephone calls or other discussions 229.24 with the personal care assistant regarding services being 229.25 provided to the recipient who has requested the supervision; and 229.26 (7) daily documentation of the shared services provided by 229.27 each identified personal care assistant including: 229.28 (i) the names of each recipient receiving shared services 229.29 together; 229.30 (ii) the setting for the shared services, including the 229.31 starting and ending times that the recipient received shared 229.32 services; and 229.33 (iii) notes by the personal care assistant regarding 229.34 changes in the recipient's condition, problems that may arise 229.35 from the sharing of services, scheduling issues, care issues, 229.36 and other notes as required by the qualified professional, if a 230.1 qualified professional is requested by one of the recipients or 230.2 responsible parties. 230.3 (h) Unless otherwise provided in this subdivision, all 230.4 other statutory and regulatory provisions relating to personal 230.5 care assistant services apply to shared services. 230.6 (i) In the event that supervision by a qualified 230.7 professional has been requested by one or more recipients, but 230.8 not by all of the recipients, the supervision duties of the 230.9 qualified professional shall be limited to only those recipients 230.10 who have requested the supervision. 230.11 Nothing in this subdivision shall be construed to reduce 230.12 the total number of hours authorized for an individual recipient. 230.13 Sec. 33. Minnesota Statutes 2000, section 256B.0627, 230.14 subdivision 10, is amended to read: 230.15 Subd. 10. [FISCALAGENTINTERMEDIARY OPTION AVAILABLE FOR 230.16 PERSONAL CARE ASSISTANT SERVICES.] (a)"Fiscal agent option" is230.17an option that allows the recipient to:230.18(1) use a fiscal agent instead of a personal care provider230.19organization;230.20(2) supervise the personal care assistant; and230.21(3) use a consulting professional.230.22 The commissioner may allow a recipient of personal care 230.23 assistant services to use a fiscalagentintermediary to assist 230.24 the recipient in paying and accounting for medically necessary 230.25 covered personal care assistant services authorized in 230.26 subdivision 4 and within the payment parameters of subdivision 230.27 5. Unless otherwise provided in this subdivision, all other 230.28 statutory and regulatory provisions relating to personal care 230.29 assistant services apply to a recipient using the fiscalagent230.30 intermediary option. 230.31 (b) The recipient or responsible party shall: 230.32 (1)hire, and terminate the personal care assistant and230.33consulting professional, with the fiscal agentrecruit, hire, 230.34 and terminate a qualified professional, if a qualified 230.35 professional is requested by the recipient or responsible party; 230.36 (2)recruit the personal care assistant and consulting231.1professional and orient and train the personal care assistant in231.2areas that do not require professional delegation as determined231.3by the county public health nurseverify and document the 231.4 credentials of the qualified professional, if a qualified 231.5 professional is requested by the recipient or responsible party; 231.6 (3)supervise and evaluate the personal care assistant in231.7areas that do not require professional delegation as determined231.8in the assessment;231.9(4) cooperate with a consultingdevelop a service plan 231.10 based on physician orders and public health nurse assessment 231.11 with the assistance of a qualified professionaland implement231.12recommendations pertaining to the health and safety of the231.13recipient, if a qualified professional is requested by the 231.14 recipient or responsible party, that addresses the health and 231.15 safety of the recipient; 231.16(5) hire a qualified professional to train and supervise231.17the performance of delegated tasks done by(4) recruit, hire, 231.18 and terminate the personal care assistant; 231.19(6) monitor services and verify in writing the hours worked231.20by the personal care assistant and the consulting(5) orient and 231.21 train the personal care assistant with assistance as needed from 231.22 the qualified professional; 231.23(7) develop and revise a care plan with assistance from a231.24consulting(6) supervise and evaluate the personal care 231.25 assistant with assistance as needed from the recipient's 231.26 physician or the qualified professional; 231.27(8) verify and document the credentials of the consulting231.28 (7) monitor and verify in writing and report to the fiscal 231.29 intermediary the number of hours worked by the personal care 231.30 assistant and the qualified professional; and 231.31(9)(8) enter into a written agreement, as specified in 231.32 paragraph (f). 231.33 (c) The duties of the fiscalagentintermediary shall be to: 231.34 (1) bill the medical assistance program for personal care 231.35 assistant andconsultingqualified professional services; 231.36 (2) request and secure background checks on personal care 232.1 assistants andconsultingqualified professionals according to 232.2 section 245A.04; 232.3 (3) pay the personal care assistant andconsulting232.4 qualified professional based on actual hours of services 232.5 provided; 232.6 (4) withhold and pay all applicable federal and state 232.7 taxes; 232.8 (5) verify anddocumentkeep records hours worked by the 232.9 personal care assistant andconsultingqualified professional; 232.10 (6) make the arrangements and pay unemployment insurance, 232.11 taxes, workers' compensation, liability insurance, and other 232.12 benefits, if any; 232.13 (7) enroll in the medical assistance program as a fiscal 232.14agentintermediary; and 232.15 (8) enter into a written agreement as specified in 232.16 paragraph (f) before services are provided. 232.17 (d) The fiscalagentintermediary: 232.18 (1) may not be related to the recipient,consulting232.19 qualified professional, or the personal care assistant; 232.20 (2) must ensure arm's length transactions with the 232.21 recipient and personal care assistant; and 232.22 (3) shall be considered a joint employer of the personal 232.23 care assistant andconsultingqualified professional to the 232.24 extent specified in this section. 232.25 The fiscalagentintermediary or owners of the entity that 232.26 provides fiscalagentintermediary services under this 232.27 subdivision must pass a criminal background check as required in 232.28 section 256B.0627, subdivision 1, paragraph (e). 232.29 (e) If the recipient or responsible party requests a 232.30 qualified professional, theconsultingqualified professional 232.31 providing assistance to the recipient shall meet the 232.32 qualifications specified in section 256B.0625, subdivision 19c. 232.33 Theconsultingqualified professional shall assist the recipient 232.34 in developing and revising a plan to meet the 232.35 recipient'sassessedneeds,and supervise the performance of232.36delegated tasks, as determined by the public health nurseas 233.1 assessed by the public health nurse. In performing this 233.2 function, theconsultingqualified professional must visit the 233.3 recipient in the recipient's home at least once annually. 233.4 Theconsultingqualified professional must reportto the local233.5county public health nurse concerns relating to the health and233.6safety of the recipient, andany suspected abuse, neglect, or 233.7 financial exploitation of the recipient to the appropriate 233.8 authorities. 233.9 (f) The fiscalagentintermediary, recipient or responsible 233.10 party, personal care assistant, andconsultingqualified 233.11 professional shall enter into a written agreement before 233.12 services are started. The agreement shall include: 233.13 (1) the duties of the recipient, qualified professional, 233.14 personal care assistant, and fiscal agent based on paragraphs 233.15 (a) to (e); 233.16 (2) the salary and benefits for the personal care assistant 233.17 andthose providing professional consultationthe qualified 233.18 professional; 233.19 (3) the administrative fee of the fiscalagentintermediary 233.20 and services paid for with that fee, including background check 233.21 fees; 233.22 (4) procedures to respond to billing or payment complaints; 233.23 and 233.24 (5) procedures for hiring and terminating the personal care 233.25 assistant andthose providing professional consultationthe 233.26 qualified professional. 233.27 (g) The rates paid for personal care assistant services, 233.28 qualified professionalassistanceservices, and fiscalagency233.29 intermediary services under this subdivision shall be the same 233.30 rates paid for personal care assistant services and qualified 233.31 professional services under subdivision 2 respectively. Except 233.32 for the administrative fee of the fiscalagentintermediary 233.33 specified in paragraph (f), the remainder of the rates paid to 233.34 the fiscalagentintermediary must be used to pay for the salary 233.35 and benefits for the personal care assistant orthose providing233.36professional consultationthe qualified professional. 234.1 (h) As part of the assessment defined in subdivision 1, the 234.2 following conditions must be met to use or continue use of a 234.3 fiscalagentintermediary: 234.4 (1) the recipient must be able to direct the recipient's 234.5 own care, or the responsible party for the recipient must be 234.6 readily available to direct the care of the personal care 234.7 assistant; 234.8 (2) the recipient or responsible party must be 234.9 knowledgeable of the health care needs of the recipient and be 234.10 able to effectively communicate those needs; 234.11 (3) a face-to-face assessment must be conducted by the 234.12 local county public health nurse at least annually, or when 234.13 there is a significant change in the recipient's condition or 234.14 change in the need for personal care assistant services. The234.15county public health nurse shall determine the services that234.16require professional delegation, if any, and the amount and234.17frequency of related supervision; 234.18 (4) the recipient cannot select the shared services option 234.19 as specified in subdivision 8; and 234.20 (5) parties must be in compliance with the written 234.21 agreement specified in paragraph (f). 234.22 (i) The commissioner shall deny, revoke, or suspend the 234.23 authorization to use the fiscalagentintermediary option if: 234.24 (1) it has been determined by theconsultingqualified 234.25 professional or local county public health nurse that the use of 234.26 this option jeopardizes the recipient's health and safety; 234.27 (2) the parties have failed to comply with the written 234.28 agreement specified in paragraph (f); or 234.29 (3) the use of the option has led to abusive or fraudulent 234.30 billing for personal care assistant services. 234.31 The recipient or responsible party may appeal the 234.32 commissioner's action according to section 256.045. The denial, 234.33 revocation, or suspension to use the fiscalagentintermediary 234.34 option shall not affect the recipient's authorized level of 234.35 personal care assistant services as determined in subdivision 5. 234.36 Sec. 34. Minnesota Statutes 2000, section 256B.0627, 235.1 subdivision 11, is amended to read: 235.2 Subd. 11. [SHARED PRIVATE DUTY NURSING CARE OPTION.] (a) 235.3 Medical assistance payments for shared private duty nursing 235.4 services by a private duty nurse shall be limited according to 235.5 this subdivision. For the purposes of this section, "private 235.6 duty nursing agency" means an agency licensed under chapter 144A 235.7 to provide private duty nursing services. 235.8 (b) Recipients of private duty nursing services may share 235.9 nursing staff and the commissioner shall provide a rate 235.10 methodology for shared private duty nursing. For two persons 235.11 sharing nursing care, the rate paid to a provider shall not 235.12 exceed 1.5 times thenonwaiveredregular private duty nursing 235.13 rates paid for serving a single individualwho is not ventilator235.14dependent,by a registered nurse or licensed practical nurse. 235.15 These rates apply only to situations in which both recipients 235.16 are present and receive shared private duty nursing care on the 235.17 date for which the service is billed. No more than two persons 235.18 may receive shared private duty nursing services from a private 235.19 duty nurse in a single setting. 235.20 (c) Shared private duty nursing care is the provision of 235.21 nursing services by a private duty nurse to two recipients at 235.22 the same time and in the same setting. For the purposes of this 235.23 subdivision, "setting" means: 235.24 (1) the home or foster care home of one of the individual 235.25 recipients; or 235.26 (2) a child care program licensed under chapter 245A or 235.27 operated by a local school district or private school; or 235.28 (3) an adult day care service licensed under chapter 245A; 235.29 or 235.30 (4) outside the home or foster care home of one of the 235.31 recipients when normal life activities take the recipients 235.32 outside the home. 235.33 This subdivision does not apply when a private duty nurse 235.34 is caring for multiple recipients in more than one setting. 235.35 (d) The recipient or the recipient's legal representative, 235.36 and the recipient's physician, in conjunction with the home 236.1 health care agency, shall determine: 236.2 (1) whether shared private duty nursing care is an 236.3 appropriate option based on the individual needs and preferences 236.4 of the recipient; and 236.5 (2) the amount of shared private duty nursing services 236.6 authorized as part of the overall authorization of nursing 236.7 services. 236.8 (e) The recipient or the recipient's legal representative, 236.9 in conjunction with the private duty nursing agency, shall 236.10 approve the setting, grouping, and arrangement of shared private 236.11 duty nursing care based on the individual needs and preferences 236.12 of the recipients. Decisions on the selection of recipients to 236.13 share services must be based on the ages of the recipients, 236.14 compatibility, and coordination of their care needs. 236.15 (f) The following items must be considered by the recipient 236.16 or the recipient's legal representative and the private duty 236.17 nursing agency, and documented in the recipient's health service 236.18 record: 236.19 (1) the additional training needed by the private duty 236.20 nurse to provide care to two recipients in the same setting and 236.21 to ensure that the needs of the recipients are met appropriately 236.22 and safely; 236.23 (2) the setting in which the shared private duty nursing 236.24 care will be provided; 236.25 (3) the ongoing monitoring and evaluation of the 236.26 effectiveness and appropriateness of the service and process 236.27 used to make changes in service or setting; 236.28 (4) a contingency plan which accounts for absence of the 236.29 recipient in a shared private duty nursing setting due to 236.30 illness or other circumstances; 236.31 (5) staffing backup contingencies in the event of employee 236.32 illness or absence; and 236.33 (6) arrangements for additional assistance to respond to 236.34 urgent or emergency care needs of the recipients. 236.35 (g) The provider must offer the recipient or responsible 236.36 party the option of shared or one-on-one private duty nursing 237.1 services. The recipient or responsible party can withdraw from 237.2 participating in a shared service arrangement at any time. 237.3 (h) The private duty nursing agency must document the 237.4 following in the health service record for each individual 237.5 recipient sharing private duty nursing care: 237.6 (1) permission by the recipient or the recipient's legal 237.7 representative for the maximum number of shared nursing care 237.8 hours per week chosen by the recipient; 237.9 (2) permission by the recipient or the recipient's legal 237.10 representative for shared private duty nursing services provided 237.11 outside the recipient's residence; 237.12 (3) permission by the recipient or the recipient's legal 237.13 representative for others to receive shared private duty nursing 237.14 services in the recipient's residence; 237.15 (4) revocation by the recipient or the recipient's legal 237.16 representative of the shared private duty nursing care 237.17 authorization, or the shared care to be provided to others in 237.18 the recipient's residence, or the shared private duty nursing 237.19 services to be provided outside the recipient's residence; and 237.20 (5) daily documentation of the shared private duty nursing 237.21 services provided by each identified private duty nurse, 237.22 including: 237.23 (i) the names of each recipient receiving shared private 237.24 duty nursing services together; 237.25 (ii) the setting for the shared services, including the 237.26 starting and ending times that the recipient received shared 237.27 private duty nursing care; and 237.28 (iii) notes by the private duty nurse regarding changes in 237.29 the recipient's condition, problems that may arise from the 237.30 sharing of private duty nursing services, and scheduling and 237.31 care issues. 237.32 (i) Unless otherwise provided in this subdivision, all 237.33 other statutory and regulatory provisions relating to private 237.34 duty nursing services apply to shared private duty nursing 237.35 services. 237.36 Nothing in this subdivision shall be construed to reduce 238.1 the total number of private duty nursing hours authorized for an 238.2 individual recipient under subdivision 5. 238.3 Sec. 35. Minnesota Statutes 2000, section 256B.0627, is 238.4 amended by adding a subdivision to read: 238.5 Subd. 13. [CONSUMER-DIRECTED HOME CARE DEMONSTRATION 238.6 PROJECT.] (a) Upon the receipt of federal waiver authority, the 238.7 commissioner shall implement a consumer-directed home care 238.8 demonstration project. The consumer-directed home care 238.9 demonstration project must demonstrate and evaluate the outcomes 238.10 of a consumer-directed service delivery alternative to improve 238.11 access, increase consumer control and accountability over 238.12 available resources, and enable the use of supports that are 238.13 more individualized and cost-effective for eligible medical 238.14 assistance recipients receiving certain medical assistance home 238.15 care services. The consumer-directed home care demonstration 238.16 project will be administered locally by county agencies, tribal 238.17 governments, or administrative entities under contract with the 238.18 state in regions where counties choose not to provide this 238.19 service. 238.20 (b) Grant awards for persons who have been receiving 238.21 medical assistance covered personal care, home health aide, or 238.22 private duty nursing services for a period of 12 consecutive 238.23 months or more prior to enrollment in the consumer-directed home 238.24 care demonstration project will be established on a case-by-case 238.25 basis using historical service expenditure data. An average 238.26 monthly expenditure for each continuing enrollee will be 238.27 calculated based on historical expenditures made on behalf of 238.28 the enrollee for personal care, home health aide, or private 238.29 duty nursing services during the 12 month period directly prior 238.30 to enrollment in the project. The grant award will equal 90 238.31 percent of the average monthly expenditure. 238.32 (c) Grant awards for project enrollees who have been 238.33 receiving medical assistance covered personal care, home health 238.34 aide, or private duty nursing services for a period of less than 238.35 12 consecutive months prior to project enrollment will be 238.36 calculated on a case-by-case basis using the service 239.1 authorization in place at the time of enrollment. The total 239.2 number of units of personal care, home health aide, or private 239.3 duty nursing services the enrollee has been authorized to 239.4 receive will be converted to the total cost of the authorized 239.5 services in a given month using the statewide average service 239.6 payment rates. To determine an estimated monthly expenditure, 239.7 the total authorized monthly personal care, home health aide or 239.8 private duty nursing service costs will be reduced by a 239.9 percentage rate equivalent to the difference between the 239.10 statewide average service authorization and the statewide 239.11 average utilization rate for each of the services by medical 239.12 assistance eligibles during the most recent fiscal year for 239.13 which 12 months of data is available. The grant award will 239.14 equal 90 percent of the estimated monthly expenditure. 239.15 Sec. 36. Minnesota Statutes 2000, section 256B.0627, is 239.16 amended by adding a subdivision to read: 239.17 Subd. 14. [TELEHOMECARE; SKILLED NURSE VISITS.] Medical 239.18 assistance covers skilled nurse visits according to section 239.19 256B.0625, subdivision 6a, provided via telehomecare, for 239.20 services which do not require hands-on care between the home 239.21 care nurse and recipient. The provision of telehomecare must be 239.22 made via live, two-way interactive audiovisual technology and 239.23 may be augmented by utilizing store-and-forward technologies. 239.24 Store-and-forward technology includes telehomecare services that 239.25 do not occur in real time via synchronous transmissions, and 239.26 that do not require a face-to-face encounter with the recipient 239.27 for all or any part of any such telehomecare visit. A 239.28 communication between the home care nurse and recipient that 239.29 consists solely of a telephone conversation, facsimile, 239.30 electronic mail, or a consultation between two health care 239.31 practitioners, is not to be considered a telehomecare visit. 239.32 Multiple daily skilled nurse visits provided via telehomecare 239.33 are allowed. Coverage of telehomecare is limited to two visits 239.34 per day. All skilled nurse visits provided via telehomecare 239.35 must be prior authorized by the commissioner or the 239.36 commissioner's designee and will be covered at the same 240.1 allowable rate as skilled nurse visits provided in-person. 240.2 Sec. 37. Minnesota Statutes 2000, section 256B.0627, is 240.3 amended by adding a subdivision to read: 240.4 Subd. 15. [THERAPIES THROUGH HOME HEALTH AGENCIES.] (a) 240.5 [PHYSICAL THERAPY.] Medical assistance covers physical therapy 240.6 and related services, including specialized maintenance 240.7 therapy. Services provided by a physical therapy assistant 240.8 shall be reimbursed at the same rate as services performed by a 240.9 physical therapist when the services of the physical therapy 240.10 assistant are provided under the direction of a physical 240.11 therapist who is on the premises. Services provided by a 240.12 physical therapy assistant that are provided under the direction 240.13 of a physical therapist who is not on the premises shall be 240.14 reimbursed at 65 percent of the physical therapist rate. 240.15 Direction of the physical therapy assistant must be provided by 240.16 the physical therapist as described in Minnesota Rules, part 240.17 9505.0390, subpart 1, item B. The physical therapist and 240.18 physical therapist assistant may not both bill for services 240.19 provided to a recipient on the same day. 240.20 (b) [OCCUPATIONAL THERAPY.] Medical assistance covers 240.21 occupational therapy and related services, including specialized 240.22 maintenance therapy. Services provided by an occupational 240.23 therapy assistant shall be reimbursed at the same rate as 240.24 services performed by an occupational therapist when the 240.25 services of the occupational therapy assistant are provided 240.26 under the direction of the occupational therapist who is on the 240.27 premises. Services provided by an occupational therapy 240.28 assistant under the direction of an occupational therapist who 240.29 is not on the premises shall be reimbursed at 65 percent of the 240.30 occupational therapist rate. Direction of the occupational 240.31 therapy assistant must be provided by the occupational therapist 240.32 as described in Minnesota Rules, part 9505.0390, subpart 1, item 240.33 B. The occupational therapist and occupational therapist 240.34 assistant may not both bill for services provided to a recipient 240.35 on the same day. 240.36 Sec. 38. Minnesota Statutes 2000, section 256B.0627, is 241.1 amended by adding a subdivision to read: 241.2 Subd. 16. [HARDSHIP CRITERIA; PRIVATE DUTY NURSING.] (a) 241.3 Payment is allowed for extraordinary services that require 241.4 specialized nursing skills and are provided by parents of minor 241.5 children, spouses, and legal guardians who are providing private 241.6 duty nursing care under the following conditions: 241.7 (1) the provision of these services is not legally required 241.8 of the parents, spouses, or legal guardians; 241.9 (2) the services are necessary to prevent hospitalization 241.10 of the recipient; and 241.11 (3) the recipient is eligible for state plan home care or a 241.12 home and community-based waiver and one of the following 241.13 hardship criteria are met: 241.14 (i) the parent, spouse, or legal guardian resigns from a 241.15 part-time or full-time job to provide nursing care for the 241.16 recipient; or 241.17 (ii) the parent, spouse, or legal guardian goes from a 241.18 full-time to a part-time job with less compensation to provide 241.19 nursing care for the recipient; or 241.20 (iii) the parent, spouse, or legal guardian takes a leave 241.21 of absence without pay to provide nursing care for the 241.22 recipient; or 241.23 (iv) because of labor conditions, special language needs, 241.24 or intermittent hours of care needed, the parent, spouse, or 241.25 legal guardian is needed in order to provide adequate private 241.26 duty nursing services to meet the medical needs of the recipient. 241.27 (b) Private duty nursing may be provided by a parent, 241.28 spouse, or legal guardian who is a nurse licensed in Minnesota. 241.29 Private duty nursing services provided by a parent, spouse, or 241.30 legal guardian cannot be used in lieu of nursing services 241.31 covered and available under liable third-party payors, including 241.32 Medicare. The private duty nursing provided by a parent, 241.33 spouse, or legal guardian must be included in the service plan. 241.34 Authorized skilled nursing services provided by the parent, 241.35 spouse, or legal guardian may not exceed 50 percent of the total 241.36 approved nursing hours, or eight hours per day, whichever is 242.1 less, up to a maximum of 40 hours per week. Nothing in this 242.2 subdivision precludes the parent's, spouse's, or legal 242.3 guardian's obligation of assuming the nonreimbursed family 242.4 responsibilities of emergency backup caregiver and primary 242.5 caregiver. 242.6 (c) A parent or a spouse may not be paid to provide private 242.7 duty nursing care if the parent or spouse fails to pass a 242.8 criminal background check according to section 245A.04, or if it 242.9 has been determined by the home health agency, the case manager, 242.10 or the physician that the private duty nursing care provided by 242.11 the parent, spouse, or legal guardian is unsafe. 242.12 Sec. 39. Minnesota Statutes 2000, section 256B.0627, is 242.13 amended by adding a subdivision to read: 242.14 Subd. 17. [QUALITY ASSURANCE PLAN FOR PERSONAL CARE 242.15 ASSISTANT SERVICES.] The commissioner shall establish a quality 242.16 assurance plan for personal care assistant services that 242.17 includes: 242.18 (1) performance-based provider agreements; 242.19 (2) meaningful consumer input, which may include consumer 242.20 surveys, that measure the extent to which participants receive 242.21 the services and supports described in the individual plan and 242.22 participant satisfaction with such services and supports; 242.23 (3) ongoing monitoring of the health and well-being of 242.24 consumers; and 242.25 (4) an ongoing public process for development, 242.26 implementation, and review of the quality assurance plan. 242.27 Sec. 40. Minnesota Statutes 2000, section 256B.0911, is 242.28 amended by adding a subdivision to read: 242.29 Subd. 4a. [PREADMISSION SCREENING OF INDIVIDUALS UNDER 65 242.30 YEARS OF AGE.] (a) It is the policy of the state of Minnesota to 242.31 ensure that individuals with disabilities or chronic illness are 242.32 served in the most integrated setting appropriate to their needs 242.33 and have the necessary information to make informed choices 242.34 about home and community-based service options. 242.35 (b) Individuals under 65 years of age who are admitted to a 242.36 nursing facility from a hospital must be screened prior to 243.1 admission as outlined in subdivision 4. 243.2 (c) Individuals under 65 years of age who are admitted to 243.3 nursing facilities with only a telephone screening must receive 243.4 a face-to-face assessment from the long-term care consultation 243.5 team member of the county in which the facility is located or 243.6 from the recipient's county case manager within 20 working days 243.7 of admission. 243.8 (d) At the face-to-face assessment, the long-term care 243.9 consultation team member or county case manager must perform the 243.10 activities required under subdivision 3. 243.11 (e) For individuals under 21 years of age, the screening or 243.12 assessment which recommends nursing facility admission must be 243.13 approved by the commissioner before the individual is admitted 243.14 to the nursing facility. 243.15 (f) In the event that an individual under 65 years of age 243.16 is admitted to a nursing facility on an emergency basis, the 243.17 county must be notified of the admission on the next working 243.18 day, and a face-to-face assessment as described in paragraph (c) 243.19 must be conducted within 20 working days of admission. 243.20 (g) At the face-to-face assessment, the long-term care 243.21 consultation team member or the case manager must present 243.22 information about home and community-based options so the 243.23 individual can make informed choices. If the individual chooses 243.24 home and community-based services, the long-term care 243.25 consultation team member or case manager must complete a written 243.26 relocation plan within 20 working days of the visit. The plan 243.27 shall describe the services needed to move out of the facility 243.28 and a timeline for the move which is designed to ensure a smooth 243.29 transition to the individual's home and community. 243.30 (h) An individual under 65 years of age residing in a 243.31 nursing facility shall receive a face-to-face assessment at 243.32 least every 12 months to review the person's service choices and 243.33 available alternatives unless the individual indicates, in 243.34 writing, that annual visits are not desired. In this case, the 243.35 individual must receive a face-to-face assessment at least once 243.36 every 36 months for the same purposes. 244.1 (i) Notwithstanding the provisions of subdivision 6, the 244.2 commissioner may pay county agencies directly for face-to-face 244.3 assessments for individuals who are eligible for medical 244.4 assistance, under 65 years of age, and being considered for 244.5 placement or residing in a nursing facility. 244.6 Sec. 41. Minnesota Statutes 2000, section 256B.093, 244.7 subdivision 3, is amended to read: 244.8 Subd. 3. [TRAUMATIC BRAIN INJURY PROGRAM DUTIES.] The 244.9 department shall fund administrative case management under this 244.10 subdivision using medical assistance administrative funds. The 244.11 traumatic brain injury program duties include: 244.12 (1) recommending to the commissioner in consultation with 244.13 the medical review agent according to Minnesota Rules, parts 244.14 9505.0500 to 9505.0540, the approval or denial of medical 244.15 assistance funds to pay for out-of-state placements for 244.16 traumatic brain injury services and in-state traumatic brain 244.17 injury services provided by designated Medicare long-term care 244.18 hospitals; 244.19 (2) coordinating the traumatic brain injury home and 244.20 community-based waiver; 244.21 (3)approving traumatic brain injury waiver eligibility or244.22care plans or both;244.23(4)providing ongoing technical assistance and consultation 244.24 to county and facility case managers to facilitate care plan 244.25 development for appropriate, accessible, and cost-effective 244.26 medical assistance services; 244.27(5)(4) providing technical assistance to promote statewide 244.28 development of appropriate, accessible, and cost-effective 244.29 medical assistance services and related policy; 244.30(6)(5) providing training and outreach to facilitate 244.31 access to appropriate home and community-based services to 244.32 prevent institutionalization; 244.33(7)(6) facilitating appropriate admissions, continued stay 244.34 review, discharges, and utilization review for neurobehavioral 244.35 hospitals and other specialized institutions; 244.36(8)(7) providing technical assistance on the use of prior 245.1 authorization of home care services and coordination of these 245.2 services with other medical assistance services; 245.3(9)(8) developing a system for identification of nursing 245.4 facility and hospital residents with traumatic brain injury to 245.5 assist in long-term planning for medical assistance services. 245.6 Factors will include, but are not limited to, number of 245.7 individuals served, length of stay, services received, and 245.8 barriers to community placement; and 245.9(10)(9) providing information, referral, and case 245.10 consultation to access medical assistance services for 245.11 recipients without a county or facility case manager. Direct 245.12 access to this assistance may be limited due to the structure of 245.13 the program. 245.14 Sec. 42. Minnesota Statutes 2000, section 256B.49, is 245.15 amended by adding a subdivision to read: 245.16 Subd. 11. [AUTHORITY.] (a) The commissioner is authorized 245.17 to apply for home and community-based service waivers, as 245.18 authorized under section 1915(c) of the Social Security Act to 245.19 serve persons under the age of 65 who are determined to require 245.20 the level of care provided in a nursing home and persons who 245.21 require the level of care provided in a hospital. The 245.22 commissioner shall apply for the home and community-based 245.23 waivers in order to: (i) promote the support of persons with 245.24 disabilities in the most integrated settings; (ii) expand the 245.25 availability of services for persons who are eligible for 245.26 medical assistance; (iii) promote cost-effective options to 245.27 institutional care; and (iv) obtain federal financial 245.28 participation. 245.29 (b) The provision of waivered services to medical 245.30 assistance recipients with disabilities shall comply with the 245.31 requirements outlined in the federally approved applications for 245.32 home and community-based services and subsequent amendments, 245.33 including provision of services according to a service plan 245.34 designated to meet the needs of the individual. For purposes of 245.35 this section, the approved home and community-based application 245.36 is considered the necessary federal requirement. 246.1 (c) The commissioner shall seek approval, as authorized 246.2 under section 1915(c) of the Social Security Act, to allow 246.3 medical assistance eligibility under this section for children 246.4 under age 21 without deeming of parental income or assets. 246.5 (d) The commissioner shall seek approval, as authorized 246.6 under section 1915(c) of the Social Security Act, to allow 246.7 medical assistance eligibility under this section for 246.8 individuals under age 65 without deeming the spouse's income or 246.9 assets. 246.10 (e) Prior to submitting to the federal government any 246.11 proposed changes or amendments to federally approved 246.12 applications for home and community-based services, the 246.13 commissioner shall notify interested persons serving on 246.14 departmental advisory groups and task forces and persons who 246.15 have requested to be notified. 246.16 Sec. 43. Minnesota Statutes 2000, section 256B.49, is 246.17 amended by adding a subdivision to read: 246.18 Subd. 12. [INFORMED CHOICE.] Persons who are determined 246.19 likely to require the level of care provided in a nursing 246.20 facility or hospital shall be informed of the home and 246.21 community-based support alternatives to the provision of 246.22 inpatient hospital services or nursing facility services. Each 246.23 person must be given the choice of either institutional or home 246.24 and community-based services using the provisions described in 246.25 section 256B.77, subdivision 2, paragraph (p). 246.26 Sec. 44. Minnesota Statutes 2000, section 256B.49, is 246.27 amended by adding a subdivision to read: 246.28 Subd. 13. [CASE MANAGEMENT.] (a) Each recipient of a home 246.29 and community-based waiver shall be provided case management 246.30 services by qualified vendors as described in the federally 246.31 approved waiver application. The case management service 246.32 activities provided will include: 246.33 (1) assessing the needs of the individual within 20 working 246.34 days of a recipient's request; 246.35 (2) developing the written individual service plan within 246.36 ten working days after the assessment is completed; 247.1 (3) informing the recipient or the recipient's legal 247.2 guardian or conservator of service options; 247.3 (4) assisting the recipient in the identification of 247.4 potential service providers; 247.5 (5) assisting the recipient to access services; 247.6 (6) coordinating, evaluating, and monitoring of the 247.7 services identified in the service plan; 247.8 (7) completing the annual reviews of the service plan; and 247.9 (8) informing the recipient or legal representative of the 247.10 right to have assessments completed and service plans developed 247.11 within specified time periods, and to appeal county action or 247.12 inaction under section 256.045, subdivision 3. 247.13 (b) The case manager may delegate certain aspects of the 247.14 case management service activities to another individual 247.15 provided there is oversight by the case manager. The case 247.16 manager may not delegate those aspects which require 247.17 professional judgment including assessments, reassessments, and 247.18 care plan development. 247.19 Sec. 45. Minnesota Statutes 2000, section 256B.49, is 247.20 amended by adding a subdivision to read: 247.21 Subd. 14. [ASSESSMENT AND REASSESSMENT.] (a) Assessments 247.22 of each recipient's strengths, informal support systems, and 247.23 need for services shall be completed within 20 working days of 247.24 the recipient's request. Reassessment of each recipient's 247.25 strengths, support systems, and need for services shall be 247.26 conducted at least every 12 months and at other times when there 247.27 has been a significant change in the recipient's functioning. 247.28 (b) Persons with mental retardation or a related condition 247.29 who apply for services under the nursing facility level waiver 247.30 programs shall be screened for the appropriate level of care 247.31 according to section 256B.092. 247.32 (c) Recipients who are found eligible for home and 247.33 community-based services under this section before their 65th 247.34 birthday may remain eligible for these services after their 65th 247.35 birthday if they continue to meet all other eligibility factors. 247.36 Sec. 46. Minnesota Statutes 2000, section 256B.49, is 248.1 amended by adding a subdivision to read: 248.2 Subd. 15. [INDIVIDUALIZED SERVICE PLAN.] Each recipient of 248.3 home and community-based waivered services shall be provided a 248.4 copy of the written service plan which: 248.5 (1) is developed and signed by the recipient within ten 248.6 working days of the completion of the assessment; 248.7 (2) meets the assessed needs of the recipient; 248.8 (3) reasonably ensures the health and safety of the 248.9 recipient; 248.10 (4) promotes independence; 248.11 (5) allows for services to be provided in the most 248.12 integrated settings; and 248.13 (6) provides for an informed choice, as defined in section 248.14 256B.77, subdivision 2, paragraph (p), of service and support 248.15 providers. 248.16 Sec. 47. Minnesota Statutes 2000, section 256B.49, is 248.17 amended by adding a subdivision to read: 248.18 Subd. 16. [SERVICES AND SUPPORTS.] Services and supports 248.19 included in the home and community-based waivers for persons 248.20 with disabilities shall meet the requirements set out in United 248.21 States Code, title 42, section 1396n. The services and 248.22 supports, which are offered as alternatives to institutional 248.23 care, shall promote consumer choice, community inclusion, 248.24 self-sufficiency, and self-determination. Beginning January 1, 248.25 2003, the commissioner shall simplify and improve access to home 248.26 and community-based services, to the extent possible, through 248.27 the establishment of a common service menu that is available to 248.28 eligible recipients regardless of age, disability type, or 248.29 waiver program. Consumer-directed community support services 248.30 shall be offered as an option to all persons eligible for 248.31 services under subdivision 11 by January 1, 2002. Services and 248.32 supports shall be arranged and provided consistent with 248.33 individualized written plans of care for eligible waiver 248.34 recipients. 248.35 Sec. 48. Minnesota Statutes 2000, section 256B.49, is 248.36 amended by adding a subdivision to read: 249.1 Subd. 17. [COST OF SERVICES AND SUPPORTS.] (a) The 249.2 commissioner shall ensure that the average per capita 249.3 expenditures estimated in any fiscal year for home and 249.4 community-based waiver recipients does not exceed the average 249.5 per capita expenditures that would have been made to provide 249.6 institutional services for recipients in the absence of the 249.7 waiver. 249.8 (b) The commissioner shall implement on January 1, 2002, 249.9 one or more aggregate, need-based methods for allocating to 249.10 local agencies the home and community-based waivered service 249.11 resources available to support recipients with disabilities in 249.12 need of the level of care provided in a nursing facility or a 249.13 hospital. The commissioner shall allocate resources to single 249.14 counties and county partnerships in a manner that reflects 249.15 consideration of: 249.16 (1) an incentive-based payment process for achieving 249.17 outcomes; 249.18 (2) the need for a state-level risk pool; 249.19 (3) the need for retention of management responsibility at 249.20 the state agency level; and 249.21 (4) a phase-in strategy as appropriate. 249.22 (c) Until the allocation methods described in paragraph (b) 249.23 are implemented, the annual allowable reimbursement level of 249.24 home and community-based waiver services shall be the greater of: 249.25 (1) the statewide average payment amount which the 249.26 recipient is assigned under the waiver reimbursement system in 249.27 place on June 30, 2001, modified by the percentage of any 249.28 provider rate increase appropriated for home and community-based 249.29 services; or 249.30 (2) an amount approved by the commissioner based on the 249.31 recipient's extraordinary needs that cannot be met within the 249.32 current allowable reimbursement level. The increased 249.33 reimbursement level must be necessary to allow the recipient to 249.34 be discharged from an institution or to prevent imminent 249.35 placement in an institution. The additional reimbursement may 249.36 be used to secure environmental modifications; assistive 250.1 technology and equipment; and increased costs for supervision, 250.2 training, and support services necessary to address the 250.3 recipient's extraordinary needs. The commissioner may approve 250.4 an increased reimbursement level for up to one year of the 250.5 recipient's relocation from an institution or up to six months 250.6 of a determination that a current waiver recipient is at 250.7 imminent risk of being placed in an institution. 250.8 (d) Beginning January 1, 2003, medically necessary private 250.9 duty nursing services will be authorized under this section as 250.10 complex and regular care according to section 256B.0627. The 250.11 rate established by the commissioner for registered nurse or 250.12 licensed practical nurse services under any home and 250.13 community-based waiver as of January 1, 2001, shall not be 250.14 reduced. 250.15 Sec. 49. Minnesota Statutes 2000, section 256B.49, is 250.16 amended by adding a subdivision to read: 250.17 Subd. 18. [PAYMENTS.] The commissioner shall reimburse 250.18 approved vendors from the medical assistance account for the 250.19 costs of providing home and community-based services to eligible 250.20 recipients using the invoice processing procedures of the 250.21 Medicaid management information system (MMIS). Recipients will 250.22 be screened and authorized for services according to the 250.23 federally approved waiver application and its subsequent 250.24 amendments. 250.25 Sec. 50. Minnesota Statutes 2000, section 256B.49, is 250.26 amended by adding a subdivision to read: 250.27 Subd. 19. [HEALTH AND WELFARE.] The commissioner of human 250.28 services shall take the necessary safeguards to protect the 250.29 health and welfare of individuals provided services under the 250.30 waiver. 250.31 Sec. 51. Minnesota Statutes 2000, section 256D.35, is 250.32 amended by adding a subdivision to read: 250.33 Subd. 11a. [INSTITUTION.] "Institution" means a hospital, 250.34 consistent with Code of Federal Regulations, title 42, section 250.35 440.10; regional treatment center inpatient services, consistent 250.36 with section 245.474; a nursing facility; and an intermediate 251.1 care facility for persons with mental retardation. 251.2 Sec. 52. Minnesota Statutes 2000, section 256D.35, is 251.3 amended by adding a subdivision to read: 251.4 Subd. 18a. [SHELTER COSTS.] "Shelter costs" means rent, 251.5 manufactured home lot rentals; monthly principal, interest, 251.6 insurance premiums, and property taxes due for mortgages or 251.7 contract for deed costs; costs for utilities, including heating, 251.8 cooling, electricity, water, and sewerage; garbage collection 251.9 fees; and the basic service fee for one telephone. 251.10 Sec. 53. Minnesota Statutes 2000, section 256D.44, 251.11 subdivision 5, is amended to read: 251.12 Subd. 5. [SPECIAL NEEDS.] In addition to the state 251.13 standards of assistance established in subdivisions 1 to 4, 251.14 payments are allowed for the following special needs of 251.15 recipients of Minnesota supplemental aid who are not residents 251.16 of a nursing home, a regional treatment center, or a group 251.17 residential housing facility. 251.18 (a) The county agency shall pay a monthly allowance for 251.19 medically prescribed diets payable under the Minnesota family 251.20 investment program if the cost of those additional dietary needs 251.21 cannot be met through some other maintenance benefit. 251.22 (b) Payment for nonrecurring special needs must be allowed 251.23 for necessary home repairs or necessary repairs or replacement 251.24 of household furniture and appliances using the payment standard 251.25 of the AFDC program in effect on July 16, 1996, for these 251.26 expenses, as long as other funding sources are not available. 251.27 (c) A fee for guardian or conservator service is allowed at 251.28 a reasonable rate negotiated by the county or approved by the 251.29 court. This rate shall not exceed five percent of the 251.30 assistance unit's gross monthly income up to a maximum of $100 251.31 per month. If the guardian or conservator is a member of the 251.32 county agency staff, no fee is allowed. 251.33 (d) The county agency shall continue to pay a monthly 251.34 allowance of $68 for restaurant meals for a person who was 251.35 receiving a restaurant meal allowance on June 1, 1990, and who 251.36 eats two or more meals in a restaurant daily. The allowance 252.1 must continue until the person has not received Minnesota 252.2 supplemental aid for one full calendar month or until the 252.3 person's living arrangement changes and the person no longer 252.4 meets the criteria for the restaurant meal allowance, whichever 252.5 occurs first. 252.6 (e) A fee of ten percent of the recipient's gross income or 252.7 $25, whichever is less, is allowed for representative payee 252.8 services provided by an agency that meets the requirements under 252.9 SSI regulations to charge a fee for representative payee 252.10 services. This special need is available to all recipients of 252.11 Minnesota supplemental aid regardless of their living 252.12 arrangement. 252.13 (f) Notwithstanding the language in this subdivision, an 252.14 amount equal to the maximum allotment authorized by the federal 252.15 Food Stamp Program for a single individual which is in effect on 252.16 the first day of January of the previous year will be added to 252.17 the standards of assistance established in subdivisions 1 to 4 252.18 for individuals under the age of 65 who are relocating from an 252.19 institution and who are shelter needy. An eligible individual 252.20 who receives this benefit prior to age 65 may continue to 252.21 receive the benefit after the age of 65. 252.22 "Shelter needy" means that the assistance unit incurs 252.23 monthly shelter costs that exceed 40 percent of the assistance 252.24 unit's gross income before the application of this special needs 252.25 standard. "Gross income" for the purposes of this section is 252.26 the applicant's or recipient's income as defined in section 252.27 256D.35, subdivision 10, or the standard specified in 252.28 subdivision 3, whichever is greater. A recipient of a federal 252.29 or state housing subsidy, that limits shelter costs to a 252.30 percentage of gross income, shall not be considered shelter 252.31 needy for purposes of this paragraph. 252.32 Sec. 54. [SEMI-INDEPENDENT LIVING SERVICES (SILS) STUDY.] 252.33 The commissioner of human services, in consultation with 252.34 county representatives and other interested persons, shall 252.35 develop recommendations revising the funding methodology for 252.36 SILS as defined in Minnesota Statutes, section 252.275, 253.1 subdivisions 3, 4, 4b, and 4c, and report by January 15, 2002, 253.2 to the chair of the house of representatives health and human 253.3 services finance committee and the chair of the senate health, 253.4 human services and corrections budget division. 253.5 Sec. 55. [WAIVER REQUEST REGARDING SPOUSAL INCOME.] 253.6 By September 1, 2001, the commissioner of human services 253.7 shall seek federal approval to allow recipients of home and 253.8 community-based waivers authorized under Minnesota Statutes, 253.9 section 256B.49, to choose either a waiver of deeming of spousal 253.10 income or the spousal impoverishment protections authorized 253.11 under United States Code, title 42, section 1396r-5, with the 253.12 addition of the group residential housing rate set according to 253.13 Minnesota Statutes, section 256I.03, subdivision 5, to the 253.14 personal needs allowance authorized by Minnesota Statutes, 253.15 section 256B.0575. 253.16 Sec. 56. [GRANTS TO PROVIDE BRAIN INJURY SUPPORT.] 253.17 Subdivision 1. [GRANTS.] Within the limits of the 253.18 appropriations made specifically for this purpose, the 253.19 commissioner of health shall make grants of up to $300,000 to 253.20 nonprofit corporations to continue a pilot project that provides 253.21 information, connects to community resources, and provides 253.22 support and problem solving on an ongoing basis to individuals 253.23 with traumatic brain injuries. 253.24 Subd. 2. [REPORT.] The commissioner shall prepare a report 253.25 identifying the results of the pilot project and making 253.26 recommendations on continuation of the project. The report must 253.27 be forwarded to the legislature no later than January 15, 2004. 253.28 Sec. 57. [REPEALER.] 253.29 (a) Minnesota Statutes 2000, sections 145.9245; 256.476, 253.30 subdivision 7; 256B.0912; 256B.0915, subdivisions 3a, 3b, and 253.31 3c; 256B.49, subdivisions 1, 2, 3, 4, 5, 6, 7, 8, 9, and 10, are 253.32 repealed. 253.33 (b) Minnesota Rules, parts 9505.2455; 9505.2458; 9505.2460; 253.34 9505.2465; 9505.2470; 9505.2473; 9505.2475; 9505.2480; 253.35 9505.2485; 9505.2486; 9505.2490; 9505.2495; 9505.2496; 253.36 9505.2500; 9505.3010; 9505.3015; 9505.3020; 9505.3025; 254.1 9505.3030; 9505.3035; 9505.3040; 9505.3065; 9505.3085; 254.2 9505.3135; 9505.3500; 9505.3510; 9505.3520; 9505.3530; 254.3 9505.3535; 9505.3540; 9505.3545; 9505.3550; 9505.3560; 254.4 9505.3570; 9505.3575; 9505.3580; 9505.3585; 9505.3600; 254.5 9505.3610; 9505.3620; 9505.3622; 9505.3624; 9505.3626; 254.6 9505.3630; 9505.3635; 9505.3640; 9505.3645; 9505.3650; 254.7 9505.3660; and 9505.3670, are repealed. 254.8 ARTICLE 5 254.9 CONSUMER INFORMATION AND ASSISTANCE 254.10 AND COMMUNITY-BASED CARE 254.11 Section 1. Minnesota Statutes 2000, section 256.975, is 254.12 amended by adding a subdivision to read: 254.13 Subd. 7. [CONSUMER INFORMATION AND ASSISTANCE; SENIOR 254.14 LINKAGE.] (a) The Minnesota board on aging shall operate a 254.15 statewide information and assistance service to aid older 254.16 Minnesotans and their families in making informed choices about 254.17 long-term care options and health care benefits. Language 254.18 services to persons with limited English language skills must be 254.19 made available. The service, known as Senior LinkAge Line, must 254.20 be available during business hours through a statewide toll-free 254.21 number and must also be available through the Internet. 254.22 (b) The service must assist older adults, caregivers, and 254.23 providers in accessing information about choices in long-term 254.24 care services that are purchased through private providers or 254.25 available through public options. The service must: 254.26 (1) develop a comprehensive database that includes detailed 254.27 listings in both consumer- and provider-oriented formats; 254.28 (2) make the database accessible on the Internet and 254.29 through other telecommunication and media-related tools; 254.30 (3) link callers to interactive long-term care screening 254.31 tools and making these tools available through the Internet by 254.32 integrating the tools with the database; 254.33 (4) develop community education materials with a focus on 254.34 planning for long-term care and evaluating independent living, 254.35 housing, and service options; 254.36 (5) conduct an outreach campaign to assist older adults and 255.1 their caregivers in finding information on the Internet and 255.2 through other means of communication; 255.3 (6) implement a messaging system for overflow callers and 255.4 respond to these callers by the next business day; 255.5 (7) link callers with county human services and other 255.6 providers to receive more in-depth assistance and consultation 255.7 related to long-term care options; and 255.8 (8) link callers with quality profiles for nursing 255.9 facilities and other providers developed by the commissioner of 255.10 human services. 255.11 Sec. 2. [256.9754] [COMMUNITY SERVICES DEVELOPMENT GRANTS 255.12 PROGRAM.] 255.13 Subdivision 1. [DEFINITIONS.] For purposes of this 255.14 section, the following terms have the meanings given. 255.15 (a) "Community" means a town, township, city, or targeted 255.16 neighborhood within a city, or a consortium of towns, townships, 255.17 cities, or targeted neighborhoods within cities. 255.18 (b) "Older adult services" means any services available 255.19 under the elderly waiver program or alternative care grant 255.20 program; nursing facility services; transportation services; 255.21 respite services; and other community-based services identified 255.22 as necessary either to maintain lifestyle choices for older 255.23 Minnesotans or to promote independence. 255.24 (c) "Older adult" refers to individuals 65 years of age and 255.25 older. 255.26 Subd. 2. [CREATION.] The community services development 255.27 grants program is created under the administration of the 255.28 commissioner of human services. 255.29 Subd. 3. [PROVISION OF GRANTS.] The commissioner shall 255.30 make grants available to communities, providers of older adult 255.31 services identified in subdivision 1, or to a consortium of 255.32 providers of older adult services, to establish new older adult 255.33 services. Grants may be provided for capital and other costs 255.34 including, but not limited to, start-up and training costs, 255.35 equipment, and supplies related to the establishment of new 255.36 older adult services or other residential or service 256.1 alternatives to nursing facility care. Grants may also be made 256.2 to renovate current buildings, provide transportation services, 256.3 or expand state-funded programs in the area. 256.4 Subd. 4. [ELIGIBILITY.] Grants may be awarded only to 256.5 communities and providers or to a consortium of providers that 256.6 have a local match of 50 percent of the costs for the project in 256.7 the form of donations, local tax dollars, in-kind donations, or 256.8 other local match. 256.9 Sec. 3. Minnesota Statutes 2000, section 256B.0911, 256.10 subdivision 1, is amended to read: 256.11 Subdivision 1. [PURPOSE AND GOAL.] (a) The purpose ofthe256.12preadmission screening programlong-term care consultation 256.13 services is to assist persons with long-term or chronic care 256.14 needs in making long-term care decisions and selecting options 256.15 that meet their needs and reflect their preferences. The 256.16 availability of, and access to, information and other types of 256.17 assistance is also intended to prevent or delay certified 256.18 nursing facility placementsby assessing applicants and256.19residents and offering cost-effective alternatives appropriate256.20for the person's needsand to provide transition assistance 256.21 after admission. Further, the goal ofthe programthese 256.22 services is to contain costs associated with unnecessary 256.23 certified nursing facility admissions. The commissioners of 256.24 human services and health shall seek to maximize use of 256.25 available federal and state funds and establish the broadest 256.26 program possible within the funding available. 256.27 (b) These services must be coordinated with services 256.28 provided under sections 256.975, subdivision 7, and 256.9772, 256.29 and with services provided by other public and private agencies 256.30 in the community to offer a variety of cost-effective 256.31 alternatives to persons with disabilities and elderly persons. 256.32 The county agency providing long-term care consultation services 256.33 shall encourage the use of volunteers from families, religious 256.34 organizations, social clubs, and similar civic and service 256.35 organizations to provide community-based services. 256.36 Sec. 4. Minnesota Statutes 2000, section 256B.0911, is 257.1 amended by adding a subdivision to read: 257.2 Subd. 1a. [DEFINITIONS.] For purposes of this section, the 257.3 following definitions apply: 257.4 (a) "Long-term care consultation services" means: 257.5 (1) providing information and education to the general 257.6 public regarding availability of the services authorized under 257.7 this section; 257.8 (2) an intake process that provides access to the services 257.9 described in this section; 257.10 (3) assessment of the health, psychological, and social 257.11 needs of referred individuals; 257.12 (4) assistance in identifying services needed to maintain 257.13 an individual in the least restrictive environment; 257.14 (5) providing recommendations on cost-effective community 257.15 services that are available to the individual; 257.16 (6) development of an individual's community support plan; 257.17 (7) providing information regarding eligibility for 257.18 Minnesota health care programs; 257.19 (8) preadmission screening to determine the need for a 257.20 nursing facility level of care; 257.21 (9) preliminary determination of Minnesota health care 257.22 programs eligibility for individuals who need a nursing facility 257.23 level of care, with appropriate referrals for final 257.24 determination; 257.25 (10) providing recommendations for nursing facility 257.26 placement when there are no cost-effective community services 257.27 available; and 257.28 (11) assistance to transition people back to community 257.29 settings after facility admission. 257.30 (b) "Minnesota health care programs" means the medical 257.31 assistance program under chapter 256B, the alternative care 257.32 program under section 256B.0913, and the prescription drug 257.33 program under section 256.955. 257.34 Sec. 5. Minnesota Statutes 2000, section 256B.0911, 257.35 subdivision 3, is amended to read: 257.36 Subd. 3. [PERSONS RESPONSIBLE FOR CONDUCTING THE258.1PREADMISSION SCREENINGLONG-TERM CARE CONSULTATION TEAM.] (a) A 258.2local screeninglong-term care consultation team shall be 258.3 established by the county board of commissioners. Each local 258.4screeningconsultation team shall consist ofscreeners who are a258.5 at least one social worker andaat least one public health 258.6 nurse from their respective county agencies. The board may 258.7 designate public health or social services as the lead agency 258.8 for long-term care consultation services. If a county does not 258.9 have a public health nurse available, it may request approval 258.10 from the commissioner to assign a county registered nurse with 258.11 at least one year experience in home care to participate on the 258.12 team.The screening team members must confer regarding the most258.13appropriate care for each individual screened.Two or more 258.14 counties may collaborate to establish a joint localscreening258.15 consultation team or teams. 258.16 (b)In assessing a person's needs, screeners shall have a258.17physician available for consultation and shall consider the258.18assessment of the individual's attending physician, if any. The258.19individual's physician shall be included if the physician258.20chooses to participate. Other personnel may be included on the258.21team as deemed appropriate by the county agencies.The team is 258.22 responsible for providing long-term care consultation services 258.23 to all persons located in the county who request the services, 258.24 regardless of eligibility for Minnesota health care programs. 258.25 Sec. 6. Minnesota Statutes 2000, section 256B.0911, is 258.26 amended by adding a subdivision to read: 258.27 Subd. 3a. [ASSESSMENT AND SUPPORT PLANNING.] (a) Persons 258.28 requesting assessment, services planning, or other assistance 258.29 intended to support community-based living must be visited by a 258.30 long-term care consultation team within ten working days after 258.31 the date on which an assessment was requested or recommended. 258.32 Assessments must be conducted according to paragraphs (b) to (g). 258.33 (b) The county may utilize a team of either the social 258.34 worker or public health nurse, or both, to conduct the 258.35 assessment in a face-to-face interview. The consultation team 258.36 members must confer regarding the most appropriate care for each 259.1 individual screened or assessed. 259.2 (c) The long-term care consultation team must assess the 259.3 health and social needs of the person, using an assessment form 259.4 provided by the commissioner. 259.5 (d) The team must conduct the assessment in a face-to-face 259.6 interview with the person being assessed and the person's legal 259.7 representative, if applicable. 259.8 (e) The team must provide the person, or the person's legal 259.9 representative, with written recommendations for facility- or 259.10 community-based services. The team must document that the most 259.11 cost-effective alternatives available were offered to the 259.12 individual. For purposes of this requirement, "cost-effective 259.13 alternatives" means community services and living arrangements 259.14 that cost the same as or less than nursing facility care. 259.15 (f) If the person chooses to use community-based services, 259.16 the team must provide the person or the person's legal 259.17 representative with a written community support plan, regardless 259.18 of whether the individual is eligible for Minnesota health care 259.19 programs. The person may request assistance in developing a 259.20 community support plan without participating in a complete 259.21 assessment. 259.22 (g) The team must give the person receiving assessment or 259.23 support planning, or the person's legal representative, 259.24 materials supplied by the commissioner containing the following 259.25 information: 259.26 (1) the purpose of preadmission screening and assessment; 259.27 (2) information about Minnesota health care programs; 259.28 (3) the person's freedom to accept or reject the 259.29 recommendations of the team; 259.30 (4) the person's right to confidentiality under the 259.31 Minnesota Government Data Practices Act, chapter 13; and 259.32 (5) the person's right to appeal the decision regarding the 259.33 need for nursing facility level of care or the county's final 259.34 decisions regarding public programs eligibility according to 259.35 section 256.045, subdivision 3. 259.36 Sec. 7. Minnesota Statutes 2000, section 256B.0911, is 260.1 amended by adding a subdivision to read: 260.2 Subd. 3b. [TRANSITION ASSISTANCE.] (a) A long-term care 260.3 consultation team shall provide assistance to persons residing 260.4 in a nursing facility, hospital, regional treatment center, or 260.5 intermediate care facility for persons with mental retardation 260.6 who request or are referred for assistance. Transition 260.7 assistance must include assessment, community support plan 260.8 development, referrals to Minnesota health care programs, and 260.9 referrals to programs that provide assistance with housing. 260.10 (b) The county shall develop transition processes with 260.11 institutional social workers and discharge planners to ensure 260.12 that: 260.13 (1) persons admitted to facilities receive information 260.14 about transition assistance that is available; 260.15 (2) the assessment is completed for persons within ten 260.16 working days of the date of request or recommendation for 260.17 assessment; and 260.18 (3) there is a plan for transition and follow-up for the 260.19 individual's return to the community. The plan must require 260.20 notification of other local agencies when a person who may 260.21 require assistance is screened by one county for admission to a 260.22 facility located in another county. 260.23 (c) If a person who is eligible for a Minnesota health care 260.24 program is admitted to a nursing facility, the nursing facility 260.25 must include a consultation team member or the case manager in 260.26 the discharge planning process. 260.27 Sec. 8. Minnesota Statutes 2000, section 256B.0911, is 260.28 amended by adding a subdivision to read: 260.29 Subd. 3c. [ACCESS DEMONSTRATIONS.] (a) The commissioner 260.30 shall establish demonstration projects that are intended to 260.31 target critical areas for improvement in long-term care 260.32 consultation services, and to organize resources in a more 260.33 efficient, effective, and preferred way. The demonstrations may 260.34 include: 260.35 (1) development and implementation of strategies to 260.36 increase the number of people who leave nursing facilities, 261.1 hospitals, regional treatment centers, and intermediate care 261.2 facilities for persons with mental retardation and return to 261.3 community living, based on demonstration proposals that: 261.4 (i) focus on transitional planning between care settings; 261.5 (ii) engage a variety of providers and care settings; 261.6 (iii) include participants from both greater Minnesota and 261.7 metro communities; 261.8 (iv) emphasize regional or other cooperative approaches; 261.9 and 261.10 (v) identify potential obstacles to individuals returning 261.11 to community settings and propose recommendations to address 261.12 those obstacles and ways to improve the identification of people 261.13 who need transitional assistance; 261.14 (2) improved access to and expansion of the availability of 261.15 long-term care consultation services, and improved integration 261.16 of these services with other local activities designed to 261.17 support people in community living; 261.18 (3) identification of activities that increase public 261.19 awareness of and information about the various forms of 261.20 long-term care assistance available, and develop and implement 261.21 replicable training efforts; and 261.22 (4) selection of sites based on outcome and other 261.23 performance criteria outlined in an application process. 261.24 Projects can be single-county or multicounty managed. Project 261.25 budgets may include payments to increase the amount of and 261.26 encourage innovation in the development of transitional services 261.27 within demonstration sites. Payments for increased assessments, 261.28 support plan development, and other activities, as approved in 261.29 the budget proposal for selected project sites, shall be 261.30 incorporated into the reimbursement for long-term care 261.31 consultation services as described in subdivision 6. Projected 261.32 transition assessments included as part of selected 261.33 demonstration sites shall be calculated at the rate for county 261.34 case management services. 261.35 (b) The commissioner of human services shall submit a 261.36 report to the legislature describing demonstration models, 262.1 implementation activities, and projected outcomes by February 262.2 15, 2002. A final report on the performance of the models and 262.3 recommendations for strategies to address relocation or 262.4 transitional assistance shall be completed by December 15, 2003. 262.5 Sec. 9. Minnesota Statutes 2000, section 256B.0911, is 262.6 amended by adding a subdivision to read: 262.7 Subd. 4a. [PREADMISSION SCREENING ACTIVITIES RELATED TO 262.8 NURSING FACILITY ADMISSIONS.] (a) All applicants to Medicaid 262.9 certified nursing facilities, including certified boarding care 262.10 facilities, must be screened prior to admission regardless of 262.11 income, assets, or funding sources for nursing facility care, 262.12 except as described in subdivision 4b. The purpose of the 262.13 screening is to determine the need for nursing facility level of 262.14 care as described in paragraph (d) and to complete activities 262.15 required under federal law related to mental illness and mental 262.16 retardation as outlined in paragraph (b). 262.17 (b) A person who has a diagnosis or possible diagnosis of 262.18 mental illness, mental retardation, or a related condition must 262.19 receive a preadmission screening before admission regardless of 262.20 the exemptions outlined in subdivision 4b, paragraph (b), to 262.21 identify the need for further evaluation and specialized 262.22 services, unless the admission prior to screening is authorized 262.23 by the local mental health authority or the local developmental 262.24 disabilities case manager, or unless authorized by the county 262.25 agency according to Public Law Number 100-508. 262.26 The following criteria apply to the preadmission screening: 262.27 (1) the county must use forms and criteria developed by the 262.28 commissioner to identify persons who require referral for 262.29 further evaluation and determination of the need for specialized 262.30 services; and 262.31 (2) the evaluation and determination of the need for 262.32 specialized services must be done by: 262.33 (i) a qualified independent mental health professional, for 262.34 persons with a primary or secondary diagnosis of a serious 262.35 mental illness; or 262.36 (ii) a qualified mental retardation professional, for 263.1 persons with a primary or secondary diagnosis of mental 263.2 retardation or related conditions. For purposes of this 263.3 requirement, a qualified mental retardation professional must 263.4 meet the standards for a qualified mental retardation 263.5 professional under Code of Federal Regulations, title 42, 263.6 section 483.430. 263.7 (c) The local county mental health authority or the state 263.8 mental retardation authority under Public Law Numbers 100-203 263.9 and 101-508 may prohibit admission to a nursing facility if the 263.10 individual does not meet the nursing facility level of care 263.11 criteria or needs specialized services as defined in Public Law 263.12 Numbers 100-203 and 101-508. For purposes of this section, 263.13 "specialized services" for a person with mental retardation or a 263.14 related condition means active treatment as that term is defined 263.15 under Code of Federal Regulations, title 42, section 483.440 263.16 (a)(1). 263.17 (d) The determination of the need for nursing facility 263.18 level of care must be made according to criteria developed by 263.19 the commissioner. In assessing a person's needs, consultation 263.20 team members shall have a physician available for consultation 263.21 and shall consider the assessment of the individual's attending 263.22 physician, if any. The individual's physician must be included 263.23 if the physician chooses to participate. Other personnel may be 263.24 included on the team as deemed appropriate by the county. 263.25 Sec. 10. Minnesota Statutes 2000, section 256B.0911, is 263.26 amended by adding a subdivision to read: 263.27 Subd. 4b. [EXEMPTIONS AND EMERGENCY ADMISSIONS.] (a) 263.28 Exemptions from the federal screening requirements outlined in 263.29 subdivision 4a, paragraphs (b) and (c), are limited to: 263.30 (1) a person who, having entered an acute care facility 263.31 from a certified nursing facility, is returning to a certified 263.32 nursing facility; and 263.33 (2) a person transferring from one certified nursing 263.34 facility in Minnesota to another certified nursing facility in 263.35 Minnesota. 263.36 (b) Persons who are exempt from preadmission screening for 264.1 purposes of level of care determination include: 264.2 (1) persons described in paragraph (a); 264.3 (2) an individual who has a contractual right to have 264.4 nursing facility care paid for indefinitely by the veterans' 264.5 administration; 264.6 (3) an individual enrolled in a demonstration project under 264.7 section 256B.69, subdivision 8, at the time of application to a 264.8 nursing facility; 264.9 (4) an individual currently being served under the 264.10 alternative care program or under a home and community-based 264.11 services waiver authorized under section 1915(c) of the federal 264.12 Social Security Act; and 264.13 (5) individuals admitted to a certified nursing facility 264.14 for a short-term stay, which is expected to be 14 days or less 264.15 in duration based upon a physician's certification, and who have 264.16 been assessed and approved for nursing facility admission within 264.17 the previous six months. This exemption applies only if the 264.18 consultation team member determines at the time of the initial 264.19 assessment of the six-month period that it is appropriate to use 264.20 the nursing facility for short-term stays and that there is an 264.21 adequate plan of care for return to the home or community-based 264.22 setting. If a stay exceeds 14 days, the individual must be 264.23 referred no later than the first county working day following 264.24 the 14th resident day for a screening, which must be completed 264.25 within five working days of the referral. The payment 264.26 limitations in subdivision 7 apply to an individual found at 264.27 screening to not meet the level of care criteria for admission 264.28 to a certified nursing facility. 264.29 (c) Persons admitted to a Medicaid-certified nursing 264.30 facility from the community on an emergency basis as described 264.31 in paragraph (d) or from an acute care facility on a nonworking 264.32 day must be screened the first working day after admission. 264.33 (d) Emergency admission to a nursing facility prior to 264.34 screening is permitted when all of the following conditions are 264.35 met: 264.36 (1) a person is admitted from the community to a certified 265.1 nursing or certified boarding care facility during county 265.2 nonworking hours; 265.3 (2) a physician has determined that delaying admission 265.4 until preadmission screening is completed would adversely affect 265.5 the person's health and safety; 265.6 (3) there is a recent precipitating event that precludes 265.7 the client from living safely in the community, such as 265.8 sustaining an injury, sudden onset of acute illness, or a 265.9 caregiver's inability to continue to provide care; 265.10 (4) the attending physician has authorized the emergency 265.11 placement and has documented the reason that the emergency 265.12 placement is recommended; and 265.13 (5) the county is contacted on the first working day 265.14 following the emergency admission. 265.15 Transfer of a patient from an acute care hospital to a nursing 265.16 facility is not considered an emergency except for a person who 265.17 has received hospital services in the following situations: 265.18 hospital admission for observation, care in an emergency room 265.19 without hospital admission, or following hospital 24-hour bed 265.20 care. 265.21 Sec. 11. Minnesota Statutes 2000, section 256B.0911, is 265.22 amended by adding a subdivision to read: 265.23 Subd. 4c. [SCREENING REQUIREMENTS.] (a) A person may be 265.24 screened for nursing facility admission by telephone or in a 265.25 face-to-face screening interview. Consultation team members 265.26 shall identify each individual's needs using the following 265.27 categories: 265.28 (1) the person needs no face-to-face screening interview to 265.29 determine the need for nursing facility level of care based on 265.30 information obtained from other health care professionals; 265.31 (2) the person needs an immediate face-to-face screening 265.32 interview to determine the need for nursing facility level of 265.33 care and complete activities required under subdivision 4a; or 265.34 (3) the person may be exempt from screening requirements as 265.35 outlined in subdivision 4b, but will need transitional 265.36 assistance after admission or in-person follow-along after a 266.1 return home. 266.2 (b) Persons admitted on a nonemergency basis to a 266.3 Medicaid-certified nursing facility must be screened prior to 266.4 admission. 266.5 (c) The long-term care consultation team shall recommend a 266.6 case mix classification for persons admitted to a certified 266.7 nursing facility when sufficient information is received to make 266.8 that classification. The nursing facility is authorized to 266.9 conduct all case mix assessments for persons who have been 266.10 screened prior to admission for whom the county did not 266.11 recommend a case mix classification. The nursing facility is 266.12 authorized to conduct all case mix assessments for persons 266.13 admitted to the facility prior to a preadmission screening. The 266.14 county retains the responsibility of distributing appropriate 266.15 case mix forms to the nursing facility. 266.16 (d) The county screening or intake activity must include 266.17 processes to identify persons who may require transition 266.18 assistance as described in subdivision 3b. 266.19 Sec. 12. Minnesota Statutes 2000, section 256B.0911, 266.20 subdivision 5, is amended to read: 266.21 Subd. 5. [SIMPLIFICATION OF FORMSADMINISTRATIVE 266.22 ACTIVITY.] The commissioner shall minimize the number of forms 266.23 required in thepreadmission screening processprovision of 266.24 long-term care consultation services and shall limit the 266.25 screening document to items necessary forcarecommunity support 266.26 plan approval, reimbursement, program planning, evaluation, and 266.27 policy development. 266.28 Sec. 13. Minnesota Statutes 2000, section 256B.0911, 266.29 subdivision 6, is amended to read: 266.30 Subd. 6. [PAYMENT FORPREADMISSION SCREENINGLONG-TERM 266.31 CARE CONSULTATION SERVICES.] (a) The totalscreeningpayment for 266.32 each county must be paid monthly by certified nursing facilities 266.33 in the county. The monthly amount to be paid by each nursing 266.34 facility for each fiscal year must be determined by dividing the 266.35 county's annual allocation forscreeningslong-term care 266.36 consultation services by 12 to determine the monthly payment and 267.1 allocating the monthly payment to each nursing facility based on 267.2 the number of licensed beds in the nursing facility. Payments 267.3 to counties in which there is no certified nursing facility must 267.4 be made by increasing the payment rate of the two facilities 267.5 located nearest to the county seat. 267.6 (b) The commissioner shall include the total annual payment 267.7for screeningdetermined under paragraph (a) for each nursing 267.8 facility reimbursed under section 256B.431 or 256B.434 according 267.9 to section 256B.431, subdivision 2b, paragraph (g), or 256B.435. 267.10 (c) In the event of the layaway, delicensure and 267.11 decertification, or removal from layaway of 25 percent or more 267.12 of the beds in a facility, the commissioner may adjust the per 267.13 diem payment amount in paragraph (b) and may adjust the monthly 267.14 payment amount in paragraph (a). The effective date of an 267.15 adjustment made under this paragraph shall be on or after the 267.16 first day of the month following the effective date of the 267.17 layaway, delicensure and decertification, or removal from 267.18 layaway. 267.19 (d) Payments forscreening activitieslong-term care 267.20 consultation services are available to the county or counties to 267.21 cover staff salaries and expenses to provide thescreening267.22functionservices described in subdivision 1a. Thelead agency267.23 county shall employ, or contract with other agencies to employ, 267.24 within the limits of available funding, sufficient personnel 267.25 toconduct the preadmission screening activityprovide long-term 267.26 care consultation services while meeting the state's long-term 267.27 care outcomes and objectives as defined in section 256B.0917, 267.28 subdivision 1. Thelocal agencycounty shall be accountable for 267.29 meeting local objectives as approved by the commissioner in the 267.30 CSSA biennial plan. 267.31(d)(e) Notwithstanding section 256B.0641, overpayments 267.32 attributable to payment of the screening costs under the medical 267.33 assistance program may not be recovered from a facility. 267.34(e)(f) The commissioner of human services shall amend the 267.35 Minnesota medical assistance plan to include reimbursement for 267.36 the localscreeningconsultation teams. 268.1 (g) The county may bill, as case management services, 268.2 assessments, support planning, and follow-along provided to 268.3 persons determined to be eligible for case management under 268.4 Minnesota health care programs. No individual or family member 268.5 shall be charged for an initial assessment or initial support 268.6 plan development provided under subdivision 3a or 3b. 268.7 Sec. 14. Minnesota Statutes 2000, section 256B.0911, 268.8 subdivision 7, is amended to read: 268.9 Subd. 7. [REIMBURSEMENT FOR CERTIFIED NURSING FACILITIES.] 268.10 (a) Medical assistance reimbursement for nursing facilities 268.11 shall be authorized for a medical assistance recipient only if a 268.12 preadmission screening has been conducted prior to admission or 268.13 thelocalcountyagencyhas authorized an exemption. Medical 268.14 assistance reimbursement for nursing facilities shall not be 268.15 provided for any recipient who the local screener has determined 268.16 does not meet the level of care criteria for nursing facility 268.17 placement or, if indicated, has not had a level IIPASARROBRA 268.18 evaluation as required under the federal Omnibus Budget 268.19 Reconciliation Act of 1987 completed unless an admission for a 268.20 recipient with mental illness is approved by the local mental 268.21 health authority or an admission for a recipient with mental 268.22 retardation or related condition is approved by the state mental 268.23 retardation authority. 268.24 (b) The nursing facility must not bill a person who is not 268.25 a medical assistance recipient for resident days that preceded 268.26 the date of completion of screening activities as required under 268.27 subdivisions 4a, 4b, and 4c. The nursing facility must include 268.28 unreimbursed resident days in the nursing facility resident day 268.29 totals reported to the commissioner. 268.30 (c) The commissioner shall make a request to the health 268.31 care financing administration for a waiver allowingscreening268.32 team approval of Medicaid payments for certified nursing 268.33 facility care. An individual has a choice and makes the final 268.34 decision between nursing facility placement and community 268.35 placement after the screening team's recommendation, except as 268.36 provided inparagraphs (b) and (c)subdivision 4a, paragraph (c). 269.1(c) The local county mental health authority or the state269.2mental retardation authority under Public Law Numbers 100-203269.3and 101-508 may prohibit admission to a nursing facility, if the269.4individual does not meet the nursing facility level of care269.5criteria or needs specialized services as defined in Public Law269.6Numbers 100-203 and 101-508. For purposes of this section,269.7"specialized services" for a person with mental retardation or a269.8related condition means "active treatment" as that term is269.9defined in Code of Federal Regulations, title 42, section269.10483.440(a)(1).269.11(e) Appeals from the screening team's recommendation or the269.12county agency's final decision shall be made according to269.13section 256.045, subdivision 3.269.14 Sec. 15. Minnesota Statutes 2000, section 256B.0913, 269.15 subdivision 1, is amended to read: 269.16 Subdivision 1. [PURPOSE AND GOALS.] The purpose of the 269.17 alternative care program is to provide funding foror access to269.18 home and community-based services forfrailelderly persons, in 269.19 order to limit nursing facility placements. The program is 269.20 designed to supportfrailelderly persons in their desire to 269.21 remain in the community as independently and as long as possible 269.22 and to support informal caregivers in their efforts to provide 269.23 care forfrailelderly people. Further, the goals of the 269.24 program are: 269.25 (1) to contain medical assistance expenditures byproviding269.26 funding care in the communityat a cost the same or less than269.27nursing facility costs; and 269.28 (2) to maintain the moratorium on new construction of 269.29 nursing home beds. 269.30 Sec. 16. Minnesota Statutes 2000, section 256B.0913, 269.31 subdivision 2, is amended to read: 269.32 Subd. 2. [ELIGIBILITY FOR SERVICES.] Alternative care 269.33 services are available toall frail olderMinnesotans. This269.34includes:269.35(1) persons who are receiving medical assistance and served269.36under the medical assistance program or the Medicaid waiver270.1program;270.2(2) personsage 65 or older who are not eligible for 270.3 medical assistance without a spenddown or waiver obligation but 270.4 who would be eligible for medical assistance within 180 days of 270.5 admission to a nursing facility andserved undersubject to 270.6 subdivisions 4 to 13; and270.7(3) persons who are paying for their services out-of-pocket. 270.8 Sec. 17. Minnesota Statutes 2000, section 256B.0913, 270.9 subdivision 4, is amended to read: 270.10 Subd. 4. [ELIGIBILITY FOR FUNDING FOR SERVICES FOR 270.11 NONMEDICAL ASSISTANCE RECIPIENTS.] (a) Funding for services 270.12 under the alternative care program is available to persons who 270.13 meet the following criteria: 270.14 (1) the person has beenscreened by the county screening270.15team or, if previously screened and served under the alternative270.16care program, assessed by the local county social worker or270.17public health nursedetermined by a community assessment under 270.18 section 256B.0911, to be a person who would require the level of 270.19 care provided in a nursing facility, but for the provision of 270.20 services under the alternative care program; 270.21 (2) the person is age 65 or older; 270.22 (3) the person would befinanciallyeligible for medical 270.23 assistance within 180 days of admission to a nursing facility; 270.24 (4) the personmeets the asset transfer requirements ofis 270.25 not ineligible for the medical assistance program due to an 270.26 asset transfer penalty; 270.27 (5)the screening team would recommend nursing facility270.28admission or continued stay for the person if alternative care270.29services were not available;270.30(6)the person needs services that are notavailable at270.31that time in the countyfunded through othercounty,state,or 270.32 federal fundingsources; and 270.33(7)(6) the monthly cost of the alternative care services 270.34 funded by the program for this person does not exceed 75 percent 270.35 of the statewideaverage monthly medical assistance payment for270.36nursing facility care at the individual's case mix271.1classificationweighted average monthly nursing facility rate of 271.2 the case mix resident class to which the individual alternative 271.3 care client would be assigned under Minnesota Rules, parts 271.4 9549.0050 to 9549.0059, less the recipient's maintenance needs 271.5 allowance as described in section 256B.0915, subdivision 1d, 271.6 paragraph (a), until the first day of the state fiscal year in 271.7 which the resident assessment system, under section 256B.437, 271.8 for nursing home rate determination is implemented. Effective 271.9 on the first day of the state fiscal year in which a resident 271.10 assessment system, under section 256B.437, for nursing home rate 271.11 determination is implemented and the first day of each 271.12 subsequent state fiscal year, the monthly cost of alternative 271.13 care services for this person shall not exceed the alternative 271.14 care monthly cap for the case mix resident class to which the 271.15 alternative care client would be assigned under Minnesota Rules, 271.16 parts 9549.0050 to 9549.0059, which was in effect on the last 271.17 day of the previous state fiscal year, and adjusted by the 271.18 greater of any legislatively adopted home and community-based 271.19 services cost-of-living percentage increase or any legislatively 271.20 adopted statewide percent rate increase for nursing facilities. 271.21 This monthly limit does not prohibit the alternative care client 271.22 from payment for additional services, but in no case may the 271.23 cost of additional services purchased under this section exceed 271.24 the difference between the client's monthly service limit 271.25 defined under section 256B.0915, subdivision 3, and the 271.26 alternative care program monthly service limit defined in this 271.27 paragraph. If medical supplies and equipment oradaptations271.28 environmental modifications are or will be purchased for an 271.29 alternative care services recipient, the costs may be prorated 271.30 on a monthly basisthroughout the year in which they are271.31purchasedfor up to 12 consecutive months beginning with the 271.32 month of purchase. If the monthly cost of a recipient's other 271.33 alternative care services exceeds the monthly limit established 271.34 in this paragraph, the annual cost of the alternative care 271.35 services shall be determined. In this event, the annual cost of 271.36 alternative care services shall not exceed 12 times the monthly 272.1 limitcalculateddescribed in this paragraph. 272.2 (b)Individuals who meet the criteria in paragraph (a) and272.3who have been approved for alternative care funding are called272.4180-day eligible clients.272.5(c) The statewide average payment for nursing facility care272.6is the statewide average monthly nursing facility rate in effect272.7on July 1 of the fiscal year in which the cost is incurred, less272.8the statewide average monthly income of nursing facility272.9residents who are age 65 or older and who are medical assistance272.10recipients in the month of March of the previous fiscal year.272.11This monthly limit does not prohibit the 180-day eligible client272.12from paying for additional services needed or desired.272.13(d) In determining the total costs of alternative care272.14services for one month, the costs of all services funded by the272.15alternative care program, including supplies and equipment, must272.16be included.272.17(e)Alternative care funding under this subdivision is not 272.18 available for a person who is a medical assistance recipient or 272.19 who would be eligible for medical assistance without a 272.20 spenddown, unless authorized by the commissioneror waiver 272.21 obligation. A person whose initial application for medical 272.22 assistance is being processed may be served under the 272.23 alternative care program for a period up to 60 days. If the 272.24 individual is found to be eligible for medical assistance,the272.25county must billmedical assistance must be billed for services 272.26 payable under the federally approved elderly waiver plan and 272.27 delivered from the date the individual was found eligible 272.28 forservices reimbursable underthe federally approved elderly 272.29 waiverprogramplan. Notwithstanding this provision, upon 272.30 federal approval, alternative care funds may not be used to pay 272.31 for any service the cost of which is payable by medical 272.32 assistance or which is used by a recipient to meet a medical 272.33 assistance income spenddown or waiver obligation. 272.34(f)(c) Alternative care funding is not available for a 272.35 person who resides in a licensed nursing homeor, certified 272.36 boarding care home, hospital, or intermediate care facility, 273.1 except for case management services which arebeingprovided in 273.2 support of the discharge planning process to a nursing home 273.3 resident or certified boarding care home resident who is 273.4 ineligible for case management funded by medical assistance. 273.5 Sec. 18. Minnesota Statutes 2000, section 256B.0913, 273.6 subdivision 5, is amended to read: 273.7 Subd. 5. [SERVICES COVERED UNDER ALTERNATIVE CARE.] (a) 273.8 Alternative care funding may be used for payment of costs of: 273.9 (1) adult foster care; 273.10 (2) adult day care; 273.11 (3) home health aide; 273.12 (4) homemaker services; 273.13 (5) personal care; 273.14 (6) case management; 273.15 (7) respite care; 273.16 (8) assisted living; 273.17 (9) residential care services; 273.18 (10) care-related supplies and equipment; 273.19 (11) meals delivered to the home; 273.20 (12) transportation; 273.21 (13) skilled nursing; 273.22 (14) chore services; 273.23 (15) companion services; 273.24 (16) nutrition services; 273.25 (17) training for direct informal caregivers; 273.26 (18) telemedicine devices to monitor recipients in their 273.27 own homes as an alternative to hospital care, nursing home care, 273.28 or home visits;and273.29 (19) "other services"includingincludes discretionary 273.30 funds and direct cash payments to clients,approved by the273.31county agencyfollowing approval by the commissioner, subject to 273.32 the provisions of paragraph(m)(j). Total annual payments for " 273.33 other services" for all clients within a county may not exceed 273.34 either ten percent of that county's annual alternative care 273.35 program base allocation or $5,000, whichever is greater. In no 273.36 case shall this amount exceed the county's total annual 274.1 alternative care program base allocation; and 274.2 (20) environmental modifications. 274.3 (b) The county agency must ensure that the funds are not 274.4 usedonly to supplement and notto supplant services available 274.5 through other public assistance or services programs. 274.6 (c) Unless specified in statute, the service definitions 274.7 and standards for alternative care services shall be the same as 274.8 the service definitions and standardsdefinedspecified in the 274.9 federally approved elderly waiver plan. Except for the county 274.10 agencies' approval of direct cash payments to clients as 274.11 described in paragraph (j) or for a provider of supplies and 274.12 equipment when the monthly cost of the supplies and equipment is 274.13 less than $250, persons or agencies must be employed by or under 274.14 a contract with the county agency or the public health nursing 274.15 agency of the local board of health in order to receive funding 274.16 under the alternative care program. Supplies and equipment may 274.17 be purchased from a vendor not certified to participate in the 274.18 Medicaid program if the cost for the item is less than that of a 274.19 Medicaid vendor. 274.20 (d) The adult foster care rate shall be considered a 274.21 difficulty of care payment and shall not include room and 274.22 board. The adult foster caredailyrate shall be negotiated 274.23 between the county agency and the foster care provider.The274.24rate established under this section shall not exceed 75 percent274.25of the state average monthly nursing home payment for the case274.26mix classification to which the individual receiving foster care274.27is assigned, and it must allow for other alternative care274.28services to be authorized by the case manager.The alternative 274.29 care payment for the foster care service in combination with the 274.30 payment for other alternative care services, including case 274.31 management, must not exceed the limit specified in subdivision 274.32 4, paragraph (a), clause (6). 274.33 (e) Personal care servicesmay be provided by a personal274.34care provider organization.must meet the service standards 274.35 defined in the federally approved elderly waiver plan, except 274.36 that a county agency may contract with a client's relativeof275.1the clientwho meets the relative hardship waiver requirement as 275.2 defined in section 256B.0627, subdivision 4, paragraph (b), 275.3 clause (10), to provide personal care services, but must ensure275.4nursingif the county agency ensures supervision of this service 275.5 by a registered nurse or mental health practitioner.Covered275.6personal care services defined in section 256B.0627, subdivision275.74, must meet applicable standards in Minnesota Rules, part275.89505.0335.275.9 (f)A county may use alternative care funds to purchase275.10medical supplies and equipment without prior approval from the275.11commissioner when: (1) there is no other funding source; (2)275.12the supplies and equipment are specified in the individual's275.13care plan as medically necessary to enable the individual to275.14remain in the community according to the criteria in Minnesota275.15Rules, part 9505.0210, item A; and (3) the supplies and275.16equipment represent an effective and appropriate use of275.17alternative care funds. A county may use alternative care funds275.18to purchase supplies and equipment from a non-Medicaid certified275.19vendor if the cost for the items is less than that of a Medicaid275.20vendor. A county is not required to contract with a provider of275.21supplies and equipment if the monthly cost of the supplies and275.22equipment is less than $250.275.23(g)For purposes of this section, residential care services 275.24 are services which are provided to individuals living in 275.25 residential care homes. Residential care homes are currently 275.26 licensed as board and lodging establishments and are registered 275.27 with the department of health as providing special 275.28 services under section 157.17 and are not subject to 275.29 registration under chapter 144D. Residential care services are 275.30 defined as "supportive services" and "health-related services." 275.31 "Supportive services" means the provision of up to 24-hour 275.32 supervision and oversight. Supportive services includes: (1) 275.33 transportation, when provided by the residential carecenter275.34 home only; (2) socialization, when socialization is part of the 275.35 plan of care, has specific goals and outcomes established, and 275.36 is not diversional or recreational in nature; (3) assisting 276.1 clients in setting up meetings and appointments; (4) assisting 276.2 clients in setting up medical and social services; (5) providing 276.3 assistance with personal laundry, such as carrying the client's 276.4 laundry to the laundry room. Assistance with personal laundry 276.5 does not include any laundry, such as bed linen, that is 276.6 included in the room and board rate. "Health-related services" 276.7 are limited to minimal assistance with dressing, grooming, and 276.8 bathing and providing reminders to residents to take medications 276.9 that are self-administered or providing storage for medications, 276.10 if requested. Individuals receiving residential care services 276.11 cannot receive homemaking services funded under this section. 276.12(h)(g) For the purposes of this section, "assisted living" 276.13 refers to supportive services provided by a single vendor to 276.14 clients who reside in the same apartment building of three or 276.15 more units which are not subject to registration under chapter 276.16 144D and are licensed by the department of health as a class A 276.17 home care provider or a class E home care provider. Assisted 276.18 living services are defined as up to 24-hour supervision, and 276.19 oversight, supportive services as defined in clause (1), 276.20 individualized home care aide tasks as defined in clause (2), 276.21 and individualized home management tasks as defined in clause 276.22 (3) provided to residents of a residential center living in 276.23 their units or apartments with a full kitchen and bathroom. A 276.24 full kitchen includes a stove, oven, refrigerator, food 276.25 preparation counter space, and a kitchen utensil storage 276.26 compartment. Assisted living services must be provided by the 276.27 management of the residential center or by providers under 276.28 contract with the management or with the county. 276.29 (1) Supportive services include: 276.30 (i) socialization, when socialization is part of the plan 276.31 of care, has specific goals and outcomes established, and is not 276.32 diversional or recreational in nature; 276.33 (ii) assisting clients in setting up meetings and 276.34 appointments; and 276.35 (iii) providing transportation, when provided by the 276.36 residential center only. 277.1Individuals receiving assisted living services will not277.2receive both assisted living services and homemaking services.277.3Individualized means services are chosen and designed277.4specifically for each resident's needs, rather than provided or277.5offered to all residents regardless of their illnesses,277.6disabilities, or physical conditions.277.7 (2) Home care aide tasks means: 277.8 (i) preparing modified diets, such as diabetic or low 277.9 sodium diets; 277.10 (ii) reminding residents to take regularly scheduled 277.11 medications or to perform exercises; 277.12 (iii) household chores in the presence of technically 277.13 sophisticated medical equipment or episodes of acute illness or 277.14 infectious disease; 277.15 (iv) household chores when the resident's care requires the 277.16 prevention of exposure to infectious disease or containment of 277.17 infectious disease; and 277.18 (v) assisting with dressing, oral hygiene, hair care, 277.19 grooming, and bathing, if the resident is ambulatory, and if the 277.20 resident has no serious acute illness or infectious disease. 277.21 Oral hygiene means care of teeth, gums, and oral prosthetic 277.22 devices. 277.23 (3) Home management tasks means: 277.24 (i) housekeeping; 277.25 (ii) laundry; 277.26 (iii) preparation of regular snacks and meals; and 277.27 (iv) shopping. 277.28 Individuals receiving assisted living services shall not 277.29 receive both assisted living services and homemaking services. 277.30 Individualized means services are chosen and designed 277.31 specifically for each resident's needs, rather than provided or 277.32 offered to all residents regardless of their illnesses, 277.33 disabilities, or physical conditions. Assisted living services 277.34 as defined in this section shall not be authorized in boarding 277.35 and lodging establishments licensed according to sections 277.36 157.011 and 157.15 to 157.22. 278.1(i)(h) For establishments registered under chapter 144D, 278.2 assisted living services under this section means either the 278.3 services describedand licensedin paragraph (g) and delivered 278.4 by a class E home care provider licensed by the department of 278.5 health or the services described under section 144A.4605 and 278.6 delivered by an assisted living home care provider or a class A 278.7 home care provider licensed by the commissioner of health. 278.8(j) For the purposes of this section, reimbursement(i) 278.9 Payment for assisted living services and residential care 278.10 services shall be a monthly rate negotiated and authorized by 278.11 the county agency based on an individualized service plan for 278.12 each resident and may not cover direct rent or food costs.The278.13rate278.14 (1) The individualized monthly negotiated payment for 278.15 assisted living services as described in paragraph (g) or (h), 278.16 and residential care services as described in paragraph (f), 278.17 shall not exceed the nonfederal share in effect on July 1 of the 278.18 state fiscal year for which the rate limit is being calculated 278.19 of the greater of either the statewide or any of the geographic 278.20 groups' weighted average monthlymedical assistancenursing 278.21 facility payment rate of the case mix resident class to which 278.22 the180-dayalternative care eligible client would be assigned 278.23 under Minnesota Rules, parts 9549.0050 to 9549.0059,unless the278.24 less the maintenance needs allowance as described in section 278.25 256B.0915, subdivision 1d, paragraph (a), until the first day of 278.26 the state fiscal year in which a resident assessment system, 278.27 under section 256B.437, of nursing home rate determination is 278.28 implemented. Effective on the first day of the state fiscal 278.29 year in which a resident assessment system, under section 278.30 256B.437, of nursing home rate determination is implemented and 278.31 the first day of each subsequent state fiscal year, the 278.32 individualized monthly negotiated payment for the services 278.33 described in this clause shall not exceed the limit described in 278.34 this clause which was in effect on the last day of the previous 278.35 state fiscal year and which has been adjusted by the greater of 278.36 any legislatively adopted home and community-based services 279.1 cost-of-living percentage increase or any legislatively adopted 279.2 statewide percent rate increase for nursing facilities. 279.3 (2) The individualized monthly negotiated payment for 279.4 assisted living servicesare provided by a home caredescribed 279.5 under section 144A.4605 and delivered by a provider licensed by 279.6 the department of health as a class A home care provider or an 279.7 assisted living home care provider andareprovided in a 279.8 building that is registered as a housing with services 279.9 establishment under chapter 144D and that provides 24-hour 279.10 supervision in combination with the payment for other 279.11 alternative care services, including case management, must not 279.12 exceed the limit specified in subdivision 4, paragraph (a), 279.13 clause (6). 279.14(k) For purposes of this section, companion services are279.15defined as nonmedical care, supervision and oversight, provided279.16to a functionally impaired adult. Companions may assist the279.17individual with such tasks as meal preparation, laundry and279.18shopping, but do not perform these activities as discrete279.19services. The provision of companion services does not entail279.20hands-on medical care. Providers may also perform light279.21housekeeping tasks which are incidental to the care and279.22supervision of the recipient. This service must be approved by279.23the case manager as part of the care plan. Companion services279.24must be provided by individuals or organizations who are under279.25contract with the local agency to provide the service. Any279.26person related to the waiver recipient by blood, marriage or279.27adoption cannot be reimbursed under this service. Persons279.28providing companion services will be monitored by the case279.29manager.279.30(l) For purposes of this section, training for direct279.31informal caregivers is defined as a classroom or home course of279.32instruction which may include: transfer and lifting skills,279.33nutrition, personal and physical cares, home safety in a home279.34environment, stress reduction and management, behavioral279.35management, long-term care decision making, care coordination279.36and family dynamics. The training is provided to an informal280.1unpaid caregiver of a 180-day eligible client which enables the280.2caregiver to deliver care in a home setting with high levels of280.3quality. The training must be approved by the case manager as280.4part of the individual care plan. Individuals, agencies, and280.5educational facilities which provide caregiver training and280.6education will be monitored by the case manager.280.7(m)(j) A county agency may make payment from their 280.8 alternative care program allocation for "other services" 280.9provided to an alternative care program recipient if those280.10services prevent, shorten, or delay institutionalization. These280.11services maywhich include use of "discretionary funds" for 280.12 services that are not otherwise defined in this section and 280.13 direct cash payments to therecipientclient for the purpose of 280.14 purchasing therecipient'sservices. The following provisions 280.15 apply to payments under this paragraph: 280.16 (1) a cash payment to a client under this provision cannot 280.17 exceed 80 percent of the monthly payment limit for that client 280.18 as specified in subdivision 4, paragraph (a), clause(7)(6); 280.19 (2) a county may not approve any cash payment for a client 280.20 who meets either of the following: 280.21 (i) has been assessed as having a dependency in 280.22 orientation, unless the client has an authorized 280.23 representativeunder section 256.476, subdivision 2, paragraph280.24(g), or for a client who. An "authorized representative" means 280.25 an individual who is at least 18 years of age and is designated 280.26 by the person or the person's legal representative to act on the 280.27 person's behalf. This individual may be a family member, 280.28 guardian, representative payee, or other individual designated 280.29 by the person or the person's legal representative, if any, to 280.30 assist in purchasing and arranging for supports; or 280.31 (ii) is concurrently receiving adult foster care, 280.32 residential care, or assisted living services; 280.33 (3)any service approved under this section must be a280.34service which meets the purpose and goals of the program as280.35listed in subdivision 1;280.36(4) cash payments must also meet the criteria of and are281.1governed by the procedures and liability protection established281.2in section 256.476, subdivision 4, paragraphs (b) through (h),281.3and recipients of cash grants must meet the requirements in281.4section 256.476, subdivision 10; andcash payments to a person 281.5 or a person's family will be provided through a monthly payment 281.6 and be in the form of cash, voucher, or direct county payment to 281.7 a vendor. Fees or premiums assessed to the person for 281.8 eligibility for health and human services are not reimbursable 281.9 through this service option. Services and goods purchased 281.10 through cash payments must be identified in the person's 281.11 individualized care plan and must meet all of the following 281.12 criteria: 281.13 (i) they must be over and above the normal cost of caring 281.14 for the person if the person did not have functional 281.15 limitations; 281.16 (ii) they must be directly attributable to the person's 281.17 functional limitations; 281.18 (iii) they must have the potential to be effective at 281.19 meeting the goals of the program; 281.20 (iv) they must be consistent with the needs identified in 281.21 the individualized service plan. The service plan shall specify 281.22 the needs of the person and family, the form and amount of 281.23 payment, the items and services to be reimbursed, and the 281.24 arrangements for management of the individual grant; and 281.25 (v) the person, the person's family, or the legal 281.26 representative shall be provided sufficient information to 281.27 ensure an informed choice of alternatives. The local agency 281.28 shall document this information in the person's care plan, 281.29 including the type and level of expenditures to be reimbursed; 281.30 (4) the county, lead agency under contract, or tribal 281.31 government under contract to administer the alternative care 281.32 program shall not be liable for damages, injuries, or 281.33 liabilities sustained through the purchase of direct supports or 281.34 goods by the person, the person's family, or the authorized 281.35 representative with funds received through the cash payments 281.36 under this section. Liabilities include, but are not limited 282.1 to, workers' compensation, the Federal Insurance Contributions 282.2 Act (FICA), or the Federal Unemployment Tax Act (FUTA); 282.3 (5) persons receiving grants under this section shall have 282.4 the following responsibilities: 282.5 (i) spend the grant money in a manner consistent with their 282.6 individualized service plan with the local agency; 282.7 (ii) notify the local agency of any necessary changes in 282.8 the grant-expenditures; 282.9 (iii) arrange and pay for supports; and 282.10 (iv) inform the local agency of areas where they have 282.11 experienced difficulty securing or maintaining supports; and 282.12(5)(6) the county shall report client outcomes, services, 282.13 and costs under this paragraph in a manner prescribed by the 282.14 commissioner. 282.15 (k) Upon implementation of direct cash payments to clients 282.16 under this section, any person determined eligible for the 282.17 alternative care program who chooses a cash payment approved by 282.18 the county agency shall receive the cash payment under this 282.19 section and not under section 256.476 unless the person was 282.20 receiving a consumer support grant under section 256.476 before 282.21 implementation of direct cash payments under this section. 282.22 Sec. 19. Minnesota Statutes 2000, section 256B.0913, 282.23 subdivision 6, is amended to read: 282.24 Subd. 6. [ALTERNATIVE CARE PROGRAM ADMINISTRATION.] The 282.25 alternative care program is administered by the county agency. 282.26 This agency is the lead agency responsible for the local 282.27 administration of the alternative care program as described in 282.28 this section. However, it may contract with the public health 282.29 nursing service to be the lead agency. The commissioner may 282.30 contract with federally recognized Indian tribes with a 282.31 reservation in Minnesota to serve as the lead agency responsible 282.32 for the local administration of the alternative care program as 282.33 described in the contract. 282.34 Sec. 20. Minnesota Statutes 2000, section 256B.0913, 282.35 subdivision 7, is amended to read: 282.36 Subd. 7. [CASE MANAGEMENT.] Providers of case management 283.1 services for persons receiving services funded by the 283.2 alternative care program must meet the qualification 283.3 requirements and standards specified in section 256B.0915, 283.4 subdivision 1b. The case manager mustensure the health and283.5safety of the individual client andnot approve alternative care 283.6 funding for a client in any setting in which the case manager 283.7 cannot reasonably ensure the client's health and safety. The 283.8 case manager is responsible for the cost-effectiveness of the 283.9 alternative care individual care plan and must not approve any 283.10 care plan in which the cost of services funded by alternative 283.11 care and client contributions exceeds the limit specified in 283.12 section 256B.0915, subdivision 3, paragraph (b). The county may 283.13 allow a case manager employed by the county to delegate certain 283.14 aspects of the case management activity to another individual 283.15 employed by the county provided there is oversight of the 283.16 individual by the case manager. The case manager may not 283.17 delegate those aspects which require professional judgment 283.18 including assessments, reassessments, and care plan development. 283.19 Sec. 21. Minnesota Statutes 2000, section 256B.0913, 283.20 subdivision 8, is amended to read: 283.21 Subd. 8. [REQUIREMENTS FOR INDIVIDUAL CARE PLAN.] (a) The 283.22 case manager shall implement the plan of care for each180-day283.23eligiblealternative care client and ensure that a client's 283.24 service needs and eligibility are reassessed at least every 12 283.25 months. The plan shall include any services prescribed by the 283.26 individual's attending physician as necessary to allow the 283.27 individual to remain in a community setting. In developing the 283.28 individual's care plan, the case manager should include the use 283.29 of volunteers from families and neighbors, religious 283.30 organizations, social clubs, and civic and service organizations 283.31 to support the formal home care services. The county shall be 283.32 held harmless for damages or injuries sustained through the use 283.33 of volunteers under this subdivision including workers' 283.34 compensation liability.The lead agency shall provide283.35documentation to the commissioner verifying that the283.36individual's alternative care is not available at that time284.1through any other public assistance or service program.The 284.2 lead agency shall provide documentation in each individual's 284.3 plan of care and, if requested, to the commissioner that the 284.4 most cost-effective alternatives available have been offered to 284.5 the individual and that the individual was free to choose among 284.6 available qualified providers, both public and private. The 284.7 case manager must give the individual a ten-day written notice 284.8 of any decrease in or termination of alternative care services. 284.9 (b) If the county administering alternative care services 284.10 is different than the county of financial responsibility, the 284.11 care plan may be implemented without the approval of the county 284.12 of financial responsibility. 284.13 Sec. 22. Minnesota Statutes 2000, section 256B.0913, 284.14 subdivision 9, is amended to read: 284.15 Subd. 9. [CONTRACTING PROVISIONS FOR PROVIDERS.]The lead284.16agency shall document to the commissioner that the agency made284.17reasonable efforts to inform potential providers of the284.18anticipated need for services under the alternative care program284.19or waiver programs under sections 256B.0915 and 256B.49,284.20including a minimum of 14 days' written advance notice of the284.21opportunity to be selected as a service provider and an annual284.22public meeting with providers to explain and review the criteria284.23for selection. The lead agency shall also document to the284.24commissioner that the agency allowed potential providers an284.25opportunity to be selected to contract with the county agency.284.26Funds reimbursed to counties under this subdivisionAlternative 284.27 care funds paid to service providers are subject to audit by the 284.28 commissioner for fiscal and utilization control. 284.29 The lead agency must select providers for contracts or 284.30 agreements using the following criteria and other criteria 284.31 established by the county: 284.32 (1) the need for the particular services offered by the 284.33 provider; 284.34 (2) the population to be served, including the number of 284.35 clients, the length of time services will be provided, and the 284.36 medical condition of clients; 285.1 (3) the geographic area to be served; 285.2 (4) quality assurance methods, including appropriate 285.3 licensure, certification, or standards, and supervision of 285.4 employees when needed; 285.5 (5) rates for each service and unit of service exclusive of 285.6 county administrative costs; 285.7 (6) evaluation of services previously delivered by the 285.8 provider; and 285.9 (7) contract or agreement conditions, including billing 285.10 requirements, cancellation, and indemnification. 285.11 The county must evaluate its own agency services under the 285.12 criteria established for other providers.The county shall285.13provide a written statement of the reasons for not selecting285.14providers.285.15 Sec. 23. Minnesota Statutes 2000, section 256B.0913, 285.16 subdivision 10, is amended to read: 285.17 Subd. 10. [ALLOCATION FORMULA.] (a) The alternative care 285.18 appropriation for fiscal years 1992 and beyond shall cover 285.19 only180-dayalternative care eligible clients. Prior to July 1 285.20 of each year, the commissioner shall allocate to county agencies 285.21 the state funds available for alternative care for persons 285.22 eligible under subdivision 2. 285.23 (b)Prior to July 1 of each year, the commissioner shall285.24allocate to county agencies the state funds available for285.25alternative care for persons eligible under subdivision 2. The285.26allocation for fiscal year 1992 shall be calculated using a base285.27that is adjusted to exclude the medical assistance share of285.28alternative care expenditures. The adjusted base is calculated285.29by multiplying each county's allocation for fiscal year 1991 by285.30the percentage of county alternative care expenditures for285.31180-day eligible clients. The percentage is determined based on285.32expenditures for services rendered in fiscal year 1989 or285.33calendar year 1989, whichever is greater.The adjusted base for 285.34 each county is the county's current fiscal year base allocation 285.35 plus any targeted funds approved during the current fiscal 285.36 year. Calculations for paragraphs (c) and (d) are to be made as 286.1 follows: for each county, the determination of alternative care 286.2 program expenditures shall be based on payments for services 286.3 rendered from April 1 through March 31 in the base year, to the 286.4 extent that claims have been submitted and paid by June 1 of 286.5 that year. 286.6 (c) If thecountyalternative care program expendituresfor286.7180-day eligible clientsas defined in paragraph (b) are 95 286.8 percent or more ofitsthe county's adjusted base allocation, 286.9 the allocation for the next fiscal year is 100 percent of the 286.10 adjusted base, plus inflation to the extent that inflation is 286.11 included in the state budget. 286.12 (d) If thecountyalternative care program expendituresfor286.13180-day eligible clientsas defined in paragraph (b) are less 286.14 than 95 percent ofitsthe county's adjusted base allocation, 286.15 the allocation for the next fiscal year is the adjusted base 286.16 allocation less the amount of unspent funds below the 95 percent 286.17 level. 286.18 (e)For fiscal year 1992 only, a county may receive an286.19increased allocation if annualized service costs for the month286.20of May 1991 for 180-day eligible clients are greater than the286.21allocation otherwise determined. A county may apply for this286.22increase by reporting projected expenditures for May to the286.23commissioner by June 1, 1991. The amount of the allocation may286.24exceed the amount calculated in paragraph (b). The projected286.25expenditures for May must be based on actual 180-day eligible286.26client caseload and the individual cost of clients' care plans.286.27If a county does not report its expenditures for May, the amount286.28in paragraph (c) or (d) shall be used.286.29(f) Calculations for paragraphs (c) and (d) are to be made286.30as follows: for each county, the determination of expenditures286.31shall be based on payments for services rendered from April 1286.32through March 31 in the base year, to the extent that claims286.33have been submitted by June 1 of that year. Calculations for286.34paragraphs (c) and (d) must also include the funds transferred286.35to the consumer support grant program for clients who have286.36transferred to that program from April 1 through March 31 in the287.1base year.287.2(g) For the biennium ending June 30, 2001, the allocation287.3of state funds to county agencies shall be calculated as287.4described in paragraphs (c) and (d).If the annual legislative 287.5 appropriation for the alternative care program is inadequate to 287.6 fund the combined county allocations forfiscal year 2000 or287.72001a biennium, the commissioner shall distribute to each 287.8 county the entire annual appropriation as that county's 287.9 percentage of the computed base as calculated inparagraph287.10(f)paragraphs (c) and (d). 287.11 Sec. 24. Minnesota Statutes 2000, section 256B.0913, 287.12 subdivision 11, is amended to read: 287.13 Subd. 11. [TARGETED FUNDING.] (a) The purpose of targeted 287.14 funding is to make additional money available to counties with 287.15 the greatest need. Targeted funds are not intended to be 287.16 distributed equitably among all counties, but rather, allocated 287.17 to those with long-term care strategies that meet state goals. 287.18 (b) The funds available for targeted funding shall be the 287.19 total appropriation for each fiscal year minus county 287.20 allocations determined under subdivision 10 as adjusted for any 287.21 inflation increases provided in appropriations for the biennium. 287.22 (c) The commissioner shall allocate targeted funds to 287.23 counties that demonstrate to the satisfaction of the 287.24 commissioner that they have developed feasible plans to increase 287.25 alternative care spending. In making targeted funding 287.26 allocations, the commissioner shall use the following priorities: 287.27 (1) counties that received a lower allocation in fiscal 287.28 year 1991 than in fiscal year 1990. Counties remain in this 287.29 priority until they have been restored to their fiscal year 1990 287.30 level plus inflation; 287.31 (2) counties that sustain a base allocation reduction for 287.32 failure to spend 95 percent of the allocation if they 287.33 demonstrate that the base reduction should be restored; 287.34 (3) counties that propose projects to divert community 287.35 residents from nursing home placement or convert nursing home 287.36 residents to community living; and 288.1 (4) counties that can otherwise justify program growth by 288.2 demonstrating the existence of waiting lists, demographically 288.3 justified needs, or other unmet needs. 288.4 (d) Counties that would receive targeted funds according to 288.5 paragraph (c) must demonstrate to the commissioner's 288.6 satisfaction that the funds would be appropriately spent by 288.7 showing how the funds would be used to further the state's 288.8 alternative care goals as described in subdivision 1, and that 288.9 the county has the administrative and service delivery 288.10 capability to use them. 288.11 (e) The commissioner shall request applicationsby June 1288.12each year, for county agencies to applyfor targeted funds by 288.13 November 1 of each year. The counties selected for targeted 288.14 funds shall be notified of the amount of their additional 288.15 fundingby August 1 of each year. Targeted funds allocated to a 288.16 county agency in one year shall be treated as part of the 288.17 county's base allocation for that year in determining 288.18 allocations for subsequent years. No reallocations between 288.19 counties shall be made. 288.20(f) The allocation for each year after fiscal year 1992288.21shall be determined using the previous fiscal year's allocation,288.22including any targeted funds, as the base and then applying the288.23criteria under subdivision 10, paragraphs (c), (d), and (f), to288.24the current year's expenditures.288.25 Sec. 25. Minnesota Statutes 2000, section 256B.0913, 288.26 subdivision 12, is amended to read: 288.27 Subd. 12. [CLIENT PREMIUMS.] (a) A premium is required for 288.28 all180-dayalternative care eligible clients to help pay for 288.29 the cost of participating in the program. The amount of the 288.30 premium for the alternative care client shall be determined as 288.31 follows: 288.32 (1) when the alternative care client's income less 288.33 recurring and predictable medical expenses is greater than the 288.34medical assistance income standardrecipient's maintenance needs 288.35 allowance as defined in section 256B.0915, subdivision 1d, 288.36 paragraph (a), but less than 150 percent of the federal poverty 289.1 guideline effective on July 1 of the state fiscal year in which 289.2 the premium is being computed, and total assets are less than 289.3 $10,000, the fee is zero; 289.4 (2) when the alternative care client's income less 289.5 recurring and predictable medical expenses is greater than 150 289.6 percent of the federal poverty guideline effective on July 1 of 289.7 the state fiscal year in which the premium is being computed, 289.8 and total assets are less than $10,000, the fee is 25 percent of 289.9 the cost of alternative care services or the difference between 289.10 150 percent of the federal poverty guideline effective on July 1 289.11 of the state fiscal year in which the premium is being computed 289.12 and the client's income less recurring and predictable medical 289.13 expenses, whichever is less; and 289.14 (3) when the alternative care client's total assets are 289.15 greater than $10,000, the fee is 25 percent of the cost of 289.16 alternative care services. 289.17 For married persons, total assets are defined as the total 289.18 marital assets less the estimated community spouse asset 289.19 allowance, under section 256B.059, if applicable. For married 289.20 persons, total income is defined as the client's income less the 289.21 monthly spousal allotment, under section 256B.058. 289.22 All alternative care services except case management shall 289.23 be included in the estimated costs for the purpose of 289.24 determining 25 percent of the costs. 289.25 The monthly premium shall be calculated based on the cost 289.26 of the first full month of alternative care services and shall 289.27 continue unaltered until the next reassessment is completed or 289.28 at the end of 12 months, whichever comes first. Premiums are 289.29 due and payable each month alternative care services are 289.30 received unless the actual cost of the services is less than the 289.31 premium. 289.32 (b) The fee shall be waived by the commissioner when: 289.33 (1) a person who is residing in a nursing facility is 289.34 receiving case management only; 289.35 (2) a person is applying for medical assistance; 289.36 (3) a married couple is requesting an asset assessment 290.1 under the spousal impoverishment provisions; 290.2 (4)a person is a medical assistance recipient, but has290.3been approved for alternative care-funded assisted living290.4services;290.5(5)a person is found eligible for alternative care, but is 290.6 not yet receiving alternative care services; or 290.7(6)(5) a person's fee under paragraph (a) is less than $25. 290.8 (c) The county agency must collect the premium from the 290.9 client and forward the amounts collected to the commissioner in 290.10 the manner and at the times prescribed by the commissioner. 290.11 Money collected must be deposited in the general fund and is 290.12 appropriated to the commissioner for the alternative care 290.13 program. The client must supply the county with the client's 290.14 social security number at the time of application. If a client 290.15 fails or refuses to pay the premium due, the county shall supply 290.16 the commissioner with the client's social security number and 290.17 other information the commissioner requires to collect the 290.18 premium from the client. The commissioner shall collect unpaid 290.19 premiums using the Revenue Recapture Act in chapter 270A and 290.20 other methods available to the commissioner. The commissioner 290.21 may require counties to inform clients of the collection 290.22 procedures that may be used by the state if a premium is not 290.23 paid. 290.24 (d) The commissioner shall begin to adopt emergency or 290.25 permanent rules governing client premiums within 30 days after 290.26 July 1, 1991, including criteria for determining when services 290.27 to a client must be terminated due to failure to pay a premium. 290.28 Sec. 26. Minnesota Statutes 2000, section 256B.0913, 290.29 subdivision 13, is amended to read: 290.30 Subd. 13. [COUNTY BIENNIAL PLAN.] The county biennial plan 290.31 forthe preadmission screening programlong-term care 290.32 consultation services under section 256B.0911, the alternative 290.33 care program under this section, and waivers for the elderly 290.34 under section 256B.0915,and waivers for the disabled under290.35section 256B.49,shall be incorporated into the biennial 290.36 Community Social Services Act plan and shall meet the 291.1 regulations and timelines of that plan.This county biennial291.2plan shall include:291.3(1) information on the administration of the preadmission291.4screening program;291.5(2) information on the administration of the home and291.6community-based services waivers for the elderly under section291.7256B.0915, and for the disabled under section 256B.49; and291.8(3) information on the administration of the alternative291.9care program.291.10 Sec. 27. Minnesota Statutes 2000, section 256B.0913, 291.11 subdivision 14, is amended to read: 291.12 Subd. 14. [REIMBURSEMENTPAYMENT AND RATE ADJUSTMENTS.] (a) 291.13ReimbursementPayment forexpenditures for theprovided 291.14 alternative care services as approved by the client's case 291.15 manager shall be through the invoice processing procedures of 291.16 the department's Medicaid Management Information System (MMIS). 291.17 To receivereimbursementpayment, the county or vendor must 291.18 submit invoices within 12 months following the date of service. 291.19 The county agency and its vendors under contract shall not be 291.20 reimbursed for services which exceed the county allocation. 291.21 (b) If a county collects less than 50 percent of the client 291.22 premiums due under subdivision 12, the commissioner may withhold 291.23 up to three percent of the county's final alternative care 291.24 program allocation determined under subdivisions 10 and 11. 291.25 (c) The county shall negotiate individual rates with 291.26 vendors and maybe reimbursedauthorize service payment for 291.27 actual costs up tothe greater ofthe county's current approved 291.28 rateor 60 percent of the maximum rate in fiscal year 1994 and291.2965 percent of the maximum rate in fiscal year 1995 for each291.30alternative care service. Notwithstanding any other rule or 291.31 statutory provision to the contrary, the commissioner shall not 291.32 be authorized to increase rates by an annual inflation factor, 291.33 unless so authorized by the legislature. 291.34 (d)On July 1, 1993, the commissioner shall increase the291.35maximum rate for home delivered meals to $4.50 per mealTo 291.36 improve access to community services and eliminate payment 292.1 disparities between the alternative care program and the elderly 292.2 waiver program, the commissioner shall establish statewide 292.3 maximum service rate limits and eliminate county-specific 292.4 service rate limits. 292.5 (1) Effective July 1, 2001, for service rate limits, except 292.6 those in subdivision 5, paragraphs (d) and (i), the rate limit 292.7 for each service shall be the greater of the alternative care 292.8 statewide maximum rate or the elderly waiver statewide maximum 292.9 rate. 292.10 (2) Counties may negotiate individual service rates with 292.11 vendors for actual costs up to the statewide maximum service 292.12 rate limit. 292.13 Sec. 28. Minnesota Statutes 2000, section 256B.0915, 292.14 subdivision 1d, is amended to read: 292.15 Subd. 1d. [POSTELIGIBILITY TREATMENT OF INCOME AND 292.16 RESOURCES FOR ELDERLY WAIVER.](a)Notwithstanding the 292.17 provisions of section 256B.056, the commissioner shall make the 292.18 following amendment to the medical assistance elderly waiver 292.19 program effective July 1, 1999, or upon federal approval, 292.20 whichever is later. 292.21 A recipient's maintenance needs will be an amount equal to 292.22 the Minnesota supplemental aid equivalent rate as defined in 292.23 section 256I.03, subdivision 5, plus the medical assistance 292.24 personal needs allowance as defined in section 256B.35, 292.25 subdivision 1, paragraph (a), when applying posteligibility 292.26 treatment of income rules to the gross income of elderly waiver 292.27 recipients, except for individuals whose income is in excess of 292.28 the special income standard according to Code of Federal 292.29 Regulations, title 42, section 435.236. Recipient maintenance 292.30 needs shall be adjusted under this provision each July 1. 292.31(b) The commissioner of human services shall secure292.32approval of additional elderly waiver slots sufficient to serve292.33persons who will qualify under the revised income standard292.34described in paragraph (a) before implementing section292.35256B.0913, subdivision 16.292.36(c) In implementing this subdivision, the commissioner293.1shall consider allowing persons who would otherwise be eligible293.2for the alternative care program but would qualify for the293.3elderly waiver with a spenddown to remain on the alternative293.4care program.293.5 Sec. 29. Minnesota Statutes 2000, section 256B.0915, 293.6 subdivision 3, is amended to read: 293.7 Subd. 3. [LIMITS OF CASES, RATES,REIMBURSEMENTPAYMENTS, 293.8 AND FORECASTING.] (a) The number of medical assistance waiver 293.9 recipients that a county may serve must be allocated according 293.10 to the number of medical assistance waiver cases open on July 1 293.11 of each fiscal year. Additional recipients may be served with 293.12 the approval of the commissioner. 293.13 (b) The monthly limit for the cost of waivered services to 293.14 an individual elderly waiver client shall be thestatewide293.15average paymentweighted average monthly nursing facility rate 293.16 of the case mix resident class to which the elderly waiver 293.17 client would be assigned underthe medical assistance case mix293.18reimbursement system.Minnesota Rules, parts 9549.0050 to 293.19 9549.0059, less the recipient's maintenance needs allowance as 293.20 described in subdivision 1d, paragraph (a), until the first day 293.21 of the state fiscal year in which the resident assessment system 293.22 as described in section 256B.437 for nursing home rate 293.23 determination is implemented. Effective on the first day of the 293.24 state fiscal year in which the resident assessment system as 293.25 described in section 256B.437 for nursing home rate 293.26 determination is implemented and the first day of each 293.27 subsequent state fiscal year, the monthly limit for the cost of 293.28 waivered services to an individual elderly waiver client shall 293.29 be the rate of the case mix resident class to which the waiver 293.30 client would be assigned under Minnesota Rules, parts 9549.0050 293.31 to 9549.0059, in effect on the last day of the previous state 293.32 fiscal year, adjusted by the greater of any legislatively 293.33 adopted home and community-based services cost-of-living 293.34 percentage increase or any legislatively adopted statewide 293.35 percent rate increase for nursing facilities. 293.36 (c) If extended medical supplies and equipment or 294.1adaptationsenvironmental modifications are or will be purchased 294.2 for an elderly waiverservices recipient, theclient, the costs 294.3 may be proratedon a monthly basis throughout the year in which294.4they are purchasedfor up to 12 consecutive months beginning 294.5 with the month of purchase. If the monthly cost of a 294.6 recipient'sotherwaivered services exceeds the monthly limit 294.7 established inthisparagraph (b), the annual cost oftheall 294.8 waivered services shall be determined. In this event, the 294.9 annual cost of all waivered services shall not exceed 12 times 294.10 the monthly limitcalculated in this paragraph. The statewide294.11average payment rate is calculated by determining the statewide294.12average monthly nursing home rate, effective July 1 of the294.13fiscal year in which the cost is incurred, less the statewide294.14average monthly income of nursing home residents who are age 65294.15or older, and who are medical assistance recipients in the month294.16of March of the previous state fiscal year. The annual cost294.17divided by 12 of elderly or disabled waivered servicesof 294.18 waivered services as described in paragraph (b). 294.19 (d) For a person who is a nursing facility resident at the 294.20 time of requesting a determination of eligibility for elderlyor294.21disabledwaivered servicesshall be the greater of the monthly294.22payment for: (i), a monthly conversion limit for the cost of 294.23 elderly waivered services may be requested. The monthly 294.24 conversion limit for the cost of elderly waiver services shall 294.25 be the resident class assigned under Minnesota Rules, parts 294.26 9549.0050 to 9549.0059, for that resident in the nursing 294.27 facility where the resident currently resides; or (ii) the294.28statewide average payment of the case mix resident class to294.29which the resident would be assigned under the medical294.30assistance case mix reimbursement system, provided thatuntil 294.31 July 1 of the state fiscal year in which the resident assessment 294.32 system as described in section 256B.437 for nursing home rate 294.33 determination is implemented. Effective on July 1 of the state 294.34 fiscal year in which the resident assessment system as described 294.35 in section 256B.437 for nursing home rate determination is 294.36 implemented, the monthly conversion limit for the cost of 295.1 elderly waiver services shall be the per diem nursing facility 295.2 rate as determined by the resident assessment system as 295.3 described in section 256B.437 for that resident in the nursing 295.4 facility where the resident currently resides multiplied by 365 295.5 and divided by 12, less the recipient's maintenance needs 295.6 allowance as described in subdivision 1d. The limit under this 295.7 clause only applies to persons discharged from a nursing 295.8 facility after a minimum 30-day stay and found eligible for 295.9 waivered services on or after July 1, 1997. The following costs 295.10 must be included in determining the total monthly costs for the 295.11 waiver client: 295.12 (1) cost of all waivered services, including extended 295.13 medical supplies and equipment and environmental modifications; 295.14 and 295.15 (2) cost of skilled nursing, home health aide, and personal 295.16 care services reimbursable by medical assistance. 295.17(c)(e) Medical assistance funding for skilled nursing 295.18 services, private duty nursing, home health aide, and personal 295.19 care services for waiver recipients must be approved by the case 295.20 manager and included in the individual care plan. 295.21(d) For both the elderly waiver and the nursing facility295.22disabled waiver, a county may purchase extended supplies and295.23equipment without prior approval from the commissioner when295.24there is no other funding source and the supplies and equipment295.25are specified in the individual's care plan as medically295.26necessary to enable the individual to remain in the community295.27according to the criteria in Minnesota Rules, part 9505.0210,295.28items A and B.(f) A county is not required to contract with a 295.29 provider of supplies and equipment if the monthly cost of the 295.30 supplies and equipment is less than $250. 295.31(e)(g) The adult foster caredailyratefor the elderly295.32and disabled waiversshall be considered a difficulty of care 295.33 payment and shall not include room and board. The adult foster 295.34 care service rate shall be negotiated between the county agency 295.35 and the foster care provider.The rate established under this295.36section shall not exceed the state average monthly nursing home296.1payment for the case mix classification to which the individual296.2receiving foster care is assigned; the rate must allow for other296.3waiver and medical assistance home care services to be296.4authorized by the case manager.The elderly waiver payment for 296.5 the foster care service in combination with the payment for all 296.6 other elderly waiver services, including case management, must 296.7 not exceed the limit specified in paragraph (b). 296.8(f) The assisted living and residential care service rates296.9for elderly and community alternatives for disabled individuals296.10(CADI) waivers shall be made to the vendor as a monthly rate296.11negotiated with the county agency based on an individualized296.12service plan for each resident. The rate shall not exceed the296.13nonfederal share of the greater of either the statewide or any296.14of the geographic groups' weighted average monthly medical296.15assistance nursing facility payment rate of the case mix296.16resident class to which the elderly or disabled client would be296.17assigned under Minnesota Rules, parts 9549.0050 to 9549.0059,296.18unless the services are provided by a home care provider296.19licensed by the department of health and are provided in a296.20building that is registered as a housing with services296.21establishment under chapter 144D and that provides 24-hour296.22supervision. For alternative care assisted living projects296.23established under Laws 1988, chapter 689, article 2, section296.24256, monthly rates may not exceed 65 percent of the greater of296.25either the statewide or any of the geographic groups' weighted296.26average monthly medical assistance nursing facility payment rate296.27for the case mix resident class to which the elderly or disabled296.28client would be assigned under Minnesota Rules, parts 9549.0050296.29to 9549.0059. The rate may not cover direct rent or food costs.296.30 (h) Payment for assisted living service shall be a monthly 296.31 rate negotiated and authorized by the county agency based on an 296.32 individualized service plan for each resident and may not cover 296.33 direct rent or food costs. 296.34 (1) The individualized monthly negotiated payment for 296.35 assisted living services as described in section 256B.0913, 296.36 subdivision 5, paragraph (g) or (h), and residential care 297.1 services as described in section 256B.0913, subdivision 5, 297.2 paragraph (f), shall not exceed the nonfederal share, in effect 297.3 on July 1 of the state fiscal year for which the rate limit is 297.4 being calculated, of the greater of either the statewide or any 297.5 of the geographic groups' weighted average monthly nursing 297.6 facility rate of the case mix resident class to which the 297.7 elderly waiver eligible client would be assigned under Minnesota 297.8 Rules, parts 9549.0050 to 9549.0059, less the maintenance needs 297.9 allowance as described in subdivision 1d, paragraph (a), until 297.10 the July 1 of the state fiscal year in which the resident 297.11 assessment system as described in section 256B.437 for nursing 297.12 home rate determination is implemented. Effective on July 1 of 297.13 the state fiscal year in which the resident assessment system as 297.14 described in section 256B.437 for nursing home rate 297.15 determination is implemented and July 1 of each subsequent state 297.16 fiscal year, the individualized monthly negotiated payment for 297.17 the services described in this clause shall not exceed the limit 297.18 described in this clause which was in effect on June 30 of the 297.19 previous state fiscal year and which has been adjusted by the 297.20 greater of any legislatively adopted home and community-based 297.21 services cost-of-living percentage increase or any legislatively 297.22 adopted statewide percent rate increase for nursing facilities. 297.23 (2) The individualized monthly negotiated payment for 297.24 assisted living services described in section 144A.4605 and 297.25 delivered by a provider licensed by the department of health as 297.26 a Class A home care provider or an assisted living home care 297.27 provider and provided in a building that is registered as a 297.28 housing with services establishment under chapter 144D and that 297.29 provides 24-hour supervision in combination with the payment for 297.30 other elderly waiver services, including case management, must 297.31 not exceed the limit specified in paragraph (b). 297.32(g)(i) The county shall negotiate individual service rates 297.33 with vendors and maybe reimbursedauthorize payment for actual 297.34 costs up to thegreater of thecounty's current approved rateor297.3560 percent of the maximum rate in fiscal year 1994 and 65297.36percent of the maximum rate in fiscal year 1995 for each service298.1within each program. Persons or agencies must be employed by or 298.2 under a contract with the county agency or the public health 298.3 nursing agency of the local board of health in order to receive 298.4 funding under the elderly waiver program, except as a provider 298.5 of supplies and equipment when the monthly cost of the supplies 298.6 and equipment is less than $250. 298.7(h) On July 1, 1993, the commissioner shall increase the298.8maximum rate for home-delivered meals to $4.50 per meal.298.9(i)(j) Reimbursement for the medical assistance recipients 298.10 under the approved waiver shall be made from the medical 298.11 assistance account through the invoice processing procedures of 298.12 the department's Medicaid Management Information System (MMIS), 298.13 only with the approval of the client's case manager. The budget 298.14 for the state share of the Medicaid expenditures shall be 298.15 forecasted with the medical assistance budget, and shall be 298.16 consistent with the approved waiver. 298.17 (k) To improve access to community services and eliminate 298.18 payment disparities between the alternative care program and the 298.19 elderly waiver, the commissioner shall establish statewide 298.20 maximum service rate limits and eliminate county-specific 298.21 service rate limits. 298.22 (1) Effective July 1, 2001, for service rate limits, except 298.23 those described or defined in paragraphs (g) and (h), the rate 298.24 limit for each service shall be the greater of the alternative 298.25 care statewide maximum rate or the elderly waiver statewide 298.26 maximum rate. 298.27 (2) Counties may negotiate individual service rates with 298.28 vendors for actual costs up to the statewide maximum service 298.29 rate limit. 298.30(j)(l) Beginning July 1, 1991, the state shall reimburse 298.31 counties according to the payment schedule in section 256.025 298.32 for the county share of costs incurred under this subdivision on 298.33 or after January 1, 1991, for individuals who are receiving 298.34 medical assistance. 298.35(k) For the community alternatives for disabled individuals298.36waiver, and nursing facility disabled waivers, county may use299.1waiver funds for the cost of minor adaptations to a client's299.2residence or vehicle without prior approval from the299.3commissioner if there is no other source of funding and the299.4adaptation:299.5(1) is necessary to avoid institutionalization;299.6(2) has no utility apart from the needs of the client; and299.7(3) meets the criteria in Minnesota Rules, part 9505.0210,299.8items A and B.299.9For purposes of this subdivision, "residence" means the client's299.10own home, the client's family residence, or a family foster299.11home. For purposes of this subdivision, "vehicle" means the299.12client's vehicle, the client's family vehicle, or the client's299.13family foster home vehicle.299.14(l) The commissioner shall establish a maximum rate unit299.15for baths provided by an adult day care provider that are not299.16included in the provider's contractual daily or hourly rate.299.17This maximum rate must equal the home health aide extended rate299.18and shall be paid for baths provided to clients served under the299.19elderly and disabled waivers.299.20 Sec. 30. Minnesota Statutes 2000, section 256B.0915, 299.21 subdivision 5, is amended to read: 299.22 Subd. 5. [REASSESSMENTS FOR WAIVER CLIENTS.] A 299.23 reassessment of a client served under the elderlyor disabled299.24 waiver must be conducted at least every 12 months and at other 299.25 times when the case manager determines that there has been 299.26 significant change in the client's functioning. This may 299.27 include instances where the client is discharged from the 299.28 hospital. 299.29 Sec. 31. Minnesota Statutes 2000, section 256B.0917, is 299.30 amended by adding a subdivision to read: 299.31 Subd. 13. [COMMUNITY SERVICE GRANTS.] The commissioner 299.32 shall award contracts for grants to public and private nonprofit 299.33 agencies to establish services that strengthen a community's 299.34 ability to provide a system of home and community-based services 299.35 for elderly persons. The commissioner shall use a request for 299.36 proposal process. Communities that have a planned closure of a 300.1 nursing facility approved under section 256B.437 shall be given 300.2 preference for grants. The commissioner shall consider grants 300.3 for: 300.4 (1) caregiver support and respite care projects under 300.5 subdivision 6; 300.6 (2) on-site coordination under section 256.9731; 300.7 (3) the living-at-home/block nurse grant under subdivisions 300.8 7 to 10; and 300.9 (4) services identified as needed for community transition. 300.10 Sec. 32. [RESPITE CARE.] 300.11 The Minnesota board on aging shall present recommendations 300.12 to the legislature by February 1, 2002, on the provision of 300.13 in-home and out-of-home respite care services on a sliding scale 300.14 basis under the federal Older Americans Act. 300.15 Sec. 33. [REPEALER.] 300.16 (a) Minnesota Statutes 2000, sections 256B.0911, 300.17 subdivisions 2, 2a, 4, 8, and 9; 256B.0913, subdivisions 3, 15a, 300.18 15b, 15c, and 16; and 256B.0915, subdivisions 3a, 3b, and 3c, 300.19 are repealed. 300.20 (b) Minnesota Rules, parts 9505.2390; 9505.2395; 9505.2396; 300.21 9505.2400; 9505.2405; 9505.2410; 9505.2413; 9505.2415; 300.22 9505.2420; 9505.2425; 9505.2426; 9505.2430; 9505.2435; 300.23 9505.2440; 9505.2445; 9505.2450; 9505.2455; 9505.2458; 300.24 9505.2460; 9505.2465; 9505.2470; 9505.2473; 9505.2475; 300.25 9505.2480; 9505.2485; 9505.2486; 9505.2490; 9505.2495; 300.26 9505.2496; and 9505.2500, are repealed. 300.27 ARTICLE 6 300.28 LONG-TERM CARE SYSTEM REFORM AND REIMBURSEMENT 300.29 Section 1. Minnesota Statutes 2000, section 144.0721, 300.30 subdivision 1, is amended to read: 300.31 Subdivision 1. [APPROPRIATENESS AND QUALITY.] Until the 300.32 date of implementation of the revised case mix system based on 300.33 the minimum data set, the commissioner of health shall assess 300.34 the appropriateness and quality of care and services furnished 300.35 to private paying residents in nursing homes and boarding care 300.36 homes that are certified for participation in the medical 301.1 assistance program under United States Code, title 42, sections 301.2 1396-1396p. These assessments shall be conducted until the date 301.3 of implementation of the revised case mix system based on the 301.4 minimum data set, in accordance with section 144.072, with the 301.5 exception of provisions requiring recommendations for changes in 301.6 the level of care provided to the private paying residents. 301.7 Sec. 2. [144.0724] [RESIDENT REIMBURSEMENT 301.8 CLASSIFICATION.] 301.9 Subdivision 1. [RESIDENT REIMBURSEMENT 301.10 CLASSIFICATIONS.] The commissioner of health shall establish 301.11 resident reimbursement classifications based upon the 301.12 assessments of residents of nursing homes and boarding care 301.13 homes conducted under this section and according to section 301.14 256B.437. The reimbursement classifications established under 301.15 this section shall be implemented after June 30, 2002, but no 301.16 later than January 1, 2003. 301.17 Subd. 2. [DEFINITIONS.] For purposes of this section, the 301.18 following terms have the meanings given. 301.19 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 301.20 date" means the last day of the minimum data set observation 301.21 period. The date sets the designated endpoint of the common 301.22 observation period, and all minimum data set items refer back in 301.23 time from that point. 301.24 (b) [CASE MIX INDEX.] "Case mix index" means the weighting 301.25 factors assigned to the RUG-III classifications. 301.26 (c) [INDEX MAXIMIZATION.] "Index maximization" means 301.27 classifying a resident who could be assigned to more than one 301.28 category, to the category with the highest case mix index. 301.29 (d) [MINIMUM DATA SET.] "Minimum data set" means the 301.30 assessment instrument specified by the Health Care Financing 301.31 Administration and designated by the Minnesota department of 301.32 health. 301.33 (e) [REPRESENTATIVE.] "Representative" means a person who 301.34 is the resident's guardian or conservator, the person authorized 301.35 to pay the nursing home expenses of the resident, a 301.36 representative of the nursing home ombudsman's office whose 302.1 assistance has been requested, or any other individual 302.2 designated by the resident. 302.3 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 302.4 utilization groups" or "RUG" means the system for grouping a 302.5 nursing facility's residents according to their clinical and 302.6 functional status identified in data supplied by the facility's 302.7 minimum data set. 302.8 Subd. 3. [RESIDENT REIMBURSEMENT CLASSIFICATIONS.] (a) 302.9 Resident reimbursement classifications shall be based on the 302.10 minimum data set, version 2.0 assessment instrument, or its 302.11 successor version mandated by the Health Care Financing 302.12 Administration that nursing facilities are required to complete 302.13 for all residents. The commissioner of health shall establish 302.14 resident classes according to the 34 group, resource utilization 302.15 groups, version III or RUG-III model. Resident classes must be 302.16 established based on the individual items on the minimum data 302.17 set and must be completed according to the facility manual for 302.18 case mix classification issued by the Minnesota department of 302.19 health. The facility manual for case mix classification shall 302.20 be drafted by the Minnesota department of health and presented 302.21 to the chairs of health and human services legislative 302.22 committees by December 31, 2001. 302.23 (b) Each resident must be classified based on the 302.24 information from the minimum data set according to general 302.25 domains in clauses (1) to (7): 302.26 (1) extensive services where a resident requires 302.27 intravenous feeding or medications, suctioning, tracheostomy 302.28 care, or is on a ventilator or respirator; 302.29 (2) rehabilitation where a resident requires physical, 302.30 occupational, or speech therapy; 302.31 (3) special care where a resident has cerebral palsy; 302.32 quadriplegia; multiple sclerosis; pressure ulcers; fever with 302.33 vomiting, weight loss, or dehydration; tube feeding and aphasia; 302.34 or is receiving radiation therapy; 302.35 (4) clinically complex status where a resident has burns, 302.36 coma, septicemia, pneumonia, internal bleeding, chemotherapy, 303.1 wounds, kidney failure, urinary tract infections, oxygen, or 303.2 transfusions; 303.3 (5) impaired cognition where a resident has poor cognitive 303.4 performance; 303.5 (6) behavior problems where a resident exhibits wandering, 303.6 has hallucinations, or is physically or verbally abusive toward 303.7 others, unless the resident's other condition would place the 303.8 resident in other categories; and 303.9 (7) reduced physical functioning where a resident has no 303.10 special clinical conditions. 303.11 (c) The commissioner of health shall establish resident 303.12 classification according to a 34 group model based on the 303.13 information on the minimum data set and within the general 303.14 domains listed in paragraph (b), clauses (1) to (7). Detailed 303.15 descriptions of each resource utilization group shall be defined 303.16 in the facility manual for case mix classification issued by the 303.17 Minnesota department of health. The 34 groups are described as 303.18 follows: 303.19 (1) SE3: requires four or five extensive services; 303.20 (2) SE2: requires two or three extensive services; 303.21 (3) SE1: requires one extensive service; 303.22 (4) RAD: requires rehabilitation services and is dependent 303.23 in activity of daily living (ADL) at a count of 17 or 18; 303.24 (5) RAC: requires rehabilitation services and ADL count is 303.25 14 to 16; 303.26 (6) RAB: requires rehabilitation services and ADL count is 303.27 ten to 13; 303.28 (7) RAA: requires rehabilitation services and ADL count is 303.29 four to nine; 303.30 (8) SSC: requires special care and ADL count is 17 or 18; 303.31 (9) SSB: requires special care and ADL count is 15 or 16; 303.32 (10) SSA: requires special care and ADL count is seven to 303.33 14; 303.34 (11) CC2: clinically complex with depression and ADL count 303.35 is 17 or 18; 303.36 (12) CC1: clinically complex with no depression and ADL 304.1 count is 17 or 18; 304.2 (13) CB2: clinically complex with depression and ADL count 304.3 is 12 to 16; 304.4 (14) CB1: clinically complex with no depression and ADL 304.5 count is 12 to 16; 304.6 (15) CA2: clinically complex with depression and ADL count 304.7 is four to 11; 304.8 (16) CA1: clinically complex with no depression and ADL 304.9 count is four to 11; 304.10 (17) IB2: impaired cognition with nursing rehabilitation 304.11 and ADL count is six to ten; 304.12 (18) IB1: impaired cognition with no nursing 304.13 rehabilitation and ADL count is six to ten; 304.14 (19) IA2: impaired cognition with nursing rehabilitation 304.15 and ADL count is four or five; 304.16 (20) IA1: impaired cognition with no nursing 304.17 rehabilitation and ADL count is four or five; 304.18 (21) BB2: behavior problems with nursing rehabilitation 304.19 and ADL count is six to ten; 304.20 (22) BB1: behavior problems with no nursing rehabilitation 304.21 and ADL count is six to ten; 304.22 (23) BA2: behavior problems with nursing rehabilitation 304.23 and ADL count is four to five; 304.24 (24) BA1: behavior problems with no nursing rehabilitation 304.25 and ADL count is four to five; 304.26 (25) PE2: reduced physical functioning with nursing 304.27 rehabilitation and ADL count is 16 to 18; 304.28 (26) PE1: reduced physical functioning with no nursing 304.29 rehabilitation and ADL count is 16 to 18; 304.30 (27) PD2: reduced physical functioning with nursing 304.31 rehabilitation and ADL count is 11 to 15; 304.32 (28) PD1: reduced physical functioning with no nursing 304.33 rehabilitation and ADL count is 11 to 15; 304.34 (29) PC2: reduced physical functioning with nursing 304.35 rehabilitation and ADL count is nine or ten; 304.36 (30) PC1: reduced physical functioning with no nursing 305.1 rehabilitation and ADL count is nine or ten; 305.2 (31) PB2: reduced physical functioning with nursing 305.3 rehabilitation and ADL count is six to eight; 305.4 (32) PB1: reduced physical functioning with no nursing 305.5 rehabilitation and ADL count is six to eight; 305.6 (33) PA2: reduced physical functioning with nursing 305.7 rehabilitation and ADL count is four or five; and 305.8 (34) PA1: reduced physical functioning with no nursing 305.9 rehabilitation and ADL count is four or five. 305.10 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) A facility 305.11 must conduct and electronically submit to the commissioner of 305.12 health case mix assessments that conform with the assessment 305.13 schedule defined by the Code of Federal Regulations, title 42, 305.14 section 483.20, and published by the United States Department of 305.15 Health and Human Services, Health Care Financing Administration, 305.16 in the Long Term Care Assessment Instrument User's Manual, 305.17 version 2.0, October 1995, and subsequent clarifications made in 305.18 the Long-Term Care Assessment Instrument Questions and Answers, 305.19 version 2.0, August 1996. The commissioner of health may 305.20 substitute successor manuals or question and answer documents 305.21 published by the United States Department of Health and Human 305.22 Services, Health Care Financing Administration, to replace or 305.23 supplement the current version of the manual or document. 305.24 (b) The assessments used to determine a case mix 305.25 classification for reimbursement include the following: 305.26 (1) a new admission assessment must be completed by day 14 305.27 following admission; 305.28 (2) an annual assessment must be completed within 366 days 305.29 of the last comprehensive assessment; 305.30 (3) a significant change assessment must be completed 305.31 within 14 days of the identification of a significant change; 305.32 and 305.33 (4) the second quarterly assessment following either a new 305.34 admission assessment, an annual assessment, or a significant 305.35 change assessment. Each quarterly assessment must be completed 305.36 within 92 days of the previous assessment. 306.1 Subd. 5. [SHORT STAYS.] (a) A facility must submit to the 306.2 commissioner of health an initial admission assessment for all 306.3 residents who stay in the facility less than 14 days. 306.4 (b) Notwithstanding the admission assessment requirements 306.5 of paragraph (a), a facility may elect to accept a default rate 306.6 with a case mix index of 1.0 for all facility residents who stay 306.7 less than 14 days in lieu of submitting an initial assessment. 306.8 Facilities may make this election to be effective on the day of 306.9 implementation of the revised case mix system. 306.10 (c) After implementation of the revised case mix system, 306.11 nursing facilities must elect one of the options described in 306.12 paragraphs (a) and (b) on the annual report to the commissioner 306.13 of human services filed for each report year ending September 306.14 30. The election shall be effective on the following July 1. 306.15 (d) For residents who are admitted or readmitted and leave 306.16 the facility on a frequent basis and for whom readmission is 306.17 expected, the resident may be discharged on an extended leave 306.18 status. This status does not require reassessment each time the 306.19 resident returns to the facility unless a significant change in 306.20 the resident's status has occurred since the last assessment. 306.21 The case mix classification for these residents is determined by 306.22 the facility election made in paragraphs (a) and (b). 306.23 Subd. 6. [PENALTIES FOR LATE OR NONSUBMISSION.] A facility 306.24 that fails to complete or submit an assessment for a RUG-III 306.25 classification within seven days of the time requirements in 306.26 subdivisions 4 and 5 is subject to a reduced rate for that 306.27 resident. The reduced rate shall be the lowest rate for that 306.28 facility. The reduced rate is effective on the day of admission 306.29 for new admission assessments or on the day that the assessment 306.30 was due for all other assessments and continues in effect until 306.31 the first day of the month following the date of submission of 306.32 the resident's assessment. 306.33 Subd. 7. [NOTICE OF RESIDENT REIMBURSEMENT 306.34 CLASSIFICATION.] (a) A facility must elect between the options 306.35 in paragraphs (1) and (2) to provide notice to a resident of the 306.36 resident's case mix classification. 307.1 (1) The commissioner of health shall provide to a nursing 307.2 facility a notice for each resident of the reimbursement 307.3 classification established under subdivision 1. The notice must 307.4 inform the resident of the classification that was assigned, the 307.5 opportunity to review the documentation supporting the 307.6 classification, the opportunity to obtain clarification from the 307.7 commissioner, and the opportunity to request a reconsideration 307.8 of the classification. The commissioner must send notice of 307.9 resident classification by first class mail. A nursing facility 307.10 is responsible for the distribution of the notice to each 307.11 resident, to the person responsible for the payment of the 307.12 resident's nursing home expenses, or to another person 307.13 designated by the resident. This notice must be distributed 307.14 within three working days after the facility's receipt of the 307.15 notice from the commissioner of health. 307.16 (2) A facility may choose to provide a classification 307.17 notice, as prescribed by the commissioner of health, to a 307.18 resident upon receipt of the confirmation of the case mix 307.19 classification calculated by a facility or a corrected case mix 307.20 classification as indicated on the final validation report from 307.21 the commissioner. A nursing facility is responsible for the 307.22 distribution of the notice to each resident, to the person 307.23 responsible for the payment of the resident's nursing home 307.24 expenses, or to another person designated by the resident. This 307.25 notice must be distributed within three working days after the 307.26 facility's receipt of the validation report from the 307.27 commissioner. If a facility elects this option, the 307.28 commissioner of health shall provide the facility with a list of 307.29 residents and their case mix classifications as determined by 307.30 the commissioner. A nursing facility may make this election to 307.31 be effective on the day of implementation of the revised case 307.32 mix system. 307.33 (3) After implementation of the revised case mix system, a 307.34 nursing facility shall elect a notice of resident reimbursement 307.35 classification procedure as described in paragraph (1) or (2) on 307.36 the annual report to the commissioner of human services filed 308.1 for each report year ending September 30. The election will be 308.2 effective the following July 1. 308.3 (b) If a facility submits a correction to an assessment 308.4 conducted under subdivision 3 that results in a change in case 308.5 mix classification, the facility shall give written notice to 308.6 the resident or the resident's representative about the item 308.7 that was corrected and the reason for the correction. The 308.8 notice of corrected assessment may be provided at the same time 308.9 that the resident or resident's representative is provided the 308.10 resident's corrected notice of classification. 308.11 Subd. 8. [REQUEST FOR RECONSIDERATION OF RESIDENT 308.12 CLASSIFICATIONS.] (a) The resident, or resident's 308.13 representative, or the nursing facility or boarding care home 308.14 may request that the commissioner of health reconsider the 308.15 assigned reimbursement classification. The request for 308.16 reconsideration must be submitted in writing to the commissioner 308.17 within 30 days of the day the resident or the resident's 308.18 representative receives the resident classification notice. The 308.19 request for reconsideration must include the name of the 308.20 resident, the name and address of the facility in which the 308.21 resident resides, the reasons for the reconsideration, the 308.22 requested classification changes, and documentation supporting 308.23 the requested classification. The documentation accompanying 308.24 the reconsideration request is limited to documentation which 308.25 establishes that the needs of the resident at the time of the 308.26 assessment justify a classification which is different than the 308.27 classification established by the commissioner of health. 308.28 (b) Upon request, the nursing facility must give the 308.29 resident or the resident's representative a copy of the 308.30 assessment form and the other documentation that was given to 308.31 the commissioner of health to support the assessment findings. 308.32 The nursing facility shall also provide access to and a copy of 308.33 other information from the resident's record that has been 308.34 requested by or on behalf of the resident to support a 308.35 resident's reconsideration request. A copy of any requested 308.36 material must be provided within three working days of receipt 309.1 of a written request for the information. If a facility fails 309.2 to provide the material within this time, it is subject to the 309.3 issuance of a correction order and penalty assessment under 309.4 sections 144.653 and 144A.10. Notwithstanding those sections, 309.5 any correction order issued under this subdivision must require 309.6 that the nursing facility immediately comply with the request 309.7 for information and that as of the date of the issuance of the 309.8 correction order, the facility shall forfeit to the state a $100 309.9 fine for the first day of noncompliance, and an increase in the 309.10 $100 fine by $50 increments for each day the noncompliance 309.11 continues. 309.12 (c) In addition to the information required under 309.13 paragraphs (a) and (b), a reconsideration request from a nursing 309.14 facility must contain the following information: (i) the date 309.15 the reimbursement classification notices were received by the 309.16 facility; (ii) the date the classification notices were 309.17 distributed to the resident or the resident's representative; 309.18 and (iii) a copy of a notice sent to the resident or to the 309.19 resident's representative. This notice must inform the resident 309.20 or the resident's representative that a reconsideration of the 309.21 resident's classification is being requested, the reason for the 309.22 request, that the resident's rate will change if the request is 309.23 approved by the commissioner, the extent of the change, that 309.24 copies of the facility's request and supporting documentation 309.25 are available for review, and that the resident also has the 309.26 right to request a reconsideration. If the facility fails to 309.27 provide the required information with the reconsideration 309.28 request, the request must be denied, and the facility may not 309.29 make further reconsideration requests on that specific 309.30 reimbursement classification. 309.31 (d) Reconsideration by the commissioner must be made by 309.32 individuals not involved in reviewing the assessment, audit, or 309.33 reconsideration that established the disputed classification. 309.34 The reconsideration must be based upon the initial assessment 309.35 and upon the information provided to the commissioner under 309.36 paragraphs (a) and (b). If necessary for evaluating the 310.1 reconsideration request, the commissioner may conduct on-site 310.2 reviews. Within 15 working days of receiving the request for 310.3 reconsideration, the commissioner shall affirm or modify the 310.4 original resident classification. The original classification 310.5 must be modified if the commissioner determines that the 310.6 assessment resulting in the classification did not accurately 310.7 reflect the needs or assessment characteristics of the resident 310.8 at the time of the assessment. The resident and the nursing 310.9 facility or boarding care home shall be notified within five 310.10 working days after the decision is made. A decision by the 310.11 commissioner under this subdivision is the final administrative 310.12 decision of the agency for the party requesting reconsideration. 310.13 (e) The resident classification established by the 310.14 commissioner shall be the classification that applies to the 310.15 resident while the request for reconsideration is pending. 310.16 (f) The commissioner may request additional documentation 310.17 regarding a reconsideration necessary to make an accurate 310.18 reconsideration determination. 310.19 Subd. 9. [AUDIT AUTHORITY.] (a) The commissioner shall 310.20 audit the accuracy of resident assessments performed under 310.21 section 256B.437 through desk audits, on-site review of 310.22 residents and their records, and interviews with staff and 310.23 families. The commissioner shall reclassify a resident if the 310.24 commissioner determines that the resident was incorrectly 310.25 classified. 310.26 (b) The commissioner is authorized to conduct on-site 310.27 audits on an unannounced basis. 310.28 (c) A facility must grant the commissioner access to 310.29 examine the medical records relating to the resident assessments 310.30 selected for audit under this subdivision. The commissioner may 310.31 also observe and speak to facility staff and residents. 310.32 (d) The commissioner shall consider documentation under the 310.33 time frames for coding items on the minimum data set as set out 310.34 in the Resident Assessment Instrument Manual published by the 310.35 Health Care Financing Administration. 310.36 (e) The commissioner shall develop an audit selection 311.1 procedure that includes the following factors: 311.2 (1) The commissioner may target facilities that demonstrate 311.3 an atypical pattern of scoring minimum data set items, 311.4 nonsubmission of assessments, late submission of assessments, or 311.5 a previous history of audit changes of greater than 35 percent. 311.6 The commissioner shall select at least 20 percent of the most 311.7 current assessments submitted to the state for audit. Audits of 311.8 assessments selected in the targeted facilities must focus on 311.9 the factors leading to the audit. If the number of targeted 311.10 assessments selected does not meet the threshold of 20 percent 311.11 of the facility residents, then a stratified sample of the 311.12 remainder of assessments shall be drawn to meet the quota. If 311.13 the total change exceeds 35 percent, the commissioner may 311.14 conduct an expanded audit up to 100 percent of the remaining 311.15 current assessments. 311.16 (2) Facilities that are not a part of the targeted group 311.17 shall be placed in a general pool from which facilities will be 311.18 selected on a random basis for audit. Every facility shall be 311.19 audited annually. If a facility has two successive audits in 311.20 which the percentage of change is five percent or less and the 311.21 facility has not been the subject of a targeted audit in the 311.22 past 36 months, the facility may be audited biannually. A 311.23 stratified sample of 15 percent of the most current assessments 311.24 shall be selected for audit. If more than 20 percent of the 311.25 RUGS-III classifications after the audit are changed, the audit 311.26 shall be expanded to a second 15 percent sample. If the total 311.27 change between the first and second samples exceed 35 percent, 311.28 the commissioner may expand the audit to all of the remaining 311.29 assessments. 311.30 (3) If a facility qualifies for an expanded audit, the 311.31 commissioner may audit the facility again within six months. If 311.32 a facility has two expanded audits within a 24-month period, 311.33 that facility will be audited at least every six months for the 311.34 next 18 months. 311.35 (4) The commissioner may conduct special audits if the 311.36 commissioner determines that circumstances exist that could 312.1 alter or affect the validity of case mix classifications of 312.2 residents. These circumstances include, but are not limited to, 312.3 the following: 312.4 (i) frequent changes in the administration or management of 312.5 the facility; 312.6 (ii) an unusually high percentage of residents in a 312.7 specific case mix classification; 312.8 (iii) a high frequency in the number of reconsideration 312.9 requests received from a facility; 312.10 (iv) frequent adjustments of case mix classifications as 312.11 the result of reconsiderations or audits; 312.12 (v) a criminal indictment alleging provider fraud; or 312.13 (vi) other similar factors that relate to a facility's 312.14 ability to conduct accurate assessments. 312.15 (f) Within 15 working days of completing the audit process, 312.16 the commissioner shall mail the written results of the audit to 312.17 the facility, along with a written notice for each resident 312.18 affected to be forwarded by the facility. The notice must 312.19 contain the resident's classification and a statement informing 312.20 the resident, the resident's authorized representative, and the 312.21 facility of their right to review the commissioner's documents 312.22 supporting the classification and to request a reconsideration 312.23 of the classification. This notice must also include the 312.24 address and telephone number of the area nursing home ombudsman. 312.25 Subd. 10. [TRANSITION.] After implementation of this 312.26 section, reconsiderations requested for classifications made 312.27 under section 144.0722, subdivision 1, shall be determined under 312.28 section 144.0722, subdivision 3. 312.29 Sec. 3. Minnesota Statutes 2000, section 144A.071, 312.30 subdivision 1, is amended to read: 312.31 Subdivision 1. [FINDINGS.] The legislature declares that a 312.32 moratorium on the licensure and medical assistance certification 312.33 of new nursing home beds and construction projects that 312.34 exceed$750,000$1,000,000 is necessary to control nursing home 312.35 expenditure growth and enable the state to meet the needs of its 312.36 elderly by providing high quality services in the most 313.1 appropriate manner along a continuum of care. 313.2 Sec. 4. Minnesota Statutes 2000, section 144A.071, 313.3 subdivision 1a, is amended to read: 313.4 Subd. 1a. [DEFINITIONS.] For purposes of sections 144A.071 313.5 to 144A.073, the following terms have the meanings given them: 313.6 (a) "attached fixtures" has the meaning given in Minnesota 313.7 Rules, part 9549.0020, subpart 6. 313.8 (b) "buildings" has the meaning given in Minnesota Rules, 313.9 part 9549.0020, subpart 7. 313.10 (c) "capital assets" has the meaning given in section 313.11 256B.421, subdivision 16. 313.12 (d) "commenced construction" means that all of the 313.13 following conditions were met: the final working drawings and 313.14 specifications were approved by the commissioner of health; the 313.15 construction contracts were let; a timely construction schedule 313.16 was developed, stipulating dates for beginning, achieving 313.17 various stages, and completing construction; and all zoning and 313.18 building permits were applied for. 313.19 (e) "completion date" means the date on which a certificate 313.20 of occupancy is issued for a construction project, or if a 313.21 certificate of occupancy is not required, the date on which the 313.22 construction project is available for facility use. 313.23 (f) "construction" means any erection, building, 313.24 alteration, reconstruction, modernization, or improvement 313.25 necessary to comply with the nursing home licensure rules. 313.26 (g) "construction project" means: 313.27 (1) a capital asset addition to, or replacement of a 313.28 nursing home or certified boarding care home that results in new 313.29 space or the remodeling of or renovations to existing facility 313.30 space; 313.31 (2) the remodeling or renovation of existing facility space 313.32 the use of which is modified as a result of the project 313.33 described in clause (1). This existing space and the project 313.34 described in clause (1) must be used for the functions as 313.35 designated on the construction plans on completion of the 313.36 project described in clause (1) for a period of not less than 24 314.1 months; or 314.2 (3) capital asset additions or replacements that are 314.3 completed within 12 months before or after the completion date 314.4 of the project described in clause (1). 314.5 (h) "new licensed" or "new certified beds" means: 314.6 (1) newly constructed beds in a facility or the 314.7 construction of a new facility that would increase the total 314.8 number of licensed nursing home beds or certified boarding care 314.9 or nursing home beds in the state; or 314.10 (2) newly licensed nursing home beds or newly certified 314.11 boarding care or nursing home beds that result from remodeling 314.12 of the facility that involves relocation of beds but does not 314.13 result in an increase in the total number of beds, except when 314.14 the project involves the upgrade of boarding care beds to 314.15 nursing home beds, as defined in section 144A.073, subdivision 314.16 1. "Remodeling" includes any of the type of conversion, 314.17 renovation, replacement, or upgrading projects as defined in 314.18 section 144A.073, subdivision 1. 314.19 (i) "project construction costs" means the cost of the 314.20 facility capital asset additions, replacements, renovations, or 314.21 remodeling projects, construction site preparation costs, and 314.22 related soft costs. Project construction costsalsoinclude the 314.23 cost of any remodeling or renovation of existing facility space 314.24 which is modified as a result of the construction 314.25 project. Project construction costs also includes the cost of 314.26 new technology implemented as part of the construction project. 314.27 (j) "technology" means information systems or devices that 314.28 make documentation, charting, and staff time more efficient or 314.29 encourage and allow for care through alternative settings 314.30 including, but not limited to, touch screens, monitors, 314.31 hand-helds, swipe cards, motion detectors, pagers, telemedicine, 314.32 medication dispensers, and equipment to monitor vital signs and 314.33 self-injections, and to observe skin and other conditions. 314.34 Sec. 5. Minnesota Statutes 2000, section 144A.071, 314.35 subdivision 2, is amended to read: 314.36 Subd. 2. [MORATORIUM.] The commissioner of health, in 315.1 coordination with the commissioner of human services, shall deny 315.2 each request for new licensed or certified nursing home or 315.3 certified boarding care beds except as provided in subdivision 3 315.4 or 4a, or section 144A.073. "Certified bed" means a nursing 315.5 home bed or a boarding care bed certified by the commissioner of 315.6 health for the purposes of the medical assistance program, under 315.7 United States Code, title 42, sections 1396 et seq. 315.8 The commissioner of human services, in coordination with 315.9 the commissioner of health, shall deny any request to issue a 315.10 license under section 252.28 and chapter 245A to a nursing home 315.11 or boarding care home, if that license would result in an 315.12 increase in the medical assistance reimbursement amount. 315.13 In addition, the commissioner of health must not approve 315.14 any construction project whose cost exceeds$750,000$1,000,000, 315.15 unless: 315.16 (a) any construction costs exceeding$750,000$1,000,000 315.17 are not added to the facility's appraised value and are not 315.18 included in the facility's payment rate for reimbursement under 315.19 the medical assistance program; or 315.20 (b) the project: 315.21 (1) has been approved through the process described in 315.22 section 144A.073; 315.23 (2) meets an exception in subdivision 3 or 4a; 315.24 (3) is necessary to correct violations of state or federal 315.25 law issued by the commissioner of health; 315.26 (4) is necessary to repair or replace a portion of the 315.27 facility that was damaged by fire, lightning, groundshifts, or 315.28 other such hazards, including environmental hazards, provided 315.29 that the provisions of subdivision 4a, clause (a), are met; 315.30 (5) as of May 1, 1992, the facility has submitted to the 315.31 commissioner of health written documentation evidencing that the 315.32 facility meets the "commenced construction" definition as 315.33 specified in subdivision 1a, clause (d), or that substantial 315.34 steps have been taken prior to April 1, 1992, relating to the 315.35 construction project. "Substantial steps" require that the 315.36 facility has made arrangements with outside parties relating to 316.1 the construction project and include the hiring of an architect 316.2 or construction firm, submission of preliminary plans to the 316.3 department of health or documentation from a financial 316.4 institution that financing arrangements for the construction 316.5 project have been made; or 316.6 (6) is being proposed by a licensed nursing facility that 316.7 is not certified to participate in the medical assistance 316.8 program and will not result in new licensed or certified beds. 316.9 Prior to the final plan approval of any construction 316.10 project, the commissioner of health shall be provided with an 316.11 itemized cost estimate for the project construction costs. If a 316.12 construction project is anticipated to be completed in phases, 316.13 the total estimated cost of all phases of the project shall be 316.14 submitted to the commissioner and shall be considered as one 316.15 construction project. Once the construction project is 316.16 completed and prior to the final clearance by the commissioner, 316.17 the total project construction costs for the construction 316.18 project shall be submitted to the commissioner. If the final 316.19 project construction cost exceeds the dollar threshold in this 316.20 subdivision, the commissioner of human services shall not 316.21 recognize any of the project construction costs or the related 316.22 financing costs in excess of this threshold in establishing the 316.23 facility's property-related payment rate. 316.24 The dollar thresholds for construction projects are as 316.25 follows: for construction projects other than those authorized 316.26 in clauses (1) to (6), the dollar threshold 316.27 is$750,000$1,000,000. For projects authorized after July 1, 316.28 1993, under clause (1), the dollar threshold is the cost 316.29 estimate submitted with a proposal for an exception under 316.30 section 144A.073, plus inflation as calculated according to 316.31 section 256B.431, subdivision 3f, paragraph (a). For projects 316.32 authorized under clauses (2) to (4), the dollar threshold is the 316.33 itemized estimate project construction costs submitted to the 316.34 commissioner of health at the time of final plan approval, plus 316.35 inflation as calculated according to section 256B.431, 316.36 subdivision 3f, paragraph (a). 317.1 The commissioner of health shall adopt rules to implement 317.2 this section or to amend the emergency rules for granting 317.3 exceptions to the moratorium on nursing homes under section 317.4 144A.073. 317.5 Sec. 6. Minnesota Statutes 2000, section 144A.071, 317.6 subdivision 4a, is amended to read: 317.7 Subd. 4a. [EXCEPTIONS FOR REPLACEMENT BEDS.] It is in the 317.8 best interest of the state to ensure that nursing homes and 317.9 boarding care homes continue to meet the physical plant 317.10 licensing and certification requirements by permitting certain 317.11 construction projects. Facilities should be maintained in 317.12 condition to satisfy the physical and emotional needs of 317.13 residents while allowing the state to maintain control over 317.14 nursing home expenditure growth. 317.15 The commissioner of health in coordination with the 317.16 commissioner of human services, may approve the renovation, 317.17 replacement, upgrading, or relocation of a nursing home or 317.18 boarding care home, under the following conditions: 317.19 (a) to license or certify beds in a new facility 317.20 constructed to replace a facility or to make repairs in an 317.21 existing facility that was destroyed or damaged after June 30, 317.22 1987, by fire, lightning, or other hazard provided: 317.23 (i) destruction was not caused by the intentional act of or 317.24 at the direction of a controlling person of the facility; 317.25 (ii) at the time the facility was destroyed or damaged the 317.26 controlling persons of the facility maintained insurance 317.27 coverage for the type of hazard that occurred in an amount that 317.28 a reasonable person would conclude was adequate; 317.29 (iii) the net proceeds from an insurance settlement for the 317.30 damages caused by the hazard are applied to the cost of the new 317.31 facility or repairs; 317.32 (iv) the new facility is constructed on the same site as 317.33 the destroyed facility or on another site subject to the 317.34 restrictions in section 144A.073, subdivision 5; 317.35 (v) the number of licensed and certified beds in the new 317.36 facility does not exceed the number of licensed and certified 318.1 beds in the destroyed facility; and 318.2 (vi) the commissioner determines that the replacement beds 318.3 are needed to prevent an inadequate supply of beds. 318.4 Project construction costs incurred for repairs authorized under 318.5 this clause shall not be considered in the dollar threshold 318.6 amount defined in subdivision 2; 318.7 (b) to license or certify beds that are moved from one 318.8 location to another within a nursing home facility, provided the 318.9 total costs of remodeling performed in conjunction with the 318.10 relocation of beds does not exceed$750,000$1,000,000; 318.11 (c) to license or certify beds in a project recommended for 318.12 approval under section 144A.073; 318.13 (d) to license or certify beds that are moved from an 318.14 existing state nursing home to a different state facility, 318.15 provided there is no net increase in the number of state nursing 318.16 home beds; 318.17 (e) to certify and license as nursing home beds boarding 318.18 care beds in a certified boarding care facility if the beds meet 318.19 the standards for nursing home licensure, or in a facility that 318.20 was granted an exception to the moratorium under section 318.21 144A.073, and if the cost of any remodeling of the facility does 318.22 not exceed$750,000$1,000,000. If boarding care beds are 318.23 licensed as nursing home beds, the number of boarding care beds 318.24 in the facility must not increase beyond the number remaining at 318.25 the time of the upgrade in licensure. The provisions contained 318.26 in section 144A.073 regarding the upgrading of the facilities do 318.27 not apply to facilities that satisfy these requirements; 318.28 (f) to license and certify up to 40 beds transferred from 318.29 an existing facility owned and operated by the Amherst H. Wilder 318.30 Foundation in the city of St. Paul to a new unit at the same 318.31 location as the existing facility that will serve persons with 318.32 Alzheimer's disease and other related disorders. The transfer 318.33 of beds may occur gradually or in stages, provided the total 318.34 number of beds transferred does not exceed 40. At the time of 318.35 licensure and certification of a bed or beds in the new unit, 318.36 the commissioner of health shall delicense and decertify the 319.1 same number of beds in the existing facility. As a condition of 319.2 receiving a license or certification under this clause, the 319.3 facility must make a written commitment to the commissioner of 319.4 human services that it will not seek to receive an increase in 319.5 its property-related payment rate as a result of the transfers 319.6 allowed under this paragraph; 319.7 (g) to license and certify nursing home beds to replace 319.8 currently licensed and certified boarding care beds which may be 319.9 located either in a remodeled or renovated boarding care or 319.10 nursing home facility or in a remodeled, renovated, newly 319.11 constructed, or replacement nursing home facility within the 319.12 identifiable complex of health care facilities in which the 319.13 currently licensed boarding care beds are presently located, 319.14 provided that the number of boarding care beds in the facility 319.15 or complex are decreased by the number to be licensed as nursing 319.16 home beds and further provided that, if the total costs of new 319.17 construction, replacement, remodeling, or renovation exceed ten 319.18 percent of the appraised value of the facility or $200,000, 319.19 whichever is less, the facility makes a written commitment to 319.20 the commissioner of human services that it will not seek to 319.21 receive an increase in its property-related payment rate by 319.22 reason of the new construction, replacement, remodeling, or 319.23 renovation. The provisions contained in section 144A.073 319.24 regarding the upgrading of facilities do not apply to facilities 319.25 that satisfy these requirements; 319.26 (h) to license as a nursing home and certify as a nursing 319.27 facility a facility that is licensed as a boarding care facility 319.28 but not certified under the medical assistance program, but only 319.29 if the commissioner of human services certifies to the 319.30 commissioner of health that licensing the facility as a nursing 319.31 home and certifying the facility as a nursing facility will 319.32 result in a net annual savings to the state general fund of 319.33 $200,000 or more; 319.34 (i) to certify, after September 30, 1992, and prior to July 319.35 1, 1993, existing nursing home beds in a facility that was 319.36 licensed and in operation prior to January 1, 1992; 320.1 (j) to license and certify new nursing home beds to replace 320.2 beds in a facility acquired by the Minneapolis community 320.3 development agency as part of redevelopment activities in a city 320.4 of the first class, provided the new facility is located within 320.5 three miles of the site of the old facility. Operating and 320.6 property costs for the new facility must be determined and 320.7 allowed under section 256B.431 or 256B.434; 320.8 (k) to license and certify up to 20 new nursing home beds 320.9 in a community-operated hospital and attached convalescent and 320.10 nursing care facility with 40 beds on April 21, 1991, that 320.11 suspended operation of the hospital in April 1986. The 320.12 commissioner of human services shall provide the facility with 320.13 the same per diem property-related payment rate for each 320.14 additional licensed and certified bed as it will receive for its 320.15 existing 40 beds; 320.16 (l) to license or certify beds in renovation, replacement, 320.17 or upgrading projects as defined in section 144A.073, 320.18 subdivision 1, so long as the cumulative total costs of the 320.19 facility's remodeling projects do not 320.20 exceed$750,000$1,000,000; 320.21 (m) to license and certify beds that are moved from one 320.22 location to another for the purposes of converting up to five 320.23 four-bed wards to single or double occupancy rooms in a nursing 320.24 home that, as of January 1, 1993, was county-owned and had a 320.25 licensed capacity of 115 beds; 320.26 (n) to allow a facility that on April 16, 1993, was a 320.27 106-bed licensed and certified nursing facility located in 320.28 Minneapolis to layaway all of its licensed and certified nursing 320.29 home beds. These beds may be relicensed and recertified in a 320.30 newly-constructed teaching nursing home facility affiliated with 320.31 a teaching hospital upon approval by the legislature. The 320.32 proposal must be developed in consultation with the interagency 320.33 committee on long-term care planning. The beds on layaway 320.34 status shall have the same status as voluntarily delicensed and 320.35 decertified beds, except that beds on layaway status remain 320.36 subject to the surcharge in section 256.9657. This layaway 321.1 provision expires July 1, 1998; 321.2 (o) to allow a project which will be completed in 321.3 conjunction with an approved moratorium exception project for a 321.4 nursing home in southern Cass county and which is directly 321.5 related to that portion of the facility that must be repaired, 321.6 renovated, or replaced, to correct an emergency plumbing problem 321.7 for which a state correction order has been issued and which 321.8 must be corrected by August 31, 1993; 321.9 (p) to allow a facility that on April 16, 1993, was a 321.10 368-bed licensed and certified nursing facility located in 321.11 Minneapolis to layaway, upon 30 days prior written notice to the 321.12 commissioner, up to 30 of the facility's licensed and certified 321.13 beds by converting three-bed wards to single or double 321.14 occupancy. Beds on layaway status shall have the same status as 321.15 voluntarily delicensed and decertified beds except that beds on 321.16 layaway status remain subject to the surcharge in section 321.17 256.9657, remain subject to the license application and renewal 321.18 fees under section 144A.07 and shall be subject to a $100 per 321.19 bed reactivation fee. In addition, at any time within three 321.20 years of the effective date of the layaway, the beds on layaway 321.21 status may be: 321.22 (1) relicensed and recertified upon relocation and 321.23 reactivation of some or all of the beds to an existing licensed 321.24 and certified facility or facilities located in Pine River, 321.25 Brainerd, or International Falls; provided that the total 321.26 project construction costs related to the relocation of beds 321.27 from layaway status for any facility receiving relocated beds 321.28 may not exceed the dollar threshold provided in subdivision 2 321.29 unless the construction project has been approved through the 321.30 moratorium exception process under section 144A.073; 321.31 (2) relicensed and recertified, upon reactivation of some 321.32 or all of the beds within the facility which placed the beds in 321.33 layaway status, if the commissioner has determined a need for 321.34 the reactivation of the beds on layaway status. 321.35 The property-related payment rate of a facility placing 321.36 beds on layaway status must be adjusted by the incremental 322.1 change in its rental per diem after recalculating the rental per 322.2 diem as provided in section 256B.431, subdivision 3a, paragraph 322.3 (c). The property-related payment rate for a facility 322.4 relicensing and recertifying beds from layaway status must be 322.5 adjusted by the incremental change in its rental per diem after 322.6 recalculating its rental per diem using the number of beds after 322.7 the relicensing to establish the facility's capacity day 322.8 divisor, which shall be effective the first day of the month 322.9 following the month in which the relicensing and recertification 322.10 became effective. Any beds remaining on layaway status more 322.11 than three years after the date the layaway status became 322.12 effective must be removed from layaway status and immediately 322.13 delicensed and decertified; 322.14 (q) to license and certify beds in a renovation and 322.15 remodeling project to convert 12 four-bed wards into 24 two-bed 322.16 rooms, expand space, and add improvements in a nursing home 322.17 that, as of January 1, 1994, met the following conditions: the 322.18 nursing home was located in Ramsey county; had a licensed 322.19 capacity of 154 beds; and had been ranked among the top 15 322.20 applicants by the 1993 moratorium exceptions advisory review 322.21 panel. The total project construction cost estimate for this 322.22 project must not exceed the cost estimate submitted in 322.23 connection with the 1993 moratorium exception process; 322.24 (r) to license and certify up to 117 beds that are 322.25 relocated from a licensed and certified 138-bed nursing facility 322.26 located in St. Paul to a hospital with 130 licensed hospital 322.27 beds located in South St. Paul, provided that the nursing 322.28 facility and hospital are owned by the same or a related 322.29 organization and that prior to the date the relocation is 322.30 completed the hospital ceases operation of its inpatient 322.31 hospital services at that hospital. After relocation, the 322.32 nursing facility's status under section 256B.431, subdivision 322.33 2j, shall be the same as it was prior to relocation. The 322.34 nursing facility's property-related payment rate resulting from 322.35 the project authorized in this paragraph shall become effective 322.36 no earlier than April 1, 1996. For purposes of calculating the 323.1 incremental change in the facility's rental per diem resulting 323.2 from this project, the allowable appraised value of the nursing 323.3 facility portion of the existing health care facility physical 323.4 plant prior to the renovation and relocation may not exceed 323.5 $2,490,000; 323.6 (s) to license and certify two beds in a facility to 323.7 replace beds that were voluntarily delicensed and decertified on 323.8 June 28, 1991; 323.9 (t) to allow 16 licensed and certified beds located on July 323.10 1, 1994, in a 142-bed nursing home and 21-bed boarding care home 323.11 facility in Minneapolis, notwithstanding the licensure and 323.12 certification after July 1, 1995, of the Minneapolis facility as 323.13 a 147-bed nursing home facility after completion of a 323.14 construction project approved in 1993 under section 144A.073, to 323.15 be laid away upon 30 days' prior written notice to the 323.16 commissioner. Beds on layaway status shall have the same status 323.17 as voluntarily delicensed or decertified beds except that they 323.18 shall remain subject to the surcharge in section 256.9657. The 323.19 16 beds on layaway status may be relicensed as nursing home beds 323.20 and recertified at any time within five years of the effective 323.21 date of the layaway upon relocation of some or all of the beds 323.22 to a licensed and certified facility located in Watertown, 323.23 provided that the total project construction costs related to 323.24 the relocation of beds from layaway status for the Watertown 323.25 facility may not exceed the dollar threshold provided in 323.26 subdivision 2 unless the construction project has been approved 323.27 through the moratorium exception process under section 144A.073. 323.28 The property-related payment rate of the facility placing 323.29 beds on layaway status must be adjusted by the incremental 323.30 change in its rental per diem after recalculating the rental per 323.31 diem as provided in section 256B.431, subdivision 3a, paragraph 323.32 (c). The property-related payment rate for the facility 323.33 relicensing and recertifying beds from layaway status must be 323.34 adjusted by the incremental change in its rental per diem after 323.35 recalculating its rental per diem using the number of beds after 323.36 the relicensing to establish the facility's capacity day 324.1 divisor, which shall be effective the first day of the month 324.2 following the month in which the relicensing and recertification 324.3 became effective. Any beds remaining on layaway status more 324.4 than five years after the date the layaway status became 324.5 effective must be removed from layaway status and immediately 324.6 delicensed and decertified; 324.7 (u) to license and certify beds that are moved within an 324.8 existing area of a facility or to a newly constructed addition 324.9 which is built for the purpose of eliminating three- and 324.10 four-bed rooms and adding space for dining, lounge areas, 324.11 bathing rooms, and ancillary service areas in a nursing home 324.12 that, as of January 1, 1995, was located in Fridley and had a 324.13 licensed capacity of 129 beds; 324.14 (v) to relocate 36 beds in Crow Wing county and four beds 324.15 from Hennepin county to a 160-bed facility in Crow Wing county, 324.16 provided all the affected beds are under common ownership; 324.17 (w) to license and certify a total replacement project of 324.18 up to 49 beds located in Norman county that are relocated from a 324.19 nursing home destroyed by flood and whose residents were 324.20 relocated to other nursing homes. The operating cost payment 324.21 rates for the new nursing facility shall be determined based on 324.22 the interim and settle-up payment provisions of Minnesota Rules, 324.23 part 9549.0057, and the reimbursement provisions of section 324.24 256B.431, except that subdivision 26, paragraphs (a) and (b), 324.25 shall not apply until the second rate year after the settle-up 324.26 cost report is filed. Property-related reimbursement rates 324.27 shall be determined under section 256B.431, taking into account 324.28 any federal or state flood-related loans or grants provided to 324.29 the facility; 324.30 (x) to license and certify a total replacement project of 324.31 up to 129 beds located in Polk county that are relocated from a 324.32 nursing home destroyed by flood and whose residents were 324.33 relocated to other nursing homes. The operating cost payment 324.34 rates for the new nursing facility shall be determined based on 324.35 the interim and settle-up payment provisions of Minnesota Rules, 324.36 part 9549.0057, and the reimbursement provisions of section 325.1 256B.431, except that subdivision 26, paragraphs (a) and (b), 325.2 shall not apply until the second rate year after the settle-up 325.3 cost report is filed. Property-related reimbursement rates 325.4 shall be determined under section 256B.431, taking into account 325.5 any federal or state flood-related loans or grants provided to 325.6 the facility; 325.7 (y) to license and certify beds in a renovation and 325.8 remodeling project to convert 13 three-bed wards into 13 two-bed 325.9 rooms and 13 single-bed rooms, expand space, and add 325.10 improvements in a nursing home that, as of January 1, 1994, met 325.11 the following conditions: the nursing home was located in 325.12 Ramsey county, was not owned by a hospital corporation, had a 325.13 licensed capacity of 64 beds, and had been ranked among the top 325.14 15 applicants by the 1993 moratorium exceptions advisory review 325.15 panel. The total project construction cost estimate for this 325.16 project must not exceed the cost estimate submitted in 325.17 connection with the 1993 moratorium exception process; 325.18 (z) to license and certify up to 150 nursing home beds to 325.19 replace an existing 285 bed nursing facility located in St. 325.20 Paul. The replacement project shall include both the renovation 325.21 of existing buildings and the construction of new facilities at 325.22 the existing site. The reduction in the licensed capacity of 325.23 the existing facility shall occur during the construction 325.24 project as beds are taken out of service due to the construction 325.25 process. Prior to the start of the construction process, the 325.26 facility shall provide written information to the commissioner 325.27 of health describing the process for bed reduction, plans for 325.28 the relocation of residents, and the estimated construction 325.29 schedule. The relocation of residents shall be in accordance 325.30 with the provisions of law and rule; 325.31 (aa) to allow the commissioner of human services to license 325.32 an additional 36 beds to provide residential services for the 325.33 physically handicapped under Minnesota Rules, parts 9570.2000 to 325.34 9570.3400, in a 198-bed nursing home located in Red Wing, 325.35 provided that the total number of licensed and certified beds at 325.36 the facility does not increase; 326.1 (bb) to license and certify a new facility in St. Louis 326.2 county with 44 beds constructed to replace an existing facility 326.3 in St. Louis county with 31 beds, which has resident rooms on 326.4 two separate floors and an antiquated elevator that creates 326.5 safety concerns for residents and prevents nonambulatory 326.6 residents from residing on the second floor. The project shall 326.7 include the elimination of three- and four-bed rooms; 326.8 (cc) to license and certify four beds in a 16-bed certified 326.9 boarding care home in Minneapolis to replace beds that were 326.10 voluntarily delicensed and decertified on or before March 31, 326.11 1992. The licensure and certification is conditional upon the 326.12 facility periodically assessing and adjusting its resident mix 326.13 and other factors which may contribute to a potential 326.14 institution for mental disease declaration. The commissioner of 326.15 human services shall retain the authority to audit the facility 326.16 at any time and shall require the facility to comply with any 326.17 requirements necessary to prevent an institution for mental 326.18 disease declaration, including delicensure and decertification 326.19 of beds, if necessary;or326.20 (dd) to license and certify 72 beds in an existing facility 326.21 in Mille Lacs county with 80 beds as part of a renovation 326.22 project. The renovation must include construction of an 326.23 addition to accommodate ten residents with beginning and 326.24 midstage dementia in a self-contained living unit; creation of 326.25 three resident households where dining, activities, and support 326.26 spaces are located near resident living quarters; designation of 326.27 four beds for rehabilitation in a self-contained area; 326.28 designation of 30 private rooms; and other improvements; 326.29 (ee) to license and certify beds in a facility that has 326.30 undergone replacement or remodeling as part of a planned closure 326.31 under section 256B.437; 326.32 (ff) to transfer up to 98 beds of a 129 licensed bed 326.33 facility located in Anoka county that, as of March 25, 2001, is 326.34 in the active process of closing, to a 122 licensed bed 326.35 nonprofit nursing facility located in the city of Columbia 326.36 Heights, or its affiliate. The transfer is effective when the 327.1 receiving facility notifies the commissioner in writing of the 327.2 number of beds accepted. The commissioner shall place all 327.3 transferred beds on layaway status held in the name of the 327.4 receiving facility. The layaway adjustment provisions of 327.5 section 256B.431, subdivision 30, do not apply to this layaway. 327.6 The receiving facility may only remove the beds from layaway for 327.7 recertification and relicensure at the receiving facility's 327.8 current site, or at a newly constructed facility located in 327.9 Anoka county. The receiving facility must receive statutory 327.10 authorization before removing the beds from layaway status; 327.11 (gg) to license and certify up to 120 new nursing facility 327.12 beds to replace beds in a facility in Anoka county, which was 327.13 licensed for 98 beds as of July 1, 2000, provided the new 327.14 facility is located within four miles of the existing facility 327.15 and is in Anoka county. Operating and property rates will be 327.16 determined and allowed under section 256B.431 and Minnesota 327.17 Rules, parts 9549.0010 to 9549.0080, or section 256B.434 or 327.18 256B.435. The provisions of section 256B.431, subdivision 26, 327.19 paragraphs (a) and (b), do not apply until the second rate year 327.20 following settle-up; or 327.21 (hh) to license and certify a total replacement project of 327.22 up to 124 beds located in Wilkin county that are in need of 327.23 relocation from a nursing home substantially destroyed by 327.24 flood. The operating cost payment rates for the new nursing 327.25 facility shall be determined based on the interim and settle-up 327.26 payment provisions of Minnesota Rules, part 9549.0057, and the 327.27 reimbursement provisions of section 256B.431, except that 327.28 section 256B.431, subdivision 26, paragraphs (a) and (b), shall 327.29 not apply until the second rate year after the settle-up cost 327.30 report is filed. Property-related reimbursement rates shall be 327.31 determined under section 256B.431, taking into account any 327.32 federal or state flood-related loans or grants provided to the 327.33 facility. 327.34 Sec. 7. Minnesota Statutes 2000, section 144A.073, 327.35 subdivision 2, is amended to read: 327.36 Subd. 2. [REQUEST FOR PROPOSALS.] At the authorization by 328.1 the legislature of additional medical assistance expenditures 328.2 for exceptions to the moratorium on nursing homes, the 328.3 interagency committee shall publish in the State Register a 328.4 request for proposals for nursing home projects to be licensed 328.5 or certified under section 144A.071, subdivision 4a, clause 328.6 (c). The public notice of this funding and the request for 328.7 proposals must specify how the approval criteria will be 328.8 prioritized by the advisory review panel, the interagency 328.9 long-term care planning committee, and the commissioner. The 328.10 notice must describe the information that must accompany a 328.11 request and state that proposals must be submitted to the 328.12 interagency committee within 90 days of the date of 328.13 publication. The notice must include the amount of the 328.14 legislative appropriation available for the additional costs to 328.15 the medical assistance program of projects approved under this 328.16 section. If no money is appropriated for a year, the 328.17 interagency committee shall publish a notice to that effect, and 328.18 no proposals shall be requested. If money is appropriated, the 328.19 interagency committee shall initiate the application and review 328.20 process described in this section at least twice each biennium 328.21 and up to four times each biennium, according to dates 328.22 established by rule. Authorized funds shall be allocated 328.23 proportionally to the number of processes. Funds not encumbered 328.24 by an earlier process within a biennium shall carry forward to 328.25 subsequent iterations of the process.Authorization for328.26expenditures does not carry forward into the following328.27biennium.To be considered for approval, a proposal must 328.28 include the following information: 328.29 (1) whether the request is for renovation, replacement, 328.30 upgrading, conversion, or relocation; 328.31 (2) a description of the problem the project is designed to 328.32 address; 328.33 (3) a description of the proposed project; 328.34 (4) an analysis of projected costs of the nursing facility 328.35 proposal, which are not required to exceed the cost threshold 328.36 referred to in section 144A.071, subdivision 1, to be considered 329.1 under this section, including initial construction and 329.2 remodeling costs; site preparation costs; technology costs; 329.3 financing costs, including the current estimated long-term 329.4 financing costs of the proposal, which consists of estimates of 329.5 the amount and sources of money, reserves if required under the 329.6 proposed funding mechanism, annual payments schedule, interest 329.7 rates, length of term, closing costs and fees, insurance costs, 329.8 and any completed marketing study or underwriting review; and 329.9 estimated operating costs during the first two years after 329.10 completion of the project; 329.11 (5) for proposals involving replacement of all or part of a 329.12 facility, the proposed location of the replacement facility and 329.13 an estimate of the cost of addressing the problem through 329.14 renovation; 329.15 (6) for proposals involving renovation, an estimate of the 329.16 cost of addressing the problem through replacement; 329.17 (7) the proposed timetable for commencing construction and 329.18 completing the project; 329.19 (8) a statement of any licensure or certification issues, 329.20 such as certification survey deficiencies; 329.21 (9) the proposed relocation plan for current residents if 329.22 beds are to be closed so that the department of human services 329.23 can estimate the total costs of a proposal; and 329.24 (10) other information required by permanent rule of the 329.25 commissioner of health in accordance with subdivisions 4 and 8. 329.26 Sec. 8. [144A.161] [NURSING FACILITY RESIDENT RELOCATION.] 329.27 Subdivision 1. [DEFINITIONS.] The definitions in this 329.28 subdivision apply to subdivisions 2 to 10. 329.29 (a) "Closure" means the cessation of operations of a 329.30 nursing home and the delicensure and decertification of all beds 329.31 within the facility. 329.32 (b) "Curtailment," "reduction," or "change" refers to any 329.33 change in operations which would result in or encourage the 329.34 relocation of residents. 329.35 (c) "Facility" means a nursing home licensed pursuant to 329.36 this chapter, or a certified boarding care home licensed 330.1 pursuant to sections 144.50 to 144.56. 330.2 (d) "Licensee" means the owner of the facility or the 330.3 owner's designee or the commissioner of health for a facility in 330.4 receivership. 330.5 (e) "Local agency" means the county or multicounty social 330.6 service agency authorized under sections 393.01 and 393.07, as 330.7 the agency responsible for providing social services for the 330.8 county in which the nursing home is located. 330.9 (f) "Plan" means a process developed under subdivision 3, 330.10 paragraph (b), for the closure, curtailment, reduction, or 330.11 change in operations in a facility and the subsequent relocation 330.12 of residents. 330.13 (g) "Relocation" means the discharge of a resident and 330.14 movement of the resident to another facility or living 330.15 arrangement as a result of the closing, curtailment, reduction, 330.16 or change in operations of a nursing home or boarding care home. 330.17 Subd. 2. [INITIAL NOTICE FROM LICENSEE.] (a) The licensee 330.18 of the facility shall notify the following parties in writing 330.19 when there is an intent to close, curtail, reduce, or change 330.20 operations or services which would result in or encourage the 330.21 relocation of residents: the commissioner of health, the 330.22 commissioner of human services, the local agency, the office of 330.23 ombudsman for older Minnesotans, and the ombudsman for mental 330.24 health/mental retardation. 330.25 (b) The written notice shall include the names, telephone 330.26 numbers, facsimile numbers, and e-mail addresses of the persons 330.27 responsible for coordinating the licensee's efforts in the 330.28 planning process, and the number of residents potentially 330.29 affected by the closure, curtailment, reduction, or change in 330.30 operations. 330.31 Subd. 3. [PLANNING PROCESS.] (a) The local agency shall, 330.32 within five working days of receiving initial notice of the 330.33 licensee's intent to close, curtail, reduce, or change 330.34 operations, provide the licensee and all parties identified in 330.35 subdivision 2, paragraph (a), with the names, telephone numbers, 330.36 facsimile numbers, and e-mail addresses of those persons 331.1 responsible for coordinating local agency efforts in the 331.2 planning process. 331.3 (b) The licensee shall convene a meeting with the local 331.4 agency to jointly develop a plan regarding the closure, 331.5 curtailment, or change in facility operations. The licensee 331.6 shall notify representatives of the departments of health and 331.7 human services of the date, time, and location of the meeting so 331.8 that representatives from the departments may attend. The 331.9 licensee must allow a minimum of 28 days for this planning 331.10 process from the day of the initial notice. However, the plan 331.11 may be finalized on an earlier schedule agreed to by all 331.12 parties. To the extent practicable, consistent with 331.13 requirements to protect the safety and health of residents, the 331.14 commissioner may authorize the planning process under this 331.15 subdivision to occur concurrent with the 60 day notice required 331.16 under subdivision 5, paragraph (e). The plan shall: 331.17 (1) identify the expected date of closure, curtailment, 331.18 reduction, or change in operations; 331.19 (2) outline the process for public notification of the 331.20 closure, curtailment, reduction, or change in operations; 331.21 (3) identify and make efforts to include other stakeholders 331.22 in the planning process; 331.23 (4) outline the process to ensure 60-day advance written 331.24 notice to residents, family members, and designated 331.25 representatives; 331.26 (5) present an aggregate description of the resident 331.27 population remaining to be relocated and their needs; 331.28 (6) outline the individual resident assessment process to 331.29 be utilized; 331.30 (7) identify an inventory of available relocation options, 331.31 including home and community-based services; 331.32 (8) identify a timeline for submission of the list 331.33 identified in subdivision 5, paragraph (h); and 331.34 (9) identify a schedule for the timely completion of each 331.35 element of the plan. 331.36 Subd. 4. [RESPONSIBILITIES OF LICENSEE FOR RESIDENT 332.1 RELOCATIONS.] The licensee shall provide for the safe, orderly, 332.2 and appropriate relocation of residents. The licensee and 332.3 facility staff shall cooperate with representatives from the 332.4 local agency, the department of health, the department of human 332.5 services, the office of ombudsman for older Minnesotans, and 332.6 ombudsman for mental health/mental retardation, in planning for 332.7 and implementing the relocation of residents. The discharge and 332.8 relocation of residents must comply with all applicable state 332.9 and federal requirements. 332.10 Subd. 5. [RESPONSIBILITIES PRIOR TO RELOCATION.] (a) The 332.11 licensee shall provide an initial notice as described in 332.12 subdivision 2, when there is an intent to close, curtail, 332.13 reduce, or change in operations which would result in or 332.14 encourage the relocation of residents. 332.15 (b) The licensee shall establish an interdisciplinary team 332.16 responsible for coordinating and implementing the plan as 332.17 outlined in subdivision 3, paragraph (b). The interdisciplinary 332.18 team shall include representatives from the local agency, the 332.19 office of ombudsman for older Minnesotans, facility staff that 332.20 provide direct care services to the residents, and facility 332.21 administration. 332.22 (c) The licensee shall provide a list to the local agency 332.23 that includes the following information on each resident to be 332.24 relocated: 332.25 (1) the resident's name; 332.26 (2) date of birth; 332.27 (3) social security number; 332.28 (4) medical assistance identification number; 332.29 (5) all diagnoses; and 332.30 (6) the name and contact information for the resident's 332.31 family or other designated representative. 332.32 (d) The licensee shall consult with the local agency on the 332.33 availability and development of available resources, and on the 332.34 resident relocation process. 332.35 (e) At least 60 days before the proposed date of closing, 332.36 curtailment, reduction, or change in operations as agreed to in 333.1 the plan, the licensee shall send a written notice of closure, 333.2 curtailment, reduction, or change in operations to each resident 333.3 being relocated, the resident's family member or designated 333.4 representative, and the resident's attending physician. The 333.5 notice must include the following: 333.6 (1) the date of the proposed closure, curtailment, 333.7 reduction, or change in operations; 333.8 (2) the name, address, telephone number, facsimile number, 333.9 and e-mail address of the individual or individuals in the 333.10 facility responsible for providing assistance and information; 333.11 (3) notification of upcoming meetings for residents, 333.12 families and designated representatives, and resident and family 333.13 councils to discuss the relocation of residents; 333.14 (4) the name, address, and telephone number of the local 333.15 agency contact person; 333.16 (5) the name, address, and telephone number of the office 333.17 of ombudsman for older Minnesotans and the ombudsman for mental 333.18 health/mental retardation; and 333.19 (6) a notice of resident rights during discharge and 333.20 relocation, in a form approved by the office of ombudsman for 333.21 older Minnesotans. 333.22 The notice must comply with all applicable state and 333.23 federal requirements for notice of transfer or discharge of 333.24 nursing home residents. 333.25 (f) The licensee shall request the attending physician 333.26 provide or arrange for the release of medical information needed 333.27 to update resident medical records and prepare all required 333.28 forms and discharge summaries. 333.29 (g) The licensee shall provide sufficient preparation to 333.30 residents to ensure safe, orderly and appropriate discharge, and 333.31 relocation. The licensee shall assist residents in finding 333.32 placements that respond to personal preferences, such as desired 333.33 geographic location. 333.34 (h) The licensee shall prepare a resource list with several 333.35 relocation options for each resident. The list must contain the 333.36 following information for each relocation option, when 334.1 applicable: 334.2 (1) the name, address, and telephone and facsimile numbers 334.3 of each facility with appropriate, available beds or services; 334.4 (2) the certification level of the available beds; 334.5 (3) the types of services available; 334.6 (4) the name, address, and telephone and facsimile numbers 334.7 of appropriate available home and community-based placements, 334.8 services and settings, or other options for individuals with 334.9 special needs. 334.10 The list shall be made available to residents and their families 334.11 or designated representatives, and upon request to the office of 334.12 ombudsman for older Minnesotans and ombudsman for mental 334.13 health/mental retardation, and the local agency. 334.14 (i) Following the establishment of the plan under 334.15 subdivision 3, paragraph (b), the licensee shall conduct 334.16 meetings with residents, families and designated 334.17 representatives, and resident and family councils to notify them 334.18 of the process for resident relocation. Representatives from 334.19 the local county social services agency, the office of ombudsman 334.20 for older Minnesotans, the ombudsman for mental health and 334.21 mental retardation, the commissioner of health, and the 334.22 commissioner of human services shall receive advance notice of 334.23 the meetings. 334.24 (j) The licensee shall assist residents desiring to make 334.25 site visits to facilities with available beds or other 334.26 appropriate living options to which the resident may relocate, 334.27 unless it is medically inadvisable, as documented by the 334.28 attending physician in the resident's care record. The licensee 334.29 shall provide transportation for site visits to facilities or 334.30 other living options within a 50-mile radius to which the 334.31 resident may relocate. The licensee shall provide available 334.32 written materials to residents on a potential new facility or 334.33 living option. 334.34 (k) The licensee shall complete an inventory of resident 334.35 personal possessions and provide a copy of the final inventory 334.36 to the resident and the resident's designated representative 335.1 prior to relocation. The licensee shall be responsible for the 335.2 transfer of the resident's possessions for all relocations 335.3 within a 50-mile radius of the facility. The licensee shall 335.4 complete the transfer of resident possessions in a timely 335.5 manner, but no later than the date of the actual physical 335.6 relocation of the resident. 335.7 (l) The licensee shall complete a final accounting of 335.8 personal funds held in trust by the facility and provide a copy 335.9 of this accounting to the resident and the resident's family or 335.10 the resident's designated representative. The licensee shall be 335.11 responsible for the transfer of all personal funds held in trust 335.12 by the facility. The licensee shall complete the transfer of 335.13 all personal funds in a timely manner. 335.14 (m) The licensee shall assist residents with the transfer 335.15 and reconnection of service for telephones or other personal 335.16 communication devices or services. The licensee shall pay the 335.17 costs associated with reestablishing service for telephones or 335.18 other personal communication devices or services, such as 335.19 connection fees or other one-time charges. The transfer or 335.20 reconnection of personal communication devices or services shall 335.21 be completed in a timely manner. 335.22 (n) The licensee shall provide the resident, the resident's 335.23 family or designated representative, and the resident's 335.24 attending physician final written notice prior to the relocation 335.25 of the resident. The notice must: 335.26 (1) be provided seven days prior to the actual relocation, 335.27 unless the resident agrees to waive the right to advance notice; 335.28 and 335.29 (2) identify the date of the anticipated relocation and the 335.30 destination to which the resident is being relocated. 335.31 (o) The licensee shall provide the receiving facility or 335.32 other health, housing, or care entity with complete and accurate 335.33 resident records including information on family members, 335.34 designated representatives, guardians, social service 335.35 caseworkers, or other contact information. These records must 335.36 also include all information necessary to provide appropriate 336.1 medical care and social services. This includes, but is not 336.2 limited to, information on preadmission screening, Level I and 336.3 Level II screening, Minimum Data Set (MDS) and all other 336.4 assessments, resident diagnoses, social, behavioral, and 336.5 medication information. 336.6 Subd. 6. [RESPONSIBILITIES OF THE LICENSEE DURING 336.7 RELOCATION.] (a) The licensee shall arrange for the safe 336.8 transport of residents to the new facility or placement. 336.9 (b) The licensee must ensure that there is no disruption in 336.10 the provision of meals, medications, or treatments of the 336.11 resident during the relocation process. 336.12 (c) Beginning the week following development of the initial 336.13 relocation plan, the licensee shall submit biweekly status 336.14 reports to the commissioners of the department of health and the 336.15 department of human services or their designees, and to the 336.16 local agency. The initial status report must identify: 336.17 (1) the relocation plan developed; 336.18 (2) the interdisciplinary team members; and 336.19 (3) the number of residents to be relocated. 336.20 (d) Subsequent status reports must identify: 336.21 (1) any modifications to the plan; 336.22 (2) any change of interdisciplinary team members; 336.23 (3) the number of residents relocated; 336.24 (4) the destination to which residents have been relocated; 336.25 (5) the number of residents remaining to be relocated; and 336.26 (6) issues or problems encountered during the process and 336.27 resolution of these issues. 336.28 Subd. 7. [RESPONSIBILITIES OF THE LICENSEE FOLLOWING 336.29 RELOCATION.] The licensee shall retain or make arrangements for 336.30 the retention of all remaining resident records, for the period 336.31 required by law. The licensee shall provide the department of 336.32 health access to these records. The licensee shall notify the 336.33 department of health of the location of any resident records 336.34 that have not been transferred to the new facility or other 336.35 health care entity. 336.36 Subd. 8. [RESPONSIBILITIES OF THE LOCAL AGENCY.] (a) The 337.1 local agency shall participate in the meeting as outlined in 337.2 subdivision 3, paragraph (b), to develop a relocation plan. 337.3 (b) The local agency shall designate a representative to 337.4 the interdisciplinary team established by the licensee 337.5 responsible for coordinating the relocation efforts. 337.6 (c) The local agency shall serve as a resource in the 337.7 relocation process. 337.8 (d) Concurrent with the notice sent to residents from the 337.9 licensee as provided in subdivision 5, paragraph (e), the local 337.10 agency shall provide written notice to residents, family, or 337.11 designated representatives describing: 337.12 (1) the county's role in the relocation process and in the 337.13 follow-up to relocations; 337.14 (2) a local agency contact name, address, and telephone 337.15 number; and 337.16 (3) the name, address, and telephone number of the office 337.17 of ombudsman for older Minnesotans and the ombudsman for mental 337.18 health/mental retardation. 337.19 (e) The local agency designee shall meet with appropriate 337.20 facility staff to coordinate any assistance in the relocation 337.21 process. This coordination shall include participating in group 337.22 meetings with residents, families, and designated 337.23 representatives to explain the relocation process. 337.24 (f) The local agency shall monitor compliance with all 337.25 components of the plan. If the licensee is not in compliance, 337.26 the local agency shall notify the commissioners of the 337.27 department of health and the department of human services. 337.28 (g) The local agency shall report to the commissioners of 337.29 health and human services any relocations that endanger the 337.30 health, safety, or well-being of residents. The local agency 337.31 shall pursue remedies to protect the resident during the 337.32 relocation process, including, but not limited to, assisting the 337.33 resident with filing an appeal of transfer or discharge, 337.34 notification of all appropriate licensing boards and agencies, 337.35 and other remedies available to the county under section 337.36 626.557, subdivision 10. 338.1 (h) A member of the local agency staff shall visit 338.2 residents relocated within one hundred miles of the county 338.3 within 30 days after the relocation. Local agency staff shall 338.4 interview the resident and family or designated representative, 338.5 observe the resident on site, and review and discuss pertinent 338.6 medical or social records with facility staff to: 338.7 (1) assess the adjustment of the resident to the new 338.8 placement; 338.9 (2) recommend services or methods to meet any special needs 338.10 of the resident; and 338.11 (3) identify residents at risk. 338.12 (i) The local agency shall have the authority to conduct 338.13 subsequent follow-up visits in cases where the adjustment of the 338.14 resident to the new placement is in question. 338.15 (j) Within 60 days of the completion of the follow-up 338.16 visits, the local agency shall submit a written summary of the 338.17 follow-up work to the department of health and the department of 338.18 human services, in a manner approved by the commissioners. 338.19 (k) The local agency shall submit to the department of 338.20 health and the department of human services a report of any 338.21 issues that may require further review or monitoring. 338.22 (l) The local agency shall be responsible for the safe and 338.23 orderly relocation of residents in cases where an emergent need 338.24 arises or when the licensee has abrogated its responsibilities 338.25 under the plan. 338.26 Subd. 9. [FUNDING.] The commissioner of human services 338.27 shall negotiate with the local agency to determine an amount of 338.28 administrative funding within appropriations specified for this 338.29 purpose to make available to the local agency for the costs of 338.30 work related to the relocation process in accordance with 338.31 section 256B.437, subdivision 9. 338.32 Subd. 10. [PENALTIES.] According to sections 144.653 and 338.33 144A.10, the licensee shall be subject to correction orders and 338.34 civil monetary penalties of up to $500 per day for each 338.35 violation of this statute. 338.36 Sec. 9. [144A.1888] [REUSE OF FACILITIES.] 339.1 Notwithstanding any local ordinance related to development, 339.2 planning, or zoning to the contrary, the conversion or reuse of 339.3 a nursing home that closes or that curtails, reduces, or changes 339.4 operations shall be considered a conforming use permitted under 339.5 local law, provided that the facility is converted to another 339.6 long-term care service approved by a regional planning group 339.7 under section 256B.437 that serves a smaller number of persons 339.8 than the number of persons served before the closure or 339.9 curtailment, reduction, or change in operations. 339.10 Sec. 10. Minnesota Statutes 2000, section 144D.01, 339.11 subdivision 4, is amended to read: 339.12 Subd. 4. [HOUSING WITH SERVICES ESTABLISHMENT OR 339.13 ESTABLISHMENT.] (a) "Housing with services establishment" or 339.14 "establishment" means: 339.15 (1) an establishment providing sleeping accommodations to 339.16 one or more adult residents, at least 80 percent of which are 55 339.17 years of age or older, and offering or providing, for a fee, one 339.18 or more regularly scheduled health-related services or two or 339.19 more regularly scheduled supportive services, whether offered or 339.20 provided directly by the establishment or by another entity 339.21 arranged for by the establishment; or 339.22 (2) an establishment that registers under section 144D.025. 339.23 (b) Housing with services establishment does not include: 339.24 (1) a nursing home licensed under chapter 144A; 339.25 (2) a hospital, certified boarding care home, or supervised 339.26 living facility licensed under sections 144.50 to 144.56; 339.27 (3) a board and lodging establishment licensed under 339.28 chapter 157 and Minnesota Rules, parts 9520.0500 to 9520.0670, 339.29 9525.0215 to 9525.0355, 9525.0500 to 9525.0660, or 9530.4100 to 339.30 9530.4450, or under chapter 245B; 339.31 (4) a board and lodging establishment which serves as a 339.32 shelter for battered women or other similar purpose; 339.33 (5) a family adult foster care home licensed by the 339.34 department of human services; 339.35 (6) private homes in which the residents are related by 339.36 kinship, law, or affinity with the providers of services; 340.1 (7) residential settings for persons with mental 340.2 retardation or related conditions in which the services are 340.3 licensed under Minnesota Rules, parts 9525.2100 to 9525.2140, or 340.4 applicable successor rules or laws; 340.5 (8) a home-sharing arrangement such as when an elderly or 340.6 disabled person or single-parent family makes lodging in a 340.7 private residence available to another person in exchange for 340.8 services or rent, or both; 340.9 (9) a duly organized condominium, cooperative, common 340.10 interest community, or owners' association of the foregoing 340.11 where at least 80 percent of the units that comprise the 340.12 condominium, cooperative, or common interest community are 340.13 occupied by individuals who are the owners, members, or 340.14 shareholders of the units; or 340.15 (10) services for persons with developmental disabilities 340.16 that are provided under a license according to Minnesota Rules, 340.17 parts 9525.2000 to 9525.2140 in effect until January 1, 1998, or 340.18 under chapter 245B. 340.19 Sec. 11. [144D.025] [OPTIONAL REGISTRATION.] 340.20 An establishment that meets all the requirements of this 340.21 chapter except that fewer than 80 percent of the adult residents 340.22 are age 55 or older may, at its option, register as a housing 340.23 with services establishment. An establishment may register as a 340.24 housing with services establishment under this section if 340.25 services are delivered to residents by a provider who is 340.26 contracted to provide those services by the county agency of the 340.27 county in which the establishment is located and under an 340.28 arrangement with the management of the housing with services 340.29 establishment. 340.30 Sec. 12. Minnesota Statutes 2000, section 256B.431, 340.31 subdivision 2e, is amended to read: 340.32 Subd. 2e. [CONTRACTS FOR SERVICES FOR VENTILATOR-DEPENDENT 340.33 PERSONS.] The commissioner may contract with a nursing facility 340.34 eligible to receive medical assistance payments to provide 340.35 services to a ventilator-dependent person identified by the 340.36 commissioner according to criteria developed by the 341.1 commissioner, including: 341.2 (1) nursing facility care has been recommended for the 341.3 person by a preadmission screening team; 341.4 (2) the person has been assessed at case mix classification 341.5 K; 341.6 (3) the person has been hospitalizedfor at least six341.7monthsand no longer requires inpatient acute care hospital 341.8 services; and 341.9 (4) the commissioner has determined that necessary services 341.10 for the person cannot be provided under existing nursing 341.11 facility rates. 341.12 The commissioner may issue a request for proposals to 341.13 provide services to a ventilator-dependent person to nursing 341.14 facilities eligible to receive medical assistance payments and 341.15 shall select nursing facilities from among respondents according 341.16 to criteria developed by the commissioner, including: 341.17 (1) the cost-effectiveness and appropriateness of services; 341.18 (2) the nursing facility's compliance with federal and 341.19 state licensing and certification standards; and 341.20 (3) the proximity of the nursing facility to a 341.21 ventilator-dependent person identified by the commissioner who 341.22 requires nursing facility placement. 341.23 The commissioner may negotiate an adjustment to the 341.24 operating cost payment rate for a nursing facility selected by 341.25 the commissioner from among respondents to the request for 341.26 proposals. The negotiated adjustment must reflect only the 341.27 actual additional cost of meeting the specialized care needs of 341.28 a ventilator-dependent person identified by the commissioner for 341.29 whom necessary services cannot be provided under existing 341.30 nursing facility rates and which are not otherwise covered under 341.31 Minnesota Rules, parts 9549.0010 to 9549.0080 or 9505.0170 to 341.32 9505.0475. The negotiated payment rate must not exceed 200 341.33 percent of thehighest multiple bedroom payment rate for a341.34Minnesota nursing facility, as initially established by the341.35commissioner for the rate yearfacility's multiple bedroom 341.36 payment rate for case mix classification K. The negotiated 342.1 adjustment shall not affect the payment rate charged to private 342.2 paying residents under the provisions of section 256B.48, 342.3 subdivision 1. 342.4 Sec. 13. Minnesota Statutes 2000, section 256B.431, is 342.5 amended by adding a subdivision to read: 342.6 Subd. 31. [NURSING FACILITY RATE INCREASES BEGINNING JULY 342.7 1, 2001, AND JULY 1, 2002.] (a) For the rate years beginning 342.8 July 1, 2001, and July 1, 2002, the commissioner shall make 342.9 available to each nursing facility reimbursed under this section 342.10 or section 256B.434 an adjustment of 3.0 percent to the total 342.11 operating payment rates in effect on June 30, 2001, and June 30, 342.12 2002, respectively. The operating payment rate in effect on 342.13 June 30, 2001, must include the adjustment in subdivision 2i, 342.14 paragraph (c). The adjustment must be used to increase the 342.15 wages of all employees except management fees, the 342.16 administrator, and central office staff and to pay associated 342.17 costs for FICA, the Medicare tax, workers' compensation 342.18 premiums, and federal and state unemployment insurance. 342.19 Money received by a facility as a result of the additional 342.20 rate increase provided under this paragraph must be used only 342.21 for wage increases implemented on or after July 1, 2001, or July 342.22 1, 2002, respectively, and must not be used for wage increases 342.23 implemented prior to those dates. 342.24 (b) Nursing facilities may apply for the wage-related 342.25 payment rate adjustment calculated under paragraph (a). The 342.26 application must be made to the commissioner and contain a plan 342.27 by which the nursing facility will distribute the payment rate 342.28 adjustment to employees of the nursing facility. For nursing 342.29 facilities in which the employees are represented by an 342.30 exclusive bargaining representative, an agreement negotiated and 342.31 agreed to by the employer and the exclusive bargaining 342.32 representative constitutes the plan. A negotiated agreement may 342.33 constitute the plan only if the agreement is finalized after the 342.34 date of enactment of all increases for the rate year. The 342.35 commissioner shall review the plan to ensure that the 342.36 wage-related payment rate adjustment per diem is used as 343.1 provided in paragraph (a). To be eligible, a facility must 343.2 submit its plan for the wage distribution by December 31 each 343.3 year. If a facility's plan for wage distribution is effective 343.4 for its employees after July 1 of the year that the funds are 343.5 available, the payment rate adjustment per diem is effective the 343.6 same date as its plan. 343.7 (c) A hospital-attached nursing facility may include costs 343.8 in their distribution plan for wages and wage-related costs of 343.9 employees in the organization's shared services departments, 343.10 provided that: 343.11 (1) the nursing facility and the hospital share common 343.12 ownership; and 343.13 (2) adjustments for hospital services using the 343.14 diagnostic-related grouping payment rates per admission under 343.15 medical assistance or Medicare are less than three percent 343.16 during the 12 months prior to the effective date of this 343.17 increase. 343.18 If a hospital-attached facility meets the qualifications in 343.19 this paragraph, the difference between the rate increase 343.20 approved for nursing facility services and the rate increase 343.21 approved for hospital services may be permitted as a 343.22 distribution in the hospital-attached facility's plan regardless 343.23 of whether the use of those funds is shown as being attributable 343.24 to employee hours worked in the nursing facility or employee 343.25 hours worked in the hospital. 343.26 For the purposes of this paragraph, a hospital-attached 343.27 nursing facility is one that meets the definition under 343.28 subdivision 2j, or, in the case of a facility reimbursed under 343.29 section 256B.434, met this definition at the time their last 343.30 payment rate was established under Minnesota Rules, parts 343.31 9549.0010 to 9549.0080, and this section. 343.32 (d) A copy of the approved distribution plan must be made 343.33 available to all employees by giving each employee a copy or by 343.34 posting it in an area of the nursing facility to which all 343.35 employees have access. If an employee does not receive the wage 343.36 adjustment described in the facility's approved plan and is 344.1 unable to resolve the problem with the facility's management or 344.2 through the employee's union representative, the employee may 344.3 contact the commissioner at an address or telephone number 344.4 provided by the commissioner and included in the approved plan. 344.5 (e) Notwithstanding section 256B.48, subdivision 1, clause 344.6 (a), upon the request of a nursing facility, the commissioner 344.7 may authorize the facility to raise per diem rates for 344.8 private-pay residents on July 1 by the amount anticipated to be 344.9 required upon implementation of the wage-related increase 344.10 available under this subdivision. The commissioner shall 344.11 require any amounts collected under this paragraph to be placed 344.12 in an escrow account until the medical assistance rate is 344.13 finalized. The commissioner shall conduct audits as necessary 344.14 to ensure that: 344.15 (1) the amounts collected are retained in escrow until 344.16 medical assistance rates are increased to reflect the 344.17 wage-related adjustment; and 344.18 (2) any amounts collected from private-pay residents in 344.19 excess of the final medical assistance wage-related rate 344.20 increase are repaid to the private-pay residents with interest 344.21 at the rate used by the commissioner of revenue for the late 344.22 payment of taxes and in effect on the date the distribution plan 344.23 is approved by the commissioner of human services. 344.24 (f) For the rate year beginning July 1, 2001, the 344.25 commissioner shall make available to each nursing facility that 344.26 is reimbursed under this section or section 256B.434 and had 35 344.27 or fewer admissions during calendar year 2000 an adjustment of 344.28 1.0 percent to the total operating payment rates in effect on 344.29 June 30, 2001. 344.30 The operating payment rate in effect on June 30, 2001, must 344.31 include the adjustment in subdivision 2i, paragraph (c). 344.32 Sec. 14. Minnesota Statutes 2000, section 256B.431, is 344.33 amended by adding a subdivision to read: 344.34 Subd. 32. [PAYMENT DURING FIRST 90 DAYS.] (a) For rate 344.35 years beginning on or after July 1, 2001, the total payment rate 344.36 for a facility reimbursed under this section, section 256B.434, 345.1 or any other section for the first 90 paid days after admission 345.2 shall be: 345.3 (1) for the first 30 paid days, the rate shall be 120 345.4 percent of the facility's medical assistance rate for each case 345.5 mix class; and 345.6 (2) for the next 60 paid days after the first 30 paid days, 345.7 the rate shall be 110 percent of the facility's medical 345.8 assistance rate for each case mix class. 345.9 (b) Beginning with the 91st paid day after admission, the 345.10 payment rate shall be the rate otherwise determined under this 345.11 section, section 256B.434, or any other section. 345.12 Sec. 15. Minnesota Statutes 2000, section 256B.431, is 345.13 amended by adding a subdivision to read: 345.14 Subd. 34. [STAGED REDUCTION IN RATE DISPARITIES.] (a) The 345.15 commissioner, by June 30, 2001, shall provide each nursing 345.16 facility with information on how its per diem operating payment 345.17 rates for each case mix category compare to the median per diem 345.18 rates for facilities in geographic group three, as determined 345.19 under Minnesota Rules, part 9549.0052. 345.20 (b) The commissioner shall provide nursing facilities 345.21 reimbursed under this section or section 256B.434 with the 345.22 following staged rate increases, for each case mix category 345.23 operating payment per diem that is below the median for 345.24 facilities in geographic group three: 345.25 (1) effective July 1, 2001, the commissioner shall allow 345.26 increases in the total operating payment per diems for each 345.27 facility of up to 38 percent of the difference between that 345.28 facility's operating payment rate in effect on June 30, 2001, 345.29 for each case mix category and 85 percent of the median payment 345.30 rate in effect on June 30, 2001, for that category for 345.31 facilities in geographic group three; 345.32 (2) effective July 1, 2002, the commissioner shall allow 345.33 increases in the total operating payment per diems for each 345.34 facility by 38 percent of the difference between that facility's 345.35 operating payment rate in effect on June 30, 2002, for each case 345.36 mix category and 85 percent of the median payment rate in effect 346.1 on June 30, 2002, for that category for facilities in geographic 346.2 group three; and 346.3 (3) effective July 1, 2003, the commissioner shall allow 346.4 increases in the total operating payment per diems for each 346.5 facility by 24 percent of the difference between that facility's 346.6 operating payment rate in effect on June 30, 2003, for each case 346.7 mix category and 100 percent of the median payment rate in 346.8 effect on June 30, 2003, for each case mix category for 346.9 facilities in geographic group three. 346.10 (c) In order to receive the rate increases provided in 346.11 paragraph (b), facilities must apply to the commissioner. A 346.12 facility must submit an application for each rate increase by 346.13 December 31 of the calendar year in which the increase is 346.14 allowed, using a form provided by the commissioner. The 346.15 application must include a plan for use of the rate increase and 346.16 any other information deemed necessary by the commissioner to 346.17 determine the amount of an increase that will be allowed. The 346.18 commissioner shall deny a request for a rate increase, or reduce 346.19 the rate increase provided, if the commissioner determines that 346.20 the proposed plan for using the rate increase is not an approved 346.21 use of funding under Minnesota Rules, parts 9549.0010 to 346.22 9549.0080. A facility whose request has been denied or reduced 346.23 may reapply for a rate increase. Rate increases approved by the 346.24 commissioner shall be effective on the first day of the month 346.25 following the month which the application was received by the 346.26 commissioner, but not before July 1 of the year in which it is 346.27 allowed. 346.28 (d) A facility must make a copy of the approved application 346.29 available to residents, their designated representatives, and 346.30 employees, by posting it in an area of the facility to which 346.31 these individuals have access, or by providing these individuals 346.32 with copies. 346.33 [EFFECTIVE DATE.] This section is effective the day 346.34 following final enactment. 346.35 Sec. 16. Minnesota Statutes 2000, section 256B.433, 346.36 subdivision 3a, is amended to read: 347.1 Subd. 3a. [EXEMPTION FROM REQUIREMENT FOR SEPARATE THERAPY 347.2 BILLING.] The provisions of subdivision 3 do not apply to 347.3 nursing facilities that are reimbursed according to the 347.4 provisions of section 256B.431and are located in a county347.5participating in the prepaid medical assistance program. 347.6 Nursing facilities that are reimbursed according to the 347.7 provisions of section 256B.434 and are located in a county 347.8 participating in the prepaid medical assistance program are 347.9 exempt from the maximum therapy rent revenue provisions of 347.10 subdivision 3, paragraph (c). 347.11 [EFFECTIVE DATE.] This section is effective the day 347.12 following final enactment. 347.13 Sec. 17. Minnesota Statutes 2000, section 256B.434, 347.14 subdivision 4, is amended to read: 347.15 Subd. 4. [ALTERNATE RATES FOR NURSING FACILITIES.] (a) For 347.16 nursing facilities which have their payment rates determined 347.17 under this section rather than section 256B.431, the 347.18 commissioner shall establish a rate under this subdivision. The 347.19 nursing facility must enter into a written contract with the 347.20 commissioner. 347.21 (b) A nursing facility's case mix payment rate for the 347.22 first rate year of a facility's contract under this section is 347.23 the payment rate the facility would have received under section 347.24 256B.431. 347.25 (c) A nursing facility's case mix payment rates for the 347.26 second and subsequent years of a facility's contract under this 347.27 section are the previous rate year's contract payment rates plus 347.28 an inflation adjustment. The index for the inflation adjustment 347.29 must be based on the change in the Consumer Price Index-All 347.30 Items (United States City average) (CPI-U) forecasted by Data 347.31 Resources, Inc., as forecasted in the fourth quarter of the 347.32 calendar year preceding the rate year. The inflation adjustment 347.33 must be based on the 12-month period from the midpoint of the 347.34 previous rate year to the midpoint of the rate year for which 347.35 the rate is being determined. For the rate years beginning on 347.36 July 1, 1999,andJuly 1, 2000, July 1, 2001, and July 1, 2002, 348.1 this paragraph shall apply only to the property-related payment 348.2 rate. In determining the amount of the property-related payment 348.3 rate adjustment under this paragraph, the commissioner shall 348.4 determine the proportion of the facility's rates that are 348.5 property-related based on the facility's most recent cost report. 348.6 (d) The commissioner shall develop additional 348.7 incentive-based payments of up to five percent above the 348.8 standard contract rate for achieving outcomes specified in each 348.9 contract. The specified facility-specific outcomes must be 348.10 measurable and approved by the commissioner. The commissioner 348.11 may establish, for each contract, various levels of achievement 348.12 within an outcome. After the outcomes have been specified the 348.13 commissioner shall assign various levels of payment associated 348.14 with achieving the outcome. Any incentive-based payment cancels 348.15 if there is a termination of the contract. In establishing the 348.16 specified outcomes and related criteria the commissioner shall 348.17 consider the following state policy objectives: 348.18 (1) improved cost effectiveness and quality of life as 348.19 measured by improved clinical outcomes; 348.20 (2) successful diversion or discharge to community 348.21 alternatives; 348.22 (3) decreased acute care costs; 348.23 (4) improved consumer satisfaction; 348.24 (5) the achievement of quality; or 348.25 (6) any additional outcomes proposed by a nursing facility 348.26 that the commissioner finds desirable. 348.27 Sec. 18. [256B.437] [NURSING FACILITY VOLUNTARY CLOSURES 348.28 AND PLANNING AND DEVELOPMENT OF COMMUNITY-BASED ALTERNATIVES.] 348.29 Subdivision 1. [DEFINITIONS.] (a) The definitions in this 348.30 subdivision apply to subdivisions 2 to 9. 348.31 (b) "Closure" means the cessation of operations of a 348.32 nursing facility and delicensure and decertification of all beds 348.33 within the facility. 348.34 (c) "Closure plan" means a plan to close a nursing facility 348.35 and reallocate a portion of the resulting savings to provide 348.36 planned closure rate adjustments at other facilities. 349.1 (d) "Commencement of closure" means the date on which 349.2 residents and designated representatives are notified of a 349.3 planned closure in accordance with section 144A.161, subdivision 349.4 5, paragraph (e), as part of an approved closure plan. 349.5 (e) "Completion of closure" means the date on which the 349.6 final resident of the nursing facility designated for closure in 349.7 an approved closure plan is discharged from the facility. 349.8 (f) "Partial closure" means the delicensure and 349.9 decertification of a portion of the beds within the facility. 349.10 (g) "Planned closure rate adjustment" means an increase in 349.11 a nursing facility's operating rates resulting from a planned 349.12 closure or a planned partial closure of another facility. 349.13 Subd. 2. [REGIONAL LONG-TERM CARE PLANNING AND 349.14 DEVELOPMENT.] (a) The commissioner of human services shall 349.15 establish a process to adjust the capacity and distribution of 349.16 long-term care services to equalize the supply and demand for 349.17 different types of services. The process must include community 349.18 and regional planning, expansion or establishment of needed 349.19 services, and voluntary nursing facility closures. 349.20 (b) The commissioner shall issue a request for proposals to 349.21 contract with regional long-term care planning groups. At least 349.22 one of the planning groups must be an American Indian long-term 349.23 care planning group. Each group must: 349.24 (1) consist of county health and social services agencies, 349.25 consumers, housing agencies, a representative of nursing 349.26 facilities, a representative of home and community-based 349.27 services providers, a union representative, and area agencies on 349.28 aging in the geographic area; and 349.29 (2) serve an area that has at least 2,000 people who are 85 349.30 years of age or older. American Indian long-term care planning 349.31 groups are exempt from this requirement. 349.32 In awarding contracts, the commissioner shall give preference to 349.33 groups that represent an entire area agency on aging region 349.34 where there is not already a planning and development group 349.35 established under section 256B.0917. An area not included in a 349.36 proposal must be included in a group convened by the area agency 350.1 on aging of that planning and service area through a contract 350.2 negotiated by the commissioner. 350.3 (c) Each regional long-term care planning group shall: 350.4 (1) conduct a detailed assessment of the region's long-term 350.5 care services system. This assessment must be completed within 350.6 90 days of the contract award and must evaluate the adequacy of 350.7 nursing facility beds and the impact of potential nursing 350.8 facility closures. The commissioner of health and the 350.9 commissioner of human services, as appropriate, shall provide 350.10 data to the group on nursing facility bed distribution, 350.11 housing-with-service options, the closure of nursing facilities 350.12 in the planning area that occur outside of the planned closure 350.13 process, the approval of planned closures in the planning area, 350.14 the addition of new community long-term care services in the 350.15 area, the closure of existing community long-term care services 350.16 in the area, and other available data; 350.17 (2) plan options for increasing community capacity to 350.18 provide more home and community-based services to reduce 350.19 reliance on nursing facility services; 350.20 (3) develop community services alternatives to ensure that 350.21 sufficient community-based services are available to meet 350.22 demand; 350.23 (4) assist a nursing facility in the development of a 350.24 proposal to the commissioner for voluntary bed closures under 350.25 this section; 350.26 (5) monitor the success of alternatives to nursing facility 350.27 care that are developed that meet the needs of communities; 350.28 (6) respond to requests from the commissioner for 350.29 information about long-term care planning and development 350.30 activities in the region; and 350.31 (7) review and comment on nursing facility proposals 350.32 submitted under this section. 350.33 Subd. 2a. [PLANNING AND DEVELOPMENT OF COMMUNITY-BASED 350.34 SERVICES.] (a) The purpose of this subdivision is to promote the 350.35 planning and development of community-based services prior to 350.36 the transitioning or closure of nursing facilities. This 351.1 process will support early intervention, advocacy, and consumer 351.2 protection while providing incentives for the nursing facilities 351.3 to transition to meet community needs. 351.4 (b) The commissioner shall establish a process to support 351.5 and facilitate expansion of community-based services under the 351.6 county-administered alternative care program and the elderly 351.7 waiver program. The process shall utilize community assessments 351.8 and planning developed for the community health services plan 351.9 and plan update and for the Community Social Services Act plan. 351.10 (c) The plan shall include recommendations for development 351.11 of community-based services, and both planning and 351.12 implementation shall be implemented within the amount of funding 351.13 made available to the county board for these purposes. 351.14 (d) The plan, within the funding allocated, shall: 351.15 (1) identify the need for services for all residents in 351.16 each community within the county based on demographic and 351.17 caseload information; 351.18 (2) involve providers, consumers, cities, townships, and 351.19 businesses in the planning process; 351.20 (3) address the need for all alternative care and elderly 351.21 waiver services for eligible recipients; 351.22 (4) assess the need for other supportive services such as 351.23 transit, housing, and workforce and economic development; 351.24 (5) estimate the cost and timelines for development; and 351.25 (6) coordinate with the county mental health plan, the 351.26 community health services plan, and community social services 351.27 plan. 351.28 (e) The county board shall cooperate in planning and 351.29 implementation with any county having a nursing facility that 351.30 includes their county in the immediate service area within the 351.31 funding allocated for these purposes. 351.32 (f) The commissioner of health, in cooperation with the 351.33 commissioner of human services and county boards, shall jointly 351.34 report to the legislature by January 15 of each year regarding 351.35 the development of community-based services, transition or 351.36 closure of nursing facilities, and consumer outcomes achieved. 352.1 Subd. 3. [APPLICATIONS FOR PLANNED CLOSURE OF NURSING 352.2 FACILITIES.] (a) By July 15, 2001, the commissioner of human 352.3 services shall implement and announce a program for closure or 352.4 partial closure of nursing facilities. The announcement must 352.5 specify: 352.6 (1) the criteria in subdivision 4 that will be used by the 352.7 commissioner to approve or reject applications; 352.8 (2) the information that must accompany an application; and 352.9 (3) that applications may combine planned closure rate 352.10 adjustments with moratorium exception funding, in which case a 352.11 single application may serve both purposes. 352.12 Between August 1, 2001, and June 30, 2003, the commissioner may 352.13 approve planned closures of up to 5,140 nursing facility beds, 352.14 less the number of licensed beds in facilities that close during 352.15 the same time period without approved closure plans or that have 352.16 notified the commissioner of health of their intent to close 352.17 without an approved closure plan. 352.18 (b) A facility or facilities reimbursed under section 352.19 256B.431 or 256B.434 with a closure plan approved by the 352.20 commissioner under subdivision 6 may assign a planned closure 352.21 rate adjustment to another facility or facilities that are not 352.22 closing or in the case of a partial closure, to itself. A 352.23 facility may also elect to have a planned closure rate 352.24 adjustment shared equally by the five nursing facilities with 352.25 the lowest total operating payment rates in the state 352.26 development region designated under section 462.385, in which 352.27 the facility that is closing is located. The planned closure 352.28 rate adjustment must be calculated under subdivision 7. 352.29 Facilities that close without a closure plan, or whose closure 352.30 plan is not approved by the commissioner, are not eligible to 352.31 assign a planned closure rate adjustment under subdivision 7. 352.32 The commissioner shall calculate the amount the facility would 352.33 have been eligible to assign under subdivision 7, and shall use 352.34 this amount to provide equal rate adjustments to the five 352.35 nursing facilities with the lowest total operating payment rates 352.36 in the state development region designated under section 353.1 462.385, in which the facility that closed is located. 353.2 (c) To be considered for approval, an application must 353.3 include: 353.4 (1) a description of the proposed closure plan, which must 353.5 include identification of the facility or facilities to receive 353.6 a planned closure rate adjustment and the amount and timing of a 353.7 planned closure rate adjustment proposed for each facility; 353.8 (2) the proposed timetable for any proposed closure, 353.9 including the proposed dates for announcement to residents, 353.10 commencement of closure, and completion of closure; 353.11 (3) the proposed relocation plan for current residents of 353.12 any facility designated for closure. The proposed relocation 353.13 plan must be designed to comply with all applicable state and 353.14 federal statutes and regulations, including, but not limited to, 353.15 section 144A.161; 353.16 (4) a description of the relationship between the nursing 353.17 facility that is proposed for closure and the nursing facility 353.18 or facilities proposed to receive the planned closure rate 353.19 adjustment. If these facilities are not under common ownership, 353.20 copies of any contracts, purchase agreements, or other documents 353.21 establishing a relationship or proposed relationship must be 353.22 provided; 353.23 (5) documentation, in a format approved by the 353.24 commissioner, that all the nursing facilities receiving a 353.25 planned closure rate adjustment under the plan have accepted 353.26 joint and several liability for recovery of overpayments under 353.27 section 256B.0641, subdivision 2, for the facilities designated 353.28 for closure under the plan; and 353.29 (6) comments by the affected regional planning and 353.30 development groups on the facility proposal. 353.31 (d) The application must address the criteria listed in 353.32 subdivision 4. 353.33 Subd. 4. [CRITERIA FOR REVIEW OF APPLICATION.] In 353.34 reviewing and approving closure proposals, the commissioner 353.35 shall consider, but not be limited to, the following criteria: 353.36 (1) improved quality of care and quality of life for 354.1 consumers; 354.2 (2) closure of a nursing facility that has a poor physical 354.3 plant; 354.4 (3) the existence of excess nursing facility beds, measured 354.5 in terms of beds per thousand persons aged 85 or older. The 354.6 excess must be measured in reference to: 354.7 (i) the county in which the facility is located; 354.8 (ii) the county and all contiguous counties; 354.9 (iii) the region in which the facility is located; or 354.10 (iv) the facility's service area; 354.11 the facility shall indicate in its application the service area 354.12 it believes is appropriate for this measurement. A facility in 354.13 a county that is in the lowest quartile of counties with 354.14 reference to beds per thousand persons aged 85 or older is not 354.15 in an area of excess capacity; 354.16 (4) low-occupancy rates, provided that the unoccupied beds 354.17 are not the result of a personnel shortage. In analyzing 354.18 occupancy rates, the commissioner shall examine waiting lists in 354.19 the applicant facility and at facilities in the surrounding 354.20 area, as determined under clause (3); 354.21 (5) evidence of coordination between the community planning 354.22 process and the facility application; 354.23 (6) proposed usage of funds available from a planned 354.24 closure rate adjustment for care-related purposes; 354.25 (7) innovative use planned for the closed facility's 354.26 physical plant; 354.27 (8) evidence that the proposal serves the interests of the 354.28 state; and 354.29 (9) evidence of other factors that affect the viability of 354.30 the facility, including excessive nursing pool costs. 354.31 Subd. 5. [CERTIFICATION.] Upon receipt of an application 354.32 for planned closure, the commissioner of human services shall 354.33 provide a copy of the application to the commissioner of 354.34 health. The commissioner of health shall certify to the 354.35 commissioner of human services within 14 days whether the 354.36 application, if implemented, will satisfy the requirements of 355.1 section 144A.161. The commissioner of human services shall 355.2 reject all applications for which the commissioner of health 355.3 fails to make the certification required under this subdivision 355.4 within 14 days. 355.5 Subd. 6. [REVIEW AND APPROVAL OF APPLICATIONS.] (a) The 355.6 commissioner of human services, in consultation with the 355.7 commissioner of health, shall approve or disapprove an 355.8 application within 30 days after receiving it. 355.9 (b) The commissioner shall not approve an application that 355.10 results in a closure, curtailment, reduction, or change of 355.11 operations combined with the establishment of new long-term care 355.12 facilities or services offered in the existing facilities or in 355.13 new facilities provided by the same corporation, agency, or 355.14 individual, unless: 355.15 (1) the employees at the time of the closure, curtailment, 355.16 reduction, or change of operations are given by seniority the 355.17 first priority for hiring into positions for which they are 355.18 qualified in the new facility or service; and 355.19 (2) the exclusive bargaining representative at the time of 355.20 the closure, curtailment, reduction, or change of operations is 355.21 recognized as the exclusive bargaining representative for the 355.22 new long-term care facilities or services. 355.23 (c) Approval of a planned closure expires 18 months after 355.24 approval by the commissioner of human services, unless 355.25 commencement of closure has begun. 355.26 (d) The commissioner of human services may change any 355.27 provision of the application to which the applicant, the 355.28 regional planning group, and the commissioner agree. 355.29 Subd. 7. [PLANNED CLOSURE RATE ADJUSTMENT.] (a) The 355.30 commissioner of human services shall calculate the amount of the 355.31 planned closure rate adjustment available under subdivision 3, 355.32 paragraph (b), for up to 5,140 beds according to clauses (1) to 355.33 (4): 355.34 (1) the amount available is the net reduction of nursing 355.35 facility beds multiplied by $2,080; 355.36 (2) the total number of beds in the nursing facility or 356.1 facilities receiving the planned closure rate adjustment must be 356.2 identified; 356.3 (3) capacity days are determined by multiplying the number 356.4 determined under clause (2) by 365; and 356.5 (4) the planned closure rate adjustment is the amount 356.6 available in clause (1), divided by capacity days determined 356.7 under clause (3). 356.8 (b) A planned closure rate adjustment under this section is 356.9 effective on the first day of the month following completion of 356.10 closure of the facility designated for closure in the 356.11 application and becomes part of the nursing facility's total 356.12 operating payment rate. 356.13 (c) Applicants may use the planned closure rate adjustment 356.14 to allow for a property payment for a new nursing facility or an 356.15 addition to an existing nursing facility. Applications approved 356.16 under this subdivision are exempt from other requirements for 356.17 moratorium exceptions under section 144A.073, subdivisions 2 and 356.18 3. 356.19 (d) Upon the request of a closing facility, the 356.20 commissioner must allow the facility a closure rate adjustment 356.21 equal to a 50 percent payment rate increase to reimburse 356.22 relocation costs or other costs related to facility closure. 356.23 This rate increase is effective on the date the facility's 356.24 occupancy decreases to 90 percent of capacity days after the 356.25 written notice of closure is distributed under section 144A.161, 356.26 subdivision 5, and shall remain in effect for a period of up to 356.27 60 days. The commissioner shall delay the implementation of the 356.28 planned closure rate adjustments to offset the cost of this rate 356.29 adjustment. 356.30 Subd. 8. [OTHER RATE ADJUSTMENTS.] Facilities subject to 356.31 this section remain eligible for any applicable rate adjustments 356.32 provided under section 256B.431, 256B.434, or any other section. 356.33 Subd. 9. [COUNTY COSTS.] The commissioner of human 356.34 services may allocate up to $400 total state and federal funds 356.35 per nursing facility bed that is closing, within the limits of 356.36 the appropriation specified for this purpose, to be used for 357.1 relocation costs incurred by counties for planned closures under 357.2 this section or resident relocation under section 144A.16. To 357.3 be eligible for this allocation, a county in which a nursing 357.4 facility closes must provide to the commissioner a detailed 357.5 statement in a form provided by the commissioner of additional 357.6 costs, not to exceed $400 per bed closed, that are directly 357.7 incurred related to the county's required role in the relocation 357.8 process. 357.9 [EFFECTIVE DATE.] This section is effective the day 357.10 following final enactment. 357.11 Sec. 19. [256B.438] [IMPLEMENTATION OF A CASE MIX SYSTEM 357.12 FOR NURSING FACILITIES BASED ON THE MINIMUM DATA SET.] 357.13 Subdivision 1. [SCOPE.] This section establishes the 357.14 method and criteria used to determine resident reimbursement 357.15 classifications based upon the assessments of residents of 357.16 nursing homes and boarding care homes whose payment rates are 357.17 established under section 256B.431, 256B.434, or 256B.435. 357.18 Resident reimbursement classifications shall be established 357.19 according to the 34 group, resource utilization groups, version 357.20 III or RUG-III model as described in section 144.0724. 357.21 Reimbursement classifications established under this section 357.22 shall be implemented after June 30, 2002, but no later than 357.23 January 1, 2003. 357.24 Subd. 2. [DEFINITIONS.] For purposes of this section, the 357.25 following terms have the meanings given. 357.26 (a) [ASSESSMENT REFERENCE DATE.] "Assessment reference 357.27 date" has the meaning given in section 144.0724, subdivision 2, 357.28 paragraph (a). 357.29 (b) [CASE MIX INDEX.] "Case mix index" has the meaning 357.30 given in section 144.0724, subdivision 2, paragraph (b). 357.31 (c) [INDEX MAXIMIZATION.] "Index maximization" has the 357.32 meaning given in section 144.0724, subdivision 2, paragraph (c). 357.33 (d) [MINIMUM DATA SET.] "Minimum data set" has the meaning 357.34 given in section 144.0724, subdivision 2, paragraph (d). 357.35 (e) [REPRESENTATIVE.] "Representative" has the meaning 357.36 given in section 144.0724, subdivision 2, paragraph (e). 358.1 (f) [RESOURCE UTILIZATION GROUPS OR RUG.] "Resource 358.2 utilization groups" or "RUG" has the meaning given in section 358.3 144.0724, subdivision 2, paragraph (f). 358.4 Subd. 3. [CASE MIX INDICES.] (a) The commissioner of human 358.5 services shall assign a case mix index to each resident class 358.6 based on the Health Care Financing Administration's staff time 358.7 measurement study and adjusted for Minnesota-specific wage 358.8 indices. The case mix indices assigned to each resident class 358.9 shall be published in the Minnesota State Register at least 120 358.10 days prior to the implementation of the 34 group, RUG-III 358.11 resident classification system. 358.12 (b) An index maximization approach shall be used to 358.13 classify residents. 358.14 (c) After implementation of the revised case mix system, 358.15 the commissioner of human services may annually rebase case mix 358.16 indices and base rates using more current data on average wage 358.17 rates and staff time measurement studies. This rebasing shall 358.18 be calculated under subdivision 7, paragraph (b). The 358.19 commissioner shall publish in the Minnesota State Register 358.20 adjusted case mix indices at least 45 days prior to the 358.21 effective date of the adjusted case mix indices. 358.22 Subd. 4. [RESIDENT ASSESSMENT SCHEDULE.] (a) Nursing 358.23 facilities shall conduct and submit case mix assessments 358.24 according to the schedule established by the commissioner of 358.25 health under section 144.0724, subdivisions 4 and 5. 358.26 (b) The resident reimbursement classifications established 358.27 under section 144.0724, subdivision 3, shall be effective the 358.28 day of admission for new admission assessments. The effective 358.29 date for significant change assessments shall be the assessment 358.30 reference date. The effective date for annual and second 358.31 quarterly assessments shall be the first day of the month 358.32 following assessment reference date. 358.33 Subd. 5. [NOTICE OF RESIDENT REIMBURSEMENT 358.34 CLASSIFICATION.] Nursing facilities shall provide notice to a 358.35 resident of the resident's case mix classification according to 358.36 procedures established by the commissioner of health under 359.1 section 144.0724, subdivision 7. 359.2 Subd. 6. [RECONSIDERATION OF RESIDENT CLASSIFICATION.] Any 359.3 request for reconsideration of a resident classification must be 359.4 made under section 144.0724, subdivision 8. 359.5 Subd. 7. [RATE DETERMINATION UPON TRANSITION TO RUG-III 359.6 PAYMENT RATES.] (a) The commissioner of human services shall 359.7 determine payment rates at the time of transition to the RUG 359.8 based payment model in a facility-specific, budget-neutral 359.9 manner. The case mix indices as defined in subdivision 3 shall 359.10 be used to allocate the case mix adjusted component of total 359.11 payment across all case mix groups. To transition from the 359.12 current calculation methodology to the RUG based methodology, 359.13 the commissioner of health shall report to the commissioner of 359.14 human services the resident days classified according to the 359.15 categories defined in subdivision 3 for the 12-month reporting 359.16 period ending September 30, 2001, for each nursing facility. 359.17 The commissioner of human services shall use this data to 359.18 compute the standardized days for the reporting period under the 359.19 RUG system. 359.20 (b) The commissioner of human services shall determine the 359.21 case mix adjusted component of the rate as follows: 359.22 (1) determine the case mix portion of the 11 case mix rates 359.23 in effect on June 30, 2002, or the 34 case mix rates in effect 359.24 on or after June 30, 2003; 359.25 (2) multiply each amount in clause (1) by the number of 359.26 resident days assigned to each group for the reporting period 359.27 ending September 30, 2001, or the most recent year for which 359.28 data is available; 359.29 (3) compute the sum of the amounts in clause (2); 359.30 (4) determine the total RUG standardized days for the 359.31 reporting period ending September 30, 2001, or the most recent 359.32 year for which data is available using the new indices 359.33 calculated under subdivision 3, paragraph (c); 359.34 (5) divide the amount in clause (3) by the amount in clause 359.35 (4) which shall be the average case mix adjusted component of 359.36 the rate under the RUG method; and 360.1 (6) multiply this average rate by the case mix weight in 360.2 subdivision 3 for each RUG group. 360.3 (c) The noncase mix component will be allocated to each RUG 360.4 group as a constant amount to determine the transition payment 360.5 rate. Any other rate adjustments that are effective on or after 360.6 July 1, 2002, shall be applied to the transition rates 360.7 determined under this section. 360.8 Sec. 20. [256B.439] [LONG-TERM CARE QUALITY PROFILES.] 360.9 Subdivision 1. [DEVELOPMENT AND IMPLEMENTATION OF QUALITY 360.10 PROFILES.] (a) The commissioner of human services shall develop 360.11 and implement a quality profile system for nursing facilities 360.12 and, beginning not later than July 1, 2003, other providers of 360.13 long-term care services. The system must be developed and 360.14 implemented to the extent possible without the collection of 360.15 significant amounts of new data. The system must not duplicate 360.16 the requirements of section 256B.5011, 256B.5012, or 256B.5013. 360.17 The system must be designed to provide information on quality: 360.18 (1) to consumers and their families to facilitate informed 360.19 choices of service providers; 360.20 (2) to providers to enable them to measure the results of 360.21 their quality improvement efforts and compare quality 360.22 achievements with other service providers; and 360.23 (3) to public and private purchasers of long-term care 360.24 services to enable them to purchase high-quality care. 360.25 (b) The system must be developed in consultation with the 360.26 long-term care task force and representatives of consumers, 360.27 providers, and labor unions. Within the limits of available 360.28 appropriations, the commissioner may employ consultants to 360.29 assist with this project. 360.30 Subd. 2. [QUALITY MEASUREMENT TOOLS.] The commissioner of 360.31 human services shall identify and apply existing quality 360.32 measurement tools to: 360.33 (1) emphasize quality of care and its relationship to 360.34 quality of life; and 360.35 (2) address the needs of various users of long-term care 360.36 services, including, but not limited to, short-stay residents, 361.1 persons with behavioral problems, persons with dementia, and 361.2 persons who are members of minority groups. 361.3 The tools must be identified and applied, to the extent 361.4 possible, without requiring providers to supply information 361.5 beyond current state and federal requirements. 361.6 Subd. 3. [CONSUMER SURVEYS.] Following identification of 361.7 the quality measurement tool, the commissioner of human services 361.8 shall conduct surveys of long-term care service consumers to 361.9 develop quality profiles of providers. To the extent possible, 361.10 surveys must be conducted face-to-face by state employees or 361.11 contractors. At the discretion of the commissioner, surveys may 361.12 be conducted by telephone or by provider staff. Surveys must be 361.13 conducted periodically to update quality profiles of individual 361.14 service providers. 361.15 Subd. 4. [DISSEMINATION OF QUALITY PROFILES.] By July 1, 361.16 2002, the commissioner of human services shall implement a 361.17 system to disseminate the quality profiles developed from 361.18 consumer surveys using the quality measurement tools. Profiles 361.19 must be disseminated to consumers, providers, and purchasers of 361.20 long-term care services through all feasible printed and 361.21 electronic outlets. The commissioner shall conduct a public 361.22 awareness campaign to inform potential users regarding profile 361.23 contents and potential uses. 361.24 Sec. 21. Minnesota Statutes 2000, section 256B.5012, 361.25 subdivision 3, is amended to read: 361.26 Subd. 3. [PROPERTY PAYMENT RATE.] (a) The property payment 361.27 rate effective October 1, 2000, is based on the facility's 361.28 modified property payment rate in effect on September 30, 2000. 361.29 The modified property payment rate is the actual property 361.30 payment rate exclusive of the effect of gains or losses on 361.31 disposal of capital assets or adjustments for excess 361.32 depreciation claims. Effective October 1, 2000, a facility 361.33 minimum property rate of $8.13 shall be applied to all existing 361.34 ICF/MR facilities. Facilities with a modified property payment 361.35 rate effective September 30, 2000, which is below the minimum 361.36 property rate shall receive an increase effective October 1, 362.1 2000, equal to the difference between the minimum property 362.2 payment rate and the modified property payment rate in effect as 362.3 of September 30, 2000. Facilities with a modified property 362.4 payment rate at or above the minimum property payment rate 362.5 effective September 30, 2000, shall receive the modified 362.6 property payment rate effective October 1, 2000. 362.7 (b)Within the limits of appropriations specifically for362.8this purpose,Facility property payment rates shall be increased 362.9 annually for inflation, effective January 1, 2002. The increase 362.10 shall be based on each facility's property payment rate in 362.11 effect on September 30, 2000. Modified property payment rates 362.12 effective September 30, 2000, shall be arrayed from highest to 362.13 lowest before applying the minimum property payment rate in 362.14 paragraph (a). For modified property payment rates at the 90th 362.15 percentile or above, the annual inflation increase shall be 362.16 zero. For modified property payment rates below the 90th 362.17 percentile but equal to or above the 75th percentile, the annual 362.18 inflation increase shall be one percent. For modified property 362.19 payment rates below the 75th percentile, the annual inflation 362.20 increase shall be two percent. 362.21 Sec. 22. Minnesota Statutes 2000, section 256B.5012, is 362.22 amended by adding a subdivision to read: 362.23 Subd. 4. [ICF/MR RATE INCREASES BEGINNING JULY 1, 2001, 362.24 AND JULY 1, 2002.] (a) For the rate years beginning July 1, 362.25 2001, and July 1, 2002, the commissioner shall make available to 362.26 each facility reimbursed under this section an adjustment to the 362.27 total operating payment rate of 3.5 percent. Of this 362.28 adjustment, 3.0 percentage points must be used to provide an 362.29 employee wage increase as provided under paragraph (b) and 0.5 362.30 percentage points must be used for operating costs. 362.31 (b) The adjustment under this paragraph must be used to 362.32 increase the wages of all employees except administrative and 362.33 central office employees and to pay associated costs for FICA, 362.34 the Medicare tax, workers' compensation premiums, and federal 362.35 and state unemployment insurance, provided that this increase 362.36 must be used only for wage increases implemented on or after the 363.1 first day of the rate year and must not be used for wage 363.2 increases implemented prior to that date. 363.3 (c) For each facility, the commissioner shall make 363.4 available an adjustment using the percentage specified in 363.5 paragraph (a) multiplied by the total payment rate, excluding 363.6 the property-related payment rate, in effect on the preceding 363.7 June 30. The total payment rate shall include the adjustment 363.8 provided in section 256B.501, subdivision 12. 363.9 (d) A facility whose payment rates are governed by closure 363.10 agreements, receivership agreements, or Minnesota Rules, part 363.11 9553.0075, is not eligible for an adjustment otherwise granted 363.12 under this subdivision. 363.13 (e) A facility may apply for the wage-related payment rate 363.14 adjustment provided under paragraph (b). The application must 363.15 be made to the commissioner and contain a plan by which the 363.16 facility will distribute the wage-related portion of the payment 363.17 rate adjustment to employees of the facility. For facilities in 363.18 which the employees are represented by an exclusive bargaining 363.19 representative, an agreement negotiated and agreed to by the 363.20 employer and the exclusive bargaining representative constitutes 363.21 the plan. A negotiated agreement may constitute the plan only 363.22 if the agreement is finalized after the date of enactment of all 363.23 rate increases for the rate year. The commissioner shall review 363.24 the plan to ensure that the payment rate adjustment per diem is 363.25 used as provided in this subdivision. To be eligible, a 363.26 facility must submit its plan by March 31, 2002, and March 31, 363.27 2003, respectively. If a facility's plan is effective for its 363.28 employees after the first day of the applicable rate year that 363.29 the funds are available, the payment rate adjustment per diem is 363.30 effective the same date as its plan. 363.31 (f) A copy of the approved distribution plan must be made 363.32 available to all employees by giving each employee a copy or by 363.33 posting it in an area of the facility to which all employees 363.34 have access. If an employee does not receive the wage 363.35 adjustment described in the facility's approved plan and is 363.36 unable to resolve the problem with the facility's management or 364.1 through the employee's union representative, the employee may 364.2 contact the commissioner at an address or telephone number 364.3 provided by the commissioner and included in the approved plan. 364.4 Sec. 23. Minnesota Statutes 2000, section 626.557, 364.5 subdivision 12b, is amended to read: 364.6 Subd. 12b. [DATA MANAGEMENT.] (a) [COUNTY DATA.] In 364.7 performing any of the duties of this section as a lead agency, 364.8 the county social service agency shall maintain appropriate 364.9 records. Data collected by the county social service agency 364.10 under this section are welfare data under section 13.46. 364.11 Notwithstanding section 13.46, subdivision 1, paragraph (a), 364.12 data under this paragraph that are inactive investigative data 364.13 on an individual who is a vendor of services are private data on 364.14 individuals, as defined in section 13.02. The identity of the 364.15 reporter may only be disclosed as provided in paragraph (c). 364.16 Data maintained by the common entry point are confidential 364.17 data on individuals or protected nonpublic data as defined in 364.18 section 13.02. Notwithstanding section 138.163, the common 364.19 entry point shall destroy data three calendar years after date 364.20 of receipt. 364.21 (b) [LEAD AGENCY DATA.] The commissioners of health and 364.22 human services shall prepare an investigation memorandum for 364.23 each report alleging maltreatment investigated under this 364.24 section. During an investigation by the commissioner of health 364.25 or the commissioner of human services, data collected under this 364.26 section are confidential data on individuals or protected 364.27 nonpublic data as defined in section 13.02. Upon completion of 364.28 the investigation, the data are classified as provided in 364.29 clauses (1) to (3) and paragraph (c). 364.30 (1) The investigation memorandum must contain the following 364.31 data, which are public: 364.32 (i) the name of the facility investigated; 364.33 (ii) a statement of the nature of the alleged maltreatment; 364.34 (iii) pertinent information obtained from medical or other 364.35 records reviewed; 364.36 (iv) the identity of the investigator; 365.1 (v) a summary of the investigation's findings; 365.2 (vi) statement of whether the report was found to be 365.3 substantiated, inconclusive, false, or that no determination 365.4 will be made; 365.5 (vii) a statement of any action taken by the facility; 365.6 (viii) a statement of any action taken by the lead agency; 365.7 and 365.8 (ix) when a lead agency's determination has substantiated 365.9 maltreatment, a statement of whether an individual, individuals, 365.10 or a facility were responsible for the substantiated 365.11 maltreatment, if known. 365.12 The investigation memorandum must be written in a manner 365.13 which protects the identity of the reporter and of the 365.14 vulnerable adult and may not contain the names or, to the extent 365.15 possible, data on individuals or private data listed in clause 365.16 (2). 365.17 (2) Data on individuals collected and maintained in the 365.18 investigation memorandum are private data, including: 365.19 (i) the name of the vulnerable adult; 365.20 (ii) the identity of the individual alleged to be the 365.21 perpetrator; 365.22 (iii) the identity of the individual substantiated as the 365.23 perpetrator; and 365.24 (iv) the identity of all individuals interviewed as part of 365.25 the investigation. 365.26 (3) Other data on individuals maintained as part of an 365.27 investigation under this section are private data on individuals 365.28 upon completion of the investigation. 365.29 (c) [IDENTITY OF REPORTER.] The subject of the report may 365.30 compel disclosure of the name of the reporter only with the 365.31 consent of the reporter or upon a written finding by a court 365.32 that the report was false and there is evidence that the report 365.33 was made in bad faith. This subdivision does not alter 365.34 disclosure responsibilities or obligations under the rules of 365.35 criminal procedure, except that where the identity of the 365.36 reporter is relevant to a criminal prosecution, the district 366.1 court shall do an in-camera review prior to determining whether 366.2 to order disclosure of the identity of the reporter. 366.3 (d) [DESTRUCTION OF DATA.] Notwithstanding section 366.4 138.163, data maintained under this section by the commissioners 366.5 of health and human services must be destroyed under the 366.6 following schedule: 366.7 (1) data from reports determined to be false, two years 366.8 after the finding was made; 366.9 (2) data from reports determined to be inconclusive, four 366.10 years after the finding was made; 366.11 (3) data from reports determined to be substantiated, seven 366.12 years after the finding was made; and 366.13 (4) data from reports which were not investigated by a lead 366.14 agency and for which there is no final disposition, two years 366.15 from the date of the report. 366.16 (e) [SUMMARY OF REPORTS.] The commissioners of health and 366.17 human services shall each annuallyprepare a summary ofreport 366.18 to the legislature and the governor on the number and type of 366.19 reports of alleged maltreatment involving licensed facilities 366.20 reported under this section, the number of those requiring 366.21 investigation under this section, and the resolution of those 366.22 investigations. The report shall identify: 366.23 (1) whether and where backlogs of cases result in a failure 366.24 to conform with statutory time frames; 366.25 (2) where adequate coverage requires additional 366.26 appropriations and staffing; and 366.27 (3) any other trends that affect the safety of vulnerable 366.28 adults. 366.29 (f) [RECORD RETENTION POLICY.] Each lead agency must have 366.30 a record retention policy. 366.31 (g) [EXCHANGE OF INFORMATION.] Lead agencies, prosecuting 366.32 authorities, and law enforcement agencies may exchange not 366.33 public data, as defined in section 13.02, if the agency or 366.34 authority requesting the data determines that the data are 366.35 pertinent and necessary to the requesting agency in initiating, 366.36 furthering, or completing an investigation under this section. 367.1 Data collected under this section must be made available to 367.2 prosecuting authorities and law enforcement officials, local 367.3 county agencies, and licensing agencies investigating the 367.4 alleged maltreatment under this section. The lead agency shall 367.5 exchange not public data with the vulnerable adult maltreatment 367.6 review panel established in section 256.021 if the data are 367.7 pertinent and necessary for a review requested under that 367.8 section. Upon completion of the review, not public data 367.9 received by the review panel must be returned to the lead agency. 367.10 (h) [COMPLETION TIME.] Each lead agency shall keep records 367.11 of the length of time it takes to complete its investigations. 367.12 (i) [NOTIFICATION OF OTHER AFFECTED PARTIES.] A lead 367.13 agency may notify other affected parties and their authorized 367.14 representative if the agency has reason to believe maltreatment 367.15 has occurred and determines the information will safeguard the 367.16 well-being of the affected parties or dispel widespread rumor or 367.17 unrest in the affected facility. 367.18 (j) [FEDERAL REQUIREMENTS.] Under any notification 367.19 provision of this section, where federal law specifically 367.20 prohibits the disclosure of patient identifying information, a 367.21 lead agency may not provide any notice unless the vulnerable 367.22 adult has consented to disclosure in a manner which conforms to 367.23 federal requirements. 367.24 Sec. 24. Laws 1999, chapter 245, article 3, section 45, as 367.25 amended by Laws 2000, chapter 312, section 3, is amended to read: 367.26 Sec. 45. [STATE LICENSURE CONFLICTS WITH FEDERAL 367.27 REGULATIONS.] 367.28 (a) Notwithstanding the provisions of Minnesota Rules, part 367.29 4658.0520, an incontinent resident must be checked according to 367.30 a specific time interval written in the resident's care plan. 367.31 The resident's attending physician must authorize in writing any 367.32 interval longer than two hours unless the resident, if 367.33 competent, or a family member or legally appointed conservator, 367.34 guardian, or health care agent of a resident who is not 367.35 competent, agrees in writing to waive physician involvement in 367.36 determining this interval. 368.1 (b) This section expires July 1,20012003. 368.2 Sec. 25. Laws 2000, chapter 364, section 2, is amended to 368.3 read: 368.4 Sec. 2. [MORATORIUM EXCEPTION PROCESS.] 368.5 Forfiscal yearthe biennium beginning July 1,20002001, 368.6 when approving nursing home moratorium exception projects under 368.7 Minnesota Statutes, section 144A.073, the commissioner of health 368.8 shall give priority toproposalsa proposal to build a 368.9 replacementfacilitiesfacility in the city of Anoka or within 368.10 ten miles of the city of Anoka. 368.11 Sec. 26. [DEVELOPMENT OF NEW NURSING FACILITY 368.12 REIMBURSEMENT SYSTEM.] 368.13 (a) The commissioner of human services shall develop and 368.14 report to the legislature by January 15, 2003, a system to 368.15 replace the current nursing facility reimbursement system 368.16 established under Minnesota Statutes, sections 256B.431, 368.17 256B.434, and 256B.435. 368.18 (b) The system must be developed in consultation with the 368.19 long-term care task force and with representatives of consumers, 368.20 providers, and labor unions. Within the limits of available 368.21 appropriations, the commissioner may employ consultants to 368.22 assist with this project. 368.23 (c) The new reimbursement system must: 368.24 (1) provide incentives to enhance quality of life and 368.25 quality of care; 368.26 (2) recognize cost differences in the care of different 368.27 types of populations, including subacute care and dementia care; 368.28 (3) establish rates that are sufficient without being 368.29 excessive; 368.30 (4) be affordable for the state and for private-pay 368.31 residents; 368.32 (5) be sensitive to changing conditions in the long-term 368.33 care environment; 368.34 (6) avoid creating access problems related to insufficient 368.35 funding; 368.36 (7) allow providers maximum flexibility in their business 369.1 operations; and 369.2 (8) recognize the need for capital investment to improve 369.3 physical plants. 369.4 (d) Notwithstanding Minnesota Statutes, section 256B.435, 369.5 the commissioner must not implement a performance-based 369.6 contracting system for nursing facilities prior to July 1, 2003. 369.7 The commissioner shall continue to reimburse nursing facilities 369.8 under Minnesota Statutes, section 256B.431 or 256B.434, until 369.9 otherwise directed by law. 369.10 Sec. 27. [MINIMUM STAFFING STANDARDS REPORT.] 369.11 By January 15, 2002, the commissioner of health and the 369.12 commissioner of human services shall report to the legislature 369.13 on whether they should translate the minimum nurse staffing 369.14 requirement in Minnesota Statutes, section 144A.04, subdivision 369.15 7, paragraph (a), upon the transition to the RUG-III 369.16 classification system, or whether they should establish 369.17 different time-based standards, and how to accomplish either. 369.18 Sec. 28. [TIME MOTION STUDY.] 369.19 (a) The commissioner of human services shall conduct a time 369.20 motion study to determine the amount of time devoted to the care 369.21 of high-need nursing facility residents, including, but not 369.22 limited to, persons with Alzheimer's disease and other 369.23 dementias, persons with multiple sclerosis, and persons with 369.24 mental illness. 369.25 (b) The commissioner shall report the results of the study 369.26 to the legislature by January 15, 2003, with an analysis of 369.27 whether these costs are adequately reimbursed under the current 369.28 reimbursement system and with recommendations for adjusting 369.29 nursing facility reimbursement rates as necessary to account for 369.30 these costs. 369.31 Sec. 29. [PROVIDER RATE INCREASES.] 369.32 (a) The commissioner of human services shall increase 369.33 reimbursement rates by 3.5 percent each year of the biennium for 369.34 the providers listed in paragraph (b). The increases are 369.35 effective for services rendered on or after July 1 of each year. 369.36 (b) The rate increases described in this section must be 370.1 provided to home and community-based waivered services for: 370.2 (1) persons with mental retardation or related conditions 370.3 under Minnesota Statutes, section 256B.501; 370.4 (2) home and community-based waivered services for the 370.5 elderly under Minnesota Statutes, section 256B.0915; 370.6 (3) waivered services under community alternatives for 370.7 disabled individuals under Minnesota Statutes, section 256B.49; 370.8 (4) community alternative care waivered services under 370.9 Minnesota Statutes, section 256B.49; 370.10 (5) traumatic brain injury waivered services under 370.11 Minnesota Statutes, section 256B.49; 370.12 (6) nursing services and home health services under 370.13 Minnesota Statutes, section 256B.0625, subdivision 6a; 370.14 (7) personal care services and nursing supervision of 370.15 personal care services under Minnesota Statutes, section 370.16 256B.0625, subdivision 19a; 370.17 (8) private duty nursing services under Minnesota Statutes, 370.18 section 256B.0625, subdivision 7; 370.19 (9) day training and habilitation services for adults with 370.20 mental retardation or related conditions under Minnesota 370.21 Statutes, sections 252.40 to 252.46; 370.22 (10) alternative care services under Minnesota Statutes, 370.23 section 256B.0913; 370.24 (11) adult residential program grants under Minnesota 370.25 Rules, parts 9535.2000 to 9535.3000; 370.26 (12) adult and family community support grants under 370.27 Minnesota Rules, parts 9535.1700 to 9535.1760; 370.28 (13) the group residential housing supplementary service 370.29 rate under Minnesota Statutes, section 256I.05, subdivision 1a; 370.30 (14) adult mental health integrated fund grants under 370.31 Minnesota Statutes, section 245.4661; 370.32 (15) semi-independent living services under Minnesota 370.33 Statutes, section 252.275, including SILS funding under county 370.34 social services grants formerly funded under Minnesota Statutes, 370.35 chapter 256I; 370.36 (16) community support services for deaf and 371.1 hard-of-hearing adults with mental illness who use or wish to 371.2 use sign language as their primary means of communication; and 371.3 (17) living skills training programs for persons with 371.4 intractable epilepsy who need assistance in the transition to 371.5 independent living. 371.6 (c) Providers that receive a rate increase under this 371.7 section shall use 0.5 percentage points of the additional 371.8 revenue for operating cost increases and 3.0 percentage points 371.9 of the additional revenue to increase wages for all employees 371.10 other than the administrator and central office staff and to pay 371.11 associated costs for FICA, the Medicare tax, workers' 371.12 compensation premiums, and federal and state unemployment 371.13 insurance. For public employees, the portion of this increase 371.14 reserved to increase wages for certain staff is available and 371.15 pay rates shall be increased only to the extent that they comply 371.16 with laws governing public employees collective bargaining. 371.17 Money received by a provider for pay increases under this 371.18 section must be used only for wage increases implemented on or 371.19 after the first day of the state fiscal year in which the 371.20 increase is available and must not be used for wage increases 371.21 implemented prior to that date. 371.22 (d) A copy of the provider's plan for complying with 371.23 paragraph (c) must be made available to all employees by giving 371.24 each employee a copy or by posting it in an area of the 371.25 provider's operation to which all employees have access. If an 371.26 employee does not receive the wage adjustment described in the 371.27 plan and is unable to resolve the problem with the provider, the 371.28 employee may contact the employee's union representative. If 371.29 the employee is not covered by a collective bargaining 371.30 agreement, the employee may contact the commissioner at a phone 371.31 number provided by the commissioner and included in the 371.32 provider's plan. 371.33 Sec. 30. [REGULATORY FLEXIBILITY.] 371.34 (a) By July 1, 2001, the commissioners of health and human 371.35 services shall: 371.36 (1) develop a summary of federal nursing facility and 372.1 community long-term care regulations that hamper state 372.2 flexibility and place burdens on the goal of achieving 372.3 high-quality care and optimum outcomes for consumers of 372.4 services; and 372.5 (2) share this summary with the legislature, other states, 372.6 national groups that advocate for state interests with Congress, 372.7 and the Minnesota congressional delegation. 372.8 (b) The commissioners shall conduct ongoing follow-up with 372.9 the entities to which this summary is provided and with the 372.10 health care financing administration to achieve maximum 372.11 regulatory flexibility, including the possibility of pilot 372.12 projects to demonstrate regulatory flexibility on less than a 372.13 statewide basis. 372.14 [EFFECTIVE DATE.] This section is effective the day 372.15 following final enactment. 372.16 Sec. 31. [REPORT.] 372.17 By January 15, 2003, the commissioner of health and the 372.18 commissioner of human services shall report to the senate health 372.19 and family security committee and the house health and human 372.20 services policy committee on the number of closures that have 372.21 taken place under this article, alternatives to nursing facility 372.22 care that have been developed, any problems with access to 372.23 long-term care services that have resulted, and any 372.24 recommendations for continuation of the regional long-term care 372.25 planning process and the closure process after June 30, 2003. 372.26 Sec. 32. [REVISOR INSTRUCTION.] 372.27 The revisor of statutes shall delete any reference to 372.28 Minnesota Statutes, section 144A.16, in Minnesota Statutes and 372.29 Minnesota Rules. 372.30 Sec. 33. [REPEALER.] 372.31 (a) Minnesota Statutes 2000, sections 144A.16; and 372.32 256B.434, subdivision 5, are repealed. 372.33 (b) Minnesota Rules, parts 4655.6810; 4655.6820; 4655.6830; 372.34 4658.1600; 4658.1605; 4658.1610; 4658.1690; 9546.0010; 372.35 9546.0020; 9546.0030; 9546.0040; 9546.0050; and 9546.0060, are 372.36 repealed. 373.1 ARTICLE 7 373.2 WORKFORCE RECRUITMENT AND RETENTION 373.3 Section 1. Minnesota Statutes 2000, section 116L.11, 373.4 subdivision 4, is amended to read: 373.5 Subd. 4. [QUALIFYING CONSORTIUM.] "Qualifying consortium" 373.6 means an entity thatmay includeincludes a public or private 373.7 institution of higher education, work force center, county,and 373.8 oneor moreeligibleemployers, but must include a public or373.9private institution of higher education and one or more eligible373.10employersemployer. 373.11 Sec. 2. Minnesota Statutes 2000, section 116L.12, 373.12 subdivision 4, is amended to read: 373.13 Subd. 4. [GRANTS.] Within the limits of available 373.14 appropriations, the board shall make grants not to exceed 373.15 $400,000 each to qualifying consortia to operate local, 373.16 regional, or statewide training and retention programs. Grants 373.17 may be made from TANF funds, general fund appropriations, and 373.18 any other funding sources available to the board, provided the 373.19 requirements of those funding sources are satisfied. Grant 373.20 awards must establish specific, measurable outcomes and 373.21 timelines for achieving those outcomes. 373.22 Sec. 3. Minnesota Statutes 2000, section 116L.12, 373.23 subdivision 5, is amended to read: 373.24 Subd. 5. [LOCAL MATCH REQUIREMENTS.] A consortium must 373.25provide at least a 50 percent match from local resources for373.26money appropriated under this section. The local match373.27requirement must be satisfied on an overall program basis but373.28need not be satisfied for each particular client. The local373.29match requirement may be reduced for consortia that include a373.30relatively large number of small employers whose financial373.31contribution has been reduced in accordance with section 116L.15.373.32In-kind services and expenditures under section 116L.13,373.33subdivision 2, may be used to meet this local match373.34requirement. The grant application must specify the financial373.35contribution from each member of the consortiumsatisfy the 373.36 match requirements established in section 116L.02, paragraph (a). 374.1 Sec. 4. Minnesota Statutes 2000, section 116L.13, 374.2 subdivision 1, is amended to read: 374.3 Subdivision 1. [MARKETING AND RECRUITMENT.] A qualifying 374.4 consortium must implement a marketing and outreach strategy to 374.5 recruit into the health care and human services fields persons 374.6 from one or more of the potential employee target groups. 374.7 Recruitment strategies must include: 374.8 (1) a screening process to evaluate whether potential 374.9 employees may be disqualified as the result of a required 374.10 background check or are otherwise unlikely to succeed in the 374.11 position for which they are being recruited; and 374.12 (2) a process for modifying course work to meet the 374.13 training needs of non-English-speaking persons, when appropriate. 374.14 Sec. 5. [116L.146] [EXPEDITED GRANT PROCESS.] 374.15 (a) The board may authorize grants not to exceed $50,000 374.16 each through an expedited grant approval process to: 374.17 (1) eligible employers to provide training programs for up 374.18 to 50 workers; or 374.19 (2) a public or private institution of higher education to: 374.20 (i) do predevelopment or curriculum development for 374.21 training programs prior to submission for program funding under 374.22 section 116L.12; 374.23 (ii) convert an existing curriculum for distance learning 374.24 through interactive television or other communication methods; 374.25 or 374.26 (iii) enable a training program to be offered when it would 374.27 otherwise be canceled due to an enrollment shortfall of one or 374.28 two students when the program is offered in a health-related 374.29 field with a documented worker shortage and is part of a 374.30 training program not exceeding two years in length. 374.31 (b) The board shall develop application procedures and 374.32 evaluation policies for grants made under this section. 374.33 Sec. 6. [256.956] [LONG-TERM CARE EMPLOYEE HEALTH 374.34 INSURANCE ASSISTANCE PROGRAM.] 374.35 Subdivision 1. [DEFINITIONS.] (a) For the purpose of this 374.36 section, the definitions have the meanings given them. 375.1 (b) "Commissioner" means the commissioner of human services. 375.2 (c) "Dependent" means an unmarried child who is under the 375.3 age of 19 years. For the purpose of this definition, a 375.4 dependent includes a child for whom an eligible employee or an 375.5 eligible employee's spouse has been appointed legal guardian or 375.6 an adopted child as defined under section 62A.27. A dependent 375.7 does not include: 375.8 (1) a child of an eligible employee who is eligible for 375.9 health coverage through medical assistance without a spenddown 375.10 or through an employer-subsidized health plan where an employer 375.11 other than the employer of the eligible employee pays at least 375.12 50 percent of the cost of coverage for the child; or 375.13 (2) a child of an eligible employee who is excluded from 375.14 coverage under title XXI of the Social Security Act, United 375.15 States Code, title 42, section 1397aa et seq. 375.16 (d) "Eligible employee" means an individual employed for at 375.17 least 20 hours by an employer in a position other than as an 375.18 administrator or in the central office. An "employee" does not 375.19 include an individual who: 375.20 (1) works on a temporary or substitute basis; 375.21 (2) is hired as an independent contractor; or 375.22 (3) is a state employee. 375.23 (e) "Employer" means any of the following: 375.24 (1) a nursing facility reimbursed under section 256B.431 or 375.25 256B.434; 375.26 (2) a facility reimbursed under sections 256B.501 and 375.27 256B.5011 and Laws 1993, First Special Session chapter 1, 375.28 article 4, section 11; or 375.29 (3) a provider who meets the following requirements: 375.30 (i) provides home and community-based waivered services for 375.31 persons with mental retardation or related conditions under 375.32 section 256B.501; home and community-based waivered services for 375.33 the elderly under section 256B.0915; waivered services under 375.34 community alternatives for disabled individuals under section 375.35 256B.49; community alternative care waivered services under 375.36 section 256B.49; traumatic brain injury waivered services under 376.1 section 256B.49; nursing services and home health services under 376.2 section 256B.0625, subdivision 6a; personal care services and 376.3 nursing supervision of personal care services under section 376.4 256B.0625, subdivision 19a; private duty nursing services under 376.5 section 256B.0625, subdivision 7; day training and habilitation 376.6 services for adults with mental retardation or related 376.7 conditions under sections 252.40 to 252.46; alternative care 376.8 services under section 256B.0913; adult residential program 376.9 grants under Minnesota Rules, parts 9535.2000 to 9535.3000; 376.10 adult and family community support grants under Minnesota Rules, 376.11 parts 9535.1700 to 9535.1760; semi-independent living services 376.12 under section 252.275, including SILS funding under county 376.13 social services grants formerly funded under chapter 256I; 376.14 community support services for deaf and hard-of-hearing adults 376.15 with mental illness who use or wish to use sign language as 376.16 their primary means of communication; or living skills training 376.17 programs for persons with intractable epilepsy who need 376.18 assistance in the transition to independent living; and 376.19 (ii) the revenue received by the provider from medical 376.20 assistance that equals or exceeds 20 percent of the total 376.21 revenue received by the provider from all payment sources. 376.22 Employer includes both for-profit and nonprofit entities. 376.23 (f) "Program" means the long-term care employee health 376.24 insurance assistance program. 376.25 Subd. 2. [PROGRAM.] (a) The commissioner shall establish 376.26 and administer the long-term care employee health insurance 376.27 assistance program to provide the advantages of pooling for the 376.28 purchase of health coverage for long-term care employers. 376.29 (b) The commissioner shall solicit bids from health 376.30 maintenance organizations licensed under chapter 62D to provide 376.31 health coverage to the dependents of eligible employees. Health 376.32 maintenance organizations shall submit proposals in good faith 376.33 that meet the requirements of the request for proposal from the 376.34 commissioner, provided that the requirements can reasonably be 376.35 met by the health maintenance organization. Coverage shall be 376.36 offered on a guaranteed-issue and renewal basis. No health 377.1 maintenance organization is required to provide coverage to an 377.2 eligible employee's dependent who does not reside within the 377.3 health maintenance organization's approved service area. 377.4 (c) The commissioner shall, consistent with the provisions 377.5 of this section, determine coverage options, premium 377.6 arrangements, contractual arrangements, and all other matters 377.7 necessary to administer the program. 377.8 (d) The commissioner may extend the program to include 377.9 coverage for the eligible employee and noneligible employee. 377.10 The cost of coverage for these employees shall be the 377.11 responsibility of the employer or employee. In determining 377.12 whether to extend the program to include coverage for the 377.13 employees, the commissioner shall evaluate the feasibility of 377.14 the state establishing a stop-loss insurance fund for the 377.15 purpose of lowering the cost of premiums for the employees. 377.16 (e) The commissioner shall consult with representatives of 377.17 the long-term care industry on issues related to the 377.18 administration of the program. 377.19 Subd. 3. [EMPLOYER REQUIREMENTS.] (a) All employers may 377.20 participate in the program subject to the requirements of this 377.21 section. The commissioner shall establish procedures for an 377.22 employer to apply for coverage through this program. These 377.23 procedures may include requiring eligible employees to provide 377.24 relevant financial information to determine the eligibility of 377.25 their dependents. 377.26 (b) A participating employer must offer dependent coverage 377.27 to all employees. For purposes of this paragraph, dependent 377.28 includes the children excluded under subdivision 1, paragraph 377.29 (c). 377.30 (c) The participating employer must provide to the 377.31 commissioner any employee information deemed necessary by the 377.32 commissioner to determine eligibility and premium payments and 377.33 must notify the commissioner upon a change in an employee's or 377.34 an employee's dependent's eligibility. 377.35 (d) The initial term of the employer's coverage must be for 377.36 at least one year but may be made automatically renewable from 378.1 term to term in the absence of notice of termination by either 378.2 the employer or the commissioner. 378.3 Subd. 4. [INDIVIDUAL ELIGIBILITY.] (a) The commissioner 378.4 may require a probationary period for new employees of no more 378.5 than 90 days before the dependents of a new employee become 378.6 eligible for coverage through the program. 378.7 (b) A participating employer may elect to offer coverage 378.8 through the program to: 378.9 (1) the eligible and noneligible employees, if the program 378.10 is extended by the commissioner to include these individuals; 378.11 (2) children of eligible and noneligible employees who are 378.12 under the age of 25 years and who are full-time students; and 378.13 (3) the spouses of eligible and noneligible employees. 378.14 The cost of coverage for the individuals described in this 378.15 paragraph, the dependents of noneligible employees, and any 378.16 child of an eligible or noneligible employee who is not 378.17 considered a dependent in accordance with subdivision 1, 378.18 paragraph (c), shall be the responsibility of the employer or 378.19 employee. 378.20 (c) The commissioner may require a certain percentage of 378.21 participation of the individuals described in paragraph (b) 378.22 before coverage can be offered through the program. 378.23 Subd. 5. [COVERAGE.] (a) The health plan offered must meet 378.24 all applicable requirements of chapters 62A and 62D and sections 378.25 62J.71 to 62J.73; 62M.01 to 62M.16; 62Q.1055; 62Q.106; 62Q.12; 378.26 62Q.135; 62Q.14; 62Q.145; 62Q.19; 62Q.23; 62Q.43; 62Q.47; 62Q.52 378.27 to 62Q.58; and 62Q.68 to 62Q.73. 378.28 (b) The health plan offered must meet all underwriting 378.29 requirements of chapter 62L and must provide periodic open 378.30 enrollments for eligible employees where a choice in coverage 378.31 exists. 378.32 (c) The commissioner shall establish the benefits to be 378.33 provided under this program in accordance with the following: 378.34 (1) the benefits provided must comply with title XXI of the 378.35 Social Security Act, United States Code, title 42, section 378.36 1397aa et seq., and be at least equivalent to the lowest 379.1 benchmark allowable under title XXI; 379.2 (2) preventive and restorative dental services must be 379.3 included; and 379.4 (3) except for a $20 copay per visit for emergency care, 379.5 there shall be no deductibles, copayments, or coinsurance 379.6 requirements. 379.7 (d) The health plan requirements described in paragraph (c) 379.8 apply only to coverage offered to the dependents of eligible 379.9 employees. 379.10 Subd. 6. [PREMIUMS.] (a) The commissioner shall determine 379.11 premium rates and rating methods for the coverage offered 379.12 through the program. 379.13 (b) The commissioner shall pay the premiums for the 379.14 dependents of eligible employees directly to the health 379.15 maintenance organization. 379.16 (c) Payment of any remaining premiums must be collected by 379.17 the participating employer and paid directly to the health 379.18 maintenance organization. 379.19 (d) Any premiums paid by the state under this section are 379.20 not subject to taxes or surcharges imposed under chapter 297I, 379.21 chapter 295, or section 256.9657 and shall be excluded when 379.22 determining a health maintenance organization's total premium 379.23 under section 62E.11. 379.24 [EFFECTIVE DATE.] This section is effective 90 days 379.25 following approval of a federal waiver to receive enhanced 379.26 matching funds under the state children's health insurance 379.27 program. 379.28 Sec. 7. Minnesota Statutes 2000, section 256B.431, is 379.29 amended by adding a subdivision to read: 379.30 Subd. 33. [EMPLOYEE SCHOLARSHIP COSTS AND TRAINING IN 379.31 ENGLISH AS A SECOND LANGUAGE.] (a) For the rate year beginning 379.32 July 1, 2001, the commissioner shall provide to each nursing 379.33 facility reimbursed under this section, section 256B.434, or any 379.34 other section an adjustment of 25 cents to the total operating 379.35 payment rate to be used: 379.36 (1) for employee scholarships that satisfy the following 380.1 requirements: 380.2 (i) scholarships are available to all employees who work an 380.3 average of at least 20 hours per week at the facility except the 380.4 administrator, department supervisors, registered nurses, and 380.5 licensed practical nurses; and 380.6 (ii) the course of study is expected to lead to employment 380.7 in a health-related career, including medical care interpreter 380.8 services and social work; and 380.9 (2) to provide job-related training on the job site in 380.10 English as a second language. 380.11 (b) A facility receiving a rate adjustment under this 380.12 subdivision must report to the commissioner on a form supplied 380.13 by the commissioner the following information: the amount 380.14 received from this rate adjustment; the amount used for training 380.15 in English as a second language; the number of persons receiving 380.16 the training; the name of the person or entity providing the 380.17 training; and for each scholarship recipient, the name of the 380.18 recipient, the amount awarded, the educational institution 380.19 attended, the nature of the educational program, and the program 380.20 completion date. 380.21 (c) Amounts spent by a facility for scholarships or for 380.22 training in English as a second language that satisfy the 380.23 requirements of this subdivision shall be included in the 380.24 facility's total payment rates for the purposes of determining 380.25 future rates under this section, section 256B.434, or any other 380.26 section. 380.27 Sec. 8. Minnesota Statutes 2000, section 256B.5012, is 380.28 amended by adding a subdivision to read: 380.29 Subd. 5. [EMPLOYEE SCHOLARSHIP COSTS.] (a) For the rate 380.30 year beginning July 1, 2001, the commissioner shall provide to 380.31 each facility reimbursed under this section an adjustment of 25 380.32 cents to the total payment rate to be used: 380.33 (1) for employee scholarships that satisfy the following 380.34 requirements: 380.35 (i) scholarships are available to all employees who work an 380.36 average of at least 20 hours per week at the facility except the 381.1 administrator, department supervisors, registered nurses, and 381.2 licensed practical nurses; and 381.3 (ii) the course of study is expected to lead to employment 381.4 in a health-related career, including medical care interpreter 381.5 services and social work; and 381.6 (2) to provide job-related training on the job site in 381.7 English as a second language. 381.8 (b) A facility receiving a rate adjustment under this 381.9 subdivision must report to the commissioner on a form supplied 381.10 by the commissioner the following information: the amount 381.11 received from this rate adjustment; the amount used for training 381.12 in English as a second language; the number of persons receiving 381.13 the training; the name of the person or entity providing the 381.14 training; and for each scholarship recipient, the name of the 381.15 recipient, the amount awarded, the educational institution 381.16 attended, the nature of the educational program, and the program 381.17 completion date. 381.18 (c) Amounts spent by a facility for scholarships or for 381.19 training in English as a second language that satisfy the 381.20 requirements of this subdivision shall be included in the 381.21 facility's total payment rates for the purposes of determining 381.22 future rates under this section or any other section. 381.23 Sec. 9. Minnesota Statutes 2000, section 256L.07, 381.24 subdivision 2, is amended to read: 381.25 Subd. 2. [MUST NOT HAVE ACCESS TO EMPLOYER-SUBSIDIZED 381.26 COVERAGE.] (a) To be eligible, a family or individual must not 381.27 have access to subsidized health coverage through an employer 381.28 and must not have had access to employer-subsidized coverage 381.29 through a current employer for 18 months prior to application or 381.30 reapplication. A family or individual whose employer-subsidized 381.31 coverage is lost due to an employer terminating health care 381.32 coverage as an employee benefit during the previous 18 months is 381.33 not eligible. 381.34 (b) For purposes of this requirement, subsidized health 381.35 coverage means health coverage for which the employer pays at 381.36 least 50 percent of the cost of coverage for the employee or 382.1 dependent, or a higher percentage as specified by the 382.2 commissioner. Children are eligible for employer-subsidized 382.3 coverage through either parent, including the noncustodial 382.4 parent. Children who are eligible for coverage under the 382.5 long-term care employee health insurance assistance program 382.6 established under section 256.956 are considered to have access 382.7 to subsidized health coverage under this subdivision. The 382.8 commissioner must treat employer contributions to Internal 382.9 Revenue Code Section 125 plans and any other employer benefits 382.10 intended to pay health care costs as qualified employer 382.11 subsidies toward the cost of health coverage for employees for 382.12 purposes of this subdivision. 382.13 [EFFECTIVE DATE.] This section is effective 90 days 382.14 following approval of a federal waiver to receive enhanced 382.15 matching funds under the state children's health insurance 382.16 program. 382.17 Sec. 10. [EMPLOYEE SCHOLARSHIP COSTS.] 382.18 (a) The commissioner of human services shall increase 382.19 reimbursement rates by .25 percent for the providers listed in 382.20 paragraph (d), effective for services rendered on or after July 382.21 1, 2001, to be used: 382.22 (1) for employee scholarships that satisfy the following 382.23 requirements: 382.24 (i) scholarships are available to all employees who work an 382.25 average of at least 20 hours per week at the facility except the 382.26 administrator, department supervisors, registered nurses, and 382.27 licensed practical nurses; and 382.28 (ii) the course of study is expected to lead to employment 382.29 in a health-related career, including medical care interpreter 382.30 services and social work; and 382.31 (2) to provide job-related training on the job site in 382.32 English as a second language. 382.33 (b) A provider receiving a rate adjustment under this 382.34 subdivision must report to the commissioner on a form supplied 382.35 by the commissioner the following information: the amount 382.36 received from this rate adjustment; the amount used for training 383.1 in English as a second language; the number of persons receiving 383.2 the training; the name of the person or entity providing the 383.3 training; and for each scholarship recipient, the name of the 383.4 recipient, the amount awarded, the educational institution 383.5 attended, the nature of the educational program, and the program 383.6 completion date. 383.7 (c) Amounts spent by a provider for scholarships or for 383.8 training in English as a second language that satisfy the 383.9 requirements of this section shall be included in the provider's 383.10 total payment rates for the purposes of determining future rates. 383.11 (d) The rate increases described in this section shall be 383.12 provided to home and community-based waivered services for 383.13 persons with mental retardation or related conditions under 383.14 Minnesota Statutes, section 256B.501; home and community-based 383.15 waivered services for the elderly under Minnesota Statutes, 383.16 section 256B.0915; waivered services under community 383.17 alternatives for disabled individuals under Minnesota Statutes, 383.18 section 256B.49; community alternative care waivered services 383.19 under Minnesota Statutes, section 256B.49; traumatic brain 383.20 injury waivered services under Minnesota Statutes, section 383.21 256B.49; nursing services and home health services under 383.22 Minnesota Statutes, section 256B.0625, subdivision 6a; personal 383.23 care services and nursing supervision of personal care services 383.24 under Minnesota Statutes, section 256B.0625, subdivision 19a; 383.25 private duty nursing services under Minnesota Statutes, section 383.26 256B.0625, subdivision 7; day training and habilitation services 383.27 for adults with mental retardation or related conditions under 383.28 Minnesota Statutes, sections 252.40 to 252.46; alternative care 383.29 services under Minnesota Statutes, section 256B.0913; adult 383.30 residential program grants under Minnesota Rules, parts 383.31 9535.2000 to 9535.3000; adult and family community support 383.32 grants under Minnesota Rules, parts 9535.1700 to 9535.1760; the 383.33 group residential housing supplementary service rate under 383.34 section 256I.05, subdivision 1a; adult mental health integrated 383.35 fund grants under Minnesota Statutes, section 245.4661; and 383.36 semi-independent living services under Minnesota Statutes, 384.1 section 252.275. 384.2 Sec. 11. [CHIP WAIVER.] 384.3 The commissioner of human services shall seek all waivers 384.4 necessary to obtain enhanced matching funds under the state 384.5 children's health insurance program established as title XXI of 384.6 the Social Security Act, United States Code, title 42, section 384.7 1397aa et seq. 384.8 [EFFECTIVE DATE.] This section is effective the day 384.9 following final enactment. 384.10 Sec. 12. [S-CHIP ALLOTMENT.] 384.11 Upon federal approval of the waiver required under section 384.12 4, the commissioner shall claim eligible expenditures against 384.13 Minnesota's available funding under the state children's health 384.14 insurance program in the following order: 384.15 (1) expenditures made according to Minnesota Statutes, 384.16 section 256B.057, subdivision 8; 384.17 (2) expenditures for outreach and other state or local 384.18 expenditures that are authorized to be claimed under Laws 1998, 384.19 chapter 407, article 5, section 46; 384.20 (3) expenditures under the long-term care employee health 384.21 insurance assistance program; and 384.22 (4) expenditures that may be eligible for matching funds 384.23 under S-CHIP that otherwise may be claimed as Medicaid 384.24 expenditures. 384.25 [EFFECTIVE DATE.] This section is effective the day 384.26 following final enactment. 384.27 Sec. 13. [REPEALER.] 384.28 Minnesota Statutes 2000, section 116L.12, subdivisions 2 384.29 and 7, are repealed. 384.30 ARTICLE 8 384.31 REGULATION OF SUPPLEMENTAL 384.32 NURSING SERVICES AGENCIES 384.33 Section 1. Minnesota Statutes 2000, section 144.057, is 384.34 amended to read: 384.35 144.057 [BACKGROUND STUDIES ON LICENSEES AND SUPPLEMENTAL 384.36 NURSING SERVICES AGENCY PERSONNEL.] 385.1 Subdivision 1. [BACKGROUND STUDIES REQUIRED.] The 385.2 commissioner of health shall contract with the commissioner of 385.3 human services to conduct background studies of: 385.4 (1) individuals providing services which have direct 385.5 contact, as defined under section 245A.04, subdivision 3, with 385.6 patients and residents in hospitals, boarding care homes, 385.7 outpatient surgical centers licensed under sections 144.50 to 385.8 144.58; nursing homes and home care agencies licensed under 385.9 chapter 144A; residential care homes licensed under chapter 385.10 144B, and board and lodging establishments that are registered 385.11 to provide supportive or health supervision services under 385.12 section 157.17;and385.13 (2) beginning July 1, 1999, all other employees in nursing 385.14 homes licensed under chapter 144A, and boarding care homes 385.15 licensed under sections 144.50 to 144.58. A disqualification of 385.16 an individual in this section shall disqualify the individual 385.17 from positions allowing direct contact or access to patients or 385.18 residents receiving services; 385.19 (3) individuals employed by a supplemental nursing services 385.20 agency, as defined under section 144A.70, who are providing 385.21 services in health care facilities; and 385.22 (4) controlling persons of a supplemental nursing services 385.23 agency, as defined under section 144A.70. 385.24 If a facility or program is licensed by the department of 385.25 human services and subject to the background study provisions of 385.26 chapter 245A and is also licensed by the department of health, 385.27 the department of human services is solely responsible for the 385.28 background studies of individuals in the jointly licensed 385.29 programs. 385.30 Subd. 2. [RESPONSIBILITIES OF DEPARTMENT OF HUMAN 385.31 SERVICES.] The department of human services shall conduct the 385.32 background studies required by subdivision 1 in compliance with 385.33 the provisions of chapter 245A and Minnesota Rules, parts 385.34 9543.3000 to 9543.3090. For the purpose of this section, the 385.35 term "residential program" shall include all facilities 385.36 described in subdivision 1. The department of human services 386.1 shall provide necessary forms and instructions, shall conduct 386.2 the necessary background studies of individuals, and shall 386.3 provide notification of the results of the studies to the 386.4 facilities, supplemental nursing services agencies, individuals, 386.5 and the commissioner of health. Individuals shall be 386.6 disqualified under the provisions of chapter 245A and Minnesota 386.7 Rules, parts 9543.3000 to 9543.3090. If an individual is 386.8 disqualified, the department of human services shall notify the 386.9 facility, the supplemental nursing services agency, and the 386.10 individual and shall inform the individual of the right to 386.11 request a reconsideration of the disqualification by submitting 386.12 the request to the department of health. 386.13 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 386.14 shall review and decide reconsideration requests, including the 386.15 granting of variances, in accordance with the procedures and 386.16 criteria contained in chapter 245A and Minnesota Rules, parts 386.17 9543.3000 to 9543.3090. The commissioner's decision shall be 386.18 provided to the individual and to the department of human 386.19 services. The commissioner's decision to grant or deny a 386.20 reconsideration of disqualification is the final administrative 386.21 agency action. 386.22 Subd. 4. [RESPONSIBILITIES OF FACILITIES AND AGENCIES.] 386.23 Facilities and agencies described in subdivision 1 shall be 386.24 responsible for cooperating with the departments in implementing 386.25 the provisions of this section. The responsibilities imposed on 386.26 applicants and licensees under chapter 245A and Minnesota Rules, 386.27 parts 9543.3000 to 9543.3090, shall apply to these 386.28 facilities and supplemental nursing services agencies. The 386.29 provision of section 245A.04, subdivision 3, paragraph (e), 386.30 shall apply to applicants, licensees, registrants, or an 386.31 individual's refusal to cooperate with the completion of the 386.32 background studies. Supplemental nursing services agencies 386.33 subject to the registration requirements in section 144A.71 must 386.34 maintain records verifying compliance with the background study 386.35 requirements under this section. 386.36 Sec. 2. [144A.70] [REGISTRATION OF SUPPLEMENTAL NURSING 387.1 SERVICES AGENCIES; DEFINITIONS.] 387.2 Subdivision 1. [SCOPE.] As used in sections 144A.70 to 387.3 144A.74, the terms defined in this section have the meanings 387.4 given them. 387.5 Subd. 2. [COMMISSIONER.] "Commissioner" means the 387.6 commissioner of health. 387.7 Subd. 3. [CONTROLLING PERSON.] "Controlling person" means 387.8 a business entity, officer, program administrator, or director 387.9 whose responsibilities include the direction of the management 387.10 or policies of a supplemental nursing services agency. 387.11 Controlling person also means an individual who, directly or 387.12 indirectly, beneficially owns an interest in a corporation, 387.13 partnership, or other business association that is a controlling 387.14 person. 387.15 Subd. 4. [HEALTH CARE FACILITY.] "Health care facility" 387.16 means a hospital, boarding care home, or outpatient surgical 387.17 center licensed under sections 144.50 to 144.58; a nursing home 387.18 or home care agency licensed under chapter 144A; a housing with 387.19 services establishment registered under chapter 144D; or a board 387.20 and lodging establishment that is registered to provide 387.21 supportive or health supervision services under section 157.17. 387.22 Subd. 5. [PERSON.] "Person" includes an individual, firm, 387.23 corporation, partnership, or association. 387.24 Subd. 6. [SUPPLEMENTAL NURSING SERVICES 387.25 AGENCY.] "Supplemental nursing services agency" means a person, 387.26 firm, corporation, partnership, or association engaged for hire 387.27 in the business of providing or procuring temporary employment 387.28 in health care facilities for nurses, nursing assistants, nurse 387.29 aides, and orderlies. Supplemental nursing services agency does 387.30 not include an individual who only engages in providing the 387.31 individual's services on a temporary basis to health care 387.32 facilities. Supplemental nursing services agency also does not 387.33 include any nursing service agency that is limited to providing 387.34 temporary nursing personnel solely to one or more health care 387.35 facilities owned or operated by the same person, firm, 387.36 corporation, or partnership. 388.1 Sec. 3. [144A.71] [SUPPLEMENTAL NURSING SERVICES AGENCY 388.2 REGISTRATION.] 388.3 Subdivision 1. [DUTY TO REGISTER.] A person who operates a 388.4 supplemental nursing services agency shall register the agency 388.5 with the commissioner. Each separate location of the business 388.6 of a supplemental nursing services agency shall register the 388.7 agency with the commissioner. Each separate location of the 388.8 business of a supplemental nursing services agency shall have a 388.9 separate registration. 388.10 Subd. 2. [APPLICATION INFORMATION AND FEE.] The 388.11 commissioner shall establish forms and procedures for processing 388.12 each supplemental nursing services agency registration 388.13 application. An application for a supplemental nursing services 388.14 agency registration must include at least the following: 388.15 (1) the names and addresses of the owner or owners of the 388.16 supplemental nursing services agency; 388.17 (2) if the owner is a corporation, copies of its articles 388.18 of incorporation and current bylaws, together with the names and 388.19 addresses of its officers and directors; 388.20 (3) any other relevant information that the commissioner 388.21 determines is necessary to properly evaluate an application for 388.22 registration; and 388.23 (4) the annual registration fee for a supplemental nursing 388.24 services agency, which is $891. 388.25 Subd. 3. [REGISTRATION NOT TRANSFERABLE.] A registration 388.26 issued by the commissioner according to this section is 388.27 effective for a period of one year from the date of its issuance 388.28 unless the registration is revoked or suspended under section 388.29 144A.72, subdivision 2, or unless the supplemental nursing 388.30 services agency is sold or ownership or management is 388.31 transferred. When a supplemental nursing services agency is 388.32 sold or ownership or management is transferred, the registration 388.33 of the agency must be voided and the new owner or operator may 388.34 apply for a new registration. 388.35 Sec. 4. [144A.72] [REGISTRATION REQUIREMENTS; PENALTIES.] 388.36 Subdivision 1. [MINIMUM CRITERIA.] The commissioner shall 389.1 require that, as a condition of registration: 389.2 (1) the supplemental nursing services agency shall document 389.3 that each temporary employee provided to health care facilities 389.4 currently meets the minimum licensing, training, and continuing 389.5 education standards for the position in which the employee will 389.6 be working; 389.7 (2) the supplemental nursing services agency shall comply 389.8 with all pertinent requirements relating to the health and other 389.9 qualifications of personnel employed in health care facilities; 389.10 (3) the supplemental nursing services agency must not 389.11 restrict in any manner the employment opportunities of its 389.12 employees; 389.13 (4) the supplemental nursing services agency, when 389.14 supplying temporary employees to a health care facility, and 389.15 when requested by the facility to do so, shall agree that at 389.16 least 30 percent of the total personnel hours supplied are 389.17 during night, holiday, or weekend shifts; 389.18 (5) the supplemental nursing services agency shall carry 389.19 medical malpractice insurance to insure against the loss, 389.20 damage, or expense incident to a claim arising out of the death 389.21 or injury of any person as the result of negligence or 389.22 malpractice in the provision of health care services by the 389.23 supplemental nursing services agency or by any employee of the 389.24 agency; and 389.25 (6) the supplemental nursing services agency must not, in 389.26 any contract with any employee or health care facility, require 389.27 the payment of liquidated damages, employment fees, or other 389.28 compensation should the employee be hired as a permanent 389.29 employee of a health care facility. 389.30 Subd. 2. [PENALTIES.] A pattern of failure to comply with 389.31 this section shall subject the supplemental nursing services 389.32 agency to revocation or nonrenewal of its registration. 389.33 Violations of section 144A.74 are subject to a fine equal to 200 389.34 percent of the amount billed or received in excess of the 389.35 maximum permitted under that section. 389.36 Sec. 5. [144A.73] [COMPLAINT SYSTEM.] 390.1 The commissioner shall establish a system for reporting 390.2 complaints against a supplemental nursing services agency or its 390.3 employees. Complaints may be made by any member of the public. 390.4 Written complaints must be forwarded to the employer of each 390.5 person against whom a complaint is made. The employer shall 390.6 promptly report to the commissioner any corrective action taken. 390.7 Sec. 6. [144A.74] [MAXIMUM CHARGES.] 390.8 A supplemental nursing services agency must not bill or 390.9 receive payments from a health care facility at a rate higher 390.10 than 150 percent of the average wage rate by employee 390.11 classification as identified by the commissioner of economic 390.12 security. The maximum rate must include all charges for 390.13 administrative fees, contract fees, or other special charges in 390.14 addition to the hourly rates for the temporary nursing pool 390.15 personnel supplied to a nursing home. 390.16 Sec. 7. Minnesota Statutes 2000, section 245A.04, 390.17 subdivision 3, is amended to read: 390.18 Subd. 3. [BACKGROUND STUDY OF THE APPLICANT; DEFINITIONS.] 390.19 (a) Before the commissioner issues a license, the commissioner 390.20 shall conduct a study of the individuals specified in paragraph 390.21(c)(d), clauses (1) to (5), according to rules of the 390.22 commissioner. 390.23 Beginning January 1, 1997, the commissioner shall also 390.24 conduct a study of employees providing direct contact services 390.25 for nonlicensed personal care provider organizations described 390.26 in paragraph(c)(d), clause (5). 390.27 The commissioner shall recover the cost of these background 390.28 studies through a fee of no more than $12 per study charged to 390.29 the personal care provider organization. 390.30 Beginning August 1, 1997, the commissioner shall conduct 390.31 all background studies required under this chapter for adult 390.32 foster care providers who are licensed by the commissioner of 390.33 human services and registered under chapter 144D. The 390.34 commissioner shall conduct these background studies in 390.35 accordance with this chapter. The commissioner shall initiate a 390.36 pilot project to conduct up to 5,000 background studies under 391.1 this chapter in programs with joint licensure as home and 391.2 community-based services and adult foster care for people with 391.3 developmental disabilities when the license holder does not 391.4 reside in the foster care residence. 391.5 (b) Beginning July 1, 1998, the commissioner shall conduct 391.6 a background study on individuals specified in 391.7 paragraph(c)(d), clauses (1) to (5), who perform direct 391.8 contact services in a nursing home or a home care agency 391.9 licensed under chapter 144A or a boarding care home licensed 391.10 under sections 144.50 to 144.58, when the subject of the study 391.11 resides outside Minnesota; the study must be at least as 391.12 comprehensive as that of a Minnesota resident and include a 391.13 search of information from the criminal justice data 391.14 communications network in the state where the subject of the 391.15 study resides. 391.16 (c) Beginning August 1, 2001, the commissioner shall 391.17 conduct all background studies required under this chapter and 391.18 initiated by supplemental nursing services agencies registered 391.19 under chapter 144A. Studies for the agencies must be initiated 391.20 annually by each agency. The commissioner shall conduct the 391.21 background studies according to this chapter. The commissioner 391.22 shall recover the cost of the background studies through a fee 391.23 of no more than $8 per study, charged to the supplemental 391.24 nursing services agency. Money collected under this paragraph 391.25 is appropriated to the commissioner to pay the costs of 391.26 background studies. 391.27 (d) The applicant, license holder,theregistrant, bureau 391.28 of criminal apprehension,thecommissioner of health, and county 391.29 agencies, after written notice to the individual who is the 391.30 subject of the study, shall help with the study by giving the 391.31 commissioner criminal conviction data and reports about the 391.32 maltreatment of adults substantiated under section 626.557 and 391.33 the maltreatment of minors in licensed programs substantiated 391.34 under section 626.556. The individuals to be studied shall 391.35 include: 391.36 (1) the applicant; 392.1 (2) persons over the age of 13 living in the household 392.2 where the licensed program will be provided; 392.3 (3) current employees or contractors of the applicant who 392.4 will have direct contact with persons served by the facility, 392.5 agency, or program; 392.6 (4) volunteers or student volunteers who have direct 392.7 contact with persons served by the program to provide program 392.8 services, if the contact is not directly supervised by the 392.9 individuals listed in clause (1) or (3); and 392.10 (5) any person who, as an individual or as a member of an 392.11 organization, exclusively offers, provides, or arranges for 392.12 personal care assistant services under the medical assistance 392.13 program as authorized under sections 256B.04, subdivision 16, 392.14 and 256B.0625, subdivision 19a. 392.15 The juvenile courts shall also help with the study by 392.16 giving the commissioner existing juvenile court records on 392.17 individuals described in clause (2) relating to delinquency 392.18 proceedings held within either the five years immediately 392.19 preceding the application or the five years immediately 392.20 preceding the individual's 18th birthday, whichever time period 392.21 is longer. The commissioner shall destroy juvenile records 392.22 obtained pursuant to this subdivision when the subject of the 392.23 records reaches age 23. 392.24 For purposes of this section and Minnesota Rules, part 392.25 9543.3070, a finding that a delinquency petition is proven in 392.26 juvenile court shall be considered a conviction in state 392.27 district court. 392.28 For purposes of this subdivision, "direct contact" means 392.29 providing face-to-face care, training, supervision, counseling, 392.30 consultation, or medication assistance to persons served by a 392.31 program. For purposes of this subdivision, "directly supervised" 392.32 means an individual listed in clause (1), (3), or (5) is within 392.33 sight or hearing of a volunteer to the extent that the 392.34 individual listed in clause (1), (3), or (5) is capable at all 392.35 times of intervening to protect the health and safety of the 392.36 persons served by the program who have direct contact with the 393.1 volunteer. 393.2 A study of an individual in clauses (1) to (5) shall be 393.3 conducted at least upon application for initial license or 393.4 registration and reapplication for a license or registration. 393.5 The commissioner is not required to conduct a study of an 393.6 individual at the time of reapplication for a license or if the 393.7 individual has been continuously affiliated with a foster care 393.8 provider licensed by the commissioner of human services and 393.9 registered under chapter 144D, other than a family day care or 393.10 foster care license, if: (i) a study of the individual was 393.11 conducted either at the time of initial licensure or when the 393.12 individual became affiliated with the license holder; (ii) the 393.13 individual has been continuously affiliated with the license 393.14 holder since the last study was conducted; and (iii) the 393.15 procedure described in paragraph(d)(e) has been implemented 393.16 and was in effect continuously since the last study was 393.17 conducted. For the purposes of this section, a physician 393.18 licensed under chapter 147 is considered to be continuously 393.19 affiliated upon the license holder's receipt from the 393.20 commissioner of health or human services of the physician's 393.21 background study results. For individuals who are required to 393.22 have background studies under clauses (1) to (5) and who have 393.23 been continuously affiliated with a foster care provider that is 393.24 licensed in more than one county, criminal conviction data may 393.25 be shared among those counties in which the foster care programs 393.26 are licensed. A county agency's receipt of criminal conviction 393.27 data from another county agency shall meet the criminal data 393.28 background study requirements of this section. 393.29 The commissioner may also conduct studies on individuals 393.30 specified in clauses (3) and (4) when the studies are initiated 393.31 by: 393.32 (i) personnel pool agencies; 393.33 (ii) temporary personnel agencies; 393.34 (iii) educational programs that train persons by providing 393.35 direct contact services in licensed programs; and 393.36 (iv) professional services agencies that are not licensed 394.1 and which contract with licensed programs to provide direct 394.2 contact services or individuals who provide direct contact 394.3 services. 394.4 Studies on individuals in items (i) to (iv) must be 394.5 initiated annually by these agencies, programs, and 394.6 individuals. Except for personal care provider 394.7 organizations and supplemental nursing services agencies, no 394.8 applicant, license holder, or individual who is the subject of 394.9 the study shall pay any fees required to conduct the study. 394.10 (1) At the option of the licensed facility, rather than 394.11 initiating another background study on an individual required to 394.12 be studied who has indicated to the licensed facility that a 394.13 background study by the commissioner was previously completed, 394.14 the facility may make a request to the commissioner for 394.15 documentation of the individual's background study status, 394.16 provided that: 394.17 (i) the facility makes this request using a form provided 394.18 by the commissioner; 394.19 (ii) in making the request the facility informs the 394.20 commissioner that either: 394.21 (A) the individual has been continuously affiliated with a 394.22 licensed facility since the individual's previous background 394.23 study was completed, or since October 1, 1995, whichever is 394.24 shorter; or 394.25 (B) the individual is affiliated only with a personnel pool 394.26 agency, a temporary personnel agency, an educational program 394.27 that trains persons by providing direct contact services in 394.28 licensed programs, or a professional services agency that is not 394.29 licensed and which contracts with licensed programs to provide 394.30 direct contact services or individuals who provide direct 394.31 contact services; and 394.32 (iii) the facility provides notices to the individual as 394.33 required in paragraphs (a) to(d)(e), and that the facility is 394.34 requesting written notification of the individual's background 394.35 study status from the commissioner. 394.36 (2) The commissioner shall respond to each request under 395.1 paragraph (1) with a written or electronic notice to the 395.2 facility and the study subject. If the commissioner determines 395.3 that a background study is necessary, the study shall be 395.4 completed without further request from a licensed agency or 395.5 notifications to the study subject. 395.6 (3) When a background study is being initiated by a 395.7 licensed facility or a foster care provider that is also 395.8 registered under chapter 144D, a study subject affiliated with 395.9 multiple licensed facilities may attach to the background study 395.10 form a cover letter indicating the additional facilities' names, 395.11 addresses, and background study identification numbers. When 395.12 the commissioner receives such notices, each facility identified 395.13 by the background study subject shall be notified of the study 395.14 results. The background study notice sent to the subsequent 395.15 agencies shall satisfy those facilities' responsibilities for 395.16 initiating a background study on that individual. 395.17(d)(e) If an individual who is affiliated with a program 395.18 or facility regulated by the department of human services or 395.19 department of health or who is affiliated with a nonlicensed 395.20 personal care provider organization, is convicted of a crime 395.21 constituting a disqualification under subdivision 3d, the 395.22 probation officer or corrections agent shall notify the 395.23 commissioner of the conviction. The commissioner, in 395.24 consultation with the commissioner of corrections, shall develop 395.25 forms and information necessary to implement this paragraph and 395.26 shall provide the forms and information to the commissioner of 395.27 corrections for distribution to local probation officers and 395.28 corrections agents. The commissioner shall inform individuals 395.29 subject to a background study that criminal convictions for 395.30 disqualifying crimes will be reported to the commissioner by the 395.31 corrections system. A probation officer, corrections agent, or 395.32 corrections agency is not civilly or criminally liable for 395.33 disclosing or failing to disclose the information required by 395.34 this paragraph. Upon receipt of disqualifying information, the 395.35 commissioner shall provide the notifications required in 395.36 subdivision 3a, as appropriate to agencies on record as having 396.1 initiated a background study or making a request for 396.2 documentation of the background study status of the individual. 396.3 This paragraph does not apply to family day care and child 396.4 foster care programs. 396.5(e)(f) The individual who is the subject of the study must 396.6 provide the applicant or license holder with sufficient 396.7 information to ensure an accurate study including the 396.8 individual's first, middle, and last name; home address, city, 396.9 county, and state of residence for the past five years; zip 396.10 code; sex; date of birth; and driver's license number. The 396.11 applicant or license holder shall provide this information about 396.12 an individual in paragraph(c)(d), clauses (1) to (5), on forms 396.13 prescribed by the commissioner. By January 1, 2000, for 396.14 background studies conducted by the department of human 396.15 services, the commissioner shall implement a system for the 396.16 electronic transmission of: (1) background study information to 396.17 the commissioner; and (2) background study results to the 396.18 license holder. The commissioner may request additional 396.19 information of the individual, which shall be optional for the 396.20 individual to provide, such as the individual's social security 396.21 number or race. 396.22(f)(g) Except for child foster care, adult foster care, 396.23 and family day care homes, a study must include information 396.24 related to names of substantiated perpetrators of maltreatment 396.25 of vulnerable adults that has been received by the commissioner 396.26 as required under section 626.557, subdivision 9c, paragraph 396.27 (i), and the commissioner's records relating to the maltreatment 396.28 of minors in licensed programs, information from juvenile courts 396.29 as required in paragraph(c)(d) for persons listed in paragraph 396.30(c)(d), clause (2), and information from the bureau of criminal 396.31 apprehension. For child foster care, adult foster care, and 396.32 family day care homes, the study must include information from 396.33 the county agency's record of substantiated maltreatment of 396.34 adults, and the maltreatment of minors, information from 396.35 juvenile courts as required in paragraph(c)(d) for persons 396.36 listed in paragraph(c)(d), clause (2), and information from 397.1 the bureau of criminal apprehension. The commissioner may also 397.2 review arrest and investigative information from the bureau of 397.3 criminal apprehension, the commissioner of health, a county 397.4 attorney, county sheriff, county agency, local chief of police, 397.5 other states, the courts, or the Federal Bureau of Investigation 397.6 if the commissioner has reasonable cause to believe the 397.7 information is pertinent to the disqualification of an 397.8 individual listed in paragraph(c)(d), clauses (1) to (5). The 397.9 commissioner is not required to conduct more than one review of 397.10 a subject's records from the Federal Bureau of Investigation if 397.11 a review of the subject's criminal history with the Federal 397.12 Bureau of Investigation has already been completed by the 397.13 commissioner and there has been no break in the subject's 397.14 affiliation with the license holder who initiated the background 397.15 studies. 397.16 When the commissioner has reasonable cause to believe that 397.17 further pertinent information may exist on the subject, the 397.18 subject shall provide a set of classifiable fingerprints 397.19 obtained from an authorized law enforcement agency. For 397.20 purposes of requiring fingerprints, the commissioner shall be 397.21 considered to have reasonable cause under, but not limited to, 397.22 the following circumstances: 397.23 (1) information from the bureau of criminal apprehension 397.24 indicates that the subject is a multistate offender; 397.25 (2) information from the bureau of criminal apprehension 397.26 indicates that multistate offender status is undetermined; or 397.27 (3) the commissioner has received a report from the subject 397.28 or a third party indicating that the subject has a criminal 397.29 history in a jurisdiction other than Minnesota. 397.30(g)(h) An applicant'sor, license holder's, or 397.31 registrant's failure or refusal to cooperate with the 397.32 commissioner is reasonable cause to disqualify a subject, deny a 397.33 license application or immediately suspend, suspend, or revoke a 397.34 license or registration. Failure or refusal of an individual to 397.35 cooperate with the study is just cause for denying or 397.36 terminating employment of the individual if the individual's 398.1 failure or refusal to cooperate could cause the applicant's 398.2 application to be denied or the license holder's license to be 398.3 immediately suspended, suspended, or revoked. 398.4(h)(i) The commissioner shall not consider an application 398.5 to be complete until all of the information required to be 398.6 provided under this subdivision has been received. 398.7(i)(j) No person in paragraph(c)(d), clause (1), (2), 398.8 (3), (4), or (5), who is disqualified as a result of this 398.9 section may be retained by the agency in a position involving 398.10 direct contact with persons served by the program. 398.11(j)(k) Termination of persons in paragraph(c)(d), clause 398.12 (1), (2), (3), (4), or (5), made in good faith reliance on a 398.13 notice of disqualification provided by the commissioner shall 398.14 not subject the applicant or license holder to civil liability. 398.15(k)(l) The commissioner may establish records to fulfill 398.16 the requirements of this section. 398.17(l)(m) The commissioner may not disqualify an individual 398.18 subject to a study under this section because that person has, 398.19 or has had, a mental illness as defined in section 245.462, 398.20 subdivision 20. 398.21(m)(n) An individual subject to disqualification under 398.22 this subdivision has the applicable rights in subdivision 3a, 398.23 3b, or 3c. 398.24(n)(o) For the purposes of background studies completed by 398.25 tribal organizations performing licensing activities otherwise 398.26 required of the commissioner under this chapter, after obtaining 398.27 consent from the background study subject, tribal licensing 398.28 agencies shall have access to criminal history data in the same 398.29 manner as county licensing agencies and private licensing 398.30 agencies under this chapter. 398.31 Sec. 8. Minnesota Statutes 2000, section 245A.04, 398.32 subdivision 3a, is amended to read: 398.33 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 398.34 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 398.35 commissioner shall notify the applicantor, license holder, or 398.36 registrant and the individual who is the subject of the study, 399.1 in writing or by electronic transmission, of the results of the 399.2 study. When the study is completed, a notice that the study was 399.3 undertaken and completed shall be maintained in the personnel 399.4 files of the program. For studies on individuals pertaining to 399.5 a license to provide family day care or group family day care, 399.6 foster care for children in the provider's own home, or foster 399.7 care or day care services for adults in the provider's own home, 399.8 the commissioner is not required to provide a separate notice of 399.9 the background study results to the individual who is the 399.10 subject of the study unless the study results in a 399.11 disqualification of the individual. 399.12 The commissioner shall notify the individual studied if the 399.13 information in the study indicates the individual is 399.14 disqualified from direct contact with persons served by the 399.15 program. The commissioner shall disclose the information 399.16 causing disqualification and instructions on how to request a 399.17 reconsideration of the disqualification to the individual 399.18 studied. An applicant or license holder who is not the subject 399.19 of the study shall be informed that the commissioner has found 399.20 information that disqualifies the subject from direct contact 399.21 with persons served by the program. However, only the 399.22 individual studied must be informed of the information contained 399.23 in the subject's background study unless the only basis for the 399.24 disqualification is failure to cooperate, the Data Practices Act 399.25 provides for release of the information, or the individual 399.26 studied authorizes the release of the information. 399.27 (b) If the commissioner determines that the individual 399.28 studied has a disqualifying characteristic, the commissioner 399.29 shall review the information immediately available and make a 399.30 determination as to the subject's immediate risk of harm to 399.31 persons served by the program where the individual studied will 399.32 have direct contact. The commissioner shall consider all 399.33 relevant information available, including the following factors 399.34 in determining the immediate risk of harm: the recency of the 399.35 disqualifying characteristic; the recency of discharge from 399.36 probation for the crimes; the number of disqualifying 400.1 characteristics; the intrusiveness or violence of the 400.2 disqualifying characteristic; the vulnerability of the victim 400.3 involved in the disqualifying characteristic; and the similarity 400.4 of the victim to the persons served by the program where the 400.5 individual studied will have direct contact. The commissioner 400.6 may determine that the evaluation of the information immediately 400.7 available gives the commissioner reason to believe one of the 400.8 following: 400.9 (1) The individual poses an imminent risk of harm to 400.10 persons served by the program where the individual studied will 400.11 have direct contact. If the commissioner determines that an 400.12 individual studied poses an imminent risk of harm to persons 400.13 served by the program where the individual studied will have 400.14 direct contact, the individual and the license holder must be 400.15 sent a notice of disqualification. The commissioner shall order 400.16 the license holder to immediately remove the individual studied 400.17 from direct contact. The notice to the individual studied must 400.18 include an explanation of the basis of this determination. 400.19 (2) The individual poses a risk of harm requiring 400.20 continuous supervision while providing direct contact services 400.21 during the period in which the subject may request a 400.22 reconsideration. If the commissioner determines that an 400.23 individual studied poses a risk of harm that requires continuous 400.24 supervision, the individual and the license holder must be sent 400.25 a notice of disqualification. The commissioner shall order the 400.26 license holder to immediately remove the individual studied from 400.27 direct contact services or assure that the individual studied is 400.28 within sight or hearing of another staff person when providing 400.29 direct contact services during the period in which the 400.30 individual may request a reconsideration of the 400.31 disqualification. If the individual studied does not submit a 400.32 timely request for reconsideration, or the individual submits a 400.33 timely request for reconsideration, but the disqualification is 400.34 not set aside for that license holder, the license holder will 400.35 be notified of the disqualification and ordered to immediately 400.36 remove the individual from any position allowing direct contact 401.1 with persons receiving services from the license holder. 401.2 (3) The individual does not pose an imminent risk of harm 401.3 or a risk of harm requiring continuous supervision while 401.4 providing direct contact services during the period in which the 401.5 subject may request a reconsideration. If the commissioner 401.6 determines that an individual studied does not pose a risk of 401.7 harm that requires continuous supervision, only the individual 401.8 must be sent a notice of disqualification. The license holder 401.9 must be sent a notice that more time is needed to complete the 401.10 individual's background study. If the individual studied 401.11 submits a timely request for reconsideration, and if the 401.12 disqualification is set aside for that license holder, the 401.13 license holder will receive the same notification received by 401.14 license holders in cases where the individual studied has no 401.15 disqualifying characteristic. If the individual studied does 401.16 not submit a timely request for reconsideration, or the 401.17 individual submits a timely request for reconsideration, but the 401.18 disqualification is not set aside for that license holder, the 401.19 license holder will be notified of the disqualification and 401.20 ordered to immediately remove the individual from any position 401.21 allowing direct contact with persons receiving services from the 401.22 license holder. 401.23 (c) County licensing agencies performing duties under this 401.24 subdivision may develop an alternative system for determining 401.25 the subject's immediate risk of harm to persons served by the 401.26 program, providing the notices under paragraph (b), and 401.27 documenting the action taken by the county licensing agency. 401.28 Each county licensing agency's implementation of the alternative 401.29 system is subject to approval by the commissioner. 401.30 Notwithstanding this alternative system, county licensing 401.31 agencies shall complete the requirements of paragraph (a). 401.32 Sec. 9. Minnesota Statutes 2000, section 245A.04, 401.33 subdivision 3b, is amended to read: 401.34 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 401.35 individual who is the subject of the disqualification may 401.36 request a reconsideration of the disqualification. 402.1 The individual must submit the request for reconsideration 402.2 to the commissioner in writing. A request for reconsideration 402.3 for an individual who has been sent a notice of disqualification 402.4 under subdivision 3a, paragraph (b), clause (1) or (2), must be 402.5 submitted within 30 calendar days of the disqualified 402.6 individual's receipt of the notice of disqualification. A 402.7 request for reconsideration for an individual who has been sent 402.8 a notice of disqualification under subdivision 3a, paragraph 402.9 (b), clause (3), must be submitted within 15 calendar days of 402.10 the disqualified individual's receipt of the notice of 402.11 disqualification. Removal of a disqualified individual from 402.12 direct contact shall be ordered if the individual does not 402.13 request reconsideration within the prescribed time, and for an 402.14 individual who submits a timely request for reconsideration, if 402.15 the disqualification is not set aside. The individual must 402.16 present information showing that: 402.17 (1) the information the commissioner relied upon is 402.18 incorrect or inaccurate. If the basis of a reconsideration 402.19 request is that a maltreatment determination or disposition 402.20 under section 626.556 or 626.557 is incorrect, and the 402.21 commissioner has issued a final order in an appeal of that 402.22 determination or disposition under section 256.045, the 402.23 commissioner's order is conclusive on the issue of maltreatment; 402.24 or 402.25 (2) the subject of the study does not pose a risk of harm 402.26 to any person served by the applicantor, license holder, or 402.27 registrant. 402.28 (b) The commissioner may set aside the disqualification 402.29 under this section if the commissioner finds that the 402.30 information the commissioner relied upon is incorrect or the 402.31 individual does not pose a risk of harm to any person served by 402.32 the applicantor, license holder, or registrant. In determining 402.33 that an individual does not pose a risk of harm, the 402.34 commissioner shall consider the consequences of the event or 402.35 events that lead to disqualification, whether there is more than 402.36 one disqualifying event, the vulnerability of the victim at the 403.1 time of the event, the time elapsed without a repeat of the same 403.2 or similar event, documentation of successful completion by the 403.3 individual studied of training or rehabilitation pertinent to 403.4 the event, and any other information relevant to 403.5 reconsideration. In reviewing a disqualification under this 403.6 section, the commissioner shall give preeminent weight to the 403.7 safety of each person to be served by the license holderor, 403.8 applicant, or registrant over the interests of the license 403.9 holderor, applicant, or registrant. 403.10 (c) Unless the information the commissioner relied on in 403.11 disqualifying an individual is incorrect, the commissioner may 403.12 not set aside the disqualification of an individual in 403.13 connection with a license to provide family day care for 403.14 children, foster care for children in the provider's own home, 403.15 or foster care or day care services for adults in the provider's 403.16 own home if: 403.17 (1) less than ten years have passed since the discharge of 403.18 the sentence imposed for the offense; and the individual has 403.19 been convicted of a violation of any offense listed in sections 403.20 609.20 (manslaughter in the first degree), 609.205 (manslaughter 403.21 in the second degree), criminal vehicular homicide under 609.21 403.22 (criminal vehicular homicide and injury), 609.215 (aiding 403.23 suicide or aiding attempted suicide), felony violations under 403.24 609.221 to 609.2231 (assault in the first, second, third, or 403.25 fourth degree), 609.713 (terroristic threats), 609.235 (use of 403.26 drugs to injure or to facilitate crime), 609.24 (simple 403.27 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 403.28 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 403.29 first or second degree), 609.71 (riot), burglary in the first or 403.30 second degree under 609.582 (burglary), 609.66 (dangerous 403.31 weapon), 609.665 (spring guns), 609.67 (machine guns and 403.32 short-barreled shotguns), 609.749 (harassment; stalking), 403.33 152.021 or 152.022 (controlled substance crime in the first or 403.34 second degree), 152.023, subdivision 1, clause (3) or (4), or 403.35 subdivision 2, clause (4) (controlled substance crime in the 403.36 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 404.1 (controlled substance crime in the fourth degree), 609.224, 404.2 subdivision 2, paragraph (c) (fifth-degree assault by a 404.3 caregiver against a vulnerable adult), 609.228 (great bodily 404.4 harm caused by distribution of drugs), 609.23 (mistreatment of 404.5 persons confined), 609.231 (mistreatment of residents or 404.6 patients), 609.2325 (criminal abuse of a vulnerable adult), 404.7 609.233 (criminal neglect of a vulnerable adult), 609.2335 404.8 (financial exploitation of a vulnerable adult), 609.234 (failure 404.9 to report), 609.265 (abduction), 609.2664 to 609.2665 404.10 (manslaughter of an unborn child in the first or second degree), 404.11 609.267 to 609.2672 (assault of an unborn child in the first, 404.12 second, or third degree), 609.268 (injury or death of an unborn 404.13 child in the commission of a crime), 617.293 (disseminating or 404.14 displaying harmful material to minors), a gross misdemeanor 404.15 offense under 609.324, subdivision 1 (other prohibited acts), a 404.16 gross misdemeanor offense under 609.378 (neglect or endangerment 404.17 of a child), a gross misdemeanor offense under 609.377 404.18 (malicious punishment of a child), 609.72, subdivision 3 404.19 (disorderly conduct against a vulnerable adult); or an attempt 404.20 or conspiracy to commit any of these offenses, as each of these 404.21 offenses is defined in Minnesota Statutes; or an offense in any 404.22 other state, the elements of which are substantially similar to 404.23 the elements of any of the foregoing offenses; 404.24 (2) regardless of how much time has passed since the 404.25 discharge of the sentence imposed for the offense, the 404.26 individual was convicted of a violation of any offense listed in 404.27 sections 609.185 to 609.195 (murder in the first, second, or 404.28 third degree), 609.2661 to 609.2663 (murder of an unborn child 404.29 in the first, second, or third degree), a felony offense under 404.30 609.377 (malicious punishment of a child), a felony offense 404.31 under 609.324, subdivision 1 (other prohibited acts), a felony 404.32 offense under 609.378 (neglect or endangerment of a child), 404.33 609.322 (solicitation, inducement, and promotion of 404.34 prostitution), 609.342 to 609.345 (criminal sexual conduct in 404.35 the first, second, third, or fourth degree), 609.352 404.36 (solicitation of children to engage in sexual conduct), 617.246 405.1 (use of minors in a sexual performance), 617.247 (possession of 405.2 pictorial representations of a minor), 609.365 (incest), a 405.3 felony offense under sections 609.2242 and 609.2243 (domestic 405.4 assault), a felony offense of spousal abuse, a felony offense of 405.5 child abuse or neglect, a felony offense of a crime against 405.6 children, or an attempt or conspiracy to commit any of these 405.7 offenses as defined in Minnesota Statutes, or an offense in any 405.8 other state, the elements of which are substantially similar to 405.9 any of the foregoing offenses; 405.10 (3) within the seven years preceding the study, the 405.11 individual committed an act that constitutes maltreatment of a 405.12 child under section 626.556, subdivision 10e, and that resulted 405.13 in substantial bodily harm as defined in section 609.02, 405.14 subdivision 7a, or substantial mental or emotional harm as 405.15 supported by competent psychological or psychiatric evidence; or 405.16 (4) within the seven years preceding the study, the 405.17 individual was determined under section 626.557 to be the 405.18 perpetrator of a substantiated incident of maltreatment of a 405.19 vulnerable adult that resulted in substantial bodily harm as 405.20 defined in section 609.02, subdivision 7a, or substantial mental 405.21 or emotional harm as supported by competent psychological or 405.22 psychiatric evidence. 405.23 In the case of any ground for disqualification under 405.24 clauses (1) to (4), if the act was committed by an individual 405.25 other than the applicantor, license holder, or registrant 405.26 residing in the applicant'sor, license holder's, or 405.27 registrant's home, the applicantor, license holder, or 405.28 registrant may seek reconsideration when the individual who 405.29 committed the act no longer resides in the home. 405.30 The disqualification periods provided under clauses (1), 405.31 (3), and (4) are the minimum applicable disqualification 405.32 periods. The commissioner may determine that an individual 405.33 should continue to be disqualified from licensure or 405.34 registration because the license holderor, registrant, or 405.35 applicant poses a risk of harm to a person served by that 405.36 individual after the minimum disqualification period has passed. 406.1 (d) The commissioner shall respond in writing or by 406.2 electronic transmission to all reconsideration requests for 406.3 which the basis for the request is that the information relied 406.4 upon by the commissioner to disqualify is incorrect or 406.5 inaccurate within 30 working days of receipt of a request and 406.6 all relevant information. If the basis for the request is that 406.7 the individual does not pose a risk of harm, the commissioner 406.8 shall respond to the request within 15 working days after 406.9 receiving the request for reconsideration and all relevant 406.10 information. If the disqualification is set aside, the 406.11 commissioner shall notify the applicant or license holder in 406.12 writing or by electronic transmission of the decision. 406.13 (e) Except as provided in subdivision 3c, the 406.14 commissioner's decision to disqualify an individual, including 406.15 the decision to grant or deny a rescission or set aside a 406.16 disqualification under this section, is the final administrative 406.17 agency action and shall not be subject to further review in a 406.18 contested case under chapter 14 involving a negative licensing 406.19 appeal taken in response to the disqualification or involving an 406.20 accuracy and completeness appeal under section 13.04. 406.21 Sec. 10. Minnesota Statutes 2000, section 245A.04, 406.22 subdivision 3d, is amended to read: 406.23 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 406.24 paragraph (b), when a background study completed under 406.25 subdivision 3 shows any of the following: a conviction of one 406.26 or more crimes listed in clauses (1) to (4); the individual has 406.27 admitted to or a preponderance of the evidence indicates the 406.28 individual has committed an act or acts that meet the definition 406.29 of any of the crimes listed in clauses (1) to (4); or an 406.30 administrative determination listed under clause (4), the 406.31 individual shall be disqualified from any position allowing 406.32 direct contact with persons receiving services from the license 406.33 holder or registrant: 406.34 (1) regardless of how much time has passed since the 406.35 discharge of the sentence imposed for the offense, and unless 406.36 otherwise specified, regardless of the level of the conviction, 407.1 the individual was convicted of any of the following offenses: 407.2 sections 609.185 (murder in the first degree); 609.19 (murder in 407.3 the second degree); 609.195 (murder in the third degree); 407.4 609.2661 (murder of an unborn child in the first degree); 407.5 609.2662 (murder of an unborn child in the second degree); 407.6 609.2663 (murder of an unborn child in the third degree); 407.7 609.322 (solicitation, inducement, and promotion of 407.8 prostitution); 609.342 (criminal sexual conduct in the first 407.9 degree); 609.343 (criminal sexual conduct in the second degree); 407.10 609.344 (criminal sexual conduct in the third degree); 609.345 407.11 (criminal sexual conduct in the fourth degree); 609.352 407.12 (solicitation of children to engage in sexual conduct); 609.365 407.13 (incest); felony offense under 609.377 (malicious punishment of 407.14 a child); a felony offense under 609.378 (neglect or 407.15 endangerment of a child); a felony offense under 609.324, 407.16 subdivision 1 (other prohibited acts); 617.246 (use of minors in 407.17 sexual performance prohibited); 617.247 (possession of pictorial 407.18 representations of minors); a felony offense under sections 407.19 609.2242 and 609.2243 (domestic assault), a felony offense of 407.20 spousal abuse, a felony offense of child abuse or neglect, a 407.21 felony offense of a crime against children; or attempt or 407.22 conspiracy to commit any of these offenses as defined in 407.23 Minnesota Statutes, or an offense in any other state or country, 407.24 where the elements are substantially similar to any of the 407.25 offenses listed in this clause; 407.26 (2) if less than 15 years have passed since the discharge 407.27 of the sentence imposed for the offense; and the individual has 407.28 received a felony conviction for a violation of any of these 407.29 offenses: sections 609.20 (manslaughter in the first degree); 407.30 609.205 (manslaughter in the second degree); 609.21 (criminal 407.31 vehicular homicide and injury); 609.215 (suicide); 609.221 to 407.32 609.2231 (assault in the first, second, third, or fourth 407.33 degree); repeat offenses under 609.224 (assault in the fifth 407.34 degree); repeat offenses under 609.3451 (criminal sexual conduct 407.35 in the fifth degree); 609.713 (terroristic threats); 609.235 407.36 (use of drugs to injure or facilitate crime); 609.24 (simple 408.1 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 408.2 609.255 (false imprisonment); 609.561 (arson in the first 408.3 degree); 609.562 (arson in the second degree); 609.563 (arson in 408.4 the third degree); repeat offenses under 617.23 (indecent 408.5 exposure; penalties); repeat offenses under 617.241 (obscene 408.6 materials and performances; distribution and exhibition 408.7 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 408.8 609.67 (machine guns and short-barreled shotguns); 609.749 408.9 (harassment; stalking; penalties); 609.228 (great bodily harm 408.10 caused by distribution of drugs); 609.2325 (criminal abuse of a 408.11 vulnerable adult); 609.2664 (manslaughter of an unborn child in 408.12 the first degree); 609.2665 (manslaughter of an unborn child in 408.13 the second degree); 609.267 (assault of an unborn child in the 408.14 first degree); 609.2671 (assault of an unborn child in the 408.15 second degree); 609.268 (injury or death of an unborn child in 408.16 the commission of a crime); 609.52 (theft); 609.2335 (financial 408.17 exploitation of a vulnerable adult); 609.521 (possession of 408.18 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 408.19 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 408.20 forged check); 609.635 (obtaining signature by false pretense); 408.21 609.27 (coercion); 609.275 (attempt to coerce); 609.687 408.22 (adulteration); 260C.301 (grounds for termination of parental 408.23 rights); and chapter 152 (drugs; controlled substance). An 408.24 attempt or conspiracy to commit any of these offenses, as each 408.25 of these offenses is defined in Minnesota Statutes; or an 408.26 offense in any other state or country, the elements of which are 408.27 substantially similar to the elements of the offenses in this 408.28 clause. If the individual studied is convicted of one of the 408.29 felonies listed in this clause, but the sentence is a gross 408.30 misdemeanor or misdemeanor disposition, the lookback period for 408.31 the conviction is the period applicable to the disposition, that 408.32 is the period for gross misdemeanors or misdemeanors; 408.33 (3) if less than ten years have passed since the discharge 408.34 of the sentence imposed for the offense; and the individual has 408.35 received a gross misdemeanor conviction for a violation of any 408.36 of the following offenses: sections 609.224 (assault in the 409.1 fifth degree); 609.2242 and 609.2243 (domestic assault); 409.2 violation of an order for protection under 518B.01, subdivision 409.3 14; 609.3451 (criminal sexual conduct in the fifth degree); 409.4 repeat offenses under 609.746 (interference with privacy); 409.5 repeat offenses under 617.23 (indecent exposure); 617.241 409.6 (obscene materials and performances); 617.243 (indecent 409.7 literature, distribution); 617.293 (harmful materials; 409.8 dissemination and display to minors prohibited); 609.71 (riot); 409.9 609.66 (dangerous weapons); 609.749 (harassment; stalking; 409.10 penalties); 609.224, subdivision 2, paragraph (c) (assault in 409.11 the fifth degree by a caregiver against a vulnerable adult); 409.12 609.23 (mistreatment of persons confined); 609.231 (mistreatment 409.13 of residents or patients); 609.2325 (criminal abuse of a 409.14 vulnerable adult); 609.233 (criminal neglect of a vulnerable 409.15 adult); 609.2335 (financial exploitation of a vulnerable adult); 409.16 609.234 (failure to report maltreatment of a vulnerable adult); 409.17 609.72, subdivision 3 (disorderly conduct against a vulnerable 409.18 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 409.19 a child); 609.377 (malicious punishment of a child); 609.324, 409.20 subdivision 1a (other prohibited acts; minor engaged in 409.21 prostitution); 609.33 (disorderly house); 609.52 (theft); 409.22 609.582 (burglary); 609.631 (check forgery; offering a forged 409.23 check); 609.275 (attempt to coerce); or an attempt or conspiracy 409.24 to commit any of these offenses, as each of these offenses is 409.25 defined in Minnesota Statutes; or an offense in any other state 409.26 or country, the elements of which are substantially similar to 409.27 the elements of any of the offenses listed in this clause. If 409.28 the defendant is convicted of one of the gross misdemeanors 409.29 listed in this clause, but the sentence is a misdemeanor 409.30 disposition, the lookback period for the conviction is the 409.31 period applicable to misdemeanors; or 409.32 (4) if less than seven years have passed since the 409.33 discharge of the sentence imposed for the offense; and the 409.34 individual has received a misdemeanor conviction for a violation 409.35 of any of the following offenses: sections 609.224 (assault in 409.36 the fifth degree); 609.2242 (domestic assault); violation of an 410.1 order for protection under 518B.01 (Domestic Abuse Act); 410.2 violation of an order for protection under 609.3232 (protective 410.3 order authorized; procedures; penalties); 609.746 (interference 410.4 with privacy); 609.79 (obscene or harassing phone calls); 410.5 609.795 (letter, telegram, or package; opening; harassment); 410.6 617.23 (indecent exposure; penalties); 609.2672 (assault of an 410.7 unborn child in the third degree); 617.293 (harmful materials; 410.8 dissemination and display to minors prohibited); 609.66 410.9 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 410.10 exploitation of a vulnerable adult); 609.234 (failure to report 410.11 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 410.12 (coercion); or an attempt or conspiracy to commit any of these 410.13 offenses, as each of these offenses is defined in Minnesota 410.14 Statutes; or an offense in any other state or country, the 410.15 elements of which are substantially similar to the elements of 410.16 any of the offenses listed in this clause; failure to make 410.17 required reports under section 626.556, subdivision 3, or 410.18 626.557, subdivision 3, for incidents in which: (i) the final 410.19 disposition under section 626.556 or 626.557 was substantiated 410.20 maltreatment, and (ii) the maltreatment was recurring or 410.21 serious; or substantiated serious or recurring maltreatment of a 410.22 minor under section 626.556 or of a vulnerable adult under 410.23 section 626.557 for which there is a preponderance of evidence 410.24 that the maltreatment occurred, and that the subject was 410.25 responsible for the maltreatment. 410.26 For the purposes of this section, "serious maltreatment" 410.27 means sexual abuse; maltreatment resulting in death; or 410.28 maltreatment resulting in serious injury which reasonably 410.29 requires the care of a physician whether or not the care of a 410.30 physician was sought; or abuse resulting in serious injury. For 410.31 purposes of this section, "abuse resulting in serious injury" 410.32 means: bruises, bites, skin laceration or tissue damage; 410.33 fractures; dislocations; evidence of internal injuries; head 410.34 injuries with loss of consciousness; extensive second-degree or 410.35 third-degree burns and other burns for which complications are 410.36 present; extensive second-degree or third-degree frostbite, and 411.1 others for which complications are present; irreversible 411.2 mobility or avulsion of teeth; injuries to the eyeball; 411.3 ingestion of foreign substances and objects that are harmful; 411.4 near drowning; and heat exhaustion or sunstroke. For purposes 411.5 of this section, "care of a physician" is treatment received or 411.6 ordered by a physician, but does not include diagnostic testing, 411.7 assessment, or observation. For the purposes of this section, 411.8 "recurring maltreatment" means more than one incident of 411.9 maltreatment for which there is a preponderance of evidence that 411.10 the maltreatment occurred, and that the subject was responsible 411.11 for the maltreatment. 411.12 (b) If the subject of a background study is licensed by a 411.13 health-related licensing board, the board shall make the 411.14 determination regarding a disqualification under this 411.15 subdivision based on a finding of substantiated maltreatment 411.16 under section 626.556 or 626.557. The commissioner shall notify 411.17 the health-related licensing board if a background study shows 411.18 that a licensee would be disqualified because of substantiated 411.19 maltreatment and the board shall make a determination under 411.20 section 214.104. 411.21 Sec. 11. [256B.039] [REPORTING OF SUPPLEMENTAL NURSING 411.22 SERVICES AGENCY USE.] 411.23 Beginning March 1, 2002, the commissioner shall to report 411.24 to the legislature annually on the use of supplemental nursing 411.25 services, including the number of hours worked by supplemental 411.26 nursing services agency personnel and payments to supplemental 411.27 nursing services agencies. 411.28 ARTICLE 9 411.29 LONG-TERM CARE INSURANCE 411.30 Section 1. Minnesota Statutes 2000, section 62A.48, 411.31 subdivision 4, is amended to read: 411.32 Subd. 4. [LOSS RATIO.] The anticipated loss ratio for 411.33 long-term care policies must not be less than 65 percent for 411.34 policies issued on a group basis or 60 percent for policies 411.35 issued on an individual or mass-market basis. This subdivision 411.36 does not apply to policies issued on or after January 1, 2002, 412.1 that comply with sections 62S.021 and 62S.081. 412.2 [EFFECTIVE DATE.] This section is effective the day 412.3 following final enactment. 412.4 Sec. 2. Minnesota Statutes 2000, section 62A.48, is 412.5 amended by adding a subdivision to read: 412.6 Subd. 10. [REGULATION OF PREMIUMS AND PREMIUM 412.7 INCREASES.] Policies issued under sections 62A.46 to 62A.56 on 412.8 or after January 1, 2002, must comply with sections 62S.021, 412.9 62S.081, 62S.265, and 62S.266 to the same extent as policies 412.10 issued under chapter 62S. 412.11 [EFFECTIVE DATE.] This section is effective the day 412.12 following final enactment. 412.13 Sec. 3. Minnesota Statutes 2000, section 62A.48, is 412.14 amended by adding a subdivision to read: 412.15 Subd. 11. [NONFORFEITURE BENEFITS.] Policies issued under 412.16 sections 62A.46 to 62A.56 on or after January 1, 2002, must 412.17 comply with section 62S.02, subdivision 2, to the same extent as 412.18 policies issued under chapter 62S. 412.19 [EFFECTIVE DATE.] This section is effective the day 412.20 following final enactment. 412.21 Sec. 4. Minnesota Statutes 2000, section 62S.01, is 412.22 amended by adding a subdivision to read: 412.23 Subd. 13a. [EXCEPTIONAL INCREASE.] (a) "Exceptional 412.24 increase" means only those increases filed by an insurer as 412.25 exceptional for which the commissioner determines the need for 412.26 the premium rate increase is justified due to changes in laws or 412.27 rules applicable to long-term care coverage in this state, or 412.28 due to increased and unexpected utilization that affects the 412.29 majority of insurers of similar products. 412.30 (b) Except as provided in section 62S.265, exceptional 412.31 increases are subject to the same requirements as other premium 412.32 rate schedule increases. The commissioner may request a review 412.33 by an independent actuary or a professional actuarial body of 412.34 the basis for a request that an increase be considered an 412.35 exceptional increase. The commissioner, in determining that the 412.36 necessary basis for an exceptional increase exists, shall also 413.1 determine any potential offsets to higher claims costs. 413.2 [EFFECTIVE DATE.] This section is effective the day 413.3 following final enactment. 413.4 Sec. 5. Minnesota Statutes 2000, section 62S.01, is 413.5 amended by adding a subdivision to read: 413.6 Subd. 17a. [INCIDENTAL.] "Incidental," as used in section 413.7 62S.265, subdivision 10, means that the value of the long-term 413.8 care benefits provided is less than ten percent of the total 413.9 value of the benefits provided over the life of the policy. 413.10 These values shall be measured as of the date of issue. 413.11 [EFFECTIVE DATE.] This section is effective the day 413.12 following final enactment. 413.13 Sec. 6. Minnesota Statutes 2000, section 62S.01, is 413.14 amended by adding a subdivision to read: 413.15 Subd. 23a. [QUALIFIED ACTUARY.] "Qualified actuary" means 413.16 a member in good standing of the American Academy of Actuaries. 413.17 [EFFECTIVE DATE.] This section is effective the day 413.18 following final enactment. 413.19 Sec. 7. Minnesota Statutes 2000, section 62S.01, is 413.20 amended by adding a subdivision to read: 413.21 Subd. 25a. [SIMILAR POLICY FORMS.] "Similar policy forms" 413.22 means all of the long-term care insurance policies and 413.23 certificates issued by an insurer in the same long-term care 413.24 benefit classification as the policy form being considered. 413.25 Certificates of groups that meet the definition in section 413.26 62S.01, subdivision 15, clause (1), are not considered similar 413.27 to certificates or policies otherwise issued as long-term care 413.28 insurance, but are similar to other comparable certificates with 413.29 the same long-term care benefit classifications. For purposes 413.30 of determining similar policy forms, long-term care benefit 413.31 classifications are defined as follows: institutional long-term 413.32 care benefits only, noninstitutional long-term care benefits 413.33 only, or comprehensive long-term care benefits. 413.34 [EFFECTIVE DATE.] This section is effective the day 413.35 following final enactment. 413.36 Sec. 8. [62S.021] [LONG-TERM CARE INSURANCE; INITIAL 414.1 FILING.] 414.2 Subdivision 1. [APPLICABILITY.] This section applies to 414.3 any long-term care policy issued in this state on or after 414.4 January 1, 2002, under this chapter or sections 62A.46 to 62A.56. 414.5 Subd. 2. [REQUIRED SUBMISSION TO COMMISSIONER.] An insurer 414.6 shall provide the following information to the commissioner 30 414.7 days prior to making a long-term care insurance form available 414.8 for sale: 414.9 (1) a copy of the disclosure documents required in section 414.10 62S.081; and 414.11 (2) an actuarial certification consisting of at least the 414.12 following: 414.13 (i) a statement that the initial premium rate schedule is 414.14 sufficient to cover anticipated costs under moderately adverse 414.15 experience and that the premium rate schedule is reasonably 414.16 expected to be sustainable over the life of the form with no 414.17 future premium increases anticipated; 414.18 (ii) a statement that the policy design and coverage 414.19 provided have been reviewed and taken into consideration; 414.20 (iii) a statement that the underwriting and claims 414.21 adjudication processes have been reviewed and taken into 414.22 consideration; and 414.23 (iv) a complete description of the basis for contract 414.24 reserves that are anticipated to be held under the form, to 414.25 include: 414.26 (A) sufficient detail or sample calculations provided so as 414.27 to have a complete depiction of the reserve amounts to be held; 414.28 (B) a statement that the assumptions used for reserves 414.29 contain reasonable margins for adverse experience; 414.30 (C) a statement that the net valuation premium for renewal 414.31 years does not increase, except for attained age rating where 414.32 permitted; 414.33 (D) a statement that the difference between the gross 414.34 premium and the net valuation premium for renewal years is 414.35 sufficient to cover expected renewal expenses, or if such a 414.36 statement cannot be made, a complete description of the 415.1 situations where this does not occur. An aggregate distribution 415.2 of anticipated issues may be used as long as the underlying 415.3 gross premiums maintain a reasonably consistent relationship. 415.4 If the gross premiums for certain age groups appear to be 415.5 inconsistent with this requirement, the commissioner may request 415.6 a demonstration under item (i) based on a standard age 415.7 distribution; and 415.8 (E) either a statement that the premium rate schedule is 415.9 not less than the premium rate schedule for existing similar 415.10 policy forms also available from the insurer except for 415.11 reasonable differences attributable to benefits, or a comparison 415.12 of the premium schedules for similar policy forms that are 415.13 currently available from the insurer with an explanation of the 415.14 differences. 415.15 Subd. 3. [ACTUARIAL DEMONSTRATION.] The commissioner may 415.16 request an actuarial demonstration that benefits are reasonable 415.17 in relation to premiums. The actuarial demonstration shall 415.18 include either premium and claim experience on similar policy 415.19 forms, adjusted for any premium or benefit differences, relevant 415.20 and credible data from other studies, or both. If the 415.21 commissioner asks for additional information under this 415.22 subdivision, the 30-day time limit in subdivision 2 does not 415.23 include the time during which the insurer is preparing the 415.24 requested information. 415.25 [EFFECTIVE DATE.] This section is effective the day 415.26 following final enactment. 415.27 Sec. 9. [62S.081] [REQUIRED DISCLOSURE OF RATING PRACTICES 415.28 TO CONSUMERS.] 415.29 Subdivision 1. [APPLICATION.] This section shall apply as 415.30 follows: 415.31 (a) Except as provided in paragraph (b), this section 415.32 applies to any long-term care policy or certificate issued in 415.33 this state on or after January 1, 2002. 415.34 (b) For certificates issued on or after the effective date 415.35 of this section under a policy of group long-term care insurance 415.36 as defined in section 62S.01, subdivision 15, that was in force 416.1 on the effective date of this section, this section applies on 416.2 the policy anniversary following June 30, 2002. 416.3 Subd. 2. [REQUIRED DISCLOSURES.] Other than policies for 416.4 which no applicable premium rate or rate schedule increases can 416.5 be made, insurers shall provide all of the information listed in 416.6 this subdivision to the applicant at the time of application or 416.7 enrollment, unless the method of application does not allow for 416.8 delivery at that time; in this case, an insurer shall provide 416.9 all of the information listed in this subdivision to the 416.10 applicant no later than at the time of delivery of the policy or 416.11 certificate: 416.12 (1) a statement that the policy may be subject to rate 416.13 increases in the future; 416.14 (2) an explanation of potential future premium rate 416.15 revisions and the policyholder's or certificate holder's option 416.16 in the event of a premium rate revision; 416.17 (3) the premium rate or rate schedules applicable to the 416.18 applicant that will be in effect until a request is made for an 416.19 increase; 416.20 (4) a general explanation for applying premium rate or rate 416.21 schedule adjustments that must include: 416.22 (i) a description of when premium rate or rate schedule 416.23 adjustments will be effective, for example the next anniversary 416.24 date or the next billing date; and 416.25 (ii) the right to a revised premium rate or rate schedule 416.26 as provided in clause (3) if the premium rate or rate schedule 416.27 is changed; and 416.28 (5)(i) information regarding each premium rate increase on 416.29 this policy form or similar policy forms over the past ten years 416.30 for this state or any other state that, at a minimum, identifies: 416.31 (A) the policy forms for which premium rates have been 416.32 increased; 416.33 (B) the calendar years when the form was available for 416.34 purchase; and 416.35 (C) the amount or percent of each increase. The percentage 416.36 may be expressed as a percentage of the premium rate prior to 417.1 the increase and may also be expressed as minimum and maximum 417.2 percentages if the rate increase is variable by rating 417.3 characteristics; 417.4 (ii) the insurer may, in a fair manner, provide additional 417.5 explanatory information related to the rate increases; 417.6 (iii) an insurer has the right to exclude from the 417.7 disclosure premium rate increases that apply only to blocks of 417.8 business acquired from other nonaffiliated insurers or the 417.9 long-term care policies acquired from other nonaffiliated 417.10 insurers when those increases occurred prior to the acquisition; 417.11 (iv) if an acquiring insurer files for a rate increase on a 417.12 long-term care policy form acquired from nonaffiliated insurers 417.13 or a block of policy forms acquired from nonaffiliated insurers 417.14 on or before the later of the effective date of this section, or 417.15 the end of a 24-month period following the acquisition of the 417.16 block of policies, the acquiring insurer may exclude that rate 417.17 increase from the disclosure. However, the nonaffiliated 417.18 selling company must include the disclosure of that rate 417.19 increase according to item (i); and 417.20 (v) if the acquiring insurer in item (iv) files for a 417.21 subsequent rate increase, even within the 24-month period, on 417.22 the same policy form acquired from nonaffiliated insurers or 417.23 block of policy forms acquired from nonaffiliated insurers 417.24 referenced in item (iv), the acquiring insurer shall make all 417.25 disclosures required by this subdivision, including disclosure 417.26 of the earlier rate increase referenced in item (iv). 417.27 Subd. 3. [ACKNOWLEDGMENT.] An applicant shall sign an 417.28 acknowledgment at the time of application, unless the method of 417.29 application does not allow for signature at that time, that the 417.30 insurer made the disclosure required under subdivision 2. If, 417.31 due to the method of application, the applicant cannot sign an 417.32 acknowledgment at the time of application, the applicant shall 417.33 sign no later than at the time of delivery of the policy or 417.34 certificate. 417.35 Subd. 4. [FORMS.] An insurer shall use the forms in 417.36 Appendices B and F of the Long-term Care Insurance Model 418.1 Regulation adopted by the National Association of Insurance 418.2 Commissioners to comply with the requirements of subdivisions 1 418.3 and 2. 418.4 Subd. 5. [NOTICE OF INCREASE.] An insurer shall provide 418.5 notice of an upcoming premium rate schedule increase, after the 418.6 increase has been approved by the commissioner, to all 418.7 policyholders or certificate holders, if applicable, at least 45 418.8 days prior to the implementation of the premium rate schedule 418.9 increase by the insurer. The notice shall include the 418.10 information required by subdivision 2 when the rate increase is 418.11 implemented. 418.12 [EFFECTIVE DATE.] This section is effective the day 418.13 following final enactment. 418.14 Sec. 10. Minnesota Statutes 2000, section 62S.26, is 418.15 amended to read: 418.16 62S.26 [LOSS RATIO.] 418.17 (a) The minimum loss ratio must be at least 60 percent, 418.18 calculated in a manner which provides for adequate reserving of 418.19 the long-term care insurance risk. In evaluating the expected 418.20 loss ratio, the commissioner shall give consideration to all 418.21 relevant factors, including: 418.22 (1) statistical credibility of incurred claims experience 418.23 and earned premiums; 418.24 (2) the period for which rates are computed to provide 418.25 coverage; 418.26 (3) experienced and projected trends; 418.27 (4) concentration of experience within early policy 418.28 duration; 418.29 (5) expected claim fluctuation; 418.30 (6) experience refunds, adjustments, or dividends; 418.31 (7) renewability features; 418.32 (8) all appropriate expense factors; 418.33 (9) interest; 418.34 (10) experimental nature of the coverage; 418.35 (11) policy reserves; 418.36 (12) mix of business by risk classification; and 419.1 (13) product features such as long elimination periods, 419.2 high deductibles, and high maximum limits. 419.3 (b) This section does not apply to policies or certificates 419.4 that are subject to sections 62S.021, 62S.081, and 62S.265, and 419.5 that comply with those sections. 419.6 [EFFECTIVE DATE.] This section is effective the day 419.7 following final enactment. 419.8 Sec. 11. [62S.265] [PREMIUM RATE SCHEDULE INCREASES.] 419.9 Subdivision 1. [APPLICABILITY.] (a) Except as provided in 419.10 paragraph (b), this section applies to any long-term care policy 419.11 or certificate issued in this state on or after January 1, 2002, 419.12 under this chapter or sections 62A.46 to 62A.56. 419.13 (b) For certificates issued on or after the effective date 419.14 of this section under a group long-term care insurance policy as 419.15 defined in section 62S.01, subdivision 15, that was in force on 419.16 the effective date of this section, this section applies on the 419.17 policy anniversary following June 30, 2002. 419.18 Subd. 2. [NOTICE.] An insurer shall file a requested 419.19 premium rate schedule increase, including an exceptional 419.20 increase, to the commissioner for prior approval at least 60 419.21 days prior to the notice to the policyholders and shall include: 419.22 (1) all information required by section 62S.081; 419.23 (2) certification by a qualified actuary that: 419.24 (i) if the requested premium rate schedule increase is 419.25 implemented and the underlying assumptions, which reflect 419.26 moderately adverse conditions, are realized, no further premium 419.27 rate schedule increases are anticipated; and 419.28 (ii) the premium rate filing complies with this section; 419.29 (3) an actuarial memorandum justifying the rate schedule 419.30 change request that includes: 419.31 (i) lifetime projections of earned premiums and incurred 419.32 claims based on the filed premium rate schedule increase and the 419.33 method and assumptions used in determining the projected values, 419.34 including reflection of any assumptions that deviate from those 419.35 used for pricing other forms currently available for sale; 419.36 (A) annual values for the five years preceding and the 420.1 three years following the valuation date shall be provided 420.2 separately; 420.3 (B) the projections must include the development of the 420.4 lifetime loss ratio, unless the rate increase is an exceptional 420.5 increase; 420.6 (C) the projections must demonstrate compliance with 420.7 subdivision 3; and 420.8 (D) for exceptional increases, the projected experience 420.9 must be limited to the increases in claims expenses attributable 420.10 to the approved reasons for the exceptional increase and, if the 420.11 commissioner determines that offsets to higher claim costs may 420.12 exist, the insurer shall use appropriate net projected 420.13 experience; 420.14 (ii) disclosure of how reserves have been incorporated in 420.15 this rate increase whenever the rate increase will trigger 420.16 contingent benefit upon lapse; 420.17 (iii) disclosure of the analysis performed to determine why 420.18 a rate adjustment is necessary, which pricing assumptions were 420.19 not realized and why, and what other actions taken by the 420.20 company have been relied upon by the actuary; 420.21 (iv) a statement that policy design, underwriting, and 420.22 claims adjudication practices have been taken into 420.23 consideration; and 420.24 (v) if it is necessary to maintain consistent premium rates 420.25 for new certificates and certificates receiving a rate increase, 420.26 the insurer shall file composite rates reflecting projections of 420.27 new certificates; 420.28 (4) a statement that renewal premium rate schedules are not 420.29 greater than new business premium rate schedules except for 420.30 differences attributable to benefits, unless sufficient 420.31 justification is provided to the commissioner; and 420.32 (5) sufficient information for review and approval of the 420.33 premium rate schedule increase by the commissioner. 420.34 Subd. 3. [REQUIREMENTS PERTAINING TO RATE INCREASES.] All 420.35 premium rate schedule increases must be determined according to 420.36 the following requirements: 421.1 (1) exceptional increases shall provide that 70 percent of 421.2 the present value of projected additional premiums from the 421.3 exceptional increase will be returned to policyholders in 421.4 benefits; 421.5 (2) premium rate schedule increases must be calculated so 421.6 that the sum of the accumulated value of incurred claims, 421.7 without the inclusion of active life reserves, and the present 421.8 value of future projected incurred claims, without the inclusion 421.9 of active life reserves, will not be less than the sum of the 421.10 following: 421.11 (i) the accumulated value of the initial earned premium 421.12 times 58 percent; 421.13 (ii) 85 percent of the accumulated value of prior premium 421.14 rate schedule increases on an earned basis; 421.15 (iii) the present value of future projected initial earned 421.16 premiums times 58 percent; and 421.17 (iv) 85 percent of the present value of future projected 421.18 premiums not in item (iii) on an earned basis; 421.19 (3) if a policy form has both exceptional and other 421.20 increases, the values in clause (2), items (ii) and (iv), must 421.21 also include 70 percent for exceptional rate increase amounts; 421.22 and 421.23 (4) all present and accumulated values used to determine 421.24 rate increases must use the maximum valuation interest rate for 421.25 contract reserves permitted for valuation of whole life 421.26 insurance policies issued in this state on the same date. The 421.27 actuary shall disclose as part of the actuarial memorandum the 421.28 use of any appropriate averages. 421.29 Subd. 4. [PROJECTIONS.] For each rate increase that is 421.30 implemented, the insurer shall file for approval by the 421.31 commissioner updated projections, as defined in subdivision 2, 421.32 clause (3), item (i), annually for the next three years and 421.33 include a comparison of actual results to projected values. The 421.34 commissioner may extend the period to greater than three years 421.35 if actual results are not consistent with projected values from 421.36 prior projections. For group insurance policies that meet the 422.1 conditions in subdivision 11, the projections required by this 422.2 subdivision must be provided to the policyholder in lieu of 422.3 filing with the commissioner. 422.4 Subd. 5. [LIFETIME PROJECTIONS.] If any premium rate in 422.5 the revised premium rate schedule is greater than 200 percent of 422.6 the comparable rate in the initial premium schedule, lifetime 422.7 projections, as defined in subdivision 2, clause (3), item (i), 422.8 must be filed for approval by the commissioner every five years 422.9 following the end of the required period in subdivision 4. For 422.10 group insurance policies that meet the conditions in subdivision 422.11 11, the projections required by this subdivision must be 422.12 provided to the policyholder in lieu of filing with the 422.13 commissioner. 422.14 Subd. 6. [EFFECT OF ACTUAL EXPERIENCE.] (a) If the 422.15 commissioner has determined that the actual experience following 422.16 a rate increase does not adequately match the projected 422.17 experience and that the current projections under moderately 422.18 adverse conditions demonstrate that incurred claims will not 422.19 exceed proportions of premiums specified in subdivision 3, the 422.20 commissioner may require the insurer to implement any of the 422.21 following: 422.22 (1) premium rate schedule adjustments; or 422.23 (2) other measures to reduce the difference between the 422.24 projected and actual experience. 422.25 (b) In determining whether the actual experience adequately 422.26 matches the projected experience, consideration should be given 422.27 to subdivision 2, clause (3), item (v), if applicable. 422.28 Subd. 7. [CONTINGENT BENEFIT UPON LAPSE.] If the majority 422.29 of the policies or certificates to which the increase is 422.30 applicable are eligible for the contingent benefit upon lapse, 422.31 the insurer shall file: 422.32 (1) a plan, subject to commissioner approval, for improved 422.33 administration or claims processing designed to eliminate the 422.34 potential for further deterioration of the policy form requiring 422.35 further premium rate schedule increases, or both, or a 422.36 demonstration that appropriate administration and claims 423.1 processing have been implemented or are in effect; otherwise, 423.2 the commissioner may impose the condition in subdivision 8, 423.3 paragraph (b); and 423.4 (2) the original anticipated lifetime loss ratio, and the 423.5 premium rate schedule increase that would have been calculated 423.6 according to subdivision 3 had the greater of the original 423.7 anticipated lifetime loss ratio or 58 percent been used in the 423.8 calculations described in subdivision 3, clause (2), items (i) 423.9 and (iii). 423.10 Subd. 8. [PROJECTED LAPSE RATES.] (a) For a rate increase 423.11 filing that meets the following criteria, the commissioner shall 423.12 review, for all policies included in the filing, the projected 423.13 lapse rates and past lapse rates during the 12 months following 423.14 each increase to determine if significant adverse lapsation has 423.15 occurred or is anticipated: 423.16 (1) the rate increase is not the first rate increase 423.17 requested for the specific policy form or forms; 423.18 (2) the rate increase is not an exceptional increase; and 423.19 (3) the majority of the policies or certificates to which 423.20 the increase is applicable are eligible for the contingent 423.21 benefit upon lapse. 423.22 (b) If significant adverse lapsation has occurred, is 423.23 anticipated in the filing, or is evidenced in the actual results 423.24 as presented in the updated projections provided by the insurer 423.25 following the requested rate increase, the commissioner may 423.26 determine that a rate spiral exists. Following the 423.27 determination that a rate spiral exists, the commissioner may 423.28 require the insurer to offer, without underwriting, to all 423.29 in-force insureds subject to the rate increase, the option to 423.30 replace existing coverage with one or more reasonably comparable 423.31 products being offered by the insurer or its affiliates. The 423.32 offer must: 423.33 (1) be subject to the approval of the commissioner; 423.34 (2) be based upon actuarially sound principles, but not be 423.35 based upon attained age; and 423.36 (3) provide that maximum benefits under any new policy 424.1 accepted by an insured shall be reduced by comparable benefits 424.2 already paid under the existing policy. 424.3 (c) The insurer shall maintain the experience of all the 424.4 replacement insureds separate from the experience of insureds 424.5 originally issued the policy forms. In the event of a request 424.6 for a rate increase on the policy form, the rate increase must 424.7 be limited to the lesser of the maximum rate increase determined 424.8 based on the combined experience and the maximum rate increase 424.9 determined based only upon the experience of the insureds 424.10 originally issued the form plus ten percent. 424.11 Subd. 9. [PERSISTENT PRACTICE OF INADEQUATE INITIAL 424.12 RATES.] If the commissioner determines that the insurer has 424.13 exhibited a persistent practice of filing inadequate initial 424.14 premium rates for long-term care insurance, the commissioner 424.15 may, in addition to the provisions of subdivision 8, prohibit 424.16 the insurer from either of the following: 424.17 (1) filing and marketing comparable coverage for a period 424.18 of up to five years; or 424.19 (2) offering all other similar coverages and limiting 424.20 marketing of new applications to the products subject to recent 424.21 premium rate schedule increases. 424.22 Subd. 10. [INCIDENTAL LONG-TERM CARE 424.23 BENEFITS.] Subdivisions 1 to 9 do not apply to policies for 424.24 which the long-term care benefits provided by the policy are 424.25 incidental, as defined in section 62S.01, subdivision 17a, if 424.26 the policy complies with all of the following provisions: 424.27 (1) the interest credited internally to determine cash 424.28 value accumulations, including long-term care, if any, are 424.29 guaranteed not to be less than the minimum guaranteed interest 424.30 rate for cash value accumulations without long-term care set 424.31 forth in the policy; 424.32 (2) the portion of the policy that provides insurance 424.33 benefits other than long-term care coverage meets the 424.34 nonforfeiture requirements as applicable in any of the following: 424.35 (i) for life insurance, section 61A.25; 424.36 (ii) for individual deferred annuities, section 61A.245; 425.1 and 425.2 (iii) for variable annuities, section 61A.21; 425.3 (3) the policy meets the disclosure requirements of 425.4 sections 62S.10 and 62S.11 if the policy is governed by chapter 425.5 62S and of section 62A.50 if the policy is governed by sections 425.6 62A.46 to 62A.56; 425.7 (4) the portion of the policy that provides insurance 425.8 benefits other than long-term care coverage meets the 425.9 requirements as applicable in the following: 425.10 (i) policy illustrations to the extent required by state 425.11 law applicable to life insurance; 425.12 (ii) disclosure requirements in state law applicable to 425.13 annuities; and 425.14 (iii) disclosure requirements applicable to variable 425.15 annuities; and 425.16 (5) an actuarial memorandum is filed with the commissioner 425.17 that includes: 425.18 (i) a description of the basis on which the long-term care 425.19 rates were determined; 425.20 (ii) a description of the basis for the reserves; 425.21 (iii) a summary of the type of policy, benefits, 425.22 renewability, general marketing method, and limits on ages of 425.23 issuance; 425.24 (iv) a description and a table of each actuarial assumption 425.25 used. For expenses, an insurer must include percent of premium 425.26 dollars per policy and dollars per unit of benefits, if any; 425.27 (v) a description and a table of the anticipated policy 425.28 reserves and additional reserves to be held in each future year 425.29 for active lives; 425.30 (vi) the estimated average annual premium per policy and 425.31 the average issue age; 425.32 (vii) a statement as to whether underwriting is performed 425.33 at the time of application. The statement shall indicate 425.34 whether underwriting is used and, if used, the statement shall 425.35 include a description of the type or types of underwriting used, 425.36 such as medical underwriting or functional assessment 426.1 underwriting. Concerning a group policy, the statement shall 426.2 indicate whether the enrollee or any dependent will be 426.3 underwritten and when underwriting occurs; and 426.4 (viii) a description of the effect of the long-term care 426.5 policy provision on the required premiums, nonforfeiture values, 426.6 and reserves on the underlying insurance policy, both for active 426.7 lives and those in long-term care claim status. 426.8 Subd. 11. [LARGE GROUP POLICIES.] Subdivisions 6 and 9 do 426.9 not apply to group long-term care insurance policies as defined 426.10 in section 62S.01, subdivision 15, where: 426.11 (1) the policies insure 250 or more persons, and the 426.12 policyholder has 5,000 or more eligible employees of a single 426.13 employer; or 426.14 (2) the policyholder, and not the certificate holders, pays 426.15 a material portion of the premium, which is not less than 20 426.16 percent of the total premium for the group in the calendar year 426.17 prior to the year in which a rate increase is filed. 426.18 [EFFECTIVE DATE.] This section is effective the day 426.19 following final enactment. 426.20 Sec. 12. [62S.266] [NONFORFEITURE BENEFIT REQUIREMENT.] 426.21 Subdivision 1. [APPLICABILITY.] This section does not 426.22 apply to life insurance policies or riders containing 426.23 accelerated long-term care benefits. 426.24 Subd. 2. [REQUIREMENT.] An insurer must offer each 426.25 prospective policyholder a nonforfeiture benefit in compliance 426.26 with the following requirements: 426.27 (1) a policy or certificate offered with nonforfeiture 426.28 benefits must have coverage elements, eligibility, benefit 426.29 triggers, and benefit length that are the same as coverage to be 426.30 issued without nonforfeiture benefits. The nonforfeiture 426.31 benefit included in the offer must be the benefit described in 426.32 subdivision 5; and 426.33 (2) the offer must be in writing if the nonforfeiture 426.34 benefit is not otherwise described in the outline of coverage or 426.35 other materials given to the prospective policyholder. 426.36 Subd. 3. [EFFECT OF REJECTION OF OFFER.] If the offer 427.1 required to be made under subdivision 2 is rejected, the insurer 427.2 shall provide the contingent benefit upon lapse described in 427.3 this section. 427.4 Subd. 4. [CONTINGENT BENEFIT UPON LAPSE.] (a) After 427.5 rejection of the offer required under subdivision 2, for 427.6 individual and group policies without nonforfeiture benefits 427.7 issued after the effective date of this section, the insurer 427.8 shall provide a contingent benefit upon lapse. 427.9 (b) If a group policyholder elects to make the 427.10 nonforfeiture benefit an option to the certificate holder, a 427.11 certificate shall provide either the nonforfeiture benefit or 427.12 the contingent benefit upon lapse. 427.13 (c) The contingent benefit on lapse shall be triggered 427.14 every time an insurer increases the premium rates to a level 427.15 which results in a cumulative increase of the annual premium 427.16 equal to or exceeding the percentage of the insured's initial 427.17 annual premium based on the insured's issue age, and the policy 427.18 or certificate lapses within 120 days of the due date of the 427.19 premium increase. Unless otherwise required, policyholders 427.20 shall be notified at least 30 days prior to the due date of the 427.21 premium reflecting the rate increase. 427.22 Triggers for a Substantial Premium Increase 427.23 Percent Increase 427.24 Issue Age Over Initial Premium 427.25 29 and Under 200 427.26 30-34 190 427.27 35-39 170 427.28 40-44 150 427.29 45-49 130 427.30 50-54 110 427.31 55-59 90 427.32 60 70 427.33 61 66 427.34 62 62 427.35 63 58 427.36 64 54 428.1 65 50 428.2 66 48 428.3 67 46 428.4 68 44 428.5 69 42 428.6 70 40 428.7 71 38 428.8 72 36 428.9 73 34 428.10 74 32 428.11 75 30 428.12 76 28 428.13 77 26 428.14 78 24 428.15 79 22 428.16 80 20 428.17 81 19 428.18 82 18 428.19 83 17 428.20 84 16 428.21 85 15 428.22 86 14 428.23 87 13 428.24 88 12 428.25 89 11 428.26 90 and over 10 428.27 (d) On or before the effective date of a substantial 428.28 premium increase as defined in paragraph (c), the insurer shall: 428.29 (1) offer to reduce policy benefits provided by the current 428.30 coverage without the requirement of additional underwriting so 428.31 that required premium payments are not increased; 428.32 (2) offer to convert the coverage to a paid-up status with 428.33 a shortened benefit period according to the terms of subdivision 428.34 5. This option may be elected at any time during the 120-day 428.35 period referenced in paragraph (c); and 428.36 (3) notify the policyholder or certificate holder that a 429.1 default or lapse at any time during the 120-day period 429.2 referenced in paragraph (c) shall be deemed to be the election 429.3 of the offer to convert in clause (2). 429.4 Subd. 5. [NONFORFEITURE BENEFITS; REQUIREMENTS.] (a) 429.5 Benefits continued as nonforfeiture benefits, including 429.6 contingent benefits upon lapse, must be as described in this 429.7 subdivision. 429.8 (b) For purposes of this subdivision, "attained age rating" 429.9 is defined as a schedule of premiums starting from the issue 429.10 date which increases with age at least one percent per year 429.11 prior to age 50, and at least three percent per year beyond age 429.12 50. 429.13 (c) For purposes of this subdivision, the nonforfeiture 429.14 benefit shall be of a shortened benefit period providing 429.15 paid-up, long-term care insurance coverage after lapse. The 429.16 same benefits, amounts, and frequency in effect at the time of 429.17 lapse, but not increased thereafter, will be payable for a 429.18 qualifying claim, but the lifetime maximum dollars or days of 429.19 benefits shall be determined as specified in paragraph (d). 429.20 (d) The standard nonforfeiture credit will be equal to 100 429.21 percent of the sum of all premiums paid, including the premiums 429.22 paid prior to any changes in benefits. The insurer may offer 429.23 additional shortened benefit period options, as long as the 429.24 benefits for each duration equal or exceed the standard 429.25 nonforfeiture credit for that duration. However, the minimum 429.26 nonforfeiture credit must not be less than 30 times the daily 429.27 nursing home benefit at the time of lapse. In either event, the 429.28 calculation of the nonforfeiture credit is subject to the 429.29 limitation of this subdivision. 429.30 (e) The nonforfeiture benefit must begin not later than the 429.31 end of the third year following the policy or certificate issue 429.32 date. The contingent benefit upon lapse must be effective 429.33 during the first three years as well as thereafter. 429.34 (f) Notwithstanding paragraph (e), for a policy or 429.35 certificate with attained age rating, the nonforfeiture benefit 429.36 must begin on the earlier of: 430.1 (1) the end of the tenth year following the policy or 430.2 certificate issue date; or 430.3 (2) the end of the second year following the date the 430.4 policy or certificate is no longer subject to attained age 430.5 rating. 430.6 (g) Nonforfeiture credits may be used for all care and 430.7 services qualifying for benefits under the terms of the policy 430.8 or certificate, up to the limits specified in the policy or 430.9 certificate. 430.10 Subd. 6. [BENEFIT LIMIT.] All benefits paid by the insurer 430.11 while the policy or certificate is in premium-paying status and 430.12 in the paid-up status will not exceed the maximum benefits which 430.13 would be payable if the policy or certificate had remained in 430.14 premium-paying status. 430.15 Subd. 7. [MINIMUM BENEFITS; INDIVIDUAL AND GROUP 430.16 POLICIES.] There shall be no difference in the minimum 430.17 nonforfeiture benefits as required under this section for group 430.18 and individual policies. 430.19 Subd. 8. [APPLICATION; EFFECTIVE DATES.] This section 430.20 becomes effective January 1, 2002, and applies as follows: 430.21 (a) Except as provided in paragraph (b), this section 430.22 applies to any long-term care policy issued in this state on or 430.23 after the effective date of this section. 430.24 (b) For certificates issued on or after the effective date 430.25 of this section, under a group long-term care insurance policy 430.26 that was in force on the effective date of this section, the 430.27 provisions of this section do not apply. 430.28 Subd. 9. [EFFECT ON LOSS RATIO.] Premiums charged for a 430.29 policy or certificate containing nonforfeiture benefits or a 430.30 contingent benefit on lapse are subject to the loss ratio 430.31 requirements of section 62A.48, subdivision 4, or 62S.26, 430.32 treating the policy as a whole, except for policies or 430.33 certificates that are subject to sections 62S.021, 62S.081, and 430.34 62S.265 and that comply with those sections. 430.35 Subd. 10. [PURCHASED BLOCKS OF BUSINESS.] To determine 430.36 whether contingent nonforfeiture upon lapse provisions are 431.1 triggered under subdivision 4, paragraph (c), a replacing 431.2 insurer that purchased or otherwise assumed a block or blocks of 431.3 long-term care insurance policies from another insurer shall 431.4 calculate the percentage increase based on the initial annual 431.5 premium paid by the insured when the policy was first purchased 431.6 from the original insurer. 431.7 Subd. 11. [LEVEL PREMIUM CONTRACTS.] A nonforfeiture 431.8 benefit for qualified long-term care insurance contracts that 431.9 are level premium contracts shall be offered that meets the 431.10 following requirements: 431.11 (1) the nonforfeiture provision shall be appropriately 431.12 captioned; 431.13 (2) the nonforfeiture provision shall provide a benefit 431.14 available in the event of a default in the payment of any 431.15 premiums and shall state that the amount of the benefit may be 431.16 adjusted subsequent to being initially granted only as necessary 431.17 to reflect changes in claims, persistency, and interest as 431.18 reflected in changes in rates for premium paying contracts 431.19 approved by the commissioner for the same contract form; and 431.20 (3) the nonforfeiture provision shall provide at least one 431.21 of the following: 431.22 (i) reduced paid-up insurance; 431.23 (ii) extended term insurance; 431.24 (iii) shortened benefit period; or 431.25 (iv) other similar offerings approved by the commissioner. 431.26 [EFFECTIVE DATE.] This section is effective the day 431.27 following final enactment. 431.28 Sec. 13. Minnesota Statutes 2000, section 256.975, is 431.29 amended by adding a subdivision to read: 431.30 Subd. 8. [PROMOTION OF LONG-TERM CARE INSURANCE.] The 431.31 Minnesota board on aging, either directly or through contract, 431.32 shall promote the provision of employer-sponsored, long-term 431.33 care insurance. The board shall encourage private and public 431.34 sector employers to make long-term care insurance available to 431.35 employees, provide interested employers with information on the 431.36 long-term care insurance product offered to state employees, and 432.1 provide technical assistance to employers in designing long-term 432.2 care insurance products and contacting health plan companies 432.3 offering long-term care insurance products. 432.4 ARTICLE 10 432.5 MENTAL HEALTH AND CIVIL COMMITMENT 432.6 Section 1. [62Q.471] [EXCLUSION FOR SUICIDE ATTEMPTS 432.7 PROHIBITED.] 432.8 (a) No health plan may exclude or reduce coverage for 432.9 health care for an enrollee that is otherwise covered under the 432.10 health plan, on the basis that the need for the health care 432.11 arose out of a suicide or suicide attempt by the enrollee. 432.12 (b) For purposes of this section, "health plan" has the 432.13 meaning given in section 62Q.01, subdivision 3, but includes the 432.14 coverages described in section 62A.011, clauses (7) and (10). 432.15 [EFFECTIVE DATE.] This section is effective January 1, 432.16 2002, and applies to contracts issued or renewed on or after 432.17 that date. 432.18 Sec. 2. [62Q.527] [COVERAGE OF NONFORMULARY DRUGS FOR 432.19 MENTAL ILLNESS AND EMOTIONAL DISTURBANCE.] 432.20 Subdivision 1. [DEFINITIONS.] (a) For purposes of this 432.21 section, the following terms have the meanings given to them. 432.22 (b) "Emotional disturbance" has the meaning given in 432.23 section 245.4871, subdivision 15. 432.24 (c) "Mental illness" has the meaning given in section 432.25 245.462, subdivision 20, paragraph (a). 432.26 (d) "Health plan" has the meaning given in section 62Q.01, 432.27 subdivision 3, but includes the coverages described in clauses 432.28 (7) and (10). 432.29 Subd. 2. [REQUIRED COVERAGE.] A health plan that provides 432.30 prescription drug coverage must provide coverage for an 432.31 antipsychotic drug prescribed to treat emotional disturbance or 432.32 mental illness regardless of whether the drug is in the health 432.33 plan's drug formulary, if the health care provider prescribing 432.34 the drug: 432.35 (1) indicates to the dispensing pharmacist, orally or in 432.36 writing according to section 151.21, that the prescription must 433.1 be dispensed as communicated; and 433.2 (2) certifies in writing to the health plan company that 433.3 the drug prescribed will best treat the patient's condition. 433.4 The health plan is not required to provide coverage for the drug 433.5 if the drug was removed from the formulary for safety reasons. 433.6 For drugs covered under this section, no health plan company, 433.7 which has received the certification from the health care 433.8 provider, may: 433.9 (i) impose a special deductible, copayment, coinsurance, or 433.10 other special payment requirement that the health plan does not 433.11 apply to drugs that are in the health plan's drug formulary; or 433.12 (ii) require written certification from the prescribing 433.13 provider each time a prescription is refilled or renewed that 433.14 the drug prescribed will best treat the patient's condition. 433.15 Subd. 3. [CONTINUING CARE.] Enrollees receiving a 433.16 prescribed drug to treat a diagnosed mental illness or emotional 433.17 disturbance, may continue to receive the prescribed drug without 433.18 the imposition of a special deductible, copayment, coinsurance, 433.19 or other special payment requirements, when a health plan's drug 433.20 formulary changes or an enrollee changes health plans and the 433.21 medication has been shown to effectively treat the patient's 433.22 condition. In order to be eligible for this continuing care 433.23 benefit: 433.24 (1) the patient must have been treated with the drug for 90 433.25 days prior to a change in a health plan's drug formulary or a 433.26 change in the enrollee's health plan; 433.27 (2) the health care provider prescribing the drug indicates 433.28 to the dispensing pharmacist, orally or in writing according to 433.29 section 151.21, that the prescription must be dispensed as 433.30 communicated; and 433.31 (3) annually certifies in writing to the health plan 433.32 company that the drug prescribed will best treat the patient's 433.33 condition. The health plan is not required to provide coverage 433.34 for the drug if the drug was removed from the formulary for 433.35 safety reasons. 433.36 Subd. 4. [EXCEPTION TO FORMULARY.] A health plan company 434.1 shall promptly grant an exception to the formulary when the 434.2 health care provider prescribing the drug conveys to the health 434.3 plan that: 434.4 (1) the formulary drug causes an adverse reaction; 434.5 (2) the formulary drug is contraindicated; or 434.6 (3) the prescriber demonstrates to the health plan that a 434.7 prescription drug must be dispensed as written to provide 434.8 maximum medical benefit to the patient. 434.9 [EFFECTIVE DATE.] This section is effective July 1, 2001, 434.10 and applies to contracts issued or renewed on or after that date. 434.11 Sec. 3. [62Q.535] [COVERAGE FOR COURT-ORDERED MENTAL 434.12 HEALTH SERVICES.] 434.13 Subdivision 1. [MENTAL HEALTH SERVICES.] For purposes of 434.14 this section, mental health services means all covered services 434.15 that are intended to treat or ameliorate an emotional, 434.16 behavioral, or psychiatric condition and that are covered by the 434.17 policy, contract, or certificate of coverage of the enrollee's 434.18 health plan company or by law. 434.19 Subd. 2. [COVERAGE REQUIRED.] All health plan companies 434.20 that provide coverage for mental health services must cover or 434.21 provide mental health services ordered by a court of competent 434.22 jurisdiction under a court order that is issued on the basis of 434.23 a behavioral care evaluation performed by a licensed 434.24 psychiatrist or a doctoral level licensed psychologist, which 434.25 includes a diagnosis and an individual treatment plan for care 434.26 in the most appropriate, least restrictive environment. The 434.27 health plan company must be given a copy of the court order and 434.28 the behavioral care evaluation. The health plan company shall 434.29 be financially liable for the evaluation if performed by a 434.30 participating provider of the health plan company and shall be 434.31 financially liable for the care included in the court-ordered 434.32 individual treatment plan if the care is covered by the health 434.33 plan and ordered to be provided by a participating provider or 434.34 another provider as required by rule or law. This court-ordered 434.35 coverage must not be subject to a separate medical necessity 434.36 determination by a health plan company under its utilization 435.1 procedures. 435.2 [EFFECTIVE DATE.] This section is effective July 1, 2001, 435.3 and applies to contracts issued or renewed on or after that date. 435.4 Sec. 4. [244.054] [DISCHARGE PLANS; OFFENDERS WITH SERIOUS 435.5 AND PERSISTENT MENTAL ILLNESS.] 435.6 Subdivision 1. [OFFER TO DEVELOP PLAN.] The commissioner 435.7 of human services, in collaboration with the commissioner of 435.8 corrections, shall offer to develop a discharge plan for 435.9 community-based services for every offender with serious and 435.10 persistent mental illness, as defined in section 245.462, 435.11 subdivision 20, paragraph (c), who is being released from a 435.12 correctional facility. If an offender is being released 435.13 pursuant to section 244.05, the offender may choose to have the 435.14 discharge plan made one of the conditions of the offender's 435.15 supervised release and shall follow the conditions to the extent 435.16 that services are available and offered to the offender. 435.17 Subd. 2. [CONTENT OF PLAN.] If an offender chooses to have 435.18 a discharge plan developed, the commissioner of human services 435.19 shall develop and implement a discharge plan, which must include 435.20 at least the following: 435.21 (1) at least 90 days before the offender is due to be 435.22 discharged, the commissioner of human services shall designate 435.23 an agent of the department of human services with mental health 435.24 training to serve as the primary person responsible for carrying 435.25 out discharge planning activities; 435.26 (2) at least 75 days before the offender is due to be 435.27 discharged, the offender's designated agent shall: 435.28 (i) obtain informed consent and releases of information 435.29 from the offender that are needed for transition services; 435.30 (ii) contact the county human services department in the 435.31 community where the offender expects to reside following 435.32 discharge, and inform the department of the offender's impending 435.33 discharge and the planned date of the offender's return to the 435.34 community; determine whether the county or a designated 435.35 contracted provider will provide case management services to the 435.36 offender; refer the offender to the case management services 436.1 provider; and confirm that the case management services provider 436.2 will have opened the offender's case prior to the offender's 436.3 discharge; and 436.4 (iii) refer the offender to appropriate staff in the county 436.5 human services department in the community where the offender 436.6 expects to reside following discharge, for enrollment of the 436.7 offender if eligible in medical assistance or general assistance 436.8 medical care, using special procedures established by process 436.9 and department of human services bulletin; 436.10 (3) at least 2-1/2 months before discharge, the offender's 436.11 designated agent shall secure timely appointments for the 436.12 offender with a psychiatrist no later than 30 days following 436.13 discharge, and with other program staff at a community mental 436.14 health provider that is able to serve former offenders with 436.15 serious and persistent mental illness; 436.16 (4) at least 30 days before discharge, the offender's 436.17 designated agent shall convene a predischarge assessment and 436.18 planning meeting of key staff from the programs in which the 436.19 offender has participated while in the correctional facility, 436.20 the offender, and the supervising agent assigned to the 436.21 offender. At the meeting, attendees shall provide background 436.22 information and continuing care recommendations for the 436.23 offender, including information on the offender's risk for 436.24 relapse; current medications, including dosage and frequency; 436.25 therapy and behavioral goals; diagnostic and assessment 436.26 information, including results of a chemical dependency 436.27 evaluation; confirmation of appointments with a psychiatrist and 436.28 other program staff in the community; a relapse prevention plan; 436.29 continuing care needs; needs for housing, employment, and 436.30 finance support and assistance; and recommendations for 436.31 successful community integration, including chemical dependency 436.32 treatment or support if chemical dependency is a risk factor. 436.33 Immediately following this meeting, the offender's designated 436.34 agent shall summarize this background information and continuing 436.35 care recommendations in a written report; 436.36 (5) immediately following the predischarge assessment and 437.1 planning meeting, the provider of mental health case management 437.2 services who will serve the offender following discharge shall 437.3 offer to make arrangements and referrals for housing, financial 437.4 support, benefits assistance, employment counseling, and other 437.5 services required in sections 245.461 to 245.486; 437.6 (6) at least ten days before the offender's first scheduled 437.7 postdischarge appointment with a mental health provider, the 437.8 offender's designated agent shall transfer the following records 437.9 to the offender's case management services provider and 437.10 psychiatrist: the predischarge assessment and planning report, 437.11 medical records, and pharmacy records. These records may be 437.12 transferred only if the offender provides informed consent for 437.13 their release; 437.14 (7) upon discharge, the offender's designated agent shall 437.15 ensure that the offender leaves the correctional facility with 437.16 at least a ten-day supply of all necessary medications; and 437.17 (8) upon discharge, the prescribing authority at the 437.18 offender's correctional facility shall telephone in 437.19 prescriptions for all necessary medications to a pharmacy in the 437.20 community where the offender plans to reside. The prescriptions 437.21 must provide at least a 30-day supply of all necessary 437.22 medications, and must be able to be refilled once for one 437.23 additional 30-day supply. 437.24 Sec. 5. [244.25] [TRANSITIONAL SERVICES FOR MENTALLY ILL 437.25 OFFENDERS RELEASED FROM PRISON; PILOT PROGRAM.] 437.26 The commissioner of corrections, in collaboration with the 437.27 commissioner of human services, shall establish a pilot project 437.28 grant program with goals and evaluation criteria and make grants 437.29 to provide startup funding for two counties or two groups of 437.30 counties to provide transitional housing and other community 437.31 support services for former state inmates who have been 437.32 diagnosed with a serious mental illness and who have been 437.33 discharged from prison. Grant applicants must submit a proposed 437.34 comprehensive plan for providing the housing and support 437.35 services and evaluating the provision of services, and must 437.36 provide a 25 percent funding match. The commissioner shall make 438.1 grants available to successful applicants by February 1, 2002. 438.2 Grant recipients are eligible for funding under this section for 438.3 the first three years of operation of their programs for housing 438.4 and support services. 438.5 Sec. 6. Minnesota Statutes 2000, section 245.462, is 438.6 amended by adding a subdivision to read: 438.7 Subd. 7a. [CRISIS INTERVENTION SERVICES.] Crisis 438.8 intervention services are short-term, intensive, nonresidential 438.9 mental health services that include assessment, mental health 438.10 rehabilitative services, and a crisis disposition plan. Crisis 438.11 intervention services are intended to help the recipient return 438.12 to a baseline level of functioning or prevent further harmful 438.13 consequences due to the psychiatric symptoms. 438.14 Sec. 7. Minnesota Statutes 2000, section 245.462, is 438.15 amended by adding a subdivision to read: 438.16 Subd. 7b. [CRISIS STABILIZATION SERVICES.] "Crisis 438.17 stabilization services" is defined in section 256B.0624, 438.18 subdivision 2, paragraph (e). 438.19 Sec. 8. Minnesota Statutes 2000, section 245.462, is 438.20 amended by adding a subdivision to read: 438.21 Subd. 14a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 438.22 is defined in section 256B.0624, subdivision 2, paragraph (a). 438.23 Sec. 9. Minnesota Statutes 2000, section 245.462, is 438.24 amended by adding a subdivision to read: 438.25 Subd. 14b. [MENTAL HEALTH EMERGENCY.] "Mental health 438.26 emergency" is defined in section 256B.0624, subdivision 2, 438.27 paragraph (b). 438.28 Sec. 10. Minnesota Statutes 2000, section 245.462, is 438.29 amended by adding a subdivision to read: 438.30 Subd. 14c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 438.31 crisis services" means crisis assessment, crisis intervention, 438.32 and crisis stabilization services. 438.33 Sec. 11. Minnesota Statutes 2000, section 245.462, 438.34 subdivision 18, is amended to read: 438.35 Subd. 18. [MENTAL HEALTH PROFESSIONAL.] "Mental health 438.36 professional" means a person providing clinical services in the 439.1 treatment of mental illness who is qualified in at least one of 439.2 the following ways: 439.3 (1) in psychiatric nursing: a registered nurse who is 439.4 licensed under sections 148.171 to 148.285, and who is certified 439.5 as a clinical specialist in adult psychiatric and mental health 439.6 nursing by a national nurse certification organization or who 439.7 has a master's degree in nursing or one of the behavioral 439.8 sciences or related fields from an accredited college or 439.9 university or its equivalent, with at least 4,000 hours of 439.10 post-master's supervised experience in the delivery of clinical 439.11 services in the treatment of mental illness; 439.12 (2) in clinical social work: a person licensed as an 439.13 independent clinical social worker under section 148B.21, 439.14 subdivision 6, or a person with a master's degree in social work 439.15 from an accredited college or university, with at least 4,000 439.16 hours of post-master's supervised experience in the delivery of 439.17 clinical services in the treatment of mental illness; 439.18 (3) in psychology:a psychologistan individual licensed 439.19 by the board of psychology under sections 148.88 to 148.98 who 439.20 has stated to the board of psychology competencies in the 439.21 diagnosis and treatment of mental illness; 439.22 (4) in psychiatry: a physician licensed under chapter 147 439.23 and certified by the American board of psychiatry and neurology 439.24 or eligible for board certification in psychiatry; 439.25 (5) in marriage and family therapy: the mental health 439.26 professional must be a marriage and family therapist licensed 439.27 under sections 148B.29 to 148B.39 with at least two years of 439.28 post-master's supervised experience in the delivery of clinical 439.29 services in the treatment of mental illness; or 439.30 (6) in allied fields: a person with a master's degree from 439.31 an accredited college or university in one of the behavioral 439.32 sciences or related fields, with at least 4,000 hours of 439.33 post-master's supervised experience in the delivery of clinical 439.34 services in the treatment of mental illness. 439.35 Sec. 12. Minnesota Statutes 2000, section 245.466, 439.36 subdivision 2, is amended to read: 440.1 Subd. 2. [ADULT MENTAL HEALTH SERVICES.] The adult mental 440.2 health service system developed by each county board must 440.3 include the following services: 440.4 (1) education and prevention services in accordance with 440.5 section 245.468; 440.6 (2) emergency services in accordance with section 245.469; 440.7 (3) outpatient services in accordance with section 245.470; 440.8 (4) community support program services in accordance with 440.9 section 245.4711; 440.10 (5) residential treatment services in accordance with 440.11 section 245.472; 440.12 (6) acute care hospital inpatient treatment services in 440.13 accordance with section 245.473; 440.14 (7) regional treatment center inpatient services in 440.15 accordance with section 245.474; 440.16 (8) screening in accordance with section 245.476;and440.17 (9) case management in accordance with sections 245.462, 440.18 subdivision 3; and 245.4711; and 440.19 (10) mental health crisis services in accordance with 440.20 section 245.470, subdivision 3. 440.21 Sec. 13. Minnesota Statutes 2000, section 245.470, is 440.22 amended by adding a subdivision to read: 440.23 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 440.24 must provide or contract for enough mental health crisis 440.25 services within the county to meet the needs of adults with 440.26 mental illness residing in the county who are determined, 440.27 through an assessment by a mental health professional, to be 440.28 experiencing a mental health crisis or mental health emergency. 440.29 The mental health crisis services provided must be medically 440.30 necessary, as defined in section 62Q.53, subdivision 2, and 440.31 appropriate or socially necessary for the safety of the adult or 440.32 others regardless of the setting. 440.33 Sec. 14. Minnesota Statutes 2000, section 245.474, 440.34 subdivision 2, is amended to read: 440.35 Subd. 2. [QUALITY OF SERVICE.] The commissioner shall 440.36 biennially determine the needs of all adults with mental illness 441.1 who are served by regional treatment centers or at any state 441.2 facility or program as defined in section 246.50, subdivision 3, 441.3 by administering a client-based evaluation system. The 441.4 client-based evaluation system must include at least the 441.5 following independent measurements: behavioral development 441.6 assessment; habilitation program assessment; medical needs 441.7 assessment; maladaptive behavioral assessment; and vocational 441.8 behavior assessment. The commissioner shallproposeby rule 441.9 establish staff ratiosto the legislaturefor the mental health 441.10 and support units in regional treatment centers as indicated by 441.11 the results of the client-based evaluation system and the types 441.12 of state-operated services needed. Theproposedstaffing ratios 441.13 shall include professional, nursing, direct care, medical, 441.14 clerical, and support staff based on the client-based evaluation 441.15 system. The commissioner shall recompute staffing ratios 441.16 andrecommendationsamend rules on staff ratios as necessary on 441.17 a biennial basis. 441.18 Sec. 15. Minnesota Statutes 2000, section 245.474, is 441.19 amended by adding a subdivision to read: 441.20 Subd. 4. [STAFF SAFETY TRAINING.] The commissioner shall 441.21 by rule require all staff in mental health and support units at 441.22 regional treatment centers who have contact with persons with 441.23 mental illness or severe emotional disturbance to be 441.24 appropriately trained in violence reduction and violence 441.25 prevention, and shall establish criteria for such training. 441.26 Training programs shall be developed with input from consumer 441.27 advocacy organizations, and shall employ violence prevention 441.28 techniques as preferable to physical interaction. 441.29 Sec. 16. Minnesota Statutes 2000, section 245.4871, is 441.30 amended by adding a subdivision to read: 441.31 Subd. 9b. [CRISIS INTERVENTION SERVICES.] Crisis 441.32 intervention services are short-term, intensive, nonresidential 441.33 mental health services that include assessment, mental health 441.34 rehabilitative services, and a crisis disposition plan. Crisis 441.35 intervention services are intended to help the recipient return 441.36 to a baseline level of functioning or prevent further harmful 442.1 consequences due to the psychiatric symptoms. 442.2 Sec. 17. Minnesota Statutes 2000, section 245.4871, is 442.3 amended by adding a subdivision to read: 442.4 Subd. 9c. [CRISIS STABILIZATION SERVICES.] "Crisis 442.5 stabilization services" is defined in section 256B.0624, 442.6 subdivision 2, paragraph (e). 442.7 Sec. 18. Minnesota Statutes 2000, section 245.4871, is 442.8 amended by adding a subdivision to read: 442.9 Subd. 24a. [MENTAL HEALTH CRISIS.] "Mental health crisis" 442.10 is defined in section 256B.0624, subdivision 2, paragraph (a). 442.11 Sec. 19. Minnesota Statutes 2000, section 245.4871, is 442.12 amended by adding a subdivision to read: 442.13 Subd. 24b. [MENTAL HEALTH EMERGENCY.] "Mental health 442.14 emergency" is defined in section 256B.0624, subdivision 2, 442.15 paragraph (b). 442.16 Sec. 20. Minnesota Statutes 2000, section 245.4871, is 442.17 amended by adding a subdivision to read: 442.18 Subd. 24c. [MENTAL HEALTH CRISIS SERVICES.] "Mental health 442.19 crisis services" means crisis assessment, crisis intervention, 442.20 and crisis stabilization services. 442.21 Sec. 21. Minnesota Statutes 2000, section 245.4871, 442.22 subdivision 27, is amended to read: 442.23 Subd. 27. [MENTAL HEALTH PROFESSIONAL.] "Mental health 442.24 professional" means a person providing clinical services in the 442.25 diagnosis and treatment of children's emotional disorders. A 442.26 mental health professional must have training and experience in 442.27 working with children consistent with the age group to which the 442.28 mental health professional is assigned. A mental health 442.29 professional must be qualified in at least one of the following 442.30 ways: 442.31 (1) in psychiatric nursing, the mental health professional 442.32 must be a registered nurse who is licensed under sections 442.33 148.171 to 148.285 and who is certified as a clinical specialist 442.34 in child and adolescent psychiatric or mental health nursing by 442.35 a national nurse certification organization or who has a 442.36 master's degree in nursing or one of the behavioral sciences or 443.1 related fields from an accredited college or university or its 443.2 equivalent, with at least 4,000 hours of post-master's 443.3 supervised experience in the delivery of clinical services in 443.4 the treatment of mental illness; 443.5 (2) in clinical social work, the mental health professional 443.6 must be a person licensed as an independent clinical social 443.7 worker under section 148B.21, subdivision 6, or a person with a 443.8 master's degree in social work from an accredited college or 443.9 university, with at least 4,000 hours of post-master's 443.10 supervised experience in the delivery of clinical services in 443.11 the treatment of mental disorders; 443.12 (3) in psychology, the mental health professional must bea443.13psychologistan individual licensed by the board of psychology 443.14 under sections 148.88 to 148.98 who has stated to the board of 443.15 psychology competencies in the diagnosis and treatment of mental 443.16 disorders; 443.17 (4) in psychiatry, the mental health professional must be a 443.18 physician licensed under chapter 147 and certified by the 443.19 American board of psychiatry and neurology or eligible for board 443.20 certification in psychiatry; 443.21 (5) in marriage and family therapy, the mental health 443.22 professional must be a marriage and family therapist licensed 443.23 under sections 148B.29 to 148B.39 with at least two years of 443.24 post-master's supervised experience in the delivery of clinical 443.25 services in the treatment of mental disorders or emotional 443.26 disturbances; or 443.27 (6) in allied fields, the mental health professional must 443.28 be a person with a master's degree from an accredited college or 443.29 university in one of the behavioral sciences or related fields, 443.30 with at least 4,000 hours of post-master's supervised experience 443.31 in the delivery of clinical services in the treatment of 443.32 emotional disturbances. 443.33 Sec. 22. Minnesota Statutes 2000, section 245.4875, 443.34 subdivision 2, is amended to read: 443.35 Subd. 2. [CHILDREN'S MENTAL HEALTH SERVICES.] The 443.36 children's mental health service system developed by each county 444.1 board must include the following services: 444.2 (1) education and prevention services according to section 444.3 245.4877; 444.4 (2) mental health identification and intervention services 444.5 according to section 245.4878; 444.6 (3) emergency services according to section 245.4879; 444.7 (4) outpatient services according to section 245.488; 444.8 (5) family community support services according to section 444.9 245.4881; 444.10 (6) day treatment services according to section 245.4884, 444.11 subdivision 2; 444.12 (7) residential treatment services according to section 444.13 245.4882; 444.14 (8) acute care hospital inpatient treatment services 444.15 according to section 245.4883; 444.16 (9) screening according to section 245.4885; 444.17 (10) case management according to section 245.4881; 444.18 (11) therapeutic support of foster care according to 444.19 section 245.4884, subdivision 4;and444.20 (12) professional home-based family treatment according to 444.21 section 245.4884, subdivision 4; and 444.22 (13) mental health crisis services according to section 444.23 245.488, subdivision 3. 444.24 Sec. 23. Minnesota Statutes 2000, section 245.4876, 444.25 subdivision 1, is amended to read: 444.26 Subdivision 1. [CRITERIA.] Children's mental health 444.27 services required by sections 245.487 to 245.4888 must be: 444.28 (1) based, when feasible, on research findings; 444.29 (2) based on individual clinical, cultural, and ethnic 444.30 needs, and other special needs of the children being served; 444.31 (3) delivered in a manner that improves family functioning 444.32 when clinically appropriate; 444.33 (4) provided in the most appropriate, least restrictive 444.34 setting that meets the requirements in subdivision 1a, and that 444.35 is available to the county board to meet the child's treatment 444.36 needs; 445.1 (5) accessible to all age groups of children; 445.2 (6) appropriate to the developmental age of the child being 445.3 served; 445.4 (7) delivered in a manner that provides accountability to 445.5 the child for the quality of service delivered and continuity of 445.6 services to the child during the years the child needs services 445.7 from the local system of care; 445.8 (8) provided by qualified individuals as required in 445.9 sections 245.487 to 245.4888; 445.10 (9) coordinated with children's mental health services 445.11 offered by other providers; 445.12 (10) provided under conditions that protect the rights and 445.13 dignity of the individuals being served; and 445.14 (11) provided in a manner and setting most likely to 445.15 facilitate progress toward treatment goals. 445.16 Sec. 24. Minnesota Statutes 2000, section 245.4876, is 445.17 amended by adding a subdivision to read: 445.18 Subd. 1a. [APPROPRIATE SETTING TO RECEIVE SERVICES.] A 445.19 child must be provided with mental health services in the least 445.20 restrictive setting that is appropriate to the needs and current 445.21 condition of the individual child. For a child to receive 445.22 mental health services in a residential treatment or acute care 445.23 hospital inpatient setting, the family may not be required to 445.24 demonstrate that services were first provided in a less 445.25 restrictive setting and that the child failed to make progress 445.26 toward or meet treatment goals in the less restrictive setting. 445.27 Sec. 25. Minnesota Statutes 2000, section 245.488, is 445.28 amended by adding a subdivision to read: 445.29 Subd. 3. [MENTAL HEALTH CRISIS SERVICES.] County boards 445.30 must provide or contract for mental health crisis services 445.31 within the county to meet the needs of children with emotional 445.32 disturbance residing in the county who are determined, through 445.33 an assessment by a mental health professional, to be 445.34 experiencing a mental health crisis or mental health emergency. 445.35 The mental health crisis services provided must be medically 445.36 necessary, as defined in section 62Q.53, subdivision 2, and 446.1 necessary for the safety of the child or others regardless of 446.2 the setting. 446.3 Sec. 26. Minnesota Statutes 2000, section 245.4885, 446.4 subdivision 1, is amended to read: 446.5 Subdivision 1. [SCREENING REQUIRED.] The county board 446.6 shall, prior to admission, except in the case of emergency 446.7 admission, screen all children referred for treatment of severe 446.8 emotional disturbance to a residential treatment facility or 446.9 informally admitted to a regional treatment center if public 446.10 funds are used to pay for the services. The county board shall 446.11 also screen all children admitted to an acute care hospital for 446.12 treatment of severe emotional disturbance if public funds other 446.13 than reimbursement under chapters 256B and 256D are used to pay 446.14 for the services. If a child is admitted to a residential 446.15 treatment facility or acute care hospital for emergency 446.16 treatment or held for emergency care by a regional treatment 446.17 center under section 253B.05, subdivision 1, screening must 446.18 occur within three working days of admission. Screening shall 446.19 determine whether the proposed treatment: 446.20 (1) is necessary; 446.21 (2) is appropriate to the child's individual treatment 446.22 needs; 446.23 (3) cannot be effectively provided in the child's home; and 446.24 (4) provides a length of stay as short as possible 446.25 consistent with the individual child's need. 446.26 When a screening is conducted, the county board may not 446.27 determine that referral or admission to a residential treatment 446.28 facility or acute care hospital is not appropriate solely 446.29 because services were not first provided to the child in a less 446.30 restrictive setting and the child failed to make progress toward 446.31 or meet treatment goals in the less restrictive setting. 446.32 Screening shall include both a diagnostic assessment and a 446.33 functional assessment which evaluates family, school, and 446.34 community living situations. If a diagnostic assessment or 446.35 functional assessment has been completed by a mental health 446.36 professional within 180 days, a new diagnostic or functional 447.1 assessment need not be completed unless in the opinion of the 447.2 current treating mental health professional the child's mental 447.3 health status has changed markedly since the assessment was 447.4 completed. The child's parent shall be notified if an 447.5 assessment will not be completed and of the reasons. A copy of 447.6 the notice shall be placed in the child's file. Recommendations 447.7 developed as part of the screening process shall include 447.8 specific community services needed by the child and, if 447.9 appropriate, the child's family, and shall indicate whether or 447.10 not these services are available and accessible to the child and 447.11 family. 447.12 During the screening process, the child, child's family, or 447.13 child's legal representative, as appropriate, must be informed 447.14 of the child's eligibility for case management services and 447.15 family community support services and that an individual family 447.16 community support plan is being developed by the case manager, 447.17 if assigned. 447.18 Screening shall be in compliance with section 256F.07 or 447.19 260C.212, whichever applies. Wherever possible, the parent 447.20 shall be consulted in the screening process, unless clinically 447.21 inappropriate. 447.22 The screening process, and placement decision, and 447.23 recommendations for mental health services must be documented in 447.24 the child's record. 447.25 An alternate review process may be approved by the 447.26 commissioner if the county board demonstrates that an alternate 447.27 review process has been established by the county board and the 447.28 times of review, persons responsible for the review, and review 447.29 criteria are comparable to the standards in clauses (1) to (4). 447.30 Sec. 27. Minnesota Statutes 2000, section 245.4886, 447.31 subdivision 1, is amended to read: 447.32 Subdivision 1. [STATEWIDE PROGRAM; ESTABLISHMENT.] The 447.33 commissioner shall establish a statewide program to assist 447.34 counties in providing services to children with severe emotional 447.35 disturbance as defined in section 245.4871, subdivision 15, and 447.36 their families; and to young adults meeting the criteria for 448.1 transition services in section 245.4875, subdivision 8, and 448.2 their families. Services must be designed to help each child to 448.3 function and remain with the child's family in the community. 448.4 Transition services to eligible young adults must be designed to 448.5 foster independent living in the community. The commissioner 448.6 shall make grants to counties to establish, operate, or contract 448.7 with private providers to provide the following services in the 448.8 following order of priority when these cannot be reimbursed 448.9 under section 256B.0625: 448.10 (1) family community support services including crisis 448.11 placement and crisis respite care as specified in section 448.12 245.4871, subdivision 17; 448.13 (2) case management services as specified in section 448.14 245.4871, subdivision 3; 448.15 (3) day treatment services as specified in section 448.16 245.4871, subdivision 10; 448.17 (4) professional home-based family treatment as specified 448.18 in section 245.4871, subdivision 31; and 448.19 (5) therapeutic support of foster care as specified in 448.20 section 245.4871, subdivision 34. 448.21 Funding appropriated beginning July 1, 1991, must be used 448.22 by county boards to provide family community support services 448.23 and case management services. Additional services shall be 448.24 provided in the order of priority as identified in this 448.25 subdivision. 448.26 Sec. 28. Minnesota Statutes 2000, section 245.99, 448.27 subdivision 4, is amended to read: 448.28 Subd. 4. [ADMINISTRATION OF CRISIS HOUSING ASSISTANCE.] 448.29 The commissioner may contract with organizations or government 448.30 units experienced in housing assistance to operate the program 448.31 under this section. This program is not an entitlement. The 448.32 commissioner may take any of the following steps whenever the 448.33 commissioner projects that funds will be inadequate to meet 448.34 demand in a given fiscal year: 448.35 (1) transfer funds from mental health grants in the same 448.36 appropriation; and 449.1 (2) impose statewide restrictions as to the type and amount 449.2 of assistance available to each recipient under this program, 449.3 including reducing the income eligibility level, limiting 449.4 reimbursement to a percentage of each recipient's costs, 449.5 limiting housing assistance to 60 days per recipient, or closing 449.6 the program for the remainder of the fiscal year. 449.7 Sec. 29. Minnesota Statutes 2000, section 253.28, is 449.8 amended by adding a subdivision to read: 449.9 Subd. 1a. [STATE-OPERATED SERVICES 449.10 AUTHORIZATION.] According to section 246.0136, the commissioner 449.11 of human services is authorized to implement, as an enterprise 449.12 activity, state-operated adult mental health services developed 449.13 for the purposes of preventing inpatient hospitalization or 449.14 facilitating the transition from hospital to community 449.15 placement, that qualify under the standards for adult mental 449.16 health rehabilitative services in section 256B.0623 and adult 449.17 mental health crisis response services in section 256B.0624, 449.18 once those options are incorporated as part of the approved 449.19 state medical assistance plan. 449.20 Sec. 30. Minnesota Statutes 2000, section 253B.02, 449.21 subdivision 10, is amended to read: 449.22 Subd. 10. [INTERESTED PERSON.] "Interested person" means: 449.23 (1) an adult, including but not limited to, a public 449.24 official, including a local welfare agency acting under section 449.25 626.5561, and the legal guardian, spouse, parent, legal counsel, 449.26 adult child, next of kin, or other person designated by a 449.27 proposed patient; or 449.28 (2) a health plan company. 449.29 Sec. 31. Minnesota Statutes 2000, section 253B.03, 449.30 subdivision 5, is amended to read: 449.31 Subd. 5. [PERIODIC ASSESSMENT.] A patient has the right to 449.32 periodic medical assessment, including assessment of the medical 449.33 necessity of continuing care and, if the treatment facility 449.34 declines to provide continuing care, the right to receive 449.35 specific written reasons why continuing care is declined at the 449.36 time of the assessment. The treatment facility shall assess the 450.1 physical and mental condition of every patient as frequently as 450.2 necessary, but not less often than annually. If the patient 450.3 refuses to be examined, the facility shall document in the 450.4 patient's chart its attempts to examine the patient. If a 450.5 person is committed as mentally retarded for an indeterminate 450.6 period of time, the three-year judicial review must include the 450.7 annual reviews for each year as outlined in Minnesota Rules, 450.8 part 9525.0075, subpart 6. 450.9 Sec. 32. Minnesota Statutes 2000, section 253B.03, 450.10 subdivision 10, is amended to read: 450.11 Subd. 10. [NOTIFICATION.] All persons admitted or 450.12 committed to a treatment facility shall be notified in writing 450.13 of their rightsunder this chapterregarding hospitalization and 450.14 other treatment at the time of admission. This notification 450.15 must include: 450.16 (1) patient rights specified in this section and section 450.17 144.651, including nursing home discharge rights; 450.18 (2) the right to obtain treatment and services voluntarily 450.19 under this chapter; 450.20 (3) the right to voluntary admission and release under 450.21 section 253B.04; 450.22 (4) rights in case of an emergency admission under section 450.23 253B.05, including the right to documentation in support of an 450.24 emergency hold and the right to a summary hearing before a judge 450.25 if the patient believes an emergency hold is improper; 450.26 (5) the right to request expedited review under section 450.27 62M.05 if additional days of inpatient stay are denied; 450.28 (6) the right to continuing benefits pending appeal and to 450.29 an expedited administrative hearing under section 256.045 if the 450.30 patient is a recipient of medical assistance, general assistance 450.31 medical care, or MinnesotaCare; and 450.32 (7) the right to an external appeal process under section 450.33 62Q.73, including the right to a second opinion. 450.34 Sec. 33. Minnesota Statutes 2000, section 253B.03, is 450.35 amended by adding a subdivision to read: 450.36 Subd. 11. [PROXY.] A legally authorized health care proxy, 451.1 agent, guardian, or conservator may exercise the patient's 451.2 rights on the patient's behalf. 451.3 Sec. 34. Minnesota Statutes 2000, section 253B.04, 451.4 subdivision 1, is amended to read: 451.5 Subdivision 1. [VOLUNTARY ADMISSION AND TREATMENT.] (a) 451.6 Voluntary admission is preferred over involuntary commitment and 451.7 treatment. Any person 16 years of age or older may request to 451.8 be admitted to a treatment facility as a voluntary patient for 451.9 observation, evaluation, diagnosis, care and treatment without 451.10 making formal written application. Any person under the age of 451.11 16 years may be admitted as a patient with the consent of a 451.12 parent or legal guardian if it is determined by independent 451.13 examination that there is reasonable evidence that (1) the 451.14 proposed patient has a mental illness, or is mentally retarded 451.15 or chemically dependent; and (2) the proposed patient is 451.16 suitable for treatment. The head of the treatment facility 451.17 shall not arbitrarily refuse any person seeking admission as a 451.18 voluntary patient. In making decisions regarding admissions, 451.19 the facility shall use clinical admission criteria consistent 451.20 with the current applicable inpatient admission standards 451.21 established by the American Psychiatric Association or the 451.22 American Academy of Child and Adolescent Psychiatry. These 451.23 criteria must be no more restrictive than, and must be 451.24 consistent with, the requirements of section 62Q.53. The 451.25 facility may not refuse to admit a person voluntarily solely 451.26 because the person does not meet the criteria for involuntary 451.27 holds under section 253B.05 or the definition of mental illness 451.28 under section 253B.02, subdivision 13. 451.29 (b) In addition to the consent provisions of paragraph (a), 451.30 a person who is 16 or 17 years of age who refuses to consent 451.31 personally to admission may be admitted as a patient for mental 451.32 illness or chemical dependency treatment with the consent of a 451.33 parent or legal guardian if it is determined by an independent 451.34 examination that there is reasonable evidence that the proposed 451.35 patient is chemically dependent or has a mental illness and is 451.36 suitable for treatment. The person conducting the examination 452.1 shall notify the proposed patient and the parent or legal 452.2 guardian of this determination. 452.3 Sec. 35. Minnesota Statutes 2000, section 253B.04, 452.4 subdivision 1a, is amended to read: 452.5 Subd. 1a. [VOLUNTARY TREATMENT OR ADMISSION FOR PERSONS 452.6 WITH MENTAL ILLNESS.] (a) A person with a mental illness may 452.7 seek or voluntarily agree to accept treatment or admission to a 452.8 facility. If the mental health provider determines that the 452.9 person lacks the capacity to give informed consent for the 452.10 treatment or admission, and in the absence of a health care 452.11 power of attorney that authorizes consent, the designated agency 452.12 or its designee may give informed consent for mental health 452.13 treatment or admission to a treatment facility on behalf of the 452.14 person. 452.15 (b) The designated agency shall apply the following 452.16 criteria in determining the person's ability to give informed 452.17 consent: 452.18 (1) whether the person demonstrates an awareness of the 452.19 person's illness, and the reasons for treatment, its risks, 452.20 benefits and alternatives, and the possible consequences of 452.21 refusing treatment; and 452.22 (2) whether the person communicates verbally or nonverbally 452.23 a clear choice concerning treatment that is a reasoned one, not 452.24 based on delusion, even though it may not be in the person's 452.25 best interests. 452.26 (c) The basis for the designated agency's decision that the 452.27 person lacks the capacity to give informed consent for treatment 452.28 or admission, and that the patient has voluntarily accepted 452.29 treatment or admission, must be documented in writing. 452.30 (d) A mental health provider that provides treatment in 452.31 reliance on the written consent given by the designated agency 452.32 under this subdivision or by a substitute decision maker 452.33 appointed by the court is not civilly or criminally liable for 452.34 performing treatment without consent. This paragraph does not 452.35 affect any other liability that may result from the manner in 452.36 which the treatment is performed. 453.1 (e) A person who receives treatment or is admitted to a 453.2 facility under this subdivision or subdivision 1b has the right 453.3 to refuse treatment at any time or to be released from a 453.4 facility as provided under subdivision 2. The person or any 453.5 interested person acting on the person's behalf may seek court 453.6 review within five days for a determination of whether the 453.7 person's agreement to accept treatment or admission is 453.8 voluntary. At the time a person agrees to treatment or 453.9 admission to a facility under this subdivision, the designated 453.10 agency or its designee shall inform the person in writing of the 453.11 person's rights under this paragraph. 453.12 (f) This subdivision does not authorize the administration 453.13 of neuroleptic medications. Neuroleptic medications may be 453.14 administered only as provided in section 253B.092. 453.15 Sec. 36. Minnesota Statutes 2000, section 253B.04, is 453.16 amended by adding a subdivision to read: 453.17 Subd. 1b. [COURT APPOINTMENT OF SUBSTITUTE DECISION 453.18 MAKER.] If the designated agency or its designee declines or 453.19 refuses to give informed consent under subdivision 1a, the 453.20 person who is seeking treatment or admission, or an interested 453.21 person acting on behalf of the person, may petition the court 453.22 for appointment of a substitute decision maker who may give 453.23 informed consent for voluntary treatment and services. In 453.24 making this determination, the court shall apply the criteria in 453.25 subdivision 1a, paragraph (b). 453.26 Sec. 37. Minnesota Statutes 2000, section 253B.045, 453.27 subdivision 6, is amended to read: 453.28 Subd. 6. [COVERAGE.]A health plan company must provide453.29coverage, according to the terms of the policy, contract, or453.30certificate of coverage, for all medically necessary covered453.31services as determined by section 62Q.53 provided to an enrollee453.32that are ordered by the court under this chapter.(a) For 453.33 purposes of this section, "mental health services" means all 453.34 covered services that are intended to treat or ameliorate an 453.35 emotional, behavioral, or psychiatric condition and that are 453.36 covered by the policy, contract, or certificate of coverage of 454.1 the enrollee's health plan company or by law. 454.2 (b) All health plan companies that provide coverage for 454.3 mental health services must cover or provide mental health 454.4 services ordered by a court of competent jurisdiction under a 454.5 court order that is issued on the basis of a behavioral care 454.6 evaluation performed by a licensed psychiatrist or a doctoral 454.7 level licensed psychologist, which includes a diagnosis and an 454.8 individual treatment plan for care in the most appropriate, 454.9 least restrictive environment. The health plan company must be 454.10 given a copy of the court order and the behavioral care 454.11 evaluation. The health plan company shall be financially liable 454.12 for the evaluation if performed by a participating provider of 454.13 the health plan company and shall be financially liable for the 454.14 care included in the court-ordered individual treatment plan if 454.15 the care is covered by the health plan company and ordered to be 454.16 provided by a participating provider or another provider as 454.17 required by rule or law. This court-ordered coverage must not 454.18 be subject to a separate medical necessity determination by a 454.19 health plan company under its utilization procedures. 454.20 Sec. 38. Minnesota Statutes 2000, section 253B.05, 454.21 subdivision 1, is amended to read: 454.22 Subdivision 1. [EMERGENCY HOLD.] (a) Any person may be 454.23 admitted or held for emergency care and treatment in a treatment 454.24 facility with the consent of the head of the treatment facility 454.25 upon a written statement by an examiner that: 454.26 (1) the examiner has examined the person not more than 15 454.27 days prior to admission,; 454.28 (2) the examiner is of the opinion, for stated reasons, 454.29 that the person is mentally ill, mentally retarded or chemically 454.30 dependent, and is inimminentdanger of causing injury to self 454.31 or others if not immediatelyrestrained,detained; and 454.32 (3) an order of the court cannot be obtained in time to 454.33 prevent the anticipated injury. 454.34 (b) If the proposed patient has been brought to the 454.35 treatment facility by another person, the examiner shall make a 454.36 good faith effort to obtain a statement of information that is 455.1 available from that person, which must be taken into 455.2 consideration in deciding whether to place the proposed patient 455.3 on an emergency hold. The statement of information must include 455.4 direct observations of the proposed patient's behaviors, 455.5 reliable knowledge of recent and past behavior, and information 455.6 regarding psychiatric history, past treatment, and current 455.7 mental health providers. The examiner shall also inquire into 455.8 the existence of health care directives under chapter 145, and 455.9 advance psychiatric directives under section 253B.03, 455.10 subdivision 6d. 455.11 (c) The examiner's statement shall be: (1) sufficient 455.12 authority for a peace or health officer to transport a patient 455.13 to a treatment facility, (2) stated in behavioral terms and not 455.14 in conclusory language, and (3) of sufficient specificity to 455.15 provide an adequate record for review. Ifimminentdanger to 455.16 specific individuals is a basis for the emergency hold, the 455.17 statement must identify those individuals, to the extent 455.18 practicable. A copy of the examiner's statement shall be 455.19 personally served on the person immediately upon admission and a 455.20 copy shall be maintained by the treatment facility. 455.21 Sec. 39. Minnesota Statutes 2000, section 253B.07, 455.22 subdivision 1, is amended to read: 455.23 Subdivision 1. [PREPETITION SCREENING.] (a) Prior to 455.24 filing a petition for commitment of or early intervention for a 455.25 proposed patient, an interested person shall apply to the 455.26 designated agency in the county of the proposed patient's 455.27 residence or presence for conduct of a preliminary 455.28 investigation, except when the proposed patient has been 455.29 acquitted of a crime under section 611.026 and the county 455.30 attorney is required to file a petition for commitment. The 455.31 designated agency shall appoint a screening team to conduct an 455.32 investigationwhich shall include. The petitioner may not be a 455.33 member of the screening team. The investigation must include: 455.34 (i) a personal interview with the proposed patient and 455.35 other individuals who appear to have knowledge of the condition 455.36 of the proposed patient. If the proposed patient is not 456.1 interviewed, specific reasons must be documented; 456.2 (ii) identification and investigation of specific alleged 456.3 conduct which is the basis for application; 456.4 (iii) identification, exploration, and listing of 456.5 the specific reasons for rejecting or recommending alternatives 456.6 to involuntary placement; 456.7 (iv) in the case of a commitment based on mental illness, 456.8 the following information, if it is known or available:456.9information, that may be relevant to the administration of 456.10 neuroleptic medications,if necessary,including the existence 456.11 of a declaration under section 253B.03, subdivision 6d, or a 456.12 health care directive under chapter 145C or a guardian, 456.13 conservator, proxy, or agent with authority to make health care 456.14 decisions for the proposed patient; information regarding the 456.15 capacity of the proposed patient to make decisions regarding 456.16 administration of neuroleptic medication; and whether the 456.17 proposed patient is likely to consent or refuse consent to 456.18 administration of the medication; and 456.19 (v) seeking input from the proposed patient's health plan 456.20 company to provide the court with information about services the 456.21 enrollee needs and the least restrictive alternatives. 456.22 (vi) in the case of a commitment based on mental illness, 456.23 information listed in clause (iv) for other purposes relevant to 456.24 treatment. 456.25 (b) In conducting the investigation required by this 456.26 subdivision, the screening team shall have access to all 456.27 relevant medical records of proposed patients currently in 456.28 treatment facilities. Data collected pursuant to this clause 456.29 shall be considered private data on individuals. The 456.30 prepetition screening report is not admissible as evidence 456.31 except by agreement of counsel and is not admissible in any 456.32 court proceedings unrelated to the commitment proceedings. 456.33 (c) The prepetition screening team shall provide a notice, 456.34 written in easily understood language, to the proposed patient, 456.35 the petitioner, persons named in a declaration under chapter 456.36 145C or section 253B.03, subdivision 6d, and, with the proposed 457.1 patient's consent, other interested parties. The team shall ask 457.2 the patient if the patient wants the notice read and shall read 457.3 the notice to the patient upon request. The notice must contain 457.4 information regarding the process, purpose, and legal effects of 457.5 civil commitment and early intervention. The notice must inform 457.6 the proposed patient that: 457.7 (1) if a petition is filed, the patient has certain rights, 457.8 including the right to a court-appointed attorney, the right to 457.9 request a second examiner, the right to attend hearings, and the 457.10 right to oppose the proceeding and to present and contest 457.11 evidence; and 457.12 (2) if the proposed patient is committed to a state 457.13 regional treatment center or group home, the patient will be 457.14 billed for the cost of care and the state has the right to make 457.15 a claim against the patient's estate for this cost. 457.16 The ombudsman for mental health and mental retardation 457.17 shall develop a form for the notice, which includes the 457.18 requirements of this paragraph. 457.19 (d) When the prepetition screening team recommends 457.20 commitment, a written report shall be sent to the county 457.21 attorney for the county in which the petition is to be 457.22 filed. The statement of facts contained in the written report 457.23 must meet the requirements of subdivision 2, paragraph (b). 457.24(d)(e) The prepetition screening team shall refuse to 457.25 support a petition if the investigation does not disclose 457.26 evidence sufficient to support commitment. Notice of the 457.27 prepetition screening team's decision shall be provided to the 457.28 prospective petitioner and to the proposed patient. 457.29(e)(f) If the interested person wishes to proceed with a 457.30 petition contrary to the recommendation of the prepetition 457.31 screening team, application may be made directly to the county 457.32 attorney, whomayshall determine whether or not to proceed with 457.33 the petition. Notice of the county attorney's determination 457.34 shall be provided to the interested party. 457.35(f)(g) If the proposed patient has been acquitted of a 457.36 crime under section 611.026, the county attorney shall apply to 458.1 the designated county agency in the county in which the 458.2 acquittal took place for a preliminary investigation unless 458.3 substantially the same information relevant to the proposed 458.4 patient's current mental condition, as could be obtained by a 458.5 preliminary investigation, is part of the court record in the 458.6 criminal proceeding or is contained in the report of a mental 458.7 examination conducted in connection with the criminal 458.8 proceeding. If a court petitions for commitment pursuant to the 458.9 rules of criminal or juvenile procedure or a county attorney 458.10 petitions pursuant to acquittal of a criminal charge under 458.11 section 611.026, the prepetition investigation, if required by 458.12 this section, shall be completed within seven days after the 458.13 filing of the petition. 458.14 Sec. 40. Minnesota Statutes 2000, section 253B.09, 458.15 subdivision 1, is amended to read: 458.16 Subdivision 1. [STANDARD OF PROOF.] (a) If the court finds 458.17 by clear and convincing evidence that the proposed patient is a 458.18 mentally ill, mentally retarded, or chemically dependent person 458.19 and after careful consideration of reasonable alternative 458.20 dispositions, including but not limited to, dismissal of 458.21 petition, voluntary outpatient care, voluntary admission to a 458.22 treatment facility, appointment of a guardian or conservator, or 458.23 release before commitment as provided for in subdivision 4, it 458.24 finds that there is no suitable alternative to judicial 458.25 commitment, the court shall commit the patient to the least 458.26 restrictive treatment program or alternative programs which can 458.27 meet the patient's treatment needs consistent with section 458.28 253B.03, subdivision 7. 458.29 (b) In deciding on the least restrictive program, the court 458.30 shall consider a range of treatment alternatives including, but 458.31 not limited to, community-based nonresidential treatment, 458.32 community residential treatment, partial hospitalization, acute 458.33 care hospital, and regional treatment center services. The 458.34 court shall also consider the proposed patient's treatment 458.35 preferences and willingness to participate voluntarily in the 458.36 treatment ordered. The court may not commit a patient to a 459.1 facility or program that is not capable of meeting the patient's 459.2 needs. 459.3 (c) For purposes of findings under this chapter, none of 459.4 the following constitute a refusal to accept appropriate mental 459.5 health treatment: 459.6 (1) a willingness to take medication but a reasonable 459.7 disagreement about type or dosage; 459.8 (2) a good-faith effort to follow a reasonable alternative 459.9 treatment plan, including treatment as specified in a valid 459.10 advance directive under chapter 145C or section 253B.03, 459.11 subdivision 6d; 459.12 (3) an inability to obtain access to appropriate treatment 459.13 because of inadequate health care coverage or an insurer's 459.14 refusal or delay in providing coverage for the treatment; or 459.15 (4) an inability to obtain access to needed mental health 459.16 services because the provider will only accept patients who are 459.17 under a court order or because the provider gives persons under 459.18 a court order a priority over voluntary patients in obtaining 459.19 treatment and services. 459.20 Sec. 41. Minnesota Statutes 2000, section 253B.10, 459.21 subdivision 4, is amended to read: 459.22 Subd. 4. [PRIVATE TREATMENT.] Patients or other 459.23 responsible persons are required to pay the necessary charges 459.24 for patients committed or transferred to private treatment 459.25 facilities.Private treatment facilities may refuse to accept a459.26committed person.Insurers must provide court-ordered treatment 459.27 and services as ordered by the court under section 253B.045, 459.28 subdivision 6, or as required under chapter 62M. 459.29 Sec. 42. Minnesota Statutes 2000, section 256.969, 459.30 subdivision 3a, is amended to read: 459.31 Subd. 3a. [PAYMENTS.] Acute care hospital billings under 459.32 the medical assistance program must not be submitted until the 459.33 recipient is discharged. However, the commissioner shall 459.34 establish monthly interim payments for inpatient hospitals that 459.35 have individual patient lengths of stay over 30 days regardless 459.36 of diagnostic category. Except as provided in section 256.9693, 460.1 medical assistance reimbursement for treatment of mental illness 460.2 shall be reimbursed based on diagnostic classifications.The460.3commissioner may selectively contract with hospitals for460.4services within the diagnostic categories relating to mental460.5illness and chemical dependency under competitive bidding when460.6reasonable geographic access by recipients can be assured. No460.7physician shall be denied the privilege of treating a recipient460.8required to use a hospital under contract with the commissioner,460.9as long as the physician meets credentialing standards of the460.10individual hospital.Individual hospital payments established 460.11 under this section and sections 256.9685, 256.9686, and 460.12 256.9695, in addition to third party and recipient liability, 460.13 for discharges occurring during the rate year shall not exceed, 460.14 in aggregate, the charges for the medical assistance covered 460.15 inpatient services paid for the same period of time to the 460.16 hospital. This payment limitation shall be calculated 460.17 separately for medical assistance and general assistance medical 460.18 care services. The limitation on general assistance medical 460.19 care shall be effective for admissions occurring on or after 460.20 July 1, 1991. Services that have rates established under 460.21 subdivision 11 or 12, must be limited separately from other 460.22 services. After consulting with the affected hospitals, the 460.23 commissioner may consider related hospitals one entity and may 460.24 merge the payment rates while maintaining separate provider 460.25 numbers. The operating and property base rates per admission or 460.26 per day shall be derived from the best Medicare and claims data 460.27 available when rates are established. The commissioner shall 460.28 determine the best Medicare and claims data, taking into 460.29 consideration variables of recency of the data, audit 460.30 disposition, settlement status, and the ability to set rates in 460.31 a timely manner. The commissioner shall notify hospitals of 460.32 payment rates by December 1 of the year preceding the rate 460.33 year. The rate setting data must reflect the admissions data 460.34 used to establish relative values. Base year changes from 1981 460.35 to the base year established for the rate year beginning January 460.36 1, 1991, and for subsequent rate years, shall not be limited to 461.1 the limits ending June 30, 1987, on the maximum rate of increase 461.2 under subdivision 1. The commissioner may adjust base year 461.3 cost, relative value, and case mix index data to exclude the 461.4 costs of services that have been discontinued by the October 1 461.5 of the year preceding the rate year or that are paid separately 461.6 from inpatient services. Inpatient stays that encompass 461.7 portions of two or more rate years shall have payments 461.8 established based on payment rates in effect at the time of 461.9 admission unless the date of admission preceded the rate year in 461.10 effect by six months or more. In this case, operating payment 461.11 rates for services rendered during the rate year in effect and 461.12 established based on the date of admission shall be adjusted to 461.13 the rate year in effect by the hospital cost index. 461.14 Sec. 43. [256.9693] [CONTINUING CARE PROGRAM FOR PERSONS 461.15 WITH MENTAL ILLNESS.] 461.16 The commissioner shall establish a continuing care benefit 461.17 program for persons with mental illness in which persons with 461.18 mental illness may obtain acute care hospital inpatient 461.19 treatment for mental illness for up to 45 days beyond that 461.20 allowed by section 256.969. Persons with mental illness who are 461.21 eligible for medical assistance may obtain inpatient treatment 461.22 under this program in hospital beds for which the commissioner 461.23 contracts under this section. The commissioner may selectively 461.24 contract with hospitals to provide this benefit through 461.25 competitive bidding when reasonable geographic access by 461.26 recipients can be assured. Payments under this section shall 461.27 not affect payments under section 256.969. The commissioner may 461.28 contract externally with a utilization review organization to 461.29 authorize persons with mental illness to access the continuing 461.30 care benefit program. The commissioner shall, as part of the 461.31 contracting process, establish admission criteria to allow 461.32 persons with mental illness to access the continuing care 461.33 benefit program. If a court orders acute care hospital 461.34 inpatient treatment for mental illness for a person, the person 461.35 may obtain the treatment under the continuing care benefit 461.36 program. The commissioner shall not require, as part of the 462.1 admission criteria, any commitment or petition under chapter 462.2 253B as a condition of accessing the program. This benefit is 462.3 not available for people who are also eligible for Medicare and 462.4 who have not exhausted their annual or lifetime inpatient 462.5 psychiatric benefit under Medicare. If the recipient is 462.6 enrolled in a prepaid health plan, this benefit is included in 462.7 the health plan's coverage. 462.8 Sec. 44. [256B.0623] [ADULT REHABILITATIVE MENTAL HEALTH 462.9 SERVICES.] 462.10 Subdivision 1. [SCOPE.] Medical assistance covers adult 462.11 rehabilitative mental health services as defined in subdivision 462.12 2, subject to federal approval, if provided to recipients as 462.13 defined in subdivision 3 and provided by a qualified provider 462.14 entity meeting the standards in this section and by a qualified 462.15 individual provider working within the provider's scope of 462.16 practice and identified in the recipient's individual treatment 462.17 plan as defined in section 245.462, subdivision 14, and if 462.18 determined to be medically necessary according to section 62Q.53. 462.19 Subd. 2. [DEFINITIONS.] For purposes of this section, the 462.20 following terms have the meanings given them. 462.21 (a) "Adult rehabilitative mental health services" means 462.22 mental health services which are rehabilitative and enable the 462.23 recipient to develop and enhance psychiatric stability, social 462.24 competencies, personal and emotional adjustment, and independent 462.25 living and community skills, when these abilities are impaired 462.26 by the symptoms of mental illness. Adult rehabilitative mental 462.27 health services are also appropriate when provided to enable a 462.28 recipient to retain stability and functioning, if the recipient 462.29 would be at risk of significant functional decompensation or 462.30 more restrictive service settings without these services. 462.31 (1) Adult rehabilitative mental health services instruct, 462.32 assist, and support the recipient in areas such as: 462.33 interpersonal communication skills, community resource 462.34 utilization and integration skills, crisis assistance, relapse 462.35 prevention skills, health care directives, budgeting and 462.36 shopping skills, healthy lifestyle skills and practices, cooking 463.1 and nutrition skills, transportation skills, medication 463.2 education and monitoring, mental illness symptom management 463.3 skills, household management skills, employment-related skills, 463.4 and transition to community living services. 463.5 (2) These services shall be provided to the recipient on a 463.6 one-to-one basis in the recipient's home or another community 463.7 setting or in groups. 463.8 (b) "Medication education services" means services provided 463.9 individually or in groups which focus on educating the recipient 463.10 about mental illness and symptoms; the role and effects of 463.11 medications in treating symptoms of mental illness; and the side 463.12 effects of medications. Medication education is coordinated 463.13 with medication management services, and does not duplicate it. 463.14 Medication education services are provided by physicians, 463.15 pharmacists, or registered nurses. 463.16 (c) "Transition to community living services" means 463.17 services which maintain continuity of contact between the 463.18 rehabilitation services provider and the recipient and which 463.19 facilitate discharge from a hospital, residential treatment 463.20 program under Minnesota Rules, chapter 9505, board and lodging 463.21 facility, or nursing home. Transition to community living 463.22 services are not intended to provide other areas of adult 463.23 rehabilitative mental health services. 463.24 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 463.25 individual who: 463.26 (1) is age 18 or older; 463.27 (2) is diagnosed with a medical condition, such as mental 463.28 illness or traumatic brain injury, for which adult 463.29 rehabilitative mental health services are needed; 463.30 (3) has substantial disability and functional impairment in 463.31 three or more of the areas listed in section 245.462, 463.32 subdivision 11a, so that self-sufficiency is markedly reduced; 463.33 and 463.34 (4) has had a recent diagnostic assessment by a qualified 463.35 professional that documents adult rehabilitative mental health 463.36 services are medically necessary to address identified 464.1 disability and functional impairments and individual recipient 464.2 goals. 464.3 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) The provider 464.4 entity must be: 464.5 (1) a county operated entity certified by the state; or 464.6 (2) a noncounty entity certified by the entity's host 464.7 county. 464.8 (b) The certification process is a determination as to 464.9 whether the entity meets the standards in this subdivision. The 464.10 certification must specify which adult rehabilitative mental 464.11 health services the entity is qualified to provide. 464.12 (c) If an entity seeks to provide services outside its host 464.13 county, it must obtain additional certification from each county 464.14 in which it will provide services. The additional certification 464.15 must be based on the adequacy of the entity's knowledge of that 464.16 county's local health and human service system, and the ability 464.17 of the entity to coordinate its services with the other services 464.18 available in that county. 464.19 (d) Recertification must occur at least every two years. 464.20 (e) The commissioner may intervene at any time and 464.21 decertify providers with cause. The decertification is subject 464.22 to appeal to the state. A county board may recommend that the 464.23 state decertify a provider for cause. 464.24 (f) The adult rehabilitative mental health services 464.25 provider entity must meet the following standards: 464.26 (1) have capacity to recruit, hire, manage, and train 464.27 mental health professionals, mental health practitioners, and 464.28 mental health rehabilitation workers; 464.29 (2) have adequate administrative ability to ensure 464.30 availability of services; 464.31 (3) ensure adequate preservice and inservice training for 464.32 staff; 464.33 (4) ensure that mental health professionals, mental health 464.34 practitioners, and mental health rehabilitation workers are 464.35 skilled in the delivery of the specific adult rehabilitative 464.36 mental health services provided to the individual eligible 465.1 recipient; 465.2 (5) ensure that staff is capable of implementing culturally 465.3 specific services that are culturally competent and appropriate 465.4 as determined by the recipient's culture, beliefs, values, and 465.5 language as identified in the individual treatment plan; 465.6 (6) ensure enough flexibility in service delivery to 465.7 respond to the changing and intermittent care needs of a 465.8 recipient as identified by the recipient and the individual 465.9 treatment plan; 465.10 (7) ensure that the mental health professional or mental 465.11 health practitioner, who is under the clinical supervision of a 465.12 mental health professional, involved in a recipient's services 465.13 participates in the development of the individual treatment 465.14 plan; 465.15 (8) assist the recipient in arranging needed crisis 465.16 assessment, intervention, and stabilization services; 465.17 (9) ensure that services are coordinated with other 465.18 recipient mental health services providers and the county mental 465.19 health authority and the federally recognized American Indian 465.20 authority and necessary others after obtaining the consent of 465.21 the recipient. Services must also be coordinated with the 465.22 recipient's case manager or care coordinator, if the recipient 465.23 is receiving case management or care coordination services; 465.24 (10) develop and maintain recipient files, individual 465.25 treatment plans, and contact charting; 465.26 (11) develop and maintain staff training and personnel 465.27 files; 465.28 (12) submit information as required by the state; 465.29 (13) establish and maintain a quality assurance plan to 465.30 evaluate the outcome of services provided; 465.31 (14) keep all necessary records required by law; 465.32 (15) deliver services as required by section 245.461; 465.33 (16) comply with all applicable laws; 465.34 (17) be an enrolled Medicaid provider; 465.35 (18) maintain a quality assurance plan to determine 465.36 specific service outcomes and the recipient's satisfaction with 466.1 services; and 466.2 (19) develop and maintain written policies and procedures 466.3 regarding service provision and administration of the provider 466.4 entity. 466.5 (g) The commissioner shall develop statewide procedures for 466.6 provider certification, including timelines for counties to 466.7 certify qualified providers. 466.8 Subd. 5. [QUALIFICATIONS OF PROVIDER STAFF.] Adult 466.9 rehabilitative mental health services must be provided by 466.10 qualified individual provider staff of a certified provider 466.11 entity. Individual provider staff must be qualified under one 466.12 of the following criteria: 466.13 (1) a mental health professional as defined in section 466.14 245.462, subdivision 18, clauses (1) to (5); 466.15 (2) a mental health practitioner as defined in section 466.16 245.462, subdivision 17. The mental health practitioner must 466.17 work under the clinical supervision of a mental health 466.18 professional; or 466.19 (3) a mental health rehabilitation worker. A mental health 466.20 rehabilitation worker means a staff person working under the 466.21 direction of a mental health practitioner or mental health 466.22 professional, and under the clinical supervision of a mental 466.23 health professional in the implementation of rehabilitative 466.24 mental health services as identified in the recipient's 466.25 individual treatment plan; and who: 466.26 (i) is at least 21 years of age; 466.27 (ii) has a high school diploma or equivalent; 466.28 (iii) has successfully completed 30 hours of training 466.29 during the past two years in all of the following areas: 466.30 recipient rights, recipient-centered individual treatment 466.31 planning, behavioral terminology, mental illness, co-occurring 466.32 mental illness and substance abuse, psychotropic medications and 466.33 side effects, functional assessment, local community resources, 466.34 adult vulnerability, recipient confidentiality; and 466.35 (iv) meets the qualifications in (A) or (B): 466.36 (A) has an associate of arts degree in one of the 467.1 behavioral sciences or human services, or is a registered nurse 467.2 without a bachelor's degree, or who within the previous ten 467.3 years has: 467.4 (1) three years of personal life experience with serious 467.5 and persistent mental illness; 467.6 (2) three years of life experience as a primary caregiver 467.7 to an adult with a serious mental illness or traumatic brain 467.8 injury; or 467.9 (3) 4,000 hours of supervised paid work experience in the 467.10 delivery of mental health services to adults with a serious 467.11 mental illness or traumatic brain injury; or 467.12 (B)(1) be fluent in the non-English language or competent 467.13 in the culture of the ethnic group to which at least 50 percent 467.14 of the mental health rehabilitation worker's clients belong; 467.15 (2) receives during the first 2,000 hours of work, monthly 467.16 documented individual clinical supervision by a mental health 467.17 professional; 467.18 (3) has 18 hours of documented field supervision by a 467.19 mental health professional or practitioner during the first 160 467.20 hours of contact work with recipients, and at least six hours of 467.21 field supervision quarterly during the following year; 467.22 (4) has review and cosignature of charting of recipient 467.23 contacts during field supervision by a mental health 467.24 professional or practitioner; and 467.25 (5) has 40 hours of additional continuing education on 467.26 mental health topics during the first year of employment. 467.27 Subd. 6. [REQUIRED TRAINING AND SUPERVISION.] (a) Mental 467.28 health rehabilitation workers must receive ongoing continuing 467.29 education training of at least 30 hours every two years in areas 467.30 of mental illness and mental health services and other areas 467.31 specific to the population being served. Mental health 467.32 rehabilitation workers must also be subject to the ongoing 467.33 direction and clinical supervision standards in paragraphs (c) 467.34 and (d). 467.35 (b) Mental health practitioners must receive ongoing 467.36 continuing education training as required by their professional 468.1 license; or if the practitioner is not licensed, the 468.2 practitioner must receive ongoing continuing education training 468.3 of at least 30 hours every two years in areas of mental illness 468.4 and mental health services. Mental health practitioners must 468.5 meet the ongoing clinical supervision standards in paragraph (c). 468.6 (c) A mental health professional providing clinical 468.7 supervision of staff delivering adult rehabilitative mental 468.8 health services must provide the following guidance: 468.9 (1) review the information in the recipient's file; 468.10 (2) review and approve initial and updates of individual 468.11 treatment plans; 468.12 (3) meet with mental health rehabilitation workers and 468.13 practitioners, individually or in small groups, at least monthly 468.14 to discuss treatment topics of interest to the workers and 468.15 practitioners; 468.16 (4) meet with mental health rehabilitation workers and 468.17 practitioners, individually or in small groups, at least monthly 468.18 to discuss treatment plans of recipients, and approve by 468.19 signature and document in the recipient's file any resulting 468.20 plan updates; 468.21 (5) meet at least twice a month with the directing mental 468.22 health practitioner, if there is one, to review needs of the 468.23 adult rehabilitative mental health services program, review 468.24 staff on-site observations and evaluate mental health 468.25 rehabilitation workers, plan staff training, review program 468.26 evaluation and development, and consult with the directing 468.27 practitioner; 468.28 (6) be available for urgent consultation as the individual 468.29 recipient needs or the situation necessitates; and 468.30 (7) provide clinical supervision by full- or part-time 468.31 mental health professionals employed by or under contract with 468.32 the provider entity. 468.33 (d) An adult rehabilitative mental health services provider 468.34 entity must have a treatment director who is a mental health 468.35 practitioner or mental health professional. The treatment 468.36 director must ensure the following: 469.1 (1) while delivering direct services to recipients, a newly 469.2 hired mental health rehabilitation worker must be directly 469.3 observed delivering services to recipients by the mental health 469.4 practitioner or mental health professional for at least six 469.5 hours per 40 hours worked during the first 160 hours that the 469.6 mental health rehabilitation worker works; 469.7 (2) the mental health rehabilitation worker must receive 469.8 ongoing on-site direct service observation by a mental health 469.9 professional or mental health practitioner for at least six 469.10 hours for every six months of employment; 469.11 (3) progress notes are reviewed from on-site service 469.12 observation prepared by the mental health rehabilitation worker 469.13 and mental health practitioner for accuracy and consistency with 469.14 actual recipient contact and the individual treatment plan and 469.15 goals; 469.16 (4) immediate availability by phone or in person for 469.17 consultation by a mental health professional or a mental health 469.18 practitioner to the mental health rehabilitation services worker 469.19 during service provision; 469.20 (5) oversee the identification of changes in individual 469.21 recipient treatment strategies, revise the plan and communicate 469.22 treatment instructions and methodologies as appropriate to 469.23 ensure that treatment is implemented correctly; 469.24 (6) model service practices which: respect the recipient, 469.25 include the recipient in planning and implementation of the 469.26 individual treatment plan, recognize the recipient's strengths, 469.27 collaborate and coordinate with other involved parties and 469.28 providers; 469.29 (7) ensure that mental health practitioners and mental 469.30 health rehabilitation workers are able to effectively 469.31 communicate with the recipients, significant others, and 469.32 providers; and 469.33 (8) oversee the record of the results of on-site 469.34 observation and charting evaluation and corrective actions taken 469.35 to modify the work of the mental health practitioners and mental 469.36 health rehabilitation workers. 470.1 (e) A mental health practitioner who is providing treatment 470.2 direction for a provider entity must receive supervision at 470.3 least monthly from a mental health professional to: 470.4 (1) identify and plan for general needs of the recipient 470.5 population served; 470.6 (2) identify and plan to address provider entity program 470.7 needs and effectiveness; 470.8 (3) identify and plan provider entity staff training and 470.9 personnel needs and issues; and 470.10 (4) plan, implement, and evaluate provider entity quality 470.11 improvement programs. 470.12 Subd. 7. [PERSONNEL FILE.] The adult rehabilitative mental 470.13 health services provider entity must maintain a personnel file 470.14 on each staff. Each file must contain: 470.15 (1) an annual performance review; 470.16 (2) a summary of on-site service observations and charting 470.17 review; 470.18 (3) a criminal background check of all direct service 470.19 staff; 470.20 (4) evidence of academic degree and qualifications; 470.21 (5) a copy of professional license; 470.22 (6) any job performance recognition and disciplinary 470.23 actions; 470.24 (7) any individual staff written input into own personnel 470.25 file; 470.26 (8) all clinical supervision provided; and 470.27 (9) documentation of compliance with continuing education 470.28 requirements. 470.29 Subd. 8. [DIAGNOSTIC ASSESSMENT.] Providers of adult 470.30 rehabilitative mental health services must complete a diagnostic 470.31 assessment as defined in section 245.462, subdivision 9, within 470.32 five days after the recipient's second visit or within 30 days 470.33 after intake, whichever occurs first. In cases where a 470.34 diagnostic assessment is available that reflects the recipient's 470.35 current status, and has been completed within 180 days preceding 470.36 admission, an update must be completed. An update shall include 471.1 a written summary by a mental health professional of the 471.2 recipient's current mental health status and service needs. If 471.3 the recipient's mental health status has changed significantly 471.4 since the adult's most recent diagnostic assessment, a new 471.5 diagnostic assessment is required. 471.6 Subd. 9. [FUNCTIONAL ASSESSMENT.] Providers of adult 471.7 rehabilitative mental health services must complete a written 471.8 functional assessment as defined in section 245.462, subdivision 471.9 11a, for each recipient. The functional assessment must be 471.10 completed within 30 days of intake, and reviewed and updated at 471.11 least every six months after it is developed, unless there is a 471.12 significant change in the functioning of the recipient. If 471.13 there is a significant change in functioning, the assessment 471.14 must be updated. A single functional assessment can meet case 471.15 management and adult rehabilitative mental health services 471.16 requirements, if agreed to by the recipient. Unless the 471.17 recipient refuses, the recipient must have significant 471.18 participation in the development of the functional assessment. 471.19 Subd. 10. [INDIVIDUAL TREATMENT PLAN.] All providers of 471.20 adult rehabilitative mental health services must develop and 471.21 implement an individual treatment plan for each recipient. The 471.22 provisions in clauses (1) and (2) apply: 471.23 (1) Individual treatment plan means a plan of intervention, 471.24 treatment, and services for an individual recipient written by a 471.25 mental health professional or by a mental health practitioner 471.26 under the clinical supervision of a mental health professional. 471.27 The individual treatment plan must be based on diagnostic and 471.28 functional assessments. To the extent possible, the development 471.29 and implementation of a treatment plan must be a collaborative 471.30 process involving the recipient, and with the permission of the 471.31 recipient, the recipient's family and others in the recipient's 471.32 support system. Providers of adult rehabilitative mental health 471.33 services must develop the individual treatment plan within 30 471.34 calendar days of intake. The treatment plan must be updated at 471.35 least every six months thereafter, or more often when there is 471.36 significant change in the recipient's situation or functioning, 472.1 or in services or service methods to be used, or at the request 472.2 of the recipient or the recipient's legal guardian. 472.3 (2) The individual treatment plan must include: 472.4 (i) a list of problems identified in the assessment; 472.5 (ii) the recipient's strengths and resources; 472.6 (iii) concrete, measurable goals to be achieved, including 472.7 time frames for achievement; 472.8 (iv) specific objectives directed toward the achievement of 472.9 each one of the goals; 472.10 (v) documentation of participants in the treatment planning. 472.11 The recipient, if possible, must be a participant. The 472.12 recipient or the recipient's legal guardian must sign the 472.13 treatment plan, or documentation must be provided why this was 472.14 not possible. A copy of the plan must be given to the recipient 472.15 or legal guardian. Referral to formal services must be 472.16 arranged, including specific providers where applicable; 472.17 (vi) cultural considerations, resources, and needs of the 472.18 recipient must be included; 472.19 (vii) planned frequency and type of services must be 472.20 initiated; and 472.21 (viii) clear progress notes on outcome of goals. 472.22 (3) The individual community support plan defined in 472.23 section 245.462, subdivision 12, may serve as the individual 472.24 treatment plan if there is involvement of a mental health case 472.25 manager, and with the approval of the recipient. The individual 472.26 community support plan must include the criteria in clause (2). 472.27 Subd. 11. [RECIPIENT FILE.] Providers of adult 472.28 rehabilitative mental health services must maintain a file for 472.29 each recipient that contains the following information: 472.30 (1) diagnostic assessment or verification of its location, 472.31 that is current and that was reviewed by a mental health 472.32 professional who is employed by or under contract with the 472.33 provider entity; 472.34 (2) functional assessments; 472.35 (3) individual treatment plans signed by the recipient and 472.36 the mental health professional, or if the recipient refused to 473.1 sign the plan, the date and reason stated by the recipient as to 473.2 why the recipient would not sign the plan; 473.3 (4) recipient history; 473.4 (5) signed release forms; 473.5 (6) recipient health information and current medications; 473.6 (7) emergency contacts for the recipient; 473.7 (8) case records which document the date of service, the 473.8 place of service delivery, signature of the person providing the 473.9 service, nature, extent and units of service, and place of 473.10 service delivery; 473.11 (9) contacts, direct or by telephone, with recipient's 473.12 family or others, other providers, or other resources for 473.13 service coordination; 473.14 (10) summary of recipient case reviews by staff; and 473.15 (11) written information by the recipient that the 473.16 recipient requests be included in the file. 473.17 Subd. 12. [ADDITIONAL REQUIREMENTS.] (a) Providers of 473.18 adult rehabilitative mental health services must comply with the 473.19 requirements relating to referrals for case management in 473.20 section 245.467, subdivision 4. 473.21 (b) Adult rehabilitative mental health services are 473.22 provided for most recipients in the recipient's home and 473.23 community. Services may also be provided at the home of a 473.24 relative or significant other, job site, psychosocial clubhouse, 473.25 drop-in center, social setting, classroom, or other places in 473.26 the community. Except for "transition to community services," 473.27 the place of service does not include a regional treatment 473.28 center, nursing home, residential treatment facility licensed 473.29 under Minnesota Rules, parts 9520.0500 to 9520.0670 (Rule 36), 473.30 or an acute care hospital. 473.31 (c) Adult rehabilitative mental health services may be 473.32 provided in group settings if appropriate to each participating 473.33 recipient's needs and treatment plan. A group is defined as two 473.34 to ten clients, at least one of whom is a recipient, who is 473.35 concurrently receiving a service which is identified in this 473.36 section. The service and group must be specified in the 474.1 recipient's treatment plan. No more than two qualified staff 474.2 may bill Medicaid for services provided to the same group of 474.3 recipients. If two adult rehabilitative mental health workers 474.4 bill for recipients in the same group session, they must each 474.5 bill for different recipients. 474.6 Subd. 13. [EXCLUDED SERVICES.] The following services are 474.7 excluded from reimbursement as adult rehabilitative mental 474.8 health services: 474.9 (1) recipient transportation services; 474.10 (2) a service provided and billed by a provider who is not 474.11 enrolled to provide adult rehabilitative mental health service; 474.12 (3) adult rehabilitative mental health services performed 474.13 by volunteers; 474.14 (4) provider performance of household tasks, chores, or 474.15 related activities, such as laundering clothes, moving the 474.16 recipient's household, housekeeping, and grocery shopping for 474.17 the recipient; 474.18 (5) direct billing of time spent "on call" when not 474.19 delivering services to recipients; 474.20 (6) activities which are primarily social or recreational 474.21 in nature, rather than rehabilitative, for the individual 474.22 recipient, as determined by the individual's needs and treatment 474.23 plan; 474.24 (7) job-specific skills services, such as on-the-job 474.25 training; 474.26 (8) provider service time included in case management 474.27 reimbursement; 474.28 (9) outreach services to potential recipients; 474.29 (10) a mental health service that is not medically 474.30 necessary; and 474.31 (11) any services provided by a hospital, board and 474.32 lodging, or residential facility to an individual who is a 474.33 patient in or resident of that facility. 474.34 Subd. 14. [BILLING WHEN SERVICES ARE PROVIDED BY QUALIFIED 474.35 STATE STAFF.] When rehabilitative services are provided by 474.36 qualified state staff who are assigned to pilot projects under 475.1 section 245.4661, the county or other local entity to which the 475.2 qualified state staff are assigned may consider these staff part 475.3 of the local provider entity for which certification is sought 475.4 under this section, and may bill the medical assistance program 475.5 for qualifying services provided by the qualified state staff. 475.6 Notwithstanding section 256.025, subdivision 2, payments for 475.7 services provided by state staff who are assigned to adult 475.8 mental health initiatives shall only be made from federal funds. 475.9 Sec. 45. [256B.0624] [ADULT MENTAL HEALTH CRISIS RESPONSE 475.10 SERVICES.] 475.11 Subdivision 1. [SCOPE.] Medical assistance covers adult 475.12 mental health crisis response services as defined in subdivision 475.13 2, paragraphs (c) to (e), subject to federal approval, if 475.14 provided to a recipient as defined in subdivision 3 and provided 475.15 by a qualified provider entity as defined in this section and by 475.16 a qualified individual provider working within the provider's 475.17 scope of practice and as defined in this subdivision and 475.18 identified in the recipient's individual crisis treatment plan 475.19 as defined in subdivisions 10 and 13 and if determined to be 475.20 medically necessary. 475.21 Subd. 2. [DEFINITIONS.] For purposes of this section, the 475.22 following terms have the meanings given them. 475.23 (a) "Mental health crisis" is a behavioral, emotional, or 475.24 psychiatric situation which, but for the provision of crisis 475.25 response services, would likely result in significantly reduced 475.26 levels of functioning in primary activities of daily living, or 475.27 in an emergency situation, or in the placement of the recipient 475.28 in a more restrictive setting, including, but not limited to, 475.29 inpatient hospitalization. 475.30 (b) "Mental health emergency" is a behavioral, emotional, 475.31 or psychiatric situation which causes an immediate need for 475.32 mental health services and is consistent with section 62Q.55. 475.33 A mental health crisis or emergency is determined for 475.34 medical assistance service reimbursement by a physician, a 475.35 mental health professional, or crisis mental health practitioner 475.36 with input from the recipient whenever possible. 476.1 (c) "Mental health crisis assessment" means an immediate 476.2 face-to-face assessment by a physician, a mental health 476.3 professional, or mental health practitioner under the clinical 476.4 supervision of a mental health professional, following a 476.5 screening that suggests that the adult may be experiencing a 476.6 mental health crisis or mental health emergency situation. 476.7 (d) "Mental health mobile crisis intervention services" 476.8 means face-to-face, short-term intensive mental health services 476.9 initiated during a mental health crisis or mental health 476.10 emergency to help the recipient cope with immediate stressors, 476.11 identify and utilize available resources and strengths, and 476.12 begin to return to the recipient's baseline level of functioning. 476.13 (1) This service is provided on-site by a mobile crisis 476.14 intervention team outside of an inpatient hospital setting. 476.15 Mental health mobile crisis intervention services must be 476.16 available 24 hours a day, seven days a week. 476.17 (2) The initial screening must consider other available 476.18 services to determine which service intervention would best 476.19 address the recipient's needs and circumstances. 476.20 (3) The mobile crisis intervention team must be available 476.21 to meet promptly face-to-face with a person in mental health 476.22 crisis or emergency in a community setting. 476.23 (4) The intervention must consist of a mental health crisis 476.24 assessment and a crisis treatment plan. 476.25 (5) The treatment plan must include recommendations for any 476.26 needed crisis stabilization services for the recipient. 476.27 (e) "Mental health crisis stabilization services" means 476.28 individualized mental health services provided to a recipient 476.29 following crisis intervention services, which are designed to 476.30 restore the recipient to the recipient's prior functional 476.31 level. Mental health crisis stabilization services may be 476.32 provided in the recipient's home, the home of a family member or 476.33 friend of the recipient, another community setting, or a 476.34 short-term supervised, licensed residential program. Mental 476.35 health crisis stabilization does not include partial 476.36 hospitalization or day treatment. 477.1 Subd. 3. [ELIGIBILITY.] An eligible recipient is an 477.2 individual who: 477.3 (1) is age 18 or older; 477.4 (2) is screened as possibly experiencing a mental health 477.5 crisis or emergency where a mental health crisis assessment is 477.6 needed; and 477.7 (3) is assessed as experiencing a mental health crisis or 477.8 emergency, and mental health crisis intervention or crisis 477.9 intervention and stabilization services are determined to be 477.10 medically necessary. 477.11 Subd. 4. [PROVIDER ENTITY STANDARDS.] (a) A provider 477.12 entity is an entity that meets the standards listed in paragraph 477.13 (b) and: 477.14 (1) is a county board operated entity; or 477.15 (2) is a provider entity that is under contract with the 477.16 county board in the county where the potential crisis or 477.17 emergency is occurring. To provide services under this section, 477.18 the provider entity must directly provide the services; or if 477.19 services are subcontracted, the provider entity must maintain 477.20 responsibility for services and billing. 477.21 (b) The adult mental health crisis response services 477.22 provider entity must meet the following standards: 477.23 (1) has the capacity to recruit, hire, and manage and train 477.24 mental health professionals, practitioners, and rehabilitation 477.25 workers; 477.26 (2) has adequate administrative ability to ensure 477.27 availability of services; 477.28 (3) is able to ensure adequate preservice and in-service 477.29 training; 477.30 (4) is able to ensure that staff providing these services 477.31 are skilled in the delivery of mental health crisis response 477.32 services to recipients; 477.33 (5) is able to ensure that staff are capable of 477.34 implementing culturally specific treatment identified in the 477.35 individual treatment plan that is meaningful and appropriate as 477.36 determined by the recipient's culture, beliefs, values, and 478.1 language; 478.2 (6) is able to ensure enough flexibility to respond to the 478.3 changing intervention and care needs of a recipient as 478.4 identified by the recipient during the service partnership 478.5 between the recipient and providers; 478.6 (7) is able to ensure that mental health professionals and 478.7 mental health practitioners have the communication tools and 478.8 procedures to communicate and consult promptly about crisis 478.9 assessment and interventions as services occur; 478.10 (8) is able to coordinate these services with county 478.11 emergency services and mental health crisis services; 478.12 (9) is able to ensure that mental health crisis assessment 478.13 and mobile crisis intervention services are available 24 hours a 478.14 day, seven days a week; 478.15 (10) is able to ensure that services are coordinated with 478.16 other mental health service providers, county mental health 478.17 authorities, or federally recognized American Indian authorities 478.18 and others as necessary, with the consent of the adult. 478.19 Services must also be coordinated with the recipient's case 478.20 manager if the adult is receiving case management services; 478.21 (11) is able to ensure that crisis intervention services 478.22 are provided in a manner consistent with sections 245.461 to 478.23 245.486; 478.24 (12) is able to submit information as required by the 478.25 state; 478.26 (13) maintains staff training and personnel files; 478.27 (14) is able to establish and maintain a quality assurance 478.28 and evaluation plan to evaluate the outcomes of services and 478.29 recipient satisfaction; 478.30 (15) is able to keep records as required by applicable 478.31 laws; 478.32 (16) is able to comply with all applicable laws and 478.33 statutes; 478.34 (17) is an enrolled medical assistance provider; and 478.35 (18) develops and maintains written policies and procedures 478.36 regarding service provision and administration of the provider 479.1 entity, including safety of staff and recipients in high-risk 479.2 situations. 479.3 Subd. 5. [MOBILE CRISIS INTERVENTION STAFF 479.4 QUALIFICATIONS.] For provision of adult mental health mobile 479.5 crisis intervention services, a mobile crisis intervention team 479.6 is comprised of at least two mental health professionals as 479.7 defined in section 245.462, subdivision 18, clauses (1) to (5), 479.8 or a combination of at least one mental health professional and 479.9 one mental health practitioner as defined in section 245.462, 479.10 subdivision 17, with the required mental health crisis training 479.11 and under the clinical supervision of a mental health 479.12 professional on the team. The team must have at least two 479.13 people with at least one member providing on-site crisis 479.14 intervention services when needed. Team members must be 479.15 experienced in mental health assessment, crisis intervention 479.16 techniques, and clinical decision-making under emergency 479.17 conditions and have knowledge of local services and resources. 479.18 The team must recommend and coordinate the team's services with 479.19 appropriate local resources such as the county social services 479.20 agency, mental health services, and local law enforcement when 479.21 necessary. 479.22 Subd. 6. [INITIAL SCREENING, CRISIS ASSESSMENT, AND MOBILE 479.23 INTERVENTION TREATMENT PLANNING.] (a) Prior to initiating mobile 479.24 crisis intervention services, a screening of the potential 479.25 crisis situation must be conducted. The screening may use the 479.26 resources of crisis assistance and emergency services as defined 479.27 in sections 245.462, subdivision 6, and 245.469, subdivisions 1 479.28 and 2. The screening must gather information, determine whether 479.29 a crisis situation exists, identify parties involved, and 479.30 determine an appropriate response. 479.31 (b) If a crisis exists, a crisis assessment must be 479.32 completed. A crisis assessment evaluates any immediate needs 479.33 for which emergency services are needed and, as time permits, 479.34 the recipient's current life situation, sources of stress, 479.35 mental health problems and symptoms, strengths, cultural 479.36 considerations, support network, vulnerabilities, and current 480.1 functioning. 480.2 (c) If the crisis assessment determines mobile crisis 480.3 intervention services are needed, the intervention services must 480.4 be provided promptly. As opportunity presents during the 480.5 intervention, at least two members of the mobile crisis 480.6 intervention team must confer directly or by telephone about the 480.7 assessment, treatment plan, and actions taken and needed. At 480.8 least one of the team members must be on site providing crisis 480.9 intervention services. If providing on-site crisis intervention 480.10 services, a mental health practitioner must seek clinical 480.11 supervision as required in subdivision 9. 480.12 (d) The mobile crisis intervention team must develop an 480.13 initial, brief crisis treatment plan as soon as appropriate but 480.14 no later than 24 hours after the initial face-to-face 480.15 intervention. The plan must address the needs and problems 480.16 noted in the crisis assessment and include measurable short-term 480.17 goals, cultural considerations, and frequency and type of 480.18 services to be provided to achieve the goals and reduce or 480.19 eliminate the crisis. The treatment plan must be updated as 480.20 needed to reflect current goals and services. 480.21 (e) The team must document which short-term goals have been 480.22 met, and when no further crisis intervention services are 480.23 required. 480.24 (f) If the recipient's crisis is stabilized, but the 480.25 recipient needs a referral to other services, the team must 480.26 provide referrals to these services. If the recipient has a 480.27 case manager, planning for other services must be coordinated 480.28 with the case manager. 480.29 Subd. 7. [CRISIS STABILIZATION SERVICES.] (a) Crisis 480.30 stabilization services must be provided by qualified staff of a 480.31 crisis stabilization services provider entity and must meet the 480.32 following standards: 480.33 (1) a crisis stabilization treatment plan must be developed 480.34 which meets the criteria in subdivision 11; 480.35 (2) staff must be qualified as defined in subdivision 8; 480.36 and 481.1 (3) services must be delivered according to the treatment 481.2 plan and include face-to-face contact with the recipient by 481.3 qualified staff for further assessment, help with referrals, 481.4 updating of the crisis stabilization treatment plan, supportive 481.5 counseling, skills training, and collaboration with other 481.6 service providers in the community. 481.7 (b) If crisis stabilization services are provided in a 481.8 supervised, licensed residential setting, the recipient must be 481.9 contacted face-to-face daily by a qualified mental health 481.10 practitioner or mental health professional. The program must 481.11 have 24-hour-a-day residential staffing which may include staff 481.12 who do not meet the qualifications in subdivision 8. The 481.13 residential staff must have 24-hour-a-day immediate direct or 481.14 telephone access to a qualified mental health professional or 481.15 practitioner. 481.16 (c) If crisis stabilization services are provided in a 481.17 supervised, licensed residential setting that serves no more 481.18 than four adult residents, and no more than two are recipients 481.19 of crisis stabilization services, the residential staff must 481.20 include, for at least eight hours per day, at least one 481.21 individual who meets the qualifications in subdivision 8. 481.22 (d) If crisis stabilization services are provided in a 481.23 supervised, licensed residential setting that serves more than 481.24 four adult residents, and one or more are recipients of crisis 481.25 stabilization services, the residential staff must include, for 481.26 24 hours per day, at least one individual who meets the 481.27 qualifications in subdivision 8. During the first 48 hours that 481.28 a recipient is in the residential program, the residential 481.29 program must have at least two staff working 24 hours a day. 481.30 Staffing levels may be adjusted thereafter according to the 481.31 needs of the recipient as specified in the crisis stabilization 481.32 treatment plan. 481.33 Subd. 8. [ADULT CRISIS STABILIZATION STAFF 481.34 QUALIFICATIONS.] (a) Adult mental health crisis stabilization 481.35 services must be provided by qualified individual staff of a 481.36 qualified provider entity. Individual provider staff must have 482.1 the following qualifications: 482.2 (1) be a mental health professional as defined in section 482.3 245.462, subdivision 18, clauses (1) to (5); 482.4 (2) be a mental health practitioner as defined in section 482.5 245.462, subdivision 17. The mental health practitioner must 482.6 work under the clinical supervision of a mental health 482.7 professional; or 482.8 (3) be a mental health rehabilitation worker who meets the 482.9 criteria in section 256B.0623, subdivision 5, clause (3); works 482.10 under the direction of a mental health practitioner as defined 482.11 in section 245.462, subdivision 17, or under direction of a 482.12 mental health professional; and works under the clinical 482.13 supervision of a mental health professional. 482.14 (b) Mental health practitioners and mental health 482.15 rehabilitation workers must have completed at least 30 hours of 482.16 training in crisis intervention and stabilization during the 482.17 past two years. 482.18 Subd. 9. [SUPERVISION.] Mental health practitioners may 482.19 provide crisis assessment and mobile crisis intervention 482.20 services if the following clinical supervision requirements are 482.21 met: 482.22 (1) the mental health provider entity must accept full 482.23 responsibility for the services provided; 482.24 (2) the mental health professional of the provider entity, 482.25 who is an employee or under contract with the provider entity, 482.26 must be immediately available by phone or in person for clinical 482.27 supervision; 482.28 (3) the mental health professional is consulted, in person 482.29 or by phone, during the first three hours when a mental health 482.30 practitioner provides on-site service; 482.31 (4) the mental health professional must: 482.32 (i) review and approve of the tentative crisis assessment 482.33 and crisis treatment plan; 482.34 (ii) document the consultation; and 482.35 (iii) sign the crisis assessment and treatment plan within 482.36 the next business day; 483.1 (5) if the mobile crisis intervention services continue 483.2 into a second calendar day, a mental health professional must 483.3 contact the recipient face-to-face on the second day to provide 483.4 services and update the crisis treatment plan; and 483.5 (6) the on-site observation must be documented in the 483.6 recipient's record and signed by the mental health professional. 483.7 Subd. 10. [RECIPIENT FILE.] Providers of mobile crisis 483.8 intervention or crisis stabilization services must maintain a 483.9 file for each recipient containing the following information: 483.10 (1) individual crisis treatment plans signed by the 483.11 recipient, mental health professional, and mental health 483.12 practitioner who developed the crisis treatment plan, or if the 483.13 recipient refused to sign the plan, the date and reason stated 483.14 by the recipient as to why the recipient would not sign the 483.15 plan; 483.16 (2) signed release forms; 483.17 (3) recipient health information and current medications; 483.18 (4) emergency contacts for the recipient; 483.19 (5) case records which document the date of service, place 483.20 of service delivery, signature of the person providing the 483.21 service, and the nature, extent, and units of service. Direct 483.22 or telephone contact with the recipient's family or others 483.23 should be documented; 483.24 (6) required clinical supervision by mental health 483.25 professionals; 483.26 (7) summary of the recipient's case reviews by staff; and 483.27 (8) any written information by the recipient that the 483.28 recipient wants in the file. 483.29 Documentation in the file must comply with all requirements of 483.30 the commissioner. 483.31 Subd. 11. [TREATMENT PLAN.] The individual crisis 483.32 stabilization treatment plan must include, at a minimum: 483.33 (1) a list of problems identified in the assessment; 483.34 (2) a list of the recipient's strengths and resources; 483.35 (3) concrete, measurable short-term goals and tasks to be 483.36 achieved, including time frames for achievement; 484.1 (4) specific objectives directed toward the achievement of 484.2 each one of the goals; 484.3 (5) documentation of the participants involved in the 484.4 service planning. The recipient, if possible, must be a 484.5 participant. The recipient or the recipient's legal guardian 484.6 must sign the service plan or documentation must be provided why 484.7 this was not possible. A copy of the plan must be given to the 484.8 recipient and the recipient's legal guardian. The plan should 484.9 include services arranged, including specific providers where 484.10 applicable; 484.11 (6) planned frequency and type of services initiated; 484.12 (7) a crisis response action plan if a crisis should occur; 484.13 (8) clear progress notes on outcome of goals; 484.14 (9) a written plan must be completed within 24 hours of 484.15 beginning services with the recipient; and 484.16 (10) a treatment plan must be developed by a mental health 484.17 professional or mental health practitioner under the clinical 484.18 supervision of a mental health professional. The mental health 484.19 professional must approve and sign all treatment plans. 484.20 Subd. 12. [EXCLUDED SERVICES.] The following services are 484.21 excluded from reimbursement under this section: 484.22 (1) room and board services; 484.23 (2) services delivered to a recipient while admitted to an 484.24 inpatient hospital; 484.25 (3) recipient transportation costs may be covered under 484.26 other medical assistance provisions, but transportation services 484.27 are not an adult mental health crisis response service; 484.28 (4) services provided and billed by a provider who is not 484.29 enrolled under medical assistance to provide adult mental health 484.30 crisis response services; 484.31 (5) services performed by volunteers; 484.32 (6) direct billing of time spent "on call" when not 484.33 delivering services to a recipient; 484.34 (7) provider service time included in case management 484.35 reimbursement. When a provider is eligible to provide more than 484.36 one type of medical assistance service, the recipient must have 485.1 a choice of provider for each service, unless otherwise provided 485.2 for by law; 485.3 (8) outreach services to potential recipients; and 485.4 (9) a mental health service that is not medically necessary. 485.5 Sec. 46. Minnesota Statutes 2000, section 256B.0625, 485.6 subdivision 20, is amended to read: 485.7 Subd. 20. [MENTAL HEALTH CASE MANAGEMENT.] (a) To the 485.8 extent authorized by rule of the state agency, medical 485.9 assistance covers case management services to persons with 485.10 serious and persistent mental illness and children with severe 485.11 emotional disturbance. Services provided under this section 485.12 must meet the relevant standards in sections 245.461 to 485.13 245.4888, the Comprehensive Adult and Children's Mental Health 485.14 Acts, Minnesota Rules, parts 9520.0900 to 9520.0926, and 485.15 9505.0322, excluding subpart 10. 485.16 (b) Entities meeting program standards set out in rules 485.17 governing family community support services as defined in 485.18 section 245.4871, subdivision 17, are eligible for medical 485.19 assistance reimbursement for case management services for 485.20 children with severe emotional disturbance when these services 485.21 meet the program standards in Minnesota Rules, parts 9520.0900 485.22 to 9520.0926 and 9505.0322, excluding subparts 6 and 10. 485.23 (c) Medical assistance and MinnesotaCare payment for mental 485.24 health case management shall be made on a monthly basis. In 485.25 order to receive payment for an eligible child, the provider 485.26 must document at least a face-to-face contact with the child, 485.27 the child's parents, or the child's legal representative. To 485.28 receive payment for an eligible adult, the provider must 485.29 document: 485.30 (1) at least a face-to-face contact with the adult or the 485.31 adult's legal representative; or 485.32 (2) at least a telephone contact with the adult or the 485.33 adult's legal representative and document a face-to-face contact 485.34 with the adult or the adult's legal representative within the 485.35 preceding two months. 485.36 (d) Payment for mental health case management provided by 486.1 county or state staff shall be based on the monthly rate 486.2 methodology under section 256B.094, subdivision 6, paragraph 486.3 (b), with separate rates calculated for child welfare and mental 486.4 health, and within mental health, separate rates for children 486.5 and adults. 486.6 (e) Payment for mental health case management provided by 486.7 Indian health services or by agencies operated by Indian tribes 486.8 may be made according to this section or other relevant 486.9 federally approved rate setting methodology. 486.10 (f) Payment for mental health case management provided by 486.11county-contractedvendors who contract with a county or Indian 486.12 tribe shall be based on a monthly rate negotiated by the host 486.13 county or tribe. The negotiated rate must not exceed the rate 486.14 charged by the vendor for the same service to other payers. If 486.15 the service is provided by a team of contracted vendors, the 486.16 county or tribe may negotiate a team rate with a vendor who is a 486.17 member of the team. The team shall determine how to distribute 486.18 the rate among its members. No reimbursement received by 486.19 contracted vendors shall be returned to the county or tribe, 486.20 except to reimburse the county or tribe for advance funding 486.21 provided by the county or tribe to the vendor. 486.22(f)(g) If the service is provided by a team which includes 486.23 contracted vendors, tribal staff, and county or state staff, the 486.24 costs for county or state staff participation in the team shall 486.25 be included in the rate for county-provided services. In this 486.26 case, the contracted vendor, the tribal agency, and the county 486.27 may each receive separate payment for services provided by each 486.28 entity in the same month. In order to prevent duplication of 486.29 services,the countyeach entity must document, in the 486.30 recipient's file, the need for team case management and a 486.31 description of the roles of the team members. 486.32(g)(h) The commissioner shall calculate the nonfederal 486.33 share of actual medical assistance and general assistance 486.34 medical care payments for each county, based on the higher of 486.35 calendar year 1995 or 1996, by service date, project that amount 486.36 forward to 1999, and transfer one-half of the result from 487.1 medical assistance and general assistance medical care to each 487.2 county's mental health grants under sections 245.4886 and 487.3 256E.12 for calendar year 1999. The annualized minimum amount 487.4 added to each county's mental health grant shall be $3,000 per 487.5 year for children and $5,000 per year for adults. The 487.6 commissioner may reduce the statewide growth factor in order to 487.7 fund these minimums. The annualized total amount transferred 487.8 shall become part of the base for future mental health grants 487.9 for each county. 487.10(h)(i) Any net increase in revenue to the county or tribe 487.11 as a result of the change in this section must be used to 487.12 provide expanded mental health services as defined in sections 487.13 245.461 to 245.4888, the Comprehensive Adult and Children's 487.14 Mental Health Acts, excluding inpatient and residential 487.15 treatment. For adults, increased revenue may also be used for 487.16 services and consumer supports which are part of adult mental 487.17 health projects approved under Laws 1997, chapter 203, article 487.18 7, section 25. For children, increased revenue may also be used 487.19 for respite care and nonresidential individualized 487.20 rehabilitation services as defined in section 245.492, 487.21 subdivisions 17 and 23. "Increased revenue" has the meaning 487.22 given in Minnesota Rules, part 9520.0903, subpart 3. 487.23(i)(j) Notwithstanding section 256B.19, subdivision 1, the 487.24 nonfederal share of costs for mental health case management 487.25 shall be provided by the recipient's county of responsibility, 487.26 as defined in sections 256G.01 to 256G.12, from sources other 487.27 than federal funds or funds used to match other federal 487.28 funds. If the service is provided by a tribal agency, the 487.29 nonfederal share, if any, shall be provided by the recipient's 487.30 tribe. 487.31(j)(k) The commissioner may suspend, reduce, or terminate 487.32 the reimbursement to a provider that does not meet the reporting 487.33 or other requirements of this section. The county of 487.34 responsibility, as defined in sections 256G.01 to 256G.12, or, 487.35 if applicable, the tribal agency, is responsible for any federal 487.36 disallowances. The county or tribe may share this 488.1 responsibility with its contracted vendors. 488.2(k)(l) The commissioner shall set aside a portion of the 488.3 federal funds earned under this section to repay the special 488.4 revenue maximization account under section 256.01, subdivision 488.5 2, clause (15). The repayment is limited to: 488.6 (1) the costs of developing and implementing this section; 488.7 and 488.8 (2) programming the information systems. 488.9(l)(m) Notwithstanding section 256.025, subdivision 2, 488.10 payments to counties and tribal agencies for case management 488.11 expenditures under this section shall only be made from federal 488.12 earnings from services provided under this section. Payments to 488.13contractedcounty-contracted vendors shall include both the 488.14 federal earnings and the county share. 488.15(m)(n) Notwithstanding section 256B.041, county payments 488.16 for the cost of mental health case management services provided 488.17 by county or state staff shall not be made to the state 488.18 treasurer. For the purposes of mental health case management 488.19 services provided by county or state staff under this section, 488.20 the centralized disbursement of payments to counties under 488.21 section 256B.041 consists only of federal earnings from services 488.22 provided under this section. 488.23(n)(o) Case management services under this subdivision do 488.24 not include therapy, treatment, legal, or outreach services. 488.25(o)(p) If the recipient is a resident of a nursing 488.26 facility, intermediate care facility, or hospital, and the 488.27 recipient's institutional care is paid by medical assistance, 488.28 payment for case management services under this subdivision is 488.29 limited to the last 30 days of the recipient's residency in that 488.30 facility and may not exceed more than two months in a calendar 488.31 year. 488.32(p)(q) Payment for case management services under this 488.33 subdivision shall not duplicate payments made under other 488.34 program authorities for the same purpose. 488.35(q)(r) By July 1, 2000, the commissioner shall evaluate 488.36 the effectiveness of the changes required by this section, 489.1 including changes in number of persons receiving mental health 489.2 case management, changes in hours of service per person, and 489.3 changes in caseload size. 489.4(r)(s) For each calendar year beginning with the calendar 489.5 year 2001, the annualized amount of state funds for each county 489.6 determined under paragraph(g)(h) shall be adjusted by the 489.7 county's percentage change in the average number of clients per 489.8 month who received case management under this section during the 489.9 fiscal year that ended six months prior to the calendar year in 489.10 question, in comparison to the prior fiscal year. 489.11(s)(t) For counties receiving the minimum allocation of 489.12 $3,000 or $5,000 described in paragraph(g)(h), the adjustment 489.13 in paragraph(r)(s) shall be determined so that the county 489.14 receives the higher of the following amounts: 489.15 (1) a continuation of the minimum allocation in paragraph 489.16(g)(h); or 489.17 (2) an amount based on that county's average number of 489.18 clients per month who received case management under this 489.19 section during the fiscal year that ended six months prior to 489.20 the calendar year in question,in comparison to the prior fiscal489.21year,times the average statewide grant per person per month for 489.22 counties not receiving the minimum allocation. 489.23(t)(u) The adjustments in paragraphs(r) and(s) and (t) 489.24 shall be calculated separately for children and adults. 489.25 Sec. 47. Minnesota Statutes 2000, section 256B.0625, is 489.26 amended by adding a subdivision to read: 489.27 Subd. 45. [APPEAL PROCESS.] If a county contract or 489.28 certification is required to enroll as an authorized provider of 489.29 mental health services under medical assistance, and if a county 489.30 refuses to grant the necessary contract or certification, the 489.31 provider may appeal the county decision to the commissioner. A 489.32 recipient may initiate an appeal on behalf of a provider who has 489.33 been denied certification. The commissioner shall determine 489.34 whether the provider meets applicable standards under state laws 489.35 and rules based on an independent review of the facts, including 489.36 comments from the county review. If the commissioner finds that 490.1 the provider meets the applicable standards, the commissioner 490.2 shall enroll the provider as an authorized provider. The 490.3 commissioner shall develop procedures for providers and 490.4 recipients to appeal a county decision to refuse to enroll a 490.5 provider. After the commissioner makes a decision regarding an 490.6 appeal, the county, provider, or recipient may request that the 490.7 commissioner reconsider the commissioner's initial decision. 490.8 The commissioner's reconsideration decision is final and not 490.9 subject to further appeal. 490.10 Sec. 48. Minnesota Statutes 2000, section 256B.0625, is 490.11 amended by adding a subdivision to read: 490.12 Subd. 46. [MENTAL HEALTH PROVIDER TRAVEL TIME.] Medical 490.13 assistance covers provider travel time if a recipient's 490.14 individual treatment plan requires the provision of mental 490.15 health services outside of the provider's normal place of 490.16 business. This does not include any travel time which is 490.17 included in other billable services, and is only covered when 490.18 the mental health service being provided to a recipient is 490.19 covered under medical assistance. 490.20 Sec. 49. [256B.761] [REIMBURSEMENT FOR MENTAL HEALTH 490.21 SERVICES.] 490.22 Effective for services rendered on or after July 1, 2001, 490.23 payment for medication management provided to psychiatric 490.24 patients, outpatient mental health services, day treatment 490.25 services, home-based mental health services, and family 490.26 community support services shall be paid at the lower of (1) 490.27 submitted charges, or (2) 75.6 percent of the 50th percentile of 490.28 1999 charges. 490.29 Sec. 50. [256B.82] [PREPAID PLANS AND MENTAL HEALTH 490.30 REHABILITATIVE SERVICES.] 490.31 Medical assistance and MinnesotaCare prepaid health plans 490.32 may include coverage for adult mental health rehabilitative 490.33 services under section 256B.0623 and adult mental health crisis 490.34 response services under section 256B.0624, beginning January 1, 490.35 2004. 490.36 By January 15, 2003, the commissioner shall report to the 491.1 legislature how these services should be included in prepaid 491.2 plans. The commissioner shall consult with mental health 491.3 advocates, health plans, and counties in developing this 491.4 report. The report recommendations must include a plan to 491.5 ensure coordination of these services between health plans and 491.6 counties, assure recipient access to essential community 491.7 providers, and monitor the health plans' delivery of services 491.8 through utilization review and quality standards. 491.9 Sec. 51. [256B.83] [MAINTENANCE OF EFFORT FOR CERTAIN 491.10 MENTAL HEALTH SERVICES.] 491.11 Any net increase in revenue to the county as a result of 491.12 the change in section 256B.0623 or 256B.0624 must be used to 491.13 provide expanded mental health services as defined in sections 491.14 245.461 to 245.486, the Comprehensive Adult Mental Health Act, 491.15 excluding inpatient and residential treatment. Increased 491.16 revenue may also be used for services and consumer supports, 491.17 which are part of adult mental health projects approved under 491.18 section 245.4661. "Increased revenue" has the meaning given in 491.19 Minnesota Rules, part 9520.0903, subpart 3. 491.20 Sec. 52. Minnesota Statutes 2000, section 260C.201, 491.21 subdivision 1, is amended to read: 491.22 Subdivision 1. [DISPOSITIONS.] (a) If the court finds that 491.23 the child is in need of protection or services or neglected and 491.24 in foster care, it shall enter an order making any of the 491.25 following dispositions of the case: 491.26 (1) place the child under the protective supervision of the 491.27 local social services agency or child-placing agency in the home 491.28 of a parent of the child under conditions prescribed by the 491.29 court directed to the correction of the child's need for 491.30 protection or services, or: 491.31 (i) the court may order the child into the home of a parent 491.32 who does not otherwise have legal custody of the child, however, 491.33 an order under this section does not confer legal custody on 491.34 that parent; 491.35 (ii) if the court orders the child into the home of a 491.36 father who is not adjudicated, he must cooperate with paternity 492.1 establishment proceedings regarding the child in the appropriate 492.2 jurisdiction as one of the conditions prescribed by the court 492.3 for the child to continue in his home; 492.4 (iii) the court may order the child into the home of a 492.5 noncustodial parent with conditions and may also order both the 492.6 noncustodial and the custodial parent to comply with the 492.7 requirements of a case plan under subdivision 2; 492.8 (2) transfer legal custody to one of the following: 492.9 (i) a child-placing agency; or 492.10 (ii) the local social services agency. 492.11 In placing a child whose custody has been transferred under 492.12 this paragraph, the agencies shall follow the requirements of 492.13 section 260C.193, subdivision 3; 492.14 (3) if the child has been adjudicated as a child in need of 492.15 protection or services because the child is in need of special 492.16treatment andservices or carefor reasons of physical or mental492.17healthto treat or ameliorate a physical or mental disability, 492.18 the court may order the child's parent, guardian, or custodian 492.19 to provide it. The court may order the child's health plan 492.20 company to provide mental health services to the child. Section 492.21 62Q.535 applies to an order for mental health services directed 492.22 to the child's health plan company. If the health plan, parent, 492.23 guardian, or custodian fails or is unable to provide this 492.24 treatment or care, the court may order it provided. Absent 492.25 specific written findings by the court that the child's 492.26 disability is the result of abuse or neglect by the child's 492.27 parent or guardian, the court shall not transfer legal custody 492.28 of the child for the purpose of obtaining special treatment or 492.29 care solely because the parent is unable to provide the 492.30 treatment or care. If the court's order for mental health 492.31 treatment is based on a diagnosis made by a treatment 492.32 professional, the court may order that the diagnosing 492.33 professional not provide the treatment to the child if it finds 492.34 that such an order is in the child's best interests; or 492.35 (4) if the court believes that the child has sufficient 492.36 maturity and judgment and that it is in the best interests of 493.1 the child, the court may order a child 16 years old or older to 493.2 be allowed to live independently, either alone or with others as 493.3 approved by the court under supervision the court considers 493.4 appropriate, if the county board, after consultation with the 493.5 court, has specifically authorized this dispositional 493.6 alternative for a child. 493.7 (b) If the child was adjudicated in need of protection or 493.8 services because the child is a runaway or habitual truant, the 493.9 court may order any of the following dispositions in addition to 493.10 or as alternatives to the dispositions authorized under 493.11 paragraph (a): 493.12 (1) counsel the child or the child's parents, guardian, or 493.13 custodian; 493.14 (2) place the child under the supervision of a probation 493.15 officer or other suitable person in the child's own home under 493.16 conditions prescribed by the court, including reasonable rules 493.17 for the child's conduct and the conduct of the parents, 493.18 guardian, or custodian, designed for the physical, mental, and 493.19 moral well-being and behavior of the child; or with the consent 493.20 of the commissioner of corrections, place the child in a group 493.21 foster care facility which is under the commissioner's 493.22 management and supervision; 493.23 (3) subject to the court's supervision, transfer legal 493.24 custody of the child to one of the following: 493.25 (i) a reputable person of good moral character. No person 493.26 may receive custody of two or more unrelated children unless 493.27 licensed to operate a residential program under sections 245A.01 493.28 to 245A.16; or 493.29 (ii) a county probation officer for placement in a group 493.30 foster home established under the direction of the juvenile 493.31 court and licensed pursuant to section 241.021; 493.32 (4) require the child to pay a fine of up to $100. The 493.33 court shall order payment of the fine in a manner that will not 493.34 impose undue financial hardship upon the child; 493.35 (5) require the child to participate in a community service 493.36 project; 494.1 (6) order the child to undergo a chemical dependency 494.2 evaluation and, if warranted by the evaluation, order 494.3 participation by the child in a drug awareness program or an 494.4 inpatient or outpatient chemical dependency treatment program; 494.5 (7) if the court believes that it is in the best interests 494.6 of the child and of public safety that the child's driver's 494.7 license or instruction permit be canceled, the court may order 494.8 the commissioner of public safety to cancel the child's license 494.9 or permit for any period up to the child's 18th birthday. If 494.10 the child does not have a driver's license or permit, the court 494.11 may order a denial of driving privileges for any period up to 494.12 the child's 18th birthday. The court shall forward an order 494.13 issued under this clause to the commissioner, who shall cancel 494.14 the license or permit or deny driving privileges without a 494.15 hearing for the period specified by the court. At any time 494.16 before the expiration of the period of cancellation or denial, 494.17 the court may, for good cause, order the commissioner of public 494.18 safety to allow the child to apply for a license or permit, and 494.19 the commissioner shall so authorize; 494.20 (8) order that the child's parent or legal guardian deliver 494.21 the child to school at the beginning of each school day for a 494.22 period of time specified by the court; or 494.23 (9) require the child to perform any other activities or 494.24 participate in any other treatment programs deemed appropriate 494.25 by the court. 494.26 To the extent practicable, the court shall enter a 494.27 disposition order the same day it makes a finding that a child 494.28 is in need of protection or services or neglected and in foster 494.29 care, but in no event more than 15 days after the finding unless 494.30 the court finds that the best interests of the child will be 494.31 served by granting a delay. If the child was under eight years 494.32 of age at the time the petition was filed, the disposition order 494.33 must be entered within ten days of the finding and the court may 494.34 not grant a delay unless good cause is shown and the court finds 494.35 the best interests of the child will be served by the delay. 494.36 (c) If a child who is 14 years of age or older is 495.1 adjudicated in need of protection or services because the child 495.2 is a habitual truant and truancy procedures involving the child 495.3 were previously dealt with by a school attendance review board 495.4 or county attorney mediation program under section 260A.06 or 495.5 260A.07, the court shall order a cancellation or denial of 495.6 driving privileges under paragraph (b), clause (7), for any 495.7 period up to the child's 18th birthday. 495.8 (d) In the case of a child adjudicated in need of 495.9 protection or services because the child has committed domestic 495.10 abuse and been ordered excluded from the child's parent's home, 495.11 the court shall dismiss jurisdiction if the court, at any time, 495.12 finds the parent is able or willing to provide an alternative 495.13 safe living arrangement for the child, as defined in Laws 1997, 495.14 chapter 239, article 10, section 2. 495.15 Sec. 53. [DEVELOPMENT OF PAYMENT SYSTEM FOR ADULT 495.16 RESIDENTIAL SERVICES GRANTS.] 495.17 The commissioner of human services shall review funding 495.18 methods for adult residential services grants under Minnesota 495.19 Rules, parts 9535.2000 to 9535.3000, and shall develop a payment 495.20 system that takes into account client difficulty of care as 495.21 manifested by client physical, mental, or behavioral 495.22 conditions. The payment system must provide reimbursement for 495.23 education, consultation, and support services provided to 495.24 families and other individuals as an extension of the treatment 495.25 process. The commissioner shall present recommendations and 495.26 draft legislation for an adult residential services payment 495.27 system to the legislature by January 15, 2002. The 495.28 recommendations must address whether additional funding for 495.29 adult residential services grants is necessary for the provision 495.30 of high quality services under a payment reimbursement system. 495.31 Sec. 54. [NOTICE REGARDING ESTABLISHMENT OF CONTINUING 495.32 CARE BENEFIT PROGRAM.] 495.33 When the continuing care benefit program for persons with 495.34 mental illness under Minnesota Statutes, section 256.9693, is 495.35 established, the commissioner of human services shall notify 495.36 counties, health plan companies with prepaid medical assistance 496.1 contracts, health care providers, and enrollees of the benefit 496.2 program through bulletins, workshops, and other meetings. 496.3 Sec. 55. [STUDY OF CHILDREN'S MENTAL HEALTH SYSTEM.] 496.4 The commissioner of human services shall conduct a 496.5 comprehensive study of the children's mental health system, 496.6 including, but not limited to, governance, funding for services, 496.7 family involvement in the provision of services, the involvement 496.8 of schools and other entities in the provision of services, and 496.9 the use of a public health model for early intervention and 496.10 treatment services. This study shall be conducted in 496.11 consultation with the commissioner of health; the commissioner 496.12 of children, families, and learning; the providers of mental 496.13 health services in schools; other providers of mental health 496.14 services; parents of children receiving mental health services; 496.15 local children's mental health collaboratives; counties; and 496.16 other interested parties. The study shall include an assessment 496.17 and evaluation of the family services collaboratives and mental 496.18 health collaboratives. The commissioner shall report findings 496.19 and recommendations for changes to the children's mental health 496.20 system to the legislature by January 15, 2002. 496.21 Sec. 56. [STUDY; LENGTH OF STAY FOR MEDICARE-ELIGIBLE 496.22 PERSONS.] 496.23 The commissioner of human services shall study and make 496.24 recommendations on how Medicare-eligible persons with mental 496.25 illness may obtain acute care hospital inpatient treatment for 496.26 mental illness for a length of stay beyond that allowed by the 496.27 diagnostic classifications for mental illness according to 496.28 Minnesota Statutes, section 256.969, subdivision 3a. The study 496.29 and recommendations shall be reported to the legislature by 496.30 January 15, 2002. 496.31 Sec. 57. [TRANSITIONAL SERVICES FOR MENTALLY ILL OFFENDERS 496.32 PILOT PROGRAM REPORT.] 496.33 By January 15, 2003, the commissioner of corrections shall 496.34 report to the chairs and ranking minority members of the house 496.35 and senate committees and divisions having jurisdiction over 496.36 criminal justice policy and funding on the effectiveness of the 497.1 grants made and pilot projects funded under section 244.25. 497.2 ARTICLE 11 497.3 ASSISTANCE PROGRAMS 497.4 Section 1. Minnesota Statutes 2000, section 256.98, 497.5 subdivision 8, is amended to read: 497.6 Subd. 8. [DISQUALIFICATION FROM PROGRAM.] (a) Any person 497.7 found to be guilty of wrongfully obtaining assistance by a 497.8 federal or state court or by an administrative hearing 497.9 determination, or waiver thereof, through a disqualification 497.10 consent agreement, or as part of any approved diversion plan 497.11 under section 401.065, or any court-ordered stay which carries 497.12 with it any probationary or other conditions, in the Minnesota 497.13 familyassistanceinvestment program, the food stamp program, 497.14 the general assistance program, the group residential housing 497.15 program, or the Minnesota supplemental aid program shall be 497.16 disqualified from that program. In addition, any person 497.17 disqualified from the Minnesota family investment program shall 497.18 also be disqualified from the food stamp program. The needs of 497.19 that individual shall not be taken into consideration in 497.20 determining the grant level for that assistance unit: 497.21 (1) for one year after the first offense; 497.22 (2) for two years after the second offense; and 497.23 (3) permanently after the third or subsequent offense. 497.24 The period of program disqualification shall begin on the 497.25 date stipulated on the advance notice of disqualification 497.26 without possibility of postponement for administrative stay or 497.27 administrative hearing and shall continue through completion 497.28 unless and until the findings upon which the sanctions were 497.29 imposed are reversed by a court of competent jurisdiction. The 497.30 period for which sanctions are imposed is not subject to 497.31 review. The sanctions provided under this subdivision are in 497.32 addition to, and not in substitution for, any other sanctions 497.33 that may be provided for by law for the offense involved. A 497.34 disqualification established through hearing or waiver shall 497.35 result in the disqualification period beginning immediately 497.36 unless the person has become otherwise ineligible for 498.1 assistance. If the person is ineligible for assistance, the 498.2 disqualification period begins when the person again meets the 498.3 eligibility criteria of the program from which they were 498.4 disqualified and makes application for that program. 498.5 (b) A family receiving assistance through child care 498.6 assistance programs under chapter 119B with a family member who 498.7 is found to be guilty of wrongfully obtaining child care 498.8 assistance by a federal court, state court, or an administrative 498.9 hearing determination or waiver, through a disqualification 498.10 consent agreement, as part of an approved diversion plan under 498.11 section 401.065, or a court-ordered stay with probationary or 498.12 other conditions, is disqualified from child care assistance 498.13 programs. The disqualifications must be for periods of three 498.14 months, six months, and two years for the first, second, and 498.15 third offenses respectively. Subsequent violations must result 498.16 in permanent disqualification. During the disqualification 498.17 period, disqualification from any child care program must extend 498.18 to all child care programs and must be immediately applied. 498.19 Sec. 2. Minnesota Statutes 2000, section 256D.053, 498.20 subdivision 1, is amended to read: 498.21 Subdivision 1. [PROGRAM ESTABLISHED.] The Minnesota food 498.22 assistance program is established to provide food assistance to 498.23 legal noncitizens residing in this state who are ineligible to 498.24 participate in the federal Food Stamp Program solely due to the 498.25 provisions of section 402 or 403 of Public Law Number 104-193, 498.26 as authorized by Title VII of the 1997 Emergency Supplemental 498.27 Appropriations Act, Public Law Number 105-18, and as amended by 498.28 Public Law Number 105-185. 498.29Beginning July 1, 2002, the Minnesota food assistance498.30program is limited to those noncitizens described in this498.31subdivision who are 50 years of age or older.498.32 Sec. 3. Minnesota Statutes 2000, section 256D.425, 498.33 subdivision 1, is amended to read: 498.34 Subdivision 1. [PERSONS ENTITLED TO RECEIVE AID.] A person 498.35 who is aged, blind, or 18 years of age or older and disabled and 498.36 who is receiving supplemental security benefits under Title XVI 499.1 on the basis of age, blindness, or disability (or would be 499.2 eligible for such benefits except for excess income) is eligible 499.3 for a payment under the Minnesota supplemental aid program, if 499.4 the person's net income is less than the standards in section 499.5 256D.44. Persons who are not receiving supplemental security 499.6 income benefits under Title XVI of the Social Security Act or 499.7 disability insurance benefits under Title II of the Social 499.8 Security Act due to exhausting time limited benefits are not 499.9 eligible to receive benefits under the MSA program. Persons who 499.10 are not receiving social security or other maintenance benefits 499.11 for failure to meet or comply with the social security or other 499.12 maintenance program requirements are not eligible to receive 499.13 benefits under the MSA program. Persons who are found 499.14 ineligible for supplemental security income because of excess 499.15 income, but whose income is within the limits of the Minnesota 499.16 supplemental aid program, must have blindness or disability 499.17 determined by the state medical review team. 499.18 Sec. 4. [256J.021] [SEPARATE STATE PROGRAM FOR USE OF 499.19 STATE MONEY.] 499.20 (a) Beginning October 1, 2001, and each year thereafter, 499.21 the commissioner of human services must treat financial 499.22 assistance expenditures made to or on behalf of any minor child 499.23 under section 256J.02, subdivision 2, clause (1), who is a 499.24 resident of this state under section 256J.12, and who is part of 499.25 a two-parent eligible household as expenditures under a 499.26 separately funded state program and report those expenditures to 499.27 the federal Department of Health and Human Services as separate 499.28 state program expenditures under Code of Federal Regulations, 499.29 title 45, section 263.5. 499.30 (b) One parent in a two-parent eligible household may meet 499.31 all of the family's hourly work or work activity requirements 499.32 specified under sections 256J.49 to 256J.72, or the hourly 499.33 requirement may be divided between the caregivers as best meets 499.34 the family's needs as documented in the caregiver's workplans. 499.35 Sec. 5. Minnesota Statutes 2000, section 256J.08, 499.36 subdivision 55a, is amended to read: 500.1 Subd. 55a. [MFIP STANDARD OF NEED.] "MFIP standard of 500.2 need" means the appropriate standard used to determine MFIP 500.3 benefit payments for the MFIP unit and applies to: 500.4 (1) the transitional standard, sections 256J.08, 500.5 subdivision 85, and 256J.24, subdivision 5; and 500.6 (2) the shared household standard, section 256J.24, 500.7 subdivision 9; and500.8(3) the interstate transition standard, section 256J.43. 500.9 Sec. 6. Minnesota Statutes 2000, section 256J.08, is 500.10 amended by adding a subdivision to read: 500.11 Subd. 67a. [PERSON TRAINED IN DOMESTIC VIOLENCE.] "Person 500.12 trained in domestic violence" means an individual who works for 500.13 an organization that is designated by the Minnesota center for 500.14 crime victims services as providing services to victims of 500.15 domestic violence, or a county staff person who has received 500.16 similar specialized training, and includes any other person or 500.17 organization designated by a qualifying organization under this 500.18 section. 500.19 [EFFECTIVE DATE.] This section is effective October 1, 2001. 500.20 Sec. 7. Minnesota Statutes 2000, section 256J.21, 500.21 subdivision 2, is amended to read: 500.22 Subd. 2. [INCOME EXCLUSIONS.] (a) The following must be 500.23 excluded in determining a family's available income: 500.24 (1) payments for basic care, difficulty of care, and 500.25 clothing allowances received for providing family foster care to 500.26 children or adults under Minnesota Rules, parts 9545.0010 to 500.27 9545.0260 and 9555.5050 to 9555.6265, and payments received and 500.28 used for care and maintenance of a third-party beneficiary who 500.29 is not a household member; 500.30 (2) reimbursements for employment training received through 500.31 the Job Training Partnership Act, United States Code, title 29, 500.32 chapter 19, sections 1501 to 1792b; 500.33 (3) reimbursement for out-of-pocket expenses incurred while 500.34 performing volunteer services, jury duty, employment, or 500.35 informal carpooling arrangements directly related to employment; 500.36 (4) all educational assistance, except the county agency 501.1 must count graduate student teaching assistantships, 501.2 fellowships, and other similar paid work as earned income and, 501.3 after allowing deductions for any unmet and necessary 501.4 educational expenses, shall count scholarships or grants awarded 501.5 to graduate students that do not require teaching or research as 501.6 unearned income; 501.7 (5) loans, regardless of purpose, from public or private 501.8 lending institutions, governmental lending institutions, or 501.9 governmental agencies; 501.10 (6) loans from private individuals, regardless of purpose, 501.11 provided an applicant or participant documents that the lender 501.12 expects repayment; 501.13 (7)(i) state income tax refunds; and 501.14 (ii) federal income tax refunds; 501.15 (8)(i) federal earned income credits; 501.16 (ii) Minnesota working family credits; 501.17 (iii) state homeowners and renters credits under chapter 501.18 290A; and 501.19 (iv) federal or state tax rebates; 501.20 (9) funds received for reimbursement, replacement, or 501.21 rebate of personal or real property when these payments are made 501.22 by public agencies, awarded by a court, solicited through public 501.23 appeal, or made as a grant by a federal agency, state or local 501.24 government, or disaster assistance organizations, subsequent to 501.25 a presidential declaration of disaster; 501.26 (10) the portion of an insurance settlement that is used to 501.27 pay medical, funeral, and burial expenses, or to repair or 501.28 replace insured property; 501.29 (11) reimbursements for medical expenses that cannot be 501.30 paid by medical assistance; 501.31 (12) payments by a vocational rehabilitation program 501.32 administered by the state under chapter 268A, except those 501.33 payments that are for current living expenses; 501.34 (13) in-kind income, including any payments directly made 501.35 by a third party to a provider of goods and services; 501.36 (14) assistance payments to correct underpayments, but only 502.1 for the month in which the payment is received; 502.2 (15) emergency assistance payments; 502.3 (16) funeral and cemetery payments as provided by section 502.4 256.935; 502.5 (17) nonrecurring cash gifts of $30 or less, not exceeding 502.6 $30 per participant in a calendar month; 502.7 (18) any form of energy assistance payment made through 502.8 Public Law Number 97-35, Low-Income Home Energy Assistance Act 502.9 of 1981, payments made directly to energy providers by other 502.10 public and private agencies, and any form of credit or rebate 502.11 payment issued by energy providers; 502.12 (19) Supplemental Security Income (SSI), including 502.13 retroactive SSI payments and other income of an SSI recipient; 502.14 (20) Minnesota supplemental aid, including retroactive 502.15 payments; 502.16 (21) proceeds from the sale of real or personal property; 502.17 (22) adoption assistance payments under section 259.67; 502.18 (23) state-funded family subsidy program payments made 502.19 under section 252.32 to help families care for children with 502.20 mental retardation or related conditions, consumer support grant 502.21 funds under section 256.476, and resources and services for a 502.22 disabled household member under one of the home and 502.23 community-based waiver services programs under chapter 256B; 502.24 (24) interest payments and dividends from property that is 502.25 not excluded from and that does not exceed the asset limit; 502.26 (25) rent rebates; 502.27 (26) income earned by a minor caregiver, minor child 502.28 through age 6, or a minor child who is at least a half-time 502.29 student in an approved elementary or secondary education 502.30 program; 502.31 (27) income earned by a caregiver under age 20 who is at 502.32 least a half-time student in an approved elementary or secondary 502.33 education program; 502.34 (28) MFIP child care payments under section 119B.05; 502.35 (29) all other payments made through MFIP to support a 502.36 caregiver's pursuit of greater self-support; 503.1 (30) income a participant receives related to shared living 503.2 expenses; 503.3 (31) reverse mortgages; 503.4 (32) benefits provided by the Child Nutrition Act of 1966, 503.5 United States Code, title 42, chapter 13A, sections 1771 to 503.6 1790; 503.7 (33) benefits provided by the women, infants, and children 503.8 (WIC) nutrition program, United States Code, title 42, chapter 503.9 13A, section 1786; 503.10 (34) benefits from the National School Lunch Act, United 503.11 States Code, title 42, chapter 13, sections 1751 to 1769e; 503.12 (35) relocation assistance for displaced persons under the 503.13 Uniform Relocation Assistance and Real Property Acquisition 503.14 Policies Act of 1970, United States Code, title 42, chapter 61, 503.15 subchapter II, section 4636, or the National Housing Act, United 503.16 States Code, title 12, chapter 13, sections 1701 to 1750jj; 503.17 (36) benefits from the Trade Act of 1974, United States 503.18 Code, title 19, chapter 12, part 2, sections 2271 to 2322; 503.19 (37) war reparations payments to Japanese Americans and 503.20 Aleuts under United States Code, title 50, sections 1989 to 503.21 1989d; 503.22 (38) payments to veterans or their dependents as a result 503.23 of legal settlements regarding Agent Orange or other chemical 503.24 exposure under Public Law Number 101-239, section 10405, 503.25 paragraph (a)(2)(E); 503.26 (39) income that is otherwise specifically excluded from 503.27 MFIP consideration in federal law, state law, or federal 503.28 regulation; 503.29 (40) security and utility deposit refunds; 503.30 (41) American Indian tribal land settlements excluded under 503.31 Public Law Numbers 98-123, 98-124, and 99-377 to the Mississippi 503.32 Band Chippewa Indians of White Earth, Leech Lake, and Mille Lacs 503.33 reservations and payments to members of the White Earth Band, 503.34 under United States Code, title 25, chapter 9, section 331, and 503.35 chapter 16, section 1407; 503.36 (42) all income of the minor parent's parents and 504.1 stepparents when determining the grant for the minor parent in 504.2 households that include a minor parent living with parents or 504.3 stepparents on MFIP with other children; and 504.4 (43) income of the minor parent's parents and stepparents 504.5 equal to 200 percent of the federal poverty guideline for a 504.6 family size not including the minor parent and the minor 504.7 parent's child in households that include a minor parent living 504.8 with parents or stepparents not on MFIP when determining the 504.9 grant for the minor parent. The remainder of income is deemed 504.10 as specified in section 256J.37, subdivision 1b; 504.11 (44) payments made to children eligible for relative 504.12 custody assistance under section 257.85; 504.13 (45) vendor payments for goods and services made on behalf 504.14 of a client unless the client has the option of receiving the 504.15 payment in cash;and504.16 (46) the principal portion of a contract for deed payment; 504.17 and 504.18 (47) participant performance bonuses under section 256J.555. 504.19 Sec. 8. Minnesota Statutes 2000, section 256J.24, 504.20 subdivision 2, is amended to read: 504.21 Subd. 2. [MANDATORY ASSISTANCE UNIT COMPOSITION.] Except 504.22 for minor caregivers and their children who must be in a 504.23 separate assistance unit from the other persons in the 504.24 household, when the following individuals live together, they 504.25 must be included in the assistance unit: 504.26 (1) a minor child, including a pregnant minor; 504.27 (2) the minor child's minor siblings, minor half-siblings, 504.28 and minor step-siblings; 504.29 (3) the minor child's natural parents, adoptive parents, 504.30 and stepparents; and 504.31 (4) the spouse of a pregnant woman. 504.32 A minor child must have a caregiver for the child to be 504.33 included in the assistance unit. 504.34 Sec. 9. Minnesota Statutes 2000, section 256J.24, 504.35 subdivision 9, is amended to read: 504.36 Subd. 9. [SHARED HOUSEHOLD STANDARD; MFIP.] (a) Except as 505.1 prohibited in paragraph (b), the county agency must use the 505.2 shared household standard when the household includes one or 505.3 more unrelated members, as that term is defined in section 505.4 256J.08, subdivision 86a. The county agency must use the shared 505.5 household standard, unless a member of the assistance unit is a 505.6 victim ofdomesticfamily violence and has anapproved safety505.7 alternative employment plan, regardless of the number of 505.8 unrelated members in the household. 505.9 (b) The county agency must not use the shared household 505.10 standard when all unrelated members are one of the following: 505.11 (1) a recipient of public assistance benefits, including 505.12 food stamps, Supplemental Security Income, adoption assistance, 505.13 relative custody assistance, or foster care payments; 505.14 (2) a roomer or boarder, or a person to whom the assistance 505.15 unit is paying room or board; 505.16 (3) a minor child under the age of 18; 505.17 (4) a minor caregiver living with the minor caregiver's 505.18 parents or in an approved supervised living arrangement; 505.19 (5) a caregiver who is not the parent of the minor child in 505.20 the assistance unit; or 505.21 (6) an individual who provides child care to a child in the 505.22 MFIP assistance unit. 505.23 (c) The shared household standard must be discontinued if 505.24 it is not approved by the United States Department of 505.25 Agriculture under the MFIP waiver. 505.26 Sec. 10. Minnesota Statutes 2000, section 256J.24, 505.27 subdivision 10, is amended to read: 505.28 Subd. 10. [MFIP EXIT LEVEL.](a) In state fiscal years505.292000 and 2001,The commissioner shall adjust the MFIP earned 505.30 income disregard to ensure that most participants do not lose 505.31 eligibility for MFIP until their income reaches at least 120 505.32 percent of the federal poverty guidelines in effect in October 505.33 of each fiscal year. The adjustment to the disregard shall be 505.34 based on a household size of three, and the resulting earned 505.35 income disregard percentage must be applied to all household 505.36 sizes. The adjustment under this subdivision must be 506.1 implemented at the same time as the October food stamp 506.2 cost-of-living adjustment is reflected in the food portion of 506.3 MFIP transitional standard as required under subdivision 5a. 506.4(b) In state fiscal year 2002 and thereafter, the earned506.5income disregard percentage must be the same as the percentage506.6implemented in October 2000.506.7 Sec. 11. Minnesota Statutes 2000, section 256J.32, 506.8 subdivision 4, is amended to read: 506.9 Subd. 4. [FACTORS TO BE VERIFIED.] The county agency shall 506.10 verify the following at application: 506.11 (1) identity of adults; 506.12 (2) presence of the minor child in the home, if 506.13 questionable; 506.14 (3) relationship of a minor child to caregivers in the 506.15 assistance unit; 506.16 (4) age, if necessary to determine MFIP eligibility; 506.17 (5) immigration status; 506.18 (6) social security number according to the requirements of 506.19 section 256J.30, subdivision 12; 506.20 (7) income; 506.21 (8) self-employment expenses used as a deduction; 506.22 (9) source and purpose of deposits and withdrawals from 506.23 business accounts; 506.24 (10) spousal support and child support payments made to 506.25 persons outside the household; 506.26 (11) real property; 506.27 (12) vehicles; 506.28 (13) checking and savings accounts; 506.29 (14) savings certificates, savings bonds, stocks, and 506.30 individual retirement accounts; 506.31 (15) pregnancy, if related to eligibility; 506.32 (16) inconsistent information, if related to eligibility; 506.33 (17) medical insurance; 506.34 (18) burial accounts; 506.35 (19) school attendance, if related to eligibility; 506.36 (20) residence; 507.1 (21) a claim ofdomesticfamily violence if used as a basis 507.2 for adeferral or exemptionwaiver from the 60-month time limit 507.3 in section 256J.42orand regular employment and training 507.4 services requirements in section 256J.56; 507.5 (22) disability if used as an exemption from employment and 507.6 training services requirements under section 256J.56; and 507.7 (23) information needed to establish an exception under 507.8 section 256J.24, subdivision 9. 507.9 [EFFECTIVE DATE.] This section is effective October 1, 2001. 507.10 Sec. 12. Minnesota Statutes 2000, section 256J.37, 507.11 subdivision 9, is amended to read: 507.12 Subd. 9. [UNEARNED INCOME.](a)The county agency must 507.13 apply unearned income to the MFIP standard of need. When 507.14 determining the amount of unearned income, the county agency 507.15 must deduct the costs necessary to secure payments of unearned 507.16 income. These costs include legal fees, medical fees, and 507.17 mandatory deductions such as federal and state income taxes. 507.18(b) Effective July 1, 2001, the county agency shall count507.19$100 of the value of public and assisted rental subsidies507.20provided through the Department of Housing and Urban Development507.21(HUD) as unearned income. The full amount of the subsidy must507.22be counted as unearned income when the subsidy is less than $100.507.23(c) The provisions of paragraph (b) shall not apply to MFIP507.24participants who are exempt from the employment and training507.25services component because they are:507.26(i) individuals who are age 60 or older;507.27(ii) individuals who are suffering from a professionally507.28certified permanent or temporary illness, injury, or incapacity507.29which is expected to continue for more than 30 days and which507.30prevents the person from obtaining or retaining employment; or507.31(iii) caregivers whose presence in the home is required507.32because of the professionally certified illness or incapacity of507.33another member in the assistance unit, a relative in the507.34household, or a foster child in the household.507.35(d) The provisions of paragraph (b) shall not apply to an507.36MFIP assistance unit where the parental caregiver receives508.1supplemental security income.508.2 Sec. 13. Minnesota Statutes 2000, section 256J.39, 508.3 subdivision 2, is amended to read: 508.4 Subd. 2. [PROTECTIVE AND VENDOR PAYMENTS.] Alternatives to 508.5 paying assistance directly to a participant may be used when: 508.6 (1) a county agency determines that a vendor payment is the 508.7 most effective way to resolve an emergency situation pertaining 508.8 to basic needs; 508.9 (2) a caregiver makes a written request to the county 508.10 agency asking that part or all of the assistance payment be 508.11 issued by protective or vendor payments for shelter and utility 508.12 service only. The caregiver may withdraw this request in 508.13 writing at any time; 508.14 (3) the vendor payment is part of a sanction under section 508.15 256J.46; 508.16 (4) the vendor payment is required under section 256J.24, 508.17 subdivision 8, or 256J.26, or 256J.43; 508.18 (5) protective payments are required for minor parents 508.19 under section 256J.14; or 508.20 (6) a caregiver has exhibited a continuing pattern of 508.21 mismanaging funds as determined by the county agency. 508.22 The director of a county agency, or the director's 508.23 designee, must approve a proposal for protective or vendor 508.24 payment for money mismanagement when there is a pattern of 508.25 mismanagement under clause (6). During the time a protective or 508.26 vendor payment is being made, the county agency must provide 508.27 services designed to alleviate the causes of the mismanagement. 508.28 The continuing need for and method of payment must be 508.29 documented and reviewed every 12 months. The director of a 508.30 county agency or the director's designee must approve the 508.31 continuation of protective or vendor payments. When it appears 508.32 that the need for protective or vendor payments will continue or 508.33 is likely to continue beyond two years because the county 508.34 agency's efforts have not resulted in sufficiently improved use 508.35 of assistance on behalf of the minor child, judicial appointment 508.36 of a legal guardian or other legal representative must be sought 509.1 by the county agency. 509.2 Sec. 14. Minnesota Statutes 2000, section 256J.42, 509.3 subdivision 1, is amended to read: 509.4 Subdivision 1. [TIME LIMIT.] (a) Exceptfor the exemptions509.5 as otherwise provided for in this section, an assistance unit in 509.6 which any adult caregiver has received 60 months of cash 509.7 assistance funded in whole or in part by the TANF block grant in 509.8 this or any other state or United States territory, or from a 509.9 tribal TANF program, MFIP, the AFDC program formerly codified in 509.10 sections 256.72 to 256.87, or the family general assistance 509.11 program formerly codified in sections 256D.01 to 256D.23, funded 509.12 in whole or in part by state appropriations, is ineligible to 509.13 receive MFIP. Any cash assistance funded with TANF dollars in 509.14 this or any other state or United States territory, or from a 509.15 tribal TANF program, or MFIP assistance funded in whole or in 509.16 part by state appropriations, that was received by the unit on 509.17 or after the date TANF was implemented, including any assistance 509.18 received in states or United States territories of prior 509.19 residence, counts toward the 60-month limitation. The 60-month 509.20 limit applies to a minorwho is the head of a household or who509.21is married to the head of a householdcaregiver except under 509.22 subdivision 5. The 60-month time period does not need to be 509.23 consecutive months for this provision to apply. 509.24 (b) The months before July 1998 in which individuals 509.25 received assistance as part of the field trials as an MFIP, 509.26 MFIP-R, or MFIP or MFIP-R comparison group family are not 509.27 included in the 60-month time limit. 509.28 Sec. 15. Minnesota Statutes 2000, section 256J.42, 509.29 subdivision 3, is amended to read: 509.30 Subd. 3. [ADULTS LIVINGON ANIN INDIAN 509.31RESERVATIONCOUNTRY.] In determining the number of months for 509.32 which an adult has received assistance under MFIP-S, the county 509.33 agency must disregard any month during which the adult livedon509.34anin Indianreservationcountry if during the month at least 50 509.35 percent of the adults livingon the reservationin Indian 509.36 country were not employed. 510.1 Sec. 16. Minnesota Statutes 2000, section 256J.42, 510.2 subdivision 4, is amended to read: 510.3 Subd. 4. [VICTIMS OFDOMESTICFAMILY VIOLENCE.] Any cash 510.4 assistance received by an assistance unit in a month when a 510.5 caregiveris complyingcomplied with a safety plan or after 510.6 October 1, 2001, complied or is complying with an alternative 510.7 employment plan underthe MFIP-S employment and training510.8componentsection 256J.49, subdivision 1a, does not count toward 510.9 the 60-month limitation on assistance. 510.10 Sec. 17. Minnesota Statutes 2000, section 256J.42, 510.11 subdivision 5, is amended to read: 510.12 Subd. 5. [EXEMPTION FOR CERTAIN FAMILIES.] (a) Any cash 510.13 assistance received by an assistance unit does not count toward 510.14 the 60-month limit on assistance during a month in which the 510.15 caregiver (1) is inthea category in section 256J.56, paragraph510.16(a), clause (1); (2) is earning income and participating in work 510.17 activities, as defined in section 256J.49, subdivision 13, for 510.18 at least 40 hours per week for a two-parent family, 20 hours per 510.19 week for a single-parent family with a child under age six 510.20 years, or 30 hours per week for a single-parent family with a 510.21 child age 6 years or older. If the individualized plan requires 510.22 fewer hours of work activities, then it is the number of hours 510.23 required in the plan; or (3) is in an education or training 510.24 program, including, but not limited to, an English as a second 510.25 language (ESL) program, in which the combination of work 510.26 activities and education are for at least 40 hours per week for 510.27 a two-parent family, or 20 hours per week for a single-parent 510.28 family with a child under age six years, or 30 hours per week 510.29 for a single-parent family with a child age 6 years or older. 510.30 If the individualized plan requires fewer hours of work 510.31 activities, then it is the number of hours required in the plan. 510.32 (b)From July 1, 1997, until the date MFIP is operative in510.33the caregiver's county of financial responsibility, any cash510.34assistance received by a caregiver who is complying with510.35Minnesota Statutes 1996, section 256.73, subdivision 5a, and510.36Minnesota Statutes 1998, section 256.736, if applicable, does511.1not count toward the 60-month limit on assistance. Thereafter,511.2any cash assistance received by a minor caregiver who is511.3complying with the requirements of sections 256J.14 and 256J.54,511.4if applicable, does not count towards the 60-month limit on511.5assistance.511.6(c)Any diversionary assistance or emergency assistance 511.7 received does not count toward the 60-month limit. 511.8(d)(c) Any cash assistance received by an 18- or 511.9 19-year-old caregiver who is complying with the requirements of 511.10 section 256J.54 does not count toward the 60-month limit. 511.11 Sec. 18. [256J.422] [60-MONTH TIME LIMIT REVIEW; 511.12 EXTENSION; APPEAL.] 511.13 Subdivision 1. [EXTENSION OF 60-MONTH TIME LIMIT.] At the 511.14 end of the participant's eligibility period when TANF assistance 511.15 has been exhausted, the participant's time limit will be 511.16 extended provided the participant meets the MFIP eligibility 511.17 criteria. Participants must comply with MFIP requirements or be 511.18 subject to a sanction. The county may choose not to provide an 511.19 extension for participants if after a face-to-face review, the 511.20 participant does not fall under any of the categories in 511.21 subdivision 2. 511.22 Subd. 2. [REVIEW.] (a) A county representative may 511.23 schedule a face-to-face review with a participant who is nearing 511.24 the 60-month time limit on TANF assistance. The face-to-face 511.25 review must be conducted with a county representative, a 511.26 representative from a legal rights organization that primarily 511.27 represents low-income individuals or an advocate, and the 511.28 participant, unless the participant requests that a 511.29 representative or advocate not be present during the review. A 511.30 face-to-face review with the participant must be conducted 511.31 before the participant is denied an extension. The county 511.32 representative makes the final determination regarding the 511.33 extension of assistance. 511.34 (b) In the face-to-face review, the individuals in 511.35 attendance shall determine if: 511.36 (1) the participant's plan is inappropriate or if it should 512.1 be modified in order for the participant to reduce barriers or 512.2 achieve goals that will lead to long-term self-sufficiency; 512.3 (2) the participant falls under any of the exempt 512.4 categories in section 256J.42; 512.5 (3) there are other substantial barriers that need to be 512.6 addressed, which include, but are not limited to, language 512.7 barriers, physical or mental health needs, or learning 512.8 disabilities; 512.9 (4) there are services that were required to be provided or 512.10 necessary in order to fulfill the requirements of the plan that 512.11 were unavailable to the participant; 512.12 (5) there are educational opportunities that will lead to 512.13 self-sufficiency that were not allowed or offered to the 512.14 participant; 512.15 (6) the participant's plan is appropriate and the 512.16 participant is meeting the expectations of the participant's 512.17 individualized plan, or in a two-parent family, at least one 512.18 participant has an appropriate plan and is meeting the 512.19 expectations of that individualized plan; 512.20 (7) the employment held by the participant will not provide 512.21 a wage of at least 120 percent of the federal poverty guidelines 512.22 for the same family size, or in a two-parent family, when at 512.23 least one parent is cooperating with the program requirements, 512.24 the employment held by the cooperating participant will not 512.25 provide a wage of at least 120 percent of the federal poverty 512.26 guidelines for the same family size; or 512.27 (8) there are other issues that need to be addressed before 512.28 the participant is denied an extension. 512.29 Subd. 3. [APPEAL OF COUNTY DECISION.] If the county denies 512.30 an extension under subdivision 2, the participant may appeal the 512.31 decision under section 256J.40. Assistance must continue until 512.32 the appeal is resolved. 512.33 Sec. 19. Minnesota Statutes 2000, section 256J.45, 512.34 subdivision 1, is amended to read: 512.35 Subdivision 1. [COUNTY AGENCY TO PROVIDE ORIENTATION.] A 512.36 county agency must provide orientation to each MFIP caregiver 513.1who is not exempt under section 256J.56, paragraph (a), clause513.2(6) or (8)unless the caregiver: (1) is a single parent, or one 513.3 parent in a two-parent family, employed at least 35 hours per 513.4 week; or (2) a second parent in a two-parent family who is 513.5 employed for 20 or more hours per week provided the first parent 513.6 is employed at least 35 hours per week, with a face-to-face 513.7 orientation. The county agency must inform caregivers who are 513.8 not exempt undersection 256J.56, paragraph (a), clause (6) or513.9(8),clause (1) or (2) that failure to attend the orientation is 513.10 considered an occurrence of noncompliance with program 513.11 requirements, and will result in the imposition of a sanction 513.12 under section 256J.46. If the client complies with the 513.13 orientation requirement prior to the first day of the month in 513.14 which the grant reduction is proposed to occur, the orientation 513.15 sanction shall be lifted. 513.16 Sec. 20. Minnesota Statutes 2000, section 256J.45, 513.17 subdivision 2, is amended to read: 513.18 Subd. 2. [GENERAL INFORMATION.] TheMFIP-SMFIP 513.19 orientation must consist of a presentation that informs 513.20 caregivers of: 513.21 (1) the necessity to obtain immediate employment; 513.22 (2) the work incentives underMFIP-SMFIP, including the 513.23 availability of the federal earned income tax credit and the 513.24 Minnesota working family tax credit; 513.25 (3) the requirement to comply with the employment plan and 513.26 other requirements of the employment and training services 513.27 component ofMFIP-SMFIP, including a description of the range 513.28 of work and training activities that are allowable underMFIP-S513.29 MFIP to meet the individual needs of participants; 513.30 (4) the consequences for failing to comply with the 513.31 employment plan and other program requirements, and that the 513.32 county agency may not impose a sanction when failure to comply 513.33 is due to the unavailability of child care or other 513.34 circumstances where the participant has good cause under 513.35 subdivision 3; 513.36 (5) the rights, responsibilities, and obligations of 514.1 participants; 514.2 (6) the types and locations of child care services 514.3 available through the county agency; 514.4 (7) the availability and the benefits of the early 514.5 childhood health and developmental screening under sections 514.6 121A.16 to 121A.19; 123B.02, subdivision 16; and 123B.10; 514.7 (8) the caregiver's eligibility for transition year child 514.8 care assistance under section 119B.05; 514.9 (9) the caregiver's eligibility for extended medical 514.10 assistance when the caregiver loses eligibility forMFIP-SMFIP 514.11 due to increased earnings or increased child or spousal support; 514.12 (10) the caregiver's option to choose an employment and 514.13 training provider and information about each provider, including 514.14 but not limited to, services offered, program components, job 514.15 placement rates, job placement wages, and job retention rates; 514.16 (11) the caregiver's option to request approval of an 514.17 education and training plan according to section 256J.52;and514.18 (12) the work study programs available under the higher 514.19 education system; and 514.20 (13) effective October 1, 2001, information about the 514.21 60-month time limit exemption and waivers of regular employment 514.22 and training requirements for family violence victims and 514.23 referral information about shelters and programs for victims of 514.24 family violence. 514.25 Sec. 21. Minnesota Statutes 2000, section 256J.46, 514.26 subdivision 1, is amended to read: 514.27 Subdivision 1. [SANCTIONS FORPARTICIPANTS NOT COMPLYING 514.28 WITH PROGRAM REQUIREMENTS.] (a) A participant who fails without 514.29 good cause to comply with the requirements of this chapter, and 514.30 who is not subject to a sanction under subdivision 2, shall be 514.31 subject to a sanction as provided in this subdivision. A 514.32 participant who fails to comply with an alternative employment 514.33 plan must have the plan reviewed by a person trained in domestic 514.34 violence and the county or a job counselor to determine if 514.35 components of the alternative employment plan are still 514.36 appropriate. If the activities are no longer appropriate, the 515.1 plan must be revised with a person trained in domestic violence 515.2 and approved by the county or a job counselor. A participant 515.3 who fails to comply with a plan that is determined not to need 515.4 revision will lose their exemption and be required to comply 515.5 with regular employment services activities. 515.6 A sanction must not be imposed for the sole purpose of 515.7 failing to participate in work activities for a specified number 515.8 of hours if the participant is a single parent or one parent in 515.9 a two-parent family and is employed at least 35 hours per week. 515.10 A sanction under this subdivision becomes effective the 515.11 month following the month in which a required notice is given. 515.12 A sanction must not be imposed when a participant comes into 515.13 compliance with the requirements for orientation under section 515.14 256J.45 or third-party liability for medical services under 515.15 section 256J.30, subdivision 10, prior to the effective date of 515.16 the sanction. A sanction must not be imposed when a participant 515.17 comes into compliance with the requirements for employment and 515.18 training services under sections 256J.49 to 256J.72 ten days 515.19 prior to the effective date of the sanction. For purposes of 515.20 this subdivision, each month that a participant fails to comply 515.21 with a requirement of this chapter shall be considered a 515.22 separate occurrence of noncompliance. A participant who has had 515.23 one or more sanctions imposed must remain in compliance with the 515.24 provisions of this chapter for six months in order for a 515.25 subsequent occurrence of noncompliance to be considered a first 515.26 occurrence. 515.27 (b) Sanctions for noncompliance shall be imposed as follows: 515.28 (1) For the first occurrence of noncompliance by a 515.29 participant in a single-parent household or by one participant 515.30 in a two-parent household, the job counselor must initiate 515.31 personal contact with the participant by either having a 515.32 personal meeting with the participant or a telephone 515.33 conversation with the participant, and thoroughly review the 515.34 exemption and good cause categories with the participant to 515.35 determine if the participant falls under one or more of the 515.36 categories. If the participant does not fall under an exemption 516.1 or good cause category, the assistance unit's grant shall be 516.2 reduced by ten percent of the MFIP standard of need for an 516.3 assistance unit of the same size with the residual grant paid to 516.4 the participant. The reduction in the grant amount must be in 516.5 effect for a minimum of one month and shall be removed in the 516.6 month following the month that the participant returns to 516.7 compliance. 516.8 (2) For a second or subsequent occurrence of noncompliance, 516.9 or when both participants in a two-parent household are out of 516.10 compliance at the same time, the assistance unit's shelter costs 516.11 shall be vendor paid up to the amount of the cash portion of the 516.12 MFIP grant for which the participant's assistance unit is 516.13 eligible. At county option, the assistance unit's utilities may 516.14 also be vendor paid up to the amount of the cash portion of the 516.15 MFIP grant remaining after vendor payment of the assistance 516.16 unit's shelter costs. The residual amount of the grant after 516.17 vendor payment, if any, must be reduced by an amount equal to 30 516.18 percent of the MFIP standard of need for an assistance unit of 516.19 the same size before the residual grant is paid to the 516.20 assistance unit. The reduction in the grant amount must be in 516.21 effect for a minimum of one month and shall be removed in the 516.22 month following the month that a participant in a one-parent 516.23 household returns to compliance. In a two-parent household, the 516.24 grant reduction must be in effect for a minimum of one month and 516.25 shall be removed in the month following the month both 516.26 participants return to compliance. The vendor payment of 516.27 shelter costs and, if applicable, utilities shall be removed six 516.28 months after the month in which the participant or participants 516.29 return to compliance. 516.30 (3) The food portion of the MFIP grant must not be 516.31 sanctioned. 516.32 (c) No later than during the second month that a sanction 516.33 under paragraph (b), clause (2), is in effect due to 516.34 noncompliance with employment services, the participant's case 516.35 file must be reviewed to determine if: 516.36 (i) the continued noncompliance can be explained and 517.1 mitigated by providing a needed preemployment activity, as 517.2 defined in section 256J.49, subdivision 13, clause (16); 517.3 (ii) the participant qualifies for a good cause exception 517.4 under section 256J.57;or517.5 (iii) the participant qualifies for an exemption under 517.6 section 256J.56; or 517.7 (iv) the participant qualifies for a waiver under section 517.8 256J.52, subdivision 6. 517.9 If the lack of an identified activity can explain the 517.10 noncompliance, the county must work with the participant to 517.11 provide the identified activity, and the county must restore the 517.12 participant's grant amount to the full amount for which the 517.13 assistance unit is eligible. The grant must be restored 517.14 retroactively to the first day of the month in which the 517.15 participant was found to lack preemployment activities or to 517.16 qualify for an exemptionor, a good cause exception, or a family 517.17 violence waiver. 517.18 If the participant is found to qualify for a good cause 517.19 exception oranexemption, or a family violence waiver, the 517.20 county must restore the participant's grant to the full amount 517.21 for which the assistance unit is eligible. 517.22 (d) In the two-parent MFIP program under section 256J.021 517.23 if only one caregiver is out of compliance with the requirements 517.24 for employment and training under sections 256J.49 to 256J.72, 517.25 the MFIP grant shall be reduced by either ten percent or 30 517.26 percent of the noncompliant parent's portion of the transitional 517.27 standard, whichever is applicable to the sanction occurrence. 517.28 [EFFECTIVE DATE.] The language in this section related to 517.29 domestic or family violence is effective October 1, 2001. 517.30 Sec. 22. Minnesota Statutes 2000, section 256J.48, 517.31 subdivision 1, is amended to read: 517.32 Subdivision 1. [EMERGENCY FINANCIAL ASSISTANCE.] County 517.33 human service agencies shall grant emergency financial 517.34 assistance to any needy pregnant woman or needy family with a 517.35 child under the age of 21 who is or was within six months prior 517.36 to application living with an eligible caregiver relative 518.1 specified in section 256J.08. 518.2 Except for ongoing special diets, emergency assistance is 518.3 available to a familyduring one 30-day period infor up to two 518.4 times a year, not to exceed a maximum of 120 days within a 518.5 consecutive 12-month period. A county shall issue assistance 518.6 for needs that accrue beforethat 30-day periodthe eligibility 518.7 period only when it is necessary to resolve emergencies arising 518.8 or continuing during the30-dayperiod of eligibility.When518.9emergency needs continue, a county may issue assistance for up518.10to 30 days beyond the initial 30-day period of eligibility, but518.11only when assistance is authorized during the initial period.518.12 Sec. 23. Minnesota Statutes 2000, section 256J.48, is 518.13 amended by adding a subdivision to read: 518.14 Subd. 1a. [PROCESSING EMERGENCY APPLICATIONS.] Within 518.15 seven days of receiving the application, or sooner if the 518.16 immediacy and severity of the situation warrants it, families 518.17 must be notified in writing whether their application was 518.18 approved, denied, or pended. 518.19 Sec. 24. Minnesota Statutes 2000, section 256J.49, is 518.20 amended by adding a subdivision to read: 518.21 Subd. 1a. [ALTERNATIVE EMPLOYMENT PLAN.] "Alternative 518.22 employment plan" means a plan that is based on an individualized 518.23 assessment of need and is developed with a person trained in 518.24 domestic violence and approved by the county or a job 518.25 counselor. The plan may address safety, legal or emotional 518.26 issues, and other demands on the family as a result of the 518.27 family violence. The information in section 256J.515, clauses 518.28 (1) to (8), must be included as part of the development of the 518.29 alternative employment plan. The primary goal of an alternative 518.30 employment plan is to ensure the safety of the caregiver and 518.31 children. To the extent it is consistent with ensuring safety, 518.32 an alternative employment plan shall also include activities 518.33 that are designed to lead to self-sufficiency. An activity is 518.34 inconsistent with ensuring safety if, in the opinion of a person 518.35 trained in domestic violence, the activity would endanger the 518.36 safety of the participant or children. An alternative 519.1 employment plan may not automatically include a provision that 519.2 requires a participant to obtain an order for protection or to 519.3 attend counseling. 519.4 [EFFECTIVE DATE.] This section is effective October 1, 2001. 519.5 Sec. 25. Minnesota Statutes 2000, section 256J.49, 519.6 subdivision 2, is amended to read: 519.7 Subd. 2. [DOMESTICFAMILY VIOLENCE.] "DomesticFamily 519.8 violence" means: 519.9 (1) physical acts that result, or threaten to result in, 519.10 physical injury to an individual; 519.11 (2) sexual abuse; 519.12 (3) sexual activity involving a minor child; 519.13 (4) being forced as the caregiver of a minor child to 519.14 engage in nonconsensual sexual acts or activities; 519.15 (5) threats of, or attempts at, physical or sexual abuse; 519.16 (6) mental abuse; or 519.17 (7) neglect or deprivation of medical care. 519.18 Claims of family violence must be documented by the applicant or 519.19 participant providing a sworn statement, which is supported by 519.20 collateral documentation. Collateral documentation may consist 519.21 of any one of the following: 519.22 (1) police, government agency, or court records; 519.23 (2) a statement from a battered woman's shelter staff with 519.24 knowledge of circumstances or credible evidence that supports 519.25 the sworn statement; 519.26 (3) a statement from a sexual assault or domestic violence 519.27 advocate with knowledge of the circumstances or credible 519.28 evidence that supports a sworn statement; 519.29 (4) a statement from professionals from whom the applicant 519.30 or recipient has sought assistance for the abuse; or 519.31 (5) a sworn statement from any other individual with 519.32 knowledge of circumstances or credible evidence that supports 519.33 the sworn statement. 519.34 [EFFECTIVE DATE.] This section is effective October 1, 2001. 519.35 Sec. 26. Minnesota Statutes 2000, section 256J.49, 519.36 subdivision 13, is amended to read: 520.1 Subd. 13. [WORK ACTIVITY.] "Work activity" means any 520.2 activity in a participant's approved employment plan that is 520.3 tied to the participant's employment goal. For purposes of the 520.4 MFIP program, any activity that is included in a participant's 520.5 approved employment plan meets the definition of work activity 520.6 as counted under the federal participation standards. Work 520.7 activity includes, but is not limited to: 520.8 (1) unsubsidized employment; 520.9 (2) subsidized private sector or public sector employment, 520.10 including grant diversion as specified in section 256J.69; 520.11 (3) work experience, including CWEP as specified in section 520.12 256J.67, and including work associated with the refurbishing of 520.13 publicly assisted housing if sufficient private sector 520.14 employment is not available; 520.15 (4) on-the-job training as specified in section 256J.66; 520.16 (5) job search, either supervised or unsupervised; 520.17 (6) job readiness assistance; 520.18 (7) job clubs, including job search workshops; 520.19 (8) job placement; 520.20 (9) job development; 520.21 (10) job-related counseling; 520.22 (11) job coaching; 520.23 (12) job retention services; 520.24 (13) job-specific training or education; 520.25 (14) job skills training directly related to employment; 520.26 (15) the self-employment investment demonstration (SEID), 520.27 as specified in section 256J.65; 520.28 (16) preemployment activities, based on availability and 520.29 resources, such as volunteer work, literacy programs and related 520.30 activities, citizenship classes, English as a second language 520.31 (ESL) classes as limited by the provisions of section 256J.52, 520.32 subdivisions 3, paragraph (d), and 5, paragraph (c), or 520.33 participation in dislocated worker services, chemical dependency 520.34 treatment, mental health services, peer group networks, 520.35 displaced homemaker programs, strength-based resiliency 520.36 training, parenting education, or other programs designed to 521.1 help families reach their employment goals and enhance their 521.2 ability to care for their children; 521.3 (17) community service programs; 521.4 (18) vocational educational training or educational 521.5 programs that can reasonably be expected to lead to employment, 521.6 as limited by the provisions of section 256J.53; 521.7 (19) apprenticeships; 521.8 (20) satisfactory attendance in general educational 521.9 development diploma classes or an adult diploma program; 521.10 (21) satisfactory attendance at secondary school, if the 521.11 participant has not received a high school diploma; 521.12 (22) adult basic education classes; 521.13 (23) internships; 521.14 (24) bilingual employment and training services; 521.15 (25) providing child care services to a participant who is 521.16 working in a community service program; and 521.17 (26) activities included ina safetyan alternative 521.18 employment plan that is developed under section 256J.52, 521.19 subdivision 6. 521.20 [EFFECTIVE DATE.] This section is effective October 1, 2001. 521.21 Sec. 27. Minnesota Statutes 2000, section 256J.50, 521.22 subdivision 5, is amended to read: 521.23 Subd. 5. [PARTICIPATION REQUIREMENTS FOR ALL CASES.] (a) 521.24 For two-parent cases, participation is required concurrent with 521.25 the receipt of MFIP cash assistance. 521.26 For single-parent cases, participation is required 521.27 concurrent with the receipt of MFIP cash assistance for all 521.28 counties except Blue Earth and Nicollet, effective July 1, 2000, 521.29 and is required for Blue Earth and Nicollet counties effective 521.30 January 1, 2001. For Blue Earth and Nicollet counties only, 521.31 from July 1, 2000 to December 31, 2000, mandatory participation 521.32 for single-parent cases must be required within six months of 521.33 eligibility for cash assistance. 521.34 (b) Beginning January 1, 1998, with the exception of 521.35 caregivers required to attend high school under the provisions 521.36 of section 256J.54, subdivision 5, MFIP caregivers, upon 522.1 completion of the secondary assessment, must develop an 522.2 employment plan and participate in work activities. 522.3 (c) Upon completion of the secondary assessment: 522.4 (1) In single-parent families with no children under six 522.5 years of age, the job counselor and the caregiver must develop 522.6 an employment plan that includes 20 to 35 hours per week of work 522.7 activities for the period January 1, 1998, to September 30, 522.8 1998; 25 to 35 hours of work activities per week in federal 522.9 fiscal year 1999; and 30 to 35 hours per week of work activities 522.10 in federal fiscal year 2000 and thereafter. 522.11 (2) In single-parent families with a child under six years 522.12 of age, the job counselor and the caregiver must develop an 522.13 employment plan that includes 20 to 35 hours per week of work 522.14 activities. 522.15 (3) In two-parent families, the job counselor and the 522.16 caregivers must develop employment plans which result in a 522.17 combined total of at least 55 hours per week of work activities, 522.18 of which at least 30 hours must be completed by one of the 522.19 parents. 522.20 Sec. 28. Minnesota Statutes 2000, section 256J.50, 522.21 subdivision 10, is amended to read: 522.22 Subd. 10. [REQUIRED NOTIFICATION TO VICTIMS OFDOMESTIC522.23 FAMILY VIOLENCE.] County agencies and their contractors must 522.24 provide universal notification to all applicants and recipients 522.25 ofMFIP-SMFIP that: 522.26 (1) referrals to counseling and supportive services are 522.27 available for victims ofdomesticfamily violence; 522.28 (2) nonpermanent resident battered individuals married to 522.29 United States citizens or permanent residents may be eligible to 522.30 petition for permanent residency under the federal Violence 522.31 Against Women Act, and that referrals to appropriate legal 522.32 services are available; 522.33 (3) victims ofdomesticfamily violence areexempt from522.34 eligible for an extension of the 60-month limit on assistance 522.35while the individual is complying with an approved safety plan,522.36as defined in section 256J.49, subdivision 11; and 523.1 (4) victims ofdomesticfamily violence may choose tobe523.2exempt or deferred fromhave regular work requirementsfor up to523.312 monthswaived while the individual is complying with 523.4 anapproved safetyalternative employment plan as defined in 523.5 section 256J.49, subdivision111a. 523.6 If an alternative plan is denied, the county or a job 523.7 counselor must provide reasons why the plan is not approved and 523.8 document how the denial of the plan does not interfere with the 523.9 safety of the participant or children. 523.10 Notification must be in writing and orally at the time of 523.11 application and recertification, when the individual is referred 523.12 to the title IV-D child support agency, and at the beginning of 523.13 any job training or work placement assistance program. 523.14 [EFFECTIVE DATE.] This section is effective October 1, 2001. 523.15 Sec. 29. Minnesota Statutes 2000, section 256J.50, is 523.16 amended by adding a subdivision to read: 523.17 Subd. 12. [ACCESS TO PERSONS TRAINED IN DOMESTIC 523.18 VIOLENCE.] In a county where there is no staff person who is 523.19 trained in domestic violence, as that term is defined in section 523.20 256J.08, subdivision 67a, the county must work with the nearest 523.21 organization that is designated as providing services to victims 523.22 of domestic violence to develop a process, which ensures that 523.23 domestic violence victims have access to a person trained in 523.24 domestic violence. 523.25 [EFFECTIVE DATE.] This section is effective October 1, 2001. 523.26 Sec. 30. Minnesota Statutes 2000, section 256J.515, is 523.27 amended to read: 523.28 256J.515 [OVERVIEW OF EMPLOYMENT AND TRAINING SERVICES.] 523.29 During the first meeting with participants, job counselors 523.30 must ensure that an overview of employment and training services 523.31 is provided that: 523.32 (1) stresses the necessity and opportunity of immediate 523.33 employment; 523.34 (2) outlines the job search resources offered; 523.35 (3) outlines education or training opportunities available; 523.36 (4) describes the range of work activities, including 524.1 activities under section 256J.49, subdivision 13, clause (18), 524.2 that are allowable under MFIP to meet the individual needs of 524.3 participants; 524.4 (5) explains the requirements to comply with an employment 524.5 plan; 524.6 (6) explains the consequences for failing to comply;and524.7 (7) explains the services that are available to support job 524.8 search and work and education; and 524.9 (8) provides referral information about shelters and 524.10 programs for victims of family violence, the time limit 524.11 exemption, and waivers of regular employment and training 524.12 requirements for family violence victims. 524.13 Failure to attend the overview of employment and training 524.14 services without good cause results in the imposition of a 524.15 sanction under section 256J.46. 524.16 Effective October 1, 2001, a participant who has an 524.17 alternative employment plan under section 256J.52, subdivision 524.18 6, as defined in section 256J.49, subdivision 1a, or who is in 524.19 the process of developing such a plan, is exempt from the 524.20 requirement to attend the overview. 524.21 Sec. 31. Minnesota Statutes 2000, section 256J.52, 524.22 subdivision 2, is amended to read: 524.23 Subd. 2. [INITIAL ASSESSMENT.] (a) The job counselor must, 524.24 with the cooperation of the participant, assess the 524.25 participant's ability to obtain and retain employment. This 524.26 initial assessment must include a review of the participant's 524.27 education level, prior employment or work experience, 524.28 transferable work skills, and existing job markets. 524.29 (b) In assessing the participant, the job counselor must 524.30 determine if the participant needs refresher courses for 524.31 professional certification or licensure, in which case, the job 524.32 search plan under subdivision 3 must include the courses 524.33 necessary to obtain the certification or licensure, in addition 524.34 to other work activities, provided the combination of the 524.35 courses and other work activities are at least for 40 hours per 524.36 week. 525.1 (c) If a participant can demonstrate to the satisfaction of 525.2 the county agency that lack of proficiency in English is a 525.3 barrier to obtaining suitable employment, the job counselor must 525.4 include participation in an intensive English as a second 525.5 language program if available or otherwise a regular English as 525.6 a second language program in the individual's employment plan 525.7 under subdivision 5. Lack of proficiency in English is not 525.8 necessarily a barrier to employment. 525.9 (d) The job counselormayshall approve an education or 525.10 training plan, and postpone the job search requirement, if less 525.11 than 30 percent of the statewide MFIP caseload is participating 525.12 in education and training, and if the participant has a proposal 525.13 for an education program which: 525.14 (1) can be completed within1224 months; 525.15 (2) meets the criteria of section 256J.53, subdivisions 2, 525.16 3, and 5; and 525.17 (3) is likely, without additional training, to lead to 525.18 monthly employment earnings which, after subtraction of the 525.19 earnings disregard under section 256J.21, equal or exceed the 525.20 family wage level for the participant's assistance unit. 525.21 (e) A participant who, at the time of the initial 525.22 assessment, presents a plan that includes farming as a 525.23 self-employed work activity must have an employment plan 525.24 developed under subdivision 5 that includes the farming as an 525.25 approved work activity. 525.26 (f) Effective October 1, 2001, an alternative employment 525.27 plan must be offered and explained to a participant who at any 525.28 time declares or reveals current or past family violence. If 525.29 the participant is interested, an alternative employment plan 525.30 must be developed and approved for the participant if it is 525.31 evident that the current or past violence affects the ability of 525.32 the person to participate with regular employment service 525.33 activities and denial of an alternative employment plan would 525.34 interfere with the safety of the participant or children. 525.35 Sec. 32. Minnesota Statutes 2000, section 256J.52, 525.36 subdivision 3, is amended to read: 526.1 Subd. 3. [JOB SEARCH; JOB SEARCH SUPPORT PLAN.] (a) If, 526.2 after the initial assessment, the job counselor determines that 526.3 the participant possesses sufficient skills that the participant 526.4 is likely to succeed in obtaining suitable employment, the 526.5 participant must conduct job search for a period of up to eight 526.6 weeks, for at least 30 hours per week.The participant must526.7accept any offer of suitable employment. Upon agreement by the526.8job counselor and the participant, a job search support plan may526.9limit a job search to jobs that are consistent with the526.10participant's employment goal.The job counselor and 526.11 participant must develop a job search support plan which 526.12 specifies, at a minimum: a job goal which realistically 526.13 reflects the individual's skills, abilities, and work experience 526.14 and meets the definition of suitable employment, and for which 526.15 there are job openings in the geographic area of the 526.16 participant's job search or an area to which the participant is 526.17 willing to relocate; whether the job search is to be supervised 526.18 or unsupervised; support services that will be provided while 526.19 the participant conducts job search activities; the courses 526.20 necessary to obtain certification or licensure, if applicable, 526.21 and after obtaining the license or certificate, the client must 526.22 comply with subdivision 5; and how frequently the participant 526.23 must report to the job counselor on the status of the 526.24 participant's job search activities. The job goal specified in 526.25 the job search support plan must be intended to enable the 526.26 participant to progress toward employment that provides wages 526.27 sufficient to allow the participant to transition off of MFIP. 526.28 The job search support plan must also specify that the 526.29 participant fulfill no more than half of the required hours of 526.30 job search through attending adult basic education or English as 526.31 a second language classes, if one or both of those activities 526.32 are approved by the job counselor. 526.33 (b) During the eight-week job search period, either the job 526.34 counselor or the participant may request a review of the 526.35 participant's job search plan and progress towards obtaining 526.36suitable employmentparticipant's job goal under paragraph (a). 527.1 If a review is requested by the participant, the job counselor 527.2 must concur that the review is appropriate for the participant 527.3 at that time. If a review is conducted, the job counselor may 527.4 make a determination to conduct a secondary assessment prior to 527.5 the conclusion of the job search. 527.6 (c) Failure to conduct the required job search, to accept 527.7 any offer ofsuitableemployment consistent with the 527.8 participant's job goal under paragraph (a), to develop or comply 527.9 with a job search support plan, or voluntarily quitting suitable 527.10 employment without good cause results in the imposition of a 527.11 sanction under section 256J.46. If at the end of eight weeks 527.12 the participant has not obtained suitable employment, the job 527.13 counselor must conduct a secondary assessment of the participant 527.14 under subdivision34. 527.15 (d) In order for an English as a second language (ESL) 527.16 class to be an approved work activity, a participant must be at 527.17 or below a spoken language proficiency level of SPL5 or its 527.18 equivalent, as measured by a nationally recognized test. A 527.19 participant may not be approved for more than a total of 24 527.20 months of ESL activities while participating in the employment 527.21 and training services component of MFIP. In approving ESL as a 527.22 work activity, the job counselor must give preference to 527.23 enrollment in an intensive ESL program, if one is available, 527.24 over a regular ESL program. If an intensive ESL program is 527.25 approved, the restriction in paragraph (a) that no more than 527.26 half of the required hours of job search is fulfilled through 527.27 attending ESL classes does not apply. 527.28 Sec. 33. Minnesota Statutes 2000, section 256J.52, 527.29 subdivision 6, is amended to read: 527.30 Subd. 6. [SAFETYALTERNATIVE EMPLOYMENT PLAN AND FAMILY 527.31 VIOLENCE WAIVER PROVISIONS.]Notwithstanding subdivisions 1 to527.325, a participant who is a victim of domestic violence and who527.33agrees to develop or has developed a safety plan meeting the527.34definition under section 256J.49, subdivision 11, is deferred527.35from the requirements of this section, sections 256J.54, and527.36256J.55 for a period of three months from the date the safety528.1plan is approved. A participant deferred under this subdivision528.2must submit a safety plan status report to the county agency on528.3a quarterly basis. Based on a review of the status report, the528.4county agency may approve or renew the participant's deferral528.5each quarter, provided the personal safety of the participant is528.6still at risk and the participant is complying with the plan. A528.7participant who is deferred under this subdivision may be528.8deferred for a total of 12 months under a safety plan, provided528.9the individual is complying with the terms of the plan.528.10 Participants who have a safety plan under section 256J.49, 528.11 subdivision 11, prior to October 1, 2001, will have that plan 528.12 converted to an alternative employment plan upon their plan 528.13 renewal date. An alternative employment plan must be reviewed 528.14 at the end of the first six months to determine if the 528.15 activities contained in the alternative employment plan are 528.16 still appropriate. It is the responsibility of the county or a 528.17 job counselor to contact the participant and notify them that 528.18 their plan is up for review, and document whether the 528.19 participant wishes to renew the plan. If the participant does 528.20 not wish to renew the plan, or if the participant fails to 528.21 respond after reasonable efforts to contact the participant are 528.22 made by the county or a job counselor, the participant must 528.23 participate in regular employment services activities. If the 528.24 participant requests renewal of the plan or if there is a 528.25 dispute over whether the plan is still appropriate, the 528.26 participant must receive the assistance of a person trained in 528.27 domestic violence. If the person trained in domestic violence 528.28 recommends that the activities are still appropriate, the county 528.29 or a job counselor must renew the alternative employment plan or 528.30 provide written reasons why the plan is not approved and 528.31 document how denial of the plan renewal does not interfere with 528.32 the safety of the participant or children. If the person 528.33 trained in domestic violence recommends that the activities are 528.34 no longer appropriate, the plan must be revised with the 528.35 assistance of a person trained in domestic violence. The county 528.36 or a job counselor must approve the revised plan or provide 529.1 written reasons why the plan is not approved and document how 529.2 denial of the plan renewal does not interfere with the safety of 529.3 the participant or children. After the first six months reviews 529.4 may take place quarterly. During the time a participant is 529.5 cooperating with the development or revision of an alternative 529.6 employment plan, the participant is not subject to a sanction 529.7 for noncompliance with regular employment services activities. 529.8 Sec. 34. Minnesota Statutes 2000, section 256J.53, 529.9 subdivision 1, is amended to read: 529.10 Subdivision 1. [LENGTH OF PROGRAM.] In order for a 529.11 post-secondary education or training program to be approved work 529.12 activity as defined in section 256J.49, subdivision 13, clause 529.13 (18), it must be a program lasting1224 months or less, and the 529.14 participant must meet the requirements of subdivisions 2 and 3. 529.15A program lasting up to 24 months may be approved on an529.16exception basis if the conditions specified in subdivisions 2 to529.174 are met. A participant may not be approved for more than a529.18total of 24 months of post-secondary education or training.529.19 Sec. 35. Minnesota Statutes 2000, section 256J.53, 529.20 subdivision 2, is amended to read: 529.21 Subd. 2. [DOCUMENTATION SUPPORTING PROGRAM.] (a) In order 529.22 for a post-secondary education or training program to be an 529.23 approved activity in a participant's employment plan, the 529.24 participant or the employment and training service provider must 529.25 provide documentation that: 529.26 (1) the participant's employment plan identifies specific 529.27 goals that can only be met with the additional education or 529.28 training; 529.29 (2) there are suitable employment opportunities that 529.30 require the specific education or training in the area in which 529.31 the participant resides or is willing to reside; 529.32 (3) the education or training will result in significantly 529.33 higher wages for the participant than the participant could earn 529.34 without the education or training; 529.35 (4) the participant can meet the requirements for admission 529.36 into the program; and 530.1 (5) there is a reasonable expectation that the participant 530.2 will complete the training program based on such factors as the 530.3 participant's MFIP-S assessment, previous education, training, 530.4 and work history; current motivation; and changes in previous 530.5 circumstances. 530.6 (b) The job counselor shall approve an education or 530.7 training program that meets the requirements under paragraph (a). 530.8 Sec. 36. Minnesota Statutes 2000, section 256J.53, 530.9 subdivision 3, is amended to read: 530.10 Subd. 3. [SATISFACTORY PROGRESS REQUIRED.] In order for a 530.11post-secondary education or training program to be an approved530.12activity in a participant's employment planparticipant to 530.13 continue with post-secondary education or training, the 530.14 participant must maintain satisfactory progress in the program. 530.15 "Satisfactory progress" in an education or training program 530.16 means (1) the participant remains in good standing while the 530.17 participant is enrolled in the program, as defined by the 530.18 education or training institution, or (2) the participant makes 530.19 satisfactory progress as the term is defined in the 530.20 participant's employment plan. 530.21 Sec. 37. [256J.555] [PARTICIPANT PERFORMANCE BONUSES.] 530.22 If a county elects to provide participant performance 530.23 bonuses under section 256J.625, subdivision 4, paragraph (d), a 530.24 participant enrolled in employment and training services is 530.25 eligible to receive the cash bonuses if the participant has been 530.26 in compliance with all the requirements of the participant's job 530.27 search support plan or employment plan for the previous six 530.28 months. A participant may receive each bonus only once. Income 530.29 received from the cash bonuses is excluded in determining MFIP 530.30 eligibility and benefits. Bonuses are available for the 530.31 completion of the following goals: 530.32 (1) for continuous employment of at least 20 hours per week 530.33 for six months, the bonus is $200. The caregiver is eligible to 530.34 receive this bonus if the participant remains on MFIP while 530.35 employed or if the participant has exited MFIP as the result of 530.36 employment; 531.1 (2) for continuous employment of at least 20 hours per week 531.2 for 12 months, the bonus is $300. The caregiver is eligible to 531.3 receive this bonus if the participant remains on MFIP while 531.4 employed or if the participant has exited MFIP as the result of 531.5 employment; 531.6 (3) for employment that leads to earnings sufficient for a 531.7 caregiver to transition off of MFIP and stay off for six months, 531.8 the bonus is $300; 531.9 (4) for completion of an English as a second language 531.10 program, the bonus is $300; 531.11 (5) for completion of a high school diploma or GED, the 531.12 bonus is $300; and 531.13 (6) for completion of a job skills training program from a 531.14 certified provider, the bonus is $300. 531.15 Sec. 38. Minnesota Statutes 2000, section 256J.56, is 531.16 amended to read: 531.17 256J.56 [EMPLOYMENT AND TRAINING SERVICES COMPONENT; 531.18 EXEMPTIONS.] 531.19 (a) An MFIP caregiver is exempt from the requirements of 531.20 sections 256J.52 to 256J.55 if the caregiver belongs to any of 531.21 the following groups: 531.22 (1) individuals who are age 60 or older; 531.23 (2) individuals who are suffering from a professionally 531.24 certified permanent or temporary illness, injury, or incapacity 531.25 which is expected to continue for more than 30 days and which 531.26 prevents the person from obtaining or retaining employment. 531.27 Persons in this category with a temporary illness, injury, or 531.28 incapacity must be reevaluated at least quarterly; 531.29 (3) caregivers whose presence in the home is required as a 531.30 caregiver because ofthea professionally certified illness or 531.31 incapacity of another member in the assistance unit, a relative 531.32 in the household, or a foster child in the household; 531.33 (4) women who are pregnant, if the pregnancy has resulted 531.34 in a professionally certified incapacity that prevents the woman 531.35 from obtaining or retaining employment; 531.36 (5) caregivers of a child under the age of one year who 532.1 personally provide full-time care for the child. This exemption 532.2 may be used for only 12 months in a lifetime. In two-parent 532.3 households, only one parent or other relative may qualify for 532.4 this exemption; 532.5 (6)individuals who are single parents, or one parent in a532.6two-parent family, employed at least 35 hours per week;532.7(7)individuals experiencing a personal or family crisis 532.8 that makes them incapable of participating in the program, as 532.9 determined by the county agency. If the participant does not 532.10 agree with the county agency's determination, the participant 532.11 may seek professional certification, as defined in section 532.12 256J.08, that the participant is incapable of participating in 532.13 the program. Persons in this exemption category must be 532.14 reevaluated every 60 days. A personal or family crisis related 532.15 to family violence, as determined by the county or a job 532.16 counselor with the assistance of a person trained in domestic 532.17 violence, should not result in an exemption, but should be 532.18 addressed through the development or revision of an alternative 532.19 employment plan under section 256J.52, subdivision 6; 532.20(8)(7) second parents in two-parent families employed for 532.21 20 or more hours per week, provided the first parent is employed 532.22 at least 35 hours per week; or 532.23(9)(8) caregivers with a child or an adult in the 532.24 household who meets the disability or medical criteria for home 532.25 care services under section 256B.0627, subdivision 1, paragraph 532.26 (c), or a home and community-based waiver services program under 532.27 chapter 256B, or meets the criteria for severe emotional 532.28 disturbance under section 245.4871, subdivision 6, or for 532.29 serious and persistent mental illness under section 245.462, 532.30 subdivision 20, paragraph (c).Caregivers in this exemption532.31category are presumed to be prevented from obtaining or532.32retaining employment.532.33 (b) A caregiver who is exempt under clause (5) must enroll 532.34 in and attend an early childhood and family education class, a 532.35 parenting class, or some similar activity, if available, during 532.36 the period of time the caregiver is exempt under this section. 533.1 Notwithstanding section 256J.46, failure to attend the required 533.2 activity shall not result in the imposition of a sanction. 533.3(b)(c) The county agency must provide employment and 533.4 training services to MFIP caregivers who are exempt under this 533.5 section, but who volunteer to participate. Exempt volunteers 533.6 may request approval for any work activity under section 533.7 256J.49, subdivision 13. The hourly participation requirements 533.8 for nonexempt caregivers under section 256J.50, subdivision 5, 533.9 do not apply to exempt caregivers who volunteer to participate. 533.10 Sec. 39. Minnesota Statutes 2000, section 256J.62, 533.11 subdivision 2a, is amended to read: 533.12 Subd. 2a. [CASELOAD-BASED FUNDS ALLOCATION.] Effective for 533.13 state fiscal year 2000, and for all subsequent years, money 533.14 shall be allocated to counties and eligible tribal providers 533.15 based on their average number of MFIP cases as a proportion of 533.16 the statewide total number of MFIP cases: 533.17 (1) the average number of cases must be based upon counts 533.18 of MFIP or tribal TANF cases as of March 31, June 30, September 533.19 30, and December 31 of the previous calendar year, less the 533.20 number of child only cases and cases where all the caregivers 533.21 are age 60 or over. Two-parent cases, with the exception of 533.22 those with a caregiver age 60 or over, will be multiplied by a 533.23 factor of two; 533.24 (2) the MFIP or tribal TANF case count for each eligible 533.25 tribal provider shall be based upon the number of MFIP or tribal 533.26 TANF cases who are enrolled in, or are eligible for enrollment 533.27 in the tribe; and the case must be an active MFIP case; and the 533.28 case members must reside within the tribal program's service 533.29 delivery area; and 533.30 (3) MFIP or tribal TANF cases counted for determining 533.31 allocations to tribal providers shall be removed from the case 533.32 counts of the respective counties where they reside to prevent 533.33 duplicate counts;. 533.34(4) prior to allocating funds to counties and tribal533.35providers, $1,000,000 shall be set aside to allow the533.36commissioner to use these set-aside funds to provide funding to534.1county or tribal providers who experience an unforeseen influx534.2of participants or other emergent situations beyond their534.3control; and534.4(5) the commissioner shall use a portion of the funds in534.5clause (4) to offset a reduction in funds allocated to any534.6county between state fiscal year 1999 and state fiscal year 2000534.7that results from the adjustment in clause (3). The funding534.8provided under this clause must reduce by half the reduction for534.9state fiscal year 2000 that any county would otherwise534.10experience in the absence of this clause.534.11Any funds specified in this clause that remain unspent by March534.1231 of each year shall be reallocated out to county and tribal534.13providers using the funding formula detailed in clauses (1) to534.14(5).534.15 Sec. 40. Minnesota Statutes 2000, section 256J.62, 534.16 subdivision 9, is amended to read: 534.17 Subd. 9. [CONTINUATION OF CERTAIN SERVICES.] At the 534.18 request of the caregiver, the county may continue to provide 534.19 case management, counseling or other support services to a 534.20 participant following the participant's achievement of the 534.21 employment goal, for up to 12 months following termination of 534.22 the participant's eligibility for MFIP, as long as the 534.23 participant's household income is below 200 percent of the 534.24 federal poverty guidelines. 534.25A county may expend funds for a specific employment and534.26training service for the duration of that service to a534.27participant if the funds are obligated or expended prior to the534.28participant losing MFIP eligibility.534.29 Sec. 41. Minnesota Statutes 2000, section 256J.625, is 534.30 amended to read: 534.31 256J.625 [LOCAL INTERVENTION GRANTS FOR SELF-SUFFICIENCY.] 534.32 Subdivision 1. [ESTABLISHMENT; GUARANTEED MINIMUM 534.33 ALLOCATION.](a)The commissioner shall make grants under this 534.34 subdivision to assist county and tribal TANF programs to more 534.35 effectively serve hard-to-employ MFIP participants. Funds 534.36 appropriated for local intervention grants for self-sufficiency 535.1 must be allocated first in amounts equal to the guaranteed 535.2 minimum inparagraph (b)subdivision 1b, and second according to 535.3 the provisions of subdivision 2. Any remaining funds must be 535.4 allocated according to the formula in subdivision 3. 535.5 Subd. 1a. [LOCAL SERVICE UNIT PLAN REQUIRED.] Counties or 535.6 tribes must have an approved local service unit plan under 535.7 section 256J.50, subdivision 7, paragraph (b), in order to 535.8 receive and expend funds under subdivisions 2 and 3. If a 535.9 county or tribe does not submit a local service unit plan under 535.10 section 256J.50, subdivision 7, paragraph (b), or if the plan is 535.11 not approved at the full amount allocated to the county or tribe 535.12 under subdivision 3, the remaining funds under subdivision 3 may 535.13 be used by the commissioner to contract with other public, 535.14 private, or nonprofit entities in the county or region to 535.15 deliver services that meet the purposes of subdivision 4. 535.16(b)Subd. 1b. [GUARANTEED MINIMUM.] Each county or tribal 535.17 program shall receive a guaranteed minimum annual allocationof535.18$25,000. The minimum annual allocation for each county or tribe 535.19 that has fewer than 25 long-term dependent adults on MFIP based 535.20 on the formula in subdivision 3 is $5,000, and the minimum 535.21 annual allocation for each county or tribe that has 25 or more 535.22 long-term dependent adults on MFIP based on the formula in 535.23 subdivision 3 is $10,000. 535.24 Subd. 2. [SET-ASIDE FUNDS.] (a) Of the funds appropriated 535.25 for grants under this section, after the allocation in 535.26 subdivision1, paragraph (b)1b, is made,20 percent of the535.27remaining funds$3,576,000 each year shall be retained by the 535.28 commissioner and awarded to counties or tribes whose approved 535.29 plans demonstrate additional need based on their identification 535.30 of hard-to-employ families and working participants in need of 535.31 job retention and wage advancement services, strong anticipated 535.32 outcomes for families and an effective plan for monitoring 535.33 performance, or, use of a multicounty, multi-entity or regional 535.34 approach to serve hard-to-employ families and working 535.35 participants in need of job retention and wage advancement 535.36 services who are identified as a target population to be served 536.1 in the plan submitted under section 256J.50, subdivision 7, 536.2 paragraph (b). In distributing funds under this paragraph, the 536.3 commissioner must achieve a geographic balance. The 536.4 commissioner may award funds under this paragraph to other 536.5 public, private, or nonprofit entities to deliver services in a 536.6 county or region where the entity or entities submit a plan that 536.7 demonstrates a strong capability to fulfill the terms of the 536.8 plan and where the plan shows an innovative or multi-entity 536.9 approach. 536.10 (b) For fiscal year 2001 only, of the funds available under 536.11 this subdivision the commissioner must allocate funding in the 536.12 amounts specified in article 1, section 2, subdivision 7, for an 536.13 intensive intervention transitional employment training project 536.14 and for nontraditional career assistance and training programs. 536.15 These allocations must occur before any set-aside funds are 536.16 allocated under paragraph (a). 536.17Subd. 2a. [ALTERNATIVE DISTRIBUTION FORMULA.] (a) By536.18January 31, 2001, the commissioner of human services must536.19develop and present to the appropriate legislative committees a536.20distribution formula that is an alternative to the formula536.21allocation specified in subdivision 3. The proposed536.22distribution formula must target hard-to-employ MFIP536.23participants, and it must include an incentive-based component536.24that is designed to encourage county and tribal programs to536.25effectively serve hard-to-employ participants. The536.26commissioner's proposal must also be designed to be implemented536.27for fiscal years 2002 and 2003 in place of the formula536.28allocation specified in subdivision 3.536.29(b) Notwithstanding the provisions of subdivision 2,536.30paragraph (a), if the commissioner does not develop a proposed536.31formula as required in paragraph (a), the set-aside funds for536.32fiscal years 2002 and 2003 that the commissioner would otherwise536.33distribute under subdivision 2, paragraph (a), must not be536.34distributed under that provision. Funds available under536.35subdivision 2, paragraph (a), must instead be allocated in equal536.36amounts to each county and tribal program in fiscal years 2002537.1and 2003.537.2 Subd. 3. [FORMULA ALLOCATION.] Funds remaining after the 537.3 allocations in subdivisions11b and 2 must be allocatedas537.4follows:to counties and tribes based on the average proportion 537.5 of the MFIP caseload that has received MFIP assistance for 24 of 537.6 the last 36 months, as sampled on March 31, June 30, September 537.7 30, and December 31 of the previous calendar year, less the 537.8 number of child-only cases and cases where all the caregivers 537.9 are age 60 or over. Two-parent cases, with the exception of 537.10 those with a caregiver age 60 or over, will be multiplied by a 537.11 factor of two. 537.12(1) 85 percent shall be allocated in proportion to each537.13county's and tribal TANF program's one-parent MFIP cases that537.14have received MFIP assistance for at least 25 months, as sampled537.15on December 31 of the previous calendar year, excluding cases537.16where all caregivers are age 60 or over.537.17(2) 15 percent shall be allocated to each county's and537.18tribal TANF program's two-parent MFIP cases that have received537.19MFIP assistance for at least 25 months, as sampled on December537.2031 of the previous calendar year, excluding cases where all537.21caregivers are age 60 or over.537.22 Subd. 4. [USE OF FUNDS.] (a) A county or tribal program, 537.23 or other public, private, or nonprofit entity in the county or 537.24 region may use funds allocated under thissubdivisionsection to 537.25 provide services to MFIP participants who are hard-to-employ and 537.26 their families. Services provided must be intended to reduce 537.27 the number of MFIP participants who are expected to reach the 537.28 60-month time limit under section 256J.42. Counties, tribes, 537.29 and other entities receiving funds under subdivision 2 or 3 must 537.30 submit semiannual progress reports to the commissioner which 537.31 detail program outcomes. 537.32 (b) Funds allocated under this section may not be used to 537.33 provide benefits that are defined as "assistance" in Code of 537.34 Federal Regulations, title 45, section 260.31, to an assistance 537.35 unit that is only receiving the food portion of MFIP benefits. 537.36 (c) A county may use funds allocated under this section for 538.1 that part of the match for federal access to jobs transportation 538.2 funds that is TANF-eligible. A county may also use funds 538.3 allocated under this section to enhance transportation choices 538.4 for eligible recipients up to 150 percent of the federal poverty 538.5 guidelines. 538.6 (d) A county may use funds allocated under this section to 538.7 provide any or all of the participant performance bonuses to 538.8 MFIP participants as defined in section 256J.555. The dollar 538.9 amount of the bonus or bonuses provided must not exceed the 538.10 amounts in section 256J.555. 538.11 Subd. 5. [SUNSET.] The grant program under this section 538.12 sunsets on June 30, 2003. 538.13 Sec. 42. Minnesota Statutes 2000, section 256J.645, is 538.14 amended to read: 538.15 256J.645 [INDIAN TRIBEMFIP-SMFIP EMPLOYMENTAND TRAINING538.16 SERVICES.] 538.17 Subdivision 1. [AUTHORIZATION TO ENTER INTO AGREEMENTS.] 538.18 Effective July 1, 1997, the commissioner may enter into 538.19 agreements with federally recognized Indian tribes with a 538.20 reservation in the state to provideMFIP-SMFIP employmentand538.21trainingservices to members of the Indian tribe and to other 538.22 caregivers who are a part of the tribal member'sMFIP-SMFIP 538.23 assistance unit. For purposes of this section, "Indian tribe" 538.24 means a tribe, band, nation, or other federally recognized group 538.25 or community of Indians. The commissioner may also enter into 538.26 an agreement with a consortium of Indian tribes providing the 538.27 governing body of each Indian tribe in the consortium complies 538.28 with the provisions of this section. 538.29 Subd. 2. [TRIBAL REQUIREMENTS.] The Indian tribe must: 538.30 (1) agree to fulfill the responsibilities provided under 538.31 the employmentand trainingservices component ofMFIP-SMFIP 538.32 regarding operation ofMFIP-SMFIP employmentand training538.33 services, as designated by the commissioner; 538.34 (2) operate its employmentand trainingservices program 538.35 within a geographic service area not to exceed the counties 538.36 within which a border of the reservation falls; 539.1 (3) operate its program in conformity with section 13.46 539.2 and any applicable federal regulations in the use of data about 539.3MFIP-SMFIP recipients; 539.4 (4) coordinate operation of its program with the county 539.5 agency,Job Training PartnershipWorkforce Investment Act 539.6 programs, and other support services or employment-related 539.7 programs in the counties in which the tribal unit's program 539.8 operates; 539.9 (5) provide financial and program participant activity 539.10 recordkeeping and reporting in the manner and using the forms 539.11 and procedures specified by the commissioner and permit 539.12 inspection of its program and records by representatives of the 539.13 state; and 539.14 (6) have the Indian tribe's employmentand trainingservice 539.15 provider certified by the commissioner of economic security, or 539.16 approved by the county. 539.17 Subd. 3. [FUNDING.] If the commissioner and an Indian 539.18 tribe are parties to an agreement under this subdivision, the 539.19 agreementmayshall annually provide to the Indian tribe the 539.20 fundingamount in clause (1) or (2):allocated in section 539.21 256J.62, subdivisions 1 and 2a. 539.22(1) if the Indian tribe operated a tribal STRIDE program539.23during state fiscal year 1997, the amount to be provided is the539.24amount the Indian tribe received from the state for operation of539.25its tribal STRIDE program in state fiscal year 1997, except that539.26the amount provided for a fiscal year may increase or decrease539.27in the same proportion that the total amount of state and539.28federal funds available for MFIP-S employment and training539.29services increased or decreased that fiscal year; or539.30(2) if the Indian tribe did not operate a tribal STRIDE539.31program during state fiscal year 1997, the commissioner may539.32provide to the Indian tribe for the first year of operations the539.33amount determined by multiplying the state allocation for MFIP-S539.34employment and training services to each county agency in the539.35Indian tribe's service delivery area by the percentage of MFIP-S539.36recipients in that county who were members of the Indian tribe540.1during the previous state fiscal year. The resulting amount540.2shall also be the amount that the commissioner may provide to540.3the Indian tribe annually thereafter through an agreement under540.4this subdivision, except that the amount provided for a fiscal540.5year may increase or decrease in the same proportion that the540.6total amount of state and federal funds available for MFIP-S540.7employment and training services increased or decreased that540.8fiscal year.540.9 Subd. 4. [COUNTY AGENCY REQUIREMENT.] Indian tribal 540.10 members receivingMFIP-SMFIP benefits and residing in the 540.11 service area of an Indian tribe operating employmentand540.12trainingservices under an agreement with the commissioner must 540.13 be referred by county agencies in the service area to the Indian 540.14 tribe for employmentand trainingservices. 540.15 Sec. 43. Minnesota Statutes 2000, section 256K.03, 540.16 subdivision 5, is amended to read: 540.17 Subd. 5. [EXEMPTION CATEGORIES.] (a) The applicant will be 540.18 exempt from the job search requirements and development of a job 540.19 search plan and an employability development plan under 540.20 subdivisions 3, 4, and 8 if the applicant belongs to any of the 540.21 following groups: 540.22 (1) individuals who are age 60 or older; 540.23 (2) individuals who are suffering from a professionally 540.24 certified permanent or temporary illness, injury, or incapacity 540.25 which is expected to continue for more than 30 days and which 540.26 prevents the person from obtaining or retaining employment. 540.27 Persons in this category with a temporary illness, injury, or 540.28 incapacity must be reevaluated at least quarterly; 540.29 (3) caregivers whose presence in the home is needed as a 540.30 caregiver because ofthea professionally certified illness or 540.31 incapacity of another member in the assistance unit, a relative 540.32 in the household, or a foster child in the household; 540.33 (4) women who are pregnant, if the pregnancy has resulted 540.34 in a professionally certified incapacity that prevents the woman 540.35 from obtaining and retaining employment; 540.36 (5) caregivers of a child under the age of one year who 541.1 personally provide full-time care for the child. This exemption 541.2 may be used for only 12 months in a lifetime. In two-parent 541.3 households, only one parent or other relative may qualify for 541.4 this exemption; 541.5 (6)individuals who are single parents or one parent in a541.6two-parent family employed at least 35 hours per week;541.7(7)individuals experiencing a personal or family crisis 541.8 that makes them incapable of participating in the program, as 541.9 determined by the county agency. If the participant does not 541.10 agree with the county agency's determination, the participant 541.11 may seek professional certification, as defined in section 541.12 256J.08, that the participant is incapable of participating in 541.13 the program. Persons in this exemption category must be 541.14 reevaluated every 60 days; or 541.15(8)(7) second parents in two-parent families employed for 541.16 20 or more hours per week provided the first parent is employed 541.17 at least 35 hours per week. 541.18 (b) A caregiver who is exempt under clause (5) must enroll 541.19 in and attend an early childhood and family education class, a 541.20 parenting class, or some similar activity, if available, during 541.21 the period of time the caregiver is exempt under this section. 541.22 Notwithstanding section 256J.46, failure to attend the required 541.23 activity shall not result in the imposition of a sanction. 541.24 Sec. 44. [DOMESTIC VIOLENCE TRAINING FOR COUNTY AGENCIES.] 541.25 During fiscal year 2002, the commissioner of human services 541.26 will provide training for county agencies that have identified a 541.27 need for staff to receive specialized domestic violence training 541.28 in order to carry out the responsibilities in Minnesota 541.29 Statutes, sections 256J.46, subdivision 1a; 256J.49, subdivision 541.30 1a; 256J.52, subdivision 6; and 256J.56, subdivision 6. This 541.31 training must be similar to the training provided to individuals 541.32 who work for an organization designated by the Minnesota center 541.33 for crime victims services as providing services to victims of 541.34 domestic violence. 541.35 Sec. 45. [SANCTION REPORT.] 541.36 The request for the report under this section must be 542.1 referred to the legislative audit commission for consideration. 542.2 If approved, the legislative auditor, with input from previous 542.3 and current MFIP participants, shall investigate inconsistent or 542.4 illegal sanctions that were imposed on MFIP participants from 542.5 January of 1998 to the present. The legislative auditor shall 542.6 report the nature of erroneous sanction activity, the scope or 542.7 extent of the errors or problems among sanctioned cases, and 542.8 provide recommendations or corrective actions to reconcile past 542.9 illegal or inconsistent sanctions, and recommend solutions that 542.10 will ensure that MFIP sanctions are imposed fairly and 542.11 consistently in the future. The report to the members of the 542.12 senate and house committees having jurisdiction over MFIP issues 542.13 is due by January 15, 2002. 542.14 Sec. 46. [REVISOR INSTRUCTION.] 542.15 In the next edition of Minnesota Statutes and Minnesota 542.16 Rules, the revisor shall change all references to Minnesota 542.17 Family Investment Program-Statewide (MFIP-S) to Minnesota Family 542.18 Investment Program (MFIP). 542.19 Sec. 47. [REPEALER.] 542.20 (a) Minnesota Statutes 2000, sections 256J.08, subdivision 542.21 50a; 256J.12, subdivision 3; 256J.43; and 256J.53, subdivision 542.22 4, are repealed. 542.23 (b) Minnesota Statutes 2000, section 256J.49, subdivision 542.24 11, is repealed October 1, 2001. 542.25 (c) Minnesota Statutes 2000, section 256D.066, is repealed. 542.26 (d) Minnesota Statutes 2000, sections 256.01, subdivision 542.27 18; 256J.32, subdivision 7a; and Laws 2000, chapter 488, article 542.28 10, section 30, are repealed effective July 1, 2001. 542.29 (e) Laws 1997, chapter 203, article 9, section 21; Laws 542.30 1998, chapter 407, article 6, section 111; and Laws 2000, 542.31 chapter 488, article 10, section 28, are repealed. 542.32 ARTICLE 12 542.33 CHILD WELFARE AND FOSTER CARE 542.34 Section 1. Minnesota Statutes 2000, section 13.461, 542.35 subdivision 17, is amended to read: 542.36 Subd. 17. [VULNERABLE ADULTMALTREATMENT REVIEWPANEL543.1 PANELS.] Data of the vulnerable adult maltreatment review 543.2 panel or the child maltreatment review panel are classified 543.3 under section 256.021 or section 2. 543.4 Sec. 2. [256.022] [CHILD MALTREATMENT REVIEW PANEL.] 543.5 Subdivision 1. [CREATION.] The commissioner of human 543.6 services shall establish a review panel for purposes of 543.7 reviewing investigating agency determinations regarding 543.8 maltreatment of a child in a facility in response to requests 543.9 received under section 626.556, subdivision 10i, paragraph (b). 543.10 The review panel consists of the commissioners of health; human 543.11 services; children, families, and learning; corrections; the 543.12 ombudsman for crime victims; and the ombudsman for mental health 543.13 and mental retardation; or their designees. 543.14 Subd. 2. [REVIEW PROCEDURE.] (a) The panel shall hold 543.15 quarterly meetings for purposes of conducting reviews under this 543.16 section. If an interested person acting on behalf of a child 543.17 requests a review under this section, the panel shall review the 543.18 request at its next quarterly meeting. If the next quarterly 543.19 meeting is within ten days of the panel's receipt of the request 543.20 for review, the review may be delayed until the next subsequent 543.21 meeting. The panel shall review the request and the final 543.22 determination regarding maltreatment made by the investigating 543.23 agency and may review any other data on the investigation 543.24 maintained by the agency that are pertinent and necessary to its 543.25 review of the determination. If more than one person requests a 543.26 review under this section with respect to the same 543.27 determination, the review panel shall combine the requests into 543.28 one review. Upon receipt of a request for a review, the panel 543.29 shall notify the alleged perpetrator of maltreatment that a 543.30 review has been requested and provide an approximate timeline 543.31 for conducting the review. 543.32 (b) Within 30 days of the review under this section, the 543.33 panel shall notify the investigating agency and the interested 543.34 person who requested the review as to whether the panel agrees 543.35 with the determination or whether the investigating agency must 543.36 reconsider the determination. If the panel determines that the 544.1 agency must reconsider the determination, the panel must make 544.2 specific investigative recommendations to the agency. Within 30 544.3 days the investigating agency shall conduct a review and report 544.4 back to the panel with its reconsidered determination and the 544.5 specific rationale for its determination. 544.6 Subd. 3. [REPORT.] By January 15 of each year, the panel 544.7 shall submit a report to the committees of the legislature with 544.8 jurisdiction over section 626.556 regarding the number of 544.9 requests for review it receives under this section, the number 544.10 of cases where the panel requires the investigating agency to 544.11 reconsider its final determination, the number of cases where 544.12 the final determination is changed, and any recommendations to 544.13 improve the review or investigative process. 544.14 Subd. 4. [DATA.] Data of the review panel created as part 544.15 of a review under this section are private data on individuals 544.16 as defined in section 13.02. 544.17 Sec. 3. Minnesota Statutes 2000, section 626.556, 544.18 subdivision 2, is amended to read: 544.19 Subd. 2. [DEFINITIONS.] As used in this section, the 544.20 following terms have the meanings given them unless the specific 544.21 content indicates otherwise: 544.22 (a) "Sexual abuse" means the subjection of a child by a 544.23 person responsible for the child's care, by a person who has a 544.24 significant relationship to the child, as defined in section 544.25 609.341, or by a person in a position of authority, as defined 544.26 in section 609.341, subdivision 10, to any act which constitutes 544.27 a violation of section 609.342 (criminal sexual conduct in the 544.28 first degree), 609.343 (criminal sexual conduct in the second 544.29 degree), 609.344 (criminal sexual conduct in the third degree), 544.30 609.345 (criminal sexual conduct in the fourth degree), or 544.31 609.3451 (criminal sexual conduct in the fifth degree). Sexual 544.32 abuse also includes any act which involves a minor which 544.33 constitutes a violation of prostitution offenses under sections 544.34 609.321 to 609.324 or 617.246. Sexual abuse includes threatened 544.35 sexual abuse. 544.36 (b) "Person responsible for the child's care" means (1) an 545.1 individual functioning within the family unit and having 545.2 responsibilities for the care of the child such as a parent, 545.3 guardian, or other person having similar care responsibilities, 545.4 or (2) an individual functioning outside the family unit and 545.5 having responsibilities for the care of the child such as a 545.6 teacher, school administrator, or other lawful custodian of a 545.7 child having either full-time or short-term care 545.8 responsibilities including, but not limited to, day care, 545.9 babysitting whether paid or unpaid, counseling, teaching, and 545.10 coaching. 545.11 (c) "Neglect" means: 545.12 (1) failure by a person responsible for a child's care to 545.13 supply a child with necessary food, clothing, shelter, health, 545.14 medical, or other care required for the child's physical or 545.15 mental health when reasonably able to do so; 545.16 (2) failure to protect a child from conditions or actions 545.17 which imminently and seriously endanger the child's physical or 545.18 mental health when reasonably able to do so; 545.19 (3) failure to provide for necessary supervision or child 545.20 care arrangements appropriate for a child after considering 545.21 factors as the child's age, mental ability, physical condition, 545.22 length of absence, or environment, when the child is unable to 545.23 care for the child's own basic needs or safety, or the basic 545.24 needs or safety of another child in their care; 545.25 (4) failure to ensure that the child is educated as defined 545.26 in sections 120A.22 and 260C.163, subdivision 11; 545.27 (5) nothing in this section shall be construed to mean that 545.28 a child is neglected solely because the child's parent, 545.29 guardian, or other person responsible for the child's care in 545.30 good faith selects and depends upon spiritual means or prayer 545.31 for treatment or care of disease or remedial care of the child 545.32 in lieu of medical care; except that a parent, guardian, or 545.33 caretaker, or a person mandated to report pursuant to 545.34 subdivision 3, has a duty to report if a lack of medical care 545.35 may cause serious danger to the child's health. This section 545.36 does not impose upon persons, not otherwise legally responsible 546.1 for providing a child with necessary food, clothing, shelter, 546.2 education, or medical care, a duty to provide that care; 546.3 (6) prenatal exposure to a controlled substance, as defined 546.4 in section 253B.02, subdivision 2, used by the mother for a 546.5 nonmedical purpose, as evidenced by withdrawal symptoms in the 546.6 child at birth, results of a toxicology test performed on the 546.7 mother at delivery or the child at birth, or medical effects or 546.8 developmental delays during the child's first year of life that 546.9 medically indicate prenatal exposure to a controlled substance; 546.10 (7) "medical neglect" as defined in section 260C.007, 546.11 subdivision 4, clause (5); 546.12 (8) chronic and severe use of alcohol or a controlled 546.13 substance by a parent or person responsible for the care of the 546.14 child that adversely affects the child's basic needs and safety; 546.15 or 546.16 (9) emotional harm from a pattern of behavior which 546.17 contributes to impaired emotional functioning of the child which 546.18 may be demonstrated by a substantial and observable effect in 546.19 the child's behavior, emotional response, or cognition that is 546.20 not within the normal range for the child's age and stage of 546.21 development, with due regard to the child's culture. 546.22 (d) "Physical abuse" means any physical injury, mental 546.23 injury, or threatened injury, inflicted by a person responsible 546.24 for the child's care on a child other than by accidental means, 546.25 or any physical or mental injury that cannot reasonably be 546.26 explained by the child's history of injuries, or any aversive 546.27 and deprivation procedures that have not been authorized under 546.28 section 245.825. Abuse does not include reasonable and moderate 546.29 physical discipline of a child administered by a parent or legal 546.30 guardian which does not result in an injury. Actions which are 546.31 not reasonable and moderate include, but are not limited to, any 546.32 of the following that are done in anger or without regard to the 546.33 safety of the child: 546.34 (1) throwing, kicking, burning, biting, or cutting a child; 546.35 (2) striking a child with a closed fist; 546.36 (3) shaking a child under age three; 547.1 (4) striking or other actions which result in any 547.2 nonaccidental injury to a child under 18 months of age; 547.3 (5) unreasonable interference with a child's breathing; 547.4 (6) threatening a child with a weapon, as defined in 547.5 section 609.02, subdivision 6; 547.6 (7) striking a child under age one on the face or head; 547.7 (8) purposely giving a child poison, alcohol, or dangerous, 547.8 harmful, or controlled substances which were not prescribed for 547.9 the child by a practitioner, in order to control or punish the 547.10 child; or other substances that substantially affect the child's 547.11 behavior, motor coordination, or judgment or that results in 547.12 sickness or internal injury, or subjects the child to medical 547.13 procedures that would be unnecessary if the child were not 547.14 exposed to the substances; or 547.15 (9) unreasonable physical confinement or restraint not 547.16 permitted under section 609.379, including but not limited to 547.17 tying, caging, or chaining. 547.18 (e) "Report" means any report received by the local welfare 547.19 agency, police department, or county sheriff pursuant to this 547.20 section. 547.21 (f) "Facility" means a licensed or unlicensed day care 547.22 facility, residential facility, agency, hospital, sanitarium, or 547.23 other facility or institution required to be licensed under 547.24 sections 144.50 to 144.58, 241.021, or 245A.01 to 245A.16, or 547.25 chapter 245B; or a school as defined in sections 120A.05, 547.26 subdivisions 9, 11, and 13; and 124D.10; or a nonlicensed 547.27 personal care provider organization as defined in sections 547.28 256B.04, subdivision 16, and 256B.0625, subdivision 19a. 547.29 (g) "Operator" means an operator or agency as defined in 547.30 section 245A.02. 547.31 (h) "Commissioner" means the commissioner of human services. 547.32 (i) "Assessment" includes authority to interview the child, 547.33 the person or persons responsible for the child's care, the 547.34 alleged perpetrator, and any other person with knowledge of the 547.35 abuse or neglect for the purpose of gathering the facts, 547.36 assessing the risk to the child, and formulating a plan. 548.1 (j) "Practice of social services," for the purposes of 548.2 subdivision 3, includes but is not limited to employee 548.3 assistance counseling and the provision of guardian ad litem and 548.4 parenting time expeditor services. 548.5 (k) "Mental injury" means an injury to the psychological 548.6 capacity or emotional stability of a child as evidenced by an 548.7 observable or substantial impairment in the child's ability to 548.8 function within a normal range of performance and behavior with 548.9 due regard to the child's culture. 548.10 (l) "Threatened injury" means a statement, overt act, 548.11 condition, or status that represents a substantial risk of 548.12 physical or sexual abuse or mental injury. 548.13 (m) Persons who conduct assessments or investigations under 548.14 this section shall take into account accepted child-rearing 548.15 practices of the culture in which a child participates, which 548.16 are not injurious to the child's health, welfare, and safety. 548.17 (n) "Maltreatment of a child in a facility" means physical 548.18 abuse, sexual abuse, or neglect that occurs while a child is 548.19 under the care of a facility, or the following acts committed by 548.20 a person other than a child receiving services, with a child or 548.21 in the presence of a child who is or should be under the 548.22 supervision of the facility: 548.23 (1) an act against a child that constitutes a violation of, 548.24 an attempt to violate, or aiding and abetting a violation of: 548.25 (i) sections 609.221 to 609.224 (assault in the first 548.26 through fifth degrees); or 548.27 (ii) section 609.52 (theft); 548.28 (2) conduct that is not an accident or authorized conduct 548.29 that produces or could reasonably be expected to produce 548.30 physical pain or injury or mental injury, including, but not 548.31 limited to, the following: 548.32 (i) hitting, slapping, kicking, pinching, biting, or 548.33 shaking; 548.34 (ii) use of an aversive or deprivation procedure, 548.35 unreasonable confinement, or involuntary seclusion, including an 548.36 unreasonable, forced separation of the child from other persons, 549.1 except aversive or deprivation procedures for developmentally 549.2 disabled children authorized under section 245.825; or 549.3 (iii) use of an unreasonable restraint, including tying, 549.4 caging, chaining, or any other unreasonable physical or manual 549.5 method of restricting or prohibiting movement; 549.6 (3) in the absence of legal authority, willfully using, 549.7 withholding, or disposing of funds or property of a child 549.8 receiving services in a facility that is not considered to be 549.9 contraband by the facility or school; 549.10 (4) sexual conduct with a child or in the presence of a 549.11 child that a reasonable person would consider to be sexual 549.12 behavior or exposing the child to sexual behavior or material 549.13 that is inappropriate for the age and developmental level of the 549.14 child; or 549.15 (5) sexual contact as defined in section 609.341 between a 549.16 facility staff, or an associate of the facility staff, and a 549.17 child receiving services. 549.18 For purposes of this paragraph, a child is not abused for 549.19 the sole reason that a person is engaged in authorized conduct. 549.20 (o) "Authorized conduct" means the provision of program 549.21 services, education for schools, health care, or other personal 549.22 care services; or provision of services or education under a 549.23 written program plan, individual education plan, or school 549.24 discipline plan, done in the best interests of the child by an 549.25 individual, facility, or employee or person providing services 549.26 or education in a facility under the rights, privileges, and 549.27 responsibilities conferred by state license, certification, or 549.28 registration. 549.29 (p) "Accident" means a sudden, unforeseen, and unexpected 549.30 occurrence or event that: 549.31 (1) was not likely to occur and could not have been 549.32 prevented by the exercise of due care; and 549.33 (2) if occurring while a child is receiving services from a 549.34 facility, occurs when the facility and the staff person 549.35 providing the services in the facility are in compliance with 549.36 applicable law relevant to the occurrence or event. 550.1 Sec. 4. Minnesota Statutes 2000, section 626.556, is 550.2 amended by adding a subdivision to read: 550.3 Subd. 3d. [FACILITY PROCEDURES; INTERNAL REPORTING.] (a) 550.4 Except for child foster care and family child care, a facility 550.5 licensed under sections 245A.01 to 245A.16 and chapter 245B 550.6 shall establish and enforce an ongoing written procedure in 550.7 compliance with applicable licensing rules to ensure that all 550.8 cases of suspected maltreatment are reported. The procedure 550.9 must include the definitions of maltreatment and the phone 550.10 numbers for the local welfare agency, police department, county 550.11 sheriff, and agency responsible for assessing or investigating 550.12 maltreatment under this section. Procedures must include a 550.13 method for providing children or family members with written 550.14 information on where to report suspected maltreatment. Mandated 550.15 reporters in a facility must receive orientation on this 550.16 procedure before having direct contact with children and annual 550.17 training on reporting of maltreatment. 550.18 (b) If a facility has an internal reporting procedure, a 550.19 mandated reporter may meet the reporting requirements of this 550.20 section by reporting internally. The facility remains 550.21 responsible for complying with the immediate reporting 550.22 requirements of this section. A facility with an internal 550.23 reporting procedure that receives an internal report from a 550.24 mandated reporter shall give the mandated reporter a written 550.25 notice if the facility has not reported the incident to the 550.26 agency responsible for assessing or investigating maltreatment. 550.27 The written notice must be provided within two working days of 550.28 receipt of the internal report in a manner that protects the 550.29 confidentiality of the reporter. The written notice to the 550.30 mandated reporter must inform the reporter that if the reporter 550.31 is not satisfied with the action taken by the facility, the 550.32 reporter may report externally. 550.33 (c) A facility may not prohibit a mandated reporter from 550.34 reporting externally and may not retaliate against a mandated 550.35 reporter who, in good faith, reports an incident to the agency 550.36 responsible for assessing or investigating maltreatment. 551.1 Sec. 5. Minnesota Statutes 2000, section 626.556, 551.2 subdivision 10, is amended to read: 551.3 Subd. 10. [DUTIES OF LOCAL WELFARE AGENCY AND LOCAL LAW 551.4 ENFORCEMENT AGENCY UPON RECEIPT OF A REPORT.] (a) If the report 551.5 alleges neglect, physical abuse, or sexual abuse by a parent, 551.6 guardian, or individual functioning within the family unit as a 551.7 person responsible for the child's care, the local welfare 551.8 agency shall immediately conduct an assessment including 551.9 gathering information on the existence of substance abuse and 551.10 offer protective social services for purposes of preventing 551.11 further abuses, safeguarding and enhancing the welfare of the 551.12 abused or neglected minor, and preserving family life whenever 551.13 possible. If the report alleges a violation of a criminal 551.14 statute involving sexual abuse, physical abuse, or neglect or 551.15 endangerment, under section 609.378, the local law enforcement 551.16 agency and local welfare agency shall coordinate the planning 551.17 and execution of their respective investigation and assessment 551.18 efforts to avoid a duplication of fact-finding efforts and 551.19 multiple interviews. Each agency shall prepare a separate 551.20 report of the results of its investigation. In cases of alleged 551.21 child maltreatment resulting in death, the local agency may rely 551.22 on the fact-finding efforts of a law enforcement investigation 551.23 to make a determination of whether or not maltreatment 551.24 occurred. When necessary the local welfare agency shall seek 551.25 authority to remove the child from the custody of a parent, 551.26 guardian, or adult with whom the child is living. In performing 551.27 any of these duties, the local welfare agency shall maintain 551.28 appropriate records. 551.29 If the assessment indicates there is a potential for abuse 551.30 of alcohol or other drugs by the parent, guardian, or person 551.31 responsible for the child's care, the local welfare agency shall 551.32 conduct a chemical use assessment pursuant to Minnesota Rules, 551.33 part 9530.6615. The local welfare agency shall report the 551.34 determination of the chemical use assessment, and the 551.35 recommendations and referrals for alcohol and other drug 551.36 treatment services to the state authority on alcohol and drug 552.1 abuse. 552.2 (b) When a local agency receives a report or otherwise has 552.3 information indicating that a child who is a client, as defined 552.4 in section 245.91, has been the subject of physical abuse, 552.5 sexual abuse, or neglect at an agency, facility, or program as 552.6 defined in section 245.91, it shall, in addition to its other 552.7 duties under this section, immediately inform the ombudsman 552.8 established under sections 245.91 to 245.97. 552.9 (c) Authority of the local welfare agency responsible for 552.10 assessing the child abuse or neglect report and of the local law 552.11 enforcement agency for investigating the alleged abuse or 552.12 neglect includes, but is not limited to, authority to interview, 552.13 without parental consent, the alleged victim and any other 552.14 minors who currently reside with or who have resided with the 552.15 alleged offender. The interview may take place at school or at 552.16 any facility or other place where the alleged victim or other 552.17 minors might be found or the child may be transported to, and 552.18 the interview conducted at, a place appropriate for the 552.19 interview of a child designated by the local welfare agency or 552.20 law enforcement agency. The interview may take place outside 552.21 the presence of the alleged offender or parent, legal custodian, 552.22 guardian, or school official. Except as provided in this 552.23 paragraph, the parent, legal custodian, or guardian shall be 552.24 notified by the responsible local welfare or law enforcement 552.25 agency no later than the conclusion of the investigation or 552.26 assessment that this interview has occurred. Notwithstanding 552.27 rule 49.02 of the Minnesota rules of procedure for juvenile 552.28 courts, the juvenile court may, after hearing on an ex parte 552.29 motion by the local welfare agency, order that, where reasonable 552.30 cause exists, the agency withhold notification of this interview 552.31 from the parent, legal custodian, or guardian. If the interview 552.32 took place or is to take place on school property, the order 552.33 shall specify that school officials may not disclose to the 552.34 parent, legal custodian, or guardian the contents of the 552.35 notification of intent to interview the child on school 552.36 property, as provided under this paragraph, and any other 553.1 related information regarding the interview that may be a part 553.2 of the child's school record. A copy of the order shall be sent 553.3 by the local welfare or law enforcement agency to the 553.4 appropriate school official. 553.5 (d) When the local welfare or local law enforcement agency 553.6 determines that an interview should take place on school 553.7 property, written notification of intent to interview the child 553.8 on school property must be received by school officials prior to 553.9 the interview. The notification shall include the name of the 553.10 child to be interviewed, the purpose of the interview, and a 553.11 reference to the statutory authority to conduct an interview on 553.12 school property. For interviews conducted by the local welfare 553.13 agency, the notification shall be signed by the chair of the 553.14 local social services agency or the chair's designee. The 553.15 notification shall be private data on individuals subject to the 553.16 provisions of this paragraph. School officials may not disclose 553.17 to the parent, legal custodian, or guardian the contents of the 553.18 notification or any other related information regarding the 553.19 interview until notified in writing by the local welfare or law 553.20 enforcement agency that the investigation or assessment has been 553.21 concluded. Until that time, the local welfare or law 553.22 enforcement agency shall be solely responsible for any 553.23 disclosures regarding the nature of the assessment or 553.24 investigation. 553.25 Except where the alleged offender is believed to be a 553.26 school official or employee, the time and place, and manner of 553.27 the interview on school premises shall be within the discretion 553.28 of school officials, but the local welfare or law enforcement 553.29 agency shall have the exclusive authority to determine who may 553.30 attend the interview. The conditions as to time, place, and 553.31 manner of the interview set by the school officials shall be 553.32 reasonable and the interview shall be conducted not more than 24 553.33 hours after the receipt of the notification unless another time 553.34 is considered necessary by agreement between the school 553.35 officials and the local welfare or law enforcement agency. 553.36 Where the school fails to comply with the provisions of this 554.1 paragraph, the juvenile court may order the school to comply. 554.2 Every effort must be made to reduce the disruption of the 554.3 educational program of the child, other students, or school 554.4 staff when an interview is conducted on school premises. 554.5 (e) Where the alleged offender or a person responsible for 554.6 the care of the alleged victim or other minor prevents access to 554.7 the victim or other minor by the local welfare agency, the 554.8 juvenile court may order the parents, legal custodian, or 554.9 guardian to produce the alleged victim or other minor for 554.10 questioning by the local welfare agency or the local law 554.11 enforcement agency outside the presence of the alleged offender 554.12 or any person responsible for the child's care at reasonable 554.13 places and times as specified by court order. 554.14 (f) Before making an order under paragraph (e), the court 554.15 shall issue an order to show cause, either upon its own motion 554.16 or upon a verified petition, specifying the basis for the 554.17 requested interviews and fixing the time and place of the 554.18 hearing. The order to show cause shall be served personally and 554.19 shall be heard in the same manner as provided in other cases in 554.20 the juvenile court. The court shall consider the need for 554.21 appointment of a guardian ad litem to protect the best interests 554.22 of the child. If appointed, the guardian ad litem shall be 554.23 present at the hearing on the order to show cause. 554.24 (g) The commissioner, the ombudsman for mental health and 554.25 mental retardation, the local welfare agencies responsible for 554.26 investigating reports, and the local law enforcement agencies 554.27 have the right to enter facilities as defined in subdivision 2 554.28 and to inspect and copy the facility's records, including 554.29 medical records, as part of the investigation. Notwithstanding 554.30 the provisions of chapter 13, they also have the right to inform 554.31 the facility under investigation that they are conducting an 554.32 investigation, to disclose to the facility the names of the 554.33 individuals under investigation for abusing or neglecting a 554.34 child, and to provide the facility with a copy of the report and 554.35 the investigative findings. 554.36 (h) The local welfare agency shall collect available and 555.1 relevant information to ascertain whether maltreatment occurred 555.2 and whether protective services are needed. Information 555.3 collected includes, when relevant, information with regard to 555.4 the person reporting the alleged maltreatment, including the 555.5 nature of the reporter's relationship to the child and to the 555.6 alleged offender, and the basis of the reporter's knowledge for 555.7 the report; the child allegedly being maltreated; the alleged 555.8 offender; the child's caretaker; and other collateral sources 555.9 having relevant information related to the alleged 555.10 maltreatment. The local welfare agency may make a determination 555.11 of no maltreatment early in an assessment, and close the case 555.12 and retain immunity, if the collected information shows no basis 555.13 for a full assessment or investigation. 555.14 Information relevant to the assessment or investigation 555.15 must be asked for, and may include: 555.16 (1) the child's sex and age, prior reports of maltreatment, 555.17 information relating to developmental functioning, credibility 555.18 of the child's statement, and whether the information provided 555.19 under this clause is consistent with other information collected 555.20 during the course of the assessment or investigation; 555.21 (2) the alleged offender's age, a record check for prior 555.22 reports of maltreatment, and criminal charges and convictions. 555.23 The local welfare agency must provide the alleged offender with 555.24 an opportunity to make a statement. The alleged offender may 555.25 submit supporting documentation relevant to the assessment or 555.26 investigation; 555.27 (3) collateral source information regarding the alleged 555.28 maltreatment and care of the child. Collateral information 555.29 includes, when relevant: (i) a medical examination of the 555.30 child; (ii) prior medical records relating to the alleged 555.31 maltreatment or the care of the child maintained by any 555.32 facility, clinic, or health care professional and an interview 555.33 with the treating professionals; and (iii) interviews with the 555.34 child's caretakers, including the child's parent, guardian, 555.35 foster parent, child care provider, teachers, counselors, family 555.36 members, relatives, and other persons who may have knowledge 556.1 regarding the alleged maltreatment and the care of the child; 556.2 and 556.3 (4) information on the existence of domestic abuse and 556.4 violence in the home of the child, and substance abuse. 556.5 Nothing in this paragraph precludes the local welfare 556.6 agency from collecting other relevant information necessary to 556.7 conduct the assessment or investigation. Notwithstanding 556.8 section 13.384 or 144.335, the local welfare agency has access 556.9 to medical data and records for purposes of clause (3). 556.10 Notwithstanding the data's classification in the possession of 556.11 any other agency, data acquired by the local welfare agency 556.12 during the course of the assessment or investigation are private 556.13 data on individuals and must be maintained in accordance with 556.14 subdivision 11. 556.15 (i) In the initial stages of an assessment or 556.16 investigation, the local welfare agency shall conduct a 556.17 face-to-face observation of the child reported to be maltreated 556.18 and a face-to-face interview of the alleged offender. The 556.19 interview with the alleged offender may be postponed if it would 556.20 jeopardize an active law enforcement investigation. 556.21 (j) The local welfare agency shall use a question and 556.22 answer interviewing format with questioning as nondirective as 556.23 possible to elicit spontaneous responses. The following 556.24 interviewing methods and procedures must be used whenever 556.25 possible when collecting information: 556.26 (1) audio recordings of all interviews with witnesses and 556.27 collateral sources; and 556.28 (2) in cases of alleged sexual abuse, audio-video 556.29 recordings of each interview with the alleged victim and child 556.30 witnesses. 556.31 Sec. 6. Minnesota Statutes 2000, section 626.556, 556.32 subdivision 10b, is amended to read: 556.33 Subd. 10b. [DUTIES OF COMMISSIONER; NEGLECT OR ABUSE IN 556.34 FACILITY.] (a) This section applies to the commissioners of 556.35 human services, health, and children, families, and learning. 556.36 The commissioner of the agency responsible for assessing or 557.1 investigating the report shall immediately investigate if the 557.2 report alleges that: 557.3 (1) a child who is in the care of a facility as defined in 557.4 subdivision 2 is neglected, physically abused,orsexually 557.5 abused, or is the victim of maltreatment in a facility by an 557.6 individual in that facility, or has been so neglected or 557.7 abused or been the victim of maltreatment in a facility by an 557.8 individual in that facility within the three years preceding the 557.9 report; or 557.10 (2) a child was neglected, physically abused,orsexually 557.11 abused, or is the victim of maltreatment in a facility by an 557.12 individual in a facility defined in subdivision 2, while in the 557.13 care of that facility within the three years preceding the 557.14 report. 557.15 The commissioner of the agency responsible for assessing or 557.16 investigating the report shall arrange for the transmittal to 557.17 the commissioner of reports received by local agencies and may 557.18 delegate to a local welfare agency the duty to investigate 557.19 reports. In conducting an investigation under this section, the 557.20 commissioner has the powers and duties specified for local 557.21 welfare agencies under this section. The commissioner of the 557.22 agency responsible for assessing or investigating the report or 557.23 local welfare agency may interview any children who are or have 557.24 been in the care of a facility under investigation and their 557.25 parents, guardians, or legal custodians. 557.26 (b) Prior to any interview, the commissioner of the agency 557.27 responsible for assessing or investigating the report or local 557.28 welfare agency shall notify the parent, guardian, or legal 557.29 custodian of a child who will be interviewed in the manner 557.30 provided for in subdivision 10d, paragraph (a). If reasonable 557.31 efforts to reach the parent, guardian, or legal custodian of a 557.32 child in an out-of-home placement have failed, the child may be 557.33 interviewed if there is reason to believe the interview is 557.34 necessary to protect the child or other children in the 557.35 facility. The commissioner of the agency responsible for 557.36 assessing or investigating the report or local agency must 558.1 provide the information required in this subdivision to the 558.2 parent, guardian, or legal custodian of a child interviewed 558.3 without parental notification as soon as possible after the 558.4 interview. When the investigation is completed, any parent, 558.5 guardian, or legal custodian notified under this subdivision 558.6 shall receive the written memorandum provided for in subdivision 558.7 10d, paragraph (c). 558.8 (c) In conducting investigations under this subdivision the 558.9 commissioner or local welfare agency shall obtain access to 558.10 information consistent with subdivision 10, paragraphs (h), (i), 558.11 and (j). 558.12 (d) Except for foster care and family child care, the 558.13 commissioner has the primary responsibility for the 558.14 investigations and notifications required under subdivisions 10d 558.15 and 10f for reports that allege maltreatment related to the care 558.16 provided by or in facilities licensed by the commissioner. The 558.17 commissioner may request assistance from the local social 558.18 services agency. 558.19 Sec. 7. Minnesota Statutes 2000, section 626.556, 558.20 subdivision 10d, is amended to read: 558.21 Subd. 10d. [NOTIFICATION OF NEGLECT OR ABUSE IN FACILITY.] 558.22 (a) When a report is received that alleges neglect, physical 558.23 abuse,orsexual abuse, or maltreatment of a child while in the 558.24 care of a licensed or unlicensed day care facility, residential 558.25 facility, agency, hospital, sanitarium, or other facility or 558.26 institution required to be licensed according to sections 144.50 558.27 to 144.58; 241.021; or 245A.01 to 245A.16; or chapter 245B, or a 558.28 school as defined in sections 120A.05, subdivisions 9, 11, and 558.29 13; and 124D.10; or a nonlicensed personal care provider 558.30 organization as defined in section 256B.04, subdivision 16, and 558.31 256B.0625, subdivision 19a, the commissioner of the agency 558.32 responsible for assessing or investigating the report or local 558.33 welfare agency investigating the report shall provide the 558.34 following information to the parent, guardian, or legal 558.35 custodian of a child alleged to have been neglected, physically 558.36 abused,orsexually abused, or the victim of maltreatment of a 559.1 child in the facility: the name of the facility; the fact that 559.2 a report alleging neglect, physical abuse,orsexual abuse, or 559.3 maltreatment of a child in the facility has been received; the 559.4 nature of the alleged neglect, physical abuse,orsexual abuse, 559.5 or maltreatment of a child in the facility; that the agency is 559.6 conducting an investigation; any protective or corrective 559.7 measures being taken pending the outcome of the investigation; 559.8 and that a written memorandum will be provided when the 559.9 investigation is completed. 559.10 (b) The commissioner of the agency responsible for 559.11 assessing or investigating the report or local welfare agency 559.12 may also provide the information in paragraph (a) to the parent, 559.13 guardian, or legal custodian of any other child in the facility 559.14 if the investigative agency knows or has reason to believe the 559.15 alleged neglect, physical abuse,orsexual abuse, or 559.16 maltreatment of a child in the facility has occurred. In 559.17 determining whether to exercise this authority, the commissioner 559.18 of the agency responsible for assessing or investigating the 559.19 report or local welfare agency shall consider the seriousness of 559.20 the alleged neglect, physical abuse,orsexual abuse, or 559.21 maltreatment of a child in the facility; the number of children 559.22 allegedly neglected, physically abused,orsexually abused, or 559.23 victims of maltreatment of a child in the facility; the number 559.24 of alleged perpetrators; and the length of the investigation. 559.25 The facility shall be notified whenever this discretion is 559.26 exercised. 559.27 (c) When the commissioner of the agency responsible for 559.28 assessing or investigating the report or local welfare agency 559.29 has completed its investigation, every parent, guardian, or 559.30 legal custodian notified of the investigation by the 559.31 commissioner or local welfare agency shall be provided with the 559.32 following information in a written memorandum: the name of the 559.33 facility investigated; the nature of the alleged neglect, 559.34 physical abuse,orsexual abuse, or maltreatment of a child in 559.35 the facility; the investigator's name; a summary of the 559.36 investigation findings; a statement whether maltreatment was 560.1 found; and the protective or corrective measures that are being 560.2 or will be taken. The memorandum shall be written in a manner 560.3 that protects the identity of the reporter and the child and 560.4 shall not contain the name, or to the extent possible, reveal 560.5 the identity of the alleged perpetrator or of those interviewed 560.6 during the investigation. If maltreatment is determined to 560.7 exist, the commissioner or local welfare agency shall also 560.8 provide the written memorandum to the parent, guardian, or legal 560.9 custodian of each child in the facilityif maltreatment is560.10determined to existwho had contact with the individual 560.11 responsible for the maltreatment. When the facility is the 560.12 responsible party for maltreatment, the commissioner or local 560.13 welfare agency shall also provide the written memorandum to the 560.14 parent, guardian, or legal custodian of each child who received 560.15 services in the population of the facility where the 560.16 maltreatment occurred. This notification must be provided to 560.17 the parent, guardian, or legal custodian of each child receiving 560.18 services from the time the maltreatment occurred until either 560.19 the individual responsible for maltreatment is no longer in 560.20 contact with a child or children in the facility or the 560.21 conclusion of the investigation. 560.22 Sec. 8. Minnesota Statutes 2000, section 626.556, 560.23 subdivision 10e, is amended to read: 560.24 Subd. 10e. [DETERMINATIONS.] Upon the conclusion of every 560.25 assessment or investigation it conducts, the local welfare 560.26 agency shall make two determinations: first, whether 560.27 maltreatment has occurred; and second, whether child protective 560.28 services are needed. When maltreatment is determined in an 560.29 investigation involving a facility, the investigating agency 560.30 shall also determine whether the facility or individual was 560.31 responsible for the maltreatment using the mitigating factors in 560.32 paragraph (d). Determinations under this subdivision must be 560.33 made based on a preponderance of the evidence. 560.34 (a) For the purposes of this subdivision, "maltreatment" 560.35 means any of the following acts or omissionscommitted by a560.36person responsible for the child's care: 561.1 (1) physical abuse as defined in subdivision 2, paragraph 561.2 (d); 561.3 (2) neglect as defined in subdivision 2, paragraph (c); 561.4 (3) sexual abuse as defined in subdivision 2, paragraph 561.5 (a);or561.6 (4) mental injury as defined in subdivision 2, paragraph 561.7 (k); or 561.8 (5) maltreatment of a child in a facility as defined in 561.9 subdivision 2, paragraph (n). 561.10 (b) For the purposes of this subdivision, a determination 561.11 that child protective services are needed means that the local 561.12 welfare agency has documented conditions during the assessment 561.13 or investigation sufficient to cause a child protection worker, 561.14 as defined in section 626.559, subdivision 1, to conclude that a 561.15 child is at significant risk of maltreatment if protective 561.16 intervention is not provided and that the individuals 561.17 responsible for the child's care have not taken or are not 561.18 likely to take actions to protect the child from maltreatment or 561.19 risk of maltreatment. 561.20 (c) This subdivision does not mean that maltreatment has 561.21 occurred solely because the child's parent, guardian, or other 561.22 person responsible for the child's care in good faith selects 561.23 and depends upon spiritual means or prayer for treatment or care 561.24 of disease or remedial care of the child, in lieu of medical 561.25 care. However, if lack of medical care may result in serious 561.26 danger to the child's health, the local welfare agency may 561.27 ensure that necessary medical services are provided to the child. 561.28 (d) When determining whether the facility or individual is 561.29 the responsible party for determined maltreatment in a facility, 561.30 the investigating agency shall consider at least the following 561.31 mitigating factors: 561.32 (1) whether the actions of the facility or the individual 561.33 caregivers were according to, and followed the terms of, an 561.34 erroneous physician order, prescription, individual care plan, 561.35 or directive; however, this is not a mitigating factor when the 561.36 facility or caregiver was responsible for the issuance of the 562.1 erroneous order, prescription, individual care plan, or 562.2 directive or knew or should have known of the errors and took no 562.3 reasonable measures to correct the defect before administering 562.4 care; 562.5 (2) comparative responsibility between the facility, other 562.6 caregivers, and requirements placed upon an employee, including 562.7 the facility's compliance with related regulatory standards and 562.8 the adequacy of facility policies and procedures, facility 562.9 training, an individual's participation in the training, the 562.10 caregiver's supervision, and facility staffing levels and the 562.11 scope of the individual employee's authority and discretion; and 562.12 (3) whether the facility or individual followed 562.13 professional standards in exercising professional judgment. 562.14 Individual counties may implement more detailed definitions 562.15 or criteria that indicate which allegations to investigate, as 562.16 long as a county's policies are consistent with the definitions 562.17 in the statutes and rules and are approved by the county board. 562.18 Each local welfare agency shall periodically inform mandated 562.19 reporters under subdivision 3 who work in the county of the 562.20 definitions of maltreatment in the statutes and rules and any 562.21 additional definitions or criteria that have been approved by 562.22 the county board. 562.23 Sec. 9. Minnesota Statutes 2000, section 626.556, 562.24 subdivision 10f, is amended to read: 562.25 Subd. 10f. [NOTICE OF DETERMINATIONS.] Within ten working 562.26 days of the conclusion of an assessment, the local welfare 562.27 agency or agency responsible for assessing or investigating the 562.28 report shall notify the parent or guardian of the child, the 562.29 person determined to be maltreating the child, and if 562.30 applicable, the director of the facility, of the determination 562.31 and a summary of the specific reasons for the determination. 562.32 The notice must also include a certification that the 562.33 information collection procedures under subdivision 10, 562.34 paragraphs (h), (i), and (j), were followed and a notice of the 562.35 right of a data subject to obtain access to other private data 562.36 on the subject collected, created, or maintained under this 563.1 section. In addition, the notice shall include the length of 563.2 time that the records will be kept under subdivision 11c. The 563.3 investigating agency shall notify the parent or guardian of the 563.4 child who is the subject of the report, and any person or 563.5 facility determined to have maltreated a child, of their 563.6 appeal or review rights under this section or section 2. 563.7 Sec. 10. Minnesota Statutes 2000, section 626.556, 563.8 subdivision 10i, is amended to read: 563.9 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 563.10 DETERMINATION OF MALTREATMENT; REVIEW PANEL.] (a) An individual 563.11 or facility that the commissioner or a local social service 563.12 agency determines has maltreated a child, orthe child's563.13designeean interested person acting on behalf of the child, 563.14 regardless of the determination, who contests the investigating 563.15 agency's final determination regarding maltreatment, may request 563.16 the investigating agency to reconsider its final determination 563.17 regarding maltreatment. The request for reconsideration must be 563.18 submitted in writing to the investigating agency within 15 563.19 calendar days after receipt of notice of the final determination 563.20 regarding maltreatment or, if the request is made by an 563.21 interested person who is not entitled to notice, within 15 days 563.22 after receipt of the notice by the parent or guardian of the 563.23 child. 563.24 (b) If the investigating agency denies the request or fails 563.25 to act upon the request within 15 calendar days after receiving 563.26 the request for reconsideration, the person or facility entitled 563.27 to a fair hearing under section 256.045 may submit to the 563.28 commissioner of human services a written request for a hearing 563.29 under that section. For reports involving maltreatment of a 563.30 child in a facility, an interested person acting on behalf of 563.31 the child may request a review by the child maltreatment review 563.32 panel under section 2 if the investigating agency denies the 563.33 request or fails to act upon the request or if the interested 563.34 person contests a reconsidered determination. The investigating 563.35 agency shall notify persons who request reconsideration of their 563.36 rights under this paragraph. The request must be submitted in 564.1 writing to the review panel and a copy sent to the investigating 564.2 agency within 30 calendar days of receipt of notice of a denial 564.3 of a request for reconsideration or of a reconsidered 564.4 determination. The request must specifically identify the 564.5 aspects of the agency determination with which the person is 564.6 dissatisfied. 564.7 (c) If, as a result ofthea reconsideration or review, the 564.8 investigating agency changes the final determination of 564.9 maltreatment, that agency shall notify the parties specified in 564.10 subdivisions 10b, 10d, and 10f. 564.11 (d) If an individual or facility contests the investigating 564.12 agency's final determination regarding maltreatment by 564.13 requesting a fair hearing under section 256.045, the 564.14 commissioner of human services shall assure that the hearing is 564.15 conducted and a decision is reached within 90 days of receipt of 564.16 the request for a hearing. The time for action on the decision 564.17 may be extended for as many days as the hearing is postponed or 564.18 the record is held open for the benefit of either party. 564.19 (e) For purposes of this subdivision, "interested person 564.20 acting on behalf of the child" means a parent or legal guardian; 564.21 stepparent; grandparent; guardian ad litem; adult stepbrother, 564.22 stepsister, or sibling; or adult aunt or uncle; unless the 564.23 person has been determined to be the perpetrator of the 564.24 maltreatment. 564.25 Sec. 11. Minnesota Statutes 2000, section 626.556, 564.26 subdivision 11, is amended to read: 564.27 Subd. 11. [RECORDS.] (a) Except as provided in paragraph 564.28 (b) or (c) and subdivisions 10b, 10d, 10g, and 11b, all records 564.29 concerning individuals maintained by a local welfare agency or 564.30 agency responsible for assessing or investigating the report 564.31 under this section, including any written reports filed under 564.32 subdivision 7, shall be private data on individuals, except 564.33 insofar as copies of reports are required by subdivision 7 to be 564.34 sent to the local police department or the county sheriff. 564.35 Reports maintained by any police department or the county 564.36 sheriff shall be private data on individuals except the reports 565.1 shall be made available to the investigating, petitioning, or 565.2 prosecuting authority, including county medical examiners or 565.3 county coroners. Section 13.82, subdivisions 7, 5a, and 5b, 565.4 apply to law enforcement data other than the reports. The local 565.5 social services agency or agency responsible for assessing or 565.6 investigating the report shall make available to the 565.7 investigating, petitioning, or prosecuting authority, including 565.8 county medical examiners or county coroners or their 565.9 professional delegates, any records which contain information 565.10 relating to a specific incident of neglect or abuse which is 565.11 under investigation, petition, or prosecution and information 565.12 relating to any prior incidents of neglect or abuse involving 565.13 any of the same persons. The records shall be collected and 565.14 maintained in accordance with the provisions of chapter 13. In 565.15 conducting investigations and assessments pursuant to this 565.16 section, the notice required by section 13.04, subdivision 2, 565.17 need not be provided to a minor under the age of ten who is the 565.18 alleged victim of abuse or neglect. An individual subject of a 565.19 record shall have access to the record in accordance with those 565.20 sections, except that the name of the reporter shall be 565.21 confidential while the report is under assessment or 565.22 investigation except as otherwise permitted by this 565.23 subdivision. Any person conducting an investigation or 565.24 assessment under this section who intentionally discloses the 565.25 identity of a reporter prior to the completion of the 565.26 investigation or assessment is guilty of a misdemeanor. After 565.27 the assessment or investigation is completed, the name of the 565.28 reporter shall be confidential. The subject of the report may 565.29 compel disclosure of the name of the reporter only with the 565.30 consent of the reporter or upon a written finding by the court 565.31 that the report was false and that there is evidence that the 565.32 report was made in bad faith. This subdivision does not alter 565.33 disclosure responsibilities or obligations under the rules of 565.34 criminal procedure. 565.35 (b) Upon request of the legislative auditor, data on 565.36 individuals maintained under this section must be released to 566.1 the legislative auditor in order for the auditor to fulfill the 566.2 auditor's duties under section 3.971. The auditor shall 566.3 maintain the data in accordance with chapter 13. 566.4 (c) The investigating agency shall exchange not public data 566.5 with the child maltreatment review panel under section 2 if the 566.6 data are pertinent and necessary for a review requested under 566.7 section 2. Upon completion of the review, the not public data 566.8 received by the review panel must be returned to the 566.9 investigating agency. 566.10 Sec. 12. Minnesota Statutes 2000, section 626.556, 566.11 subdivision 12, is amended to read: 566.12 Subd. 12. [DUTIES OF FACILITY OPERATORS.] Any operator, 566.13 employee, or volunteer worker at any facility who intentionally 566.14 neglects, physically abuses, or sexually abuses any child in the 566.15 care of that facility may be charged with a violation of section 566.16 609.255, 609.377, or 609.378. Any operator of a facility who 566.17 knowingly permits conditions to exist which result in neglect, 566.18 physical abuse,orsexual abuse, or maltreatment of a child in a 566.19 facility while in the care of that facility may be charged with 566.20 a violation of section 609.378. The facility operator shall 566.21 inform all mandated reporters employed by or otherwise 566.22 associated with the facility of the duties required of mandated 566.23 reporters and shall inform all mandatory reporters of the 566.24 prohibition against retaliation for reports made in good faith 566.25 under this section. 566.26 Sec. 13. Minnesota Statutes 2000, section 626.559, 566.27 subdivision 2, is amended to read: 566.28 Subd. 2. [JOINT TRAINING.] The commissioners of human 566.29 services and public safety shall cooperate in the development of 566.30 a joint program for training child abuse services professionals 566.31 in the appropriate techniques for child abuse assessment and 566.32 investigation. The program shall include but need not be 566.33 limited to the following areas: 566.34 (1) the public policy goals of the state as set forth in 566.35 section 260C.001 and the role of the assessment or investigation 566.36 in meeting these goals; 567.1 (2) the special duties of child protection workers and law 567.2 enforcement officers under section 626.556; 567.3 (3) the appropriate methods for directing and managing 567.4 affiliated professionals who may be utilized in providing 567.5 protective services and strengthening family ties; 567.6 (4) the appropriate methods for interviewing alleged 567.7 victims of child abuse and other minors in the course of 567.8 performing an assessment or an investigation; 567.9 (5) the dynamics of child abuse and neglect within family 567.10 systems and the appropriate methods for interviewing parents in 567.11 the course of the assessment or investigation, including 567.12 training in recognizing cases in which one of the parents is a 567.13 victim of domestic abuse and in need of special legal or medical 567.14 services; 567.15 (6) the legal, evidentiary considerations that may be 567.16 relevant to the conduct of an assessment or an investigation; 567.17 (7) the circumstances under which it is appropriate to 567.18 remove the alleged abuser or the alleged victim from the home; 567.19 (8) the protective social services that are available to 567.20 protect alleged victims from further abuse, to prevent child 567.21 abuse and domestic abuse, and to preserve the family unit, and 567.22 training in the preparation of case plans to coordinate services 567.23 for the alleged child abuse victim with services for any parents 567.24 who are victims of domestic abuse;and567.25 (9) the methods by which child protection workers and law 567.26 enforcement workers cooperate in conducting assessments and 567.27 investigations in order to avoid duplication of efforts; and 567.28 (10) appropriate methods for interviewing alleged victims 567.29 of child abuse and conducting investigations in cases where the 567.30 alleged victim is developmentally, physically, or mentally 567.31 disabled. 567.32 Sec. 14. [STUDY OF OUTCOMES FOR CHILDREN IN THE CHILD 567.33 WELFARE SYSTEM.] 567.34 (a) The commissioner of human services, in consultation 567.35 with local social services agencies, councils of color, 567.36 representatives of communities of color, child advocates, 568.1 represenatives of courts, and other interested parties, shall 568.2 study why African American children in Minnesota are 568.3 disproportionately represented in child welfare out-of-home 568.4 placements. The commissioner also shall study each stage of the 568.5 proceedings concerning children in need of protection or 568.6 services, including the point at which children enter the child 568.7 welfare system, each decision-making point in the child welfare 568.8 system, and the outcomes for children in the child welfare 568.9 system, to determine why outcomes for children differ by race. 568.10 The commissioner shall use child welfare performance and outcome 568.11 indicators and data and other available data as part of this 568.12 study. The commissioner also shall study and determine if there 568.13 are decision-making points in the child protection system that 568.14 lead to different outcomes for children and how those 568.15 decision-making points affect outcomes for children. The 568.16 commissioner shall report and make legislative recommendations 568.17 on the following: 568.18 (1) amend the child protection statutes to reduce any 568.19 identified disparities in the child protection system relating 568.20 to outcomes for children of color, as compared to white 568.21 children; 568.22 (2) reduce any identified bias in the child protection 568.23 system; 568.24 (3) reduce the number and duration of out-of-home 568.25 placements for African American children; and 568.26 (4) improve the long-term outcomes for African American 568.27 children in out-of-home placements. 568.28 (b) The commissioner of human services shall submit the 568.29 report and recommended legislation to the chairs and ranking 568.30 minority members of the committees in the house of 568.31 representatives and senate with jurisdiction over child 568.32 protection and out-of-home placement issues by January 15, 2002. 568.33 ARTICLE 13 568.34 CHILD SUPPORT 568.35 Section 1. Minnesota Statutes 2000, section 13B.06, 568.36 subdivision 7, is amended to read: 569.1 Subd. 7. [FEES.] A financial institution may charge and 569.2 collect a fee from the public authority for providing account 569.3 information to the public authority. The commissioner may pay a 569.4 financial institution up to $150 each quarter if the 569.5 commissioner and the financial institution have entered into a 569.6 signed agreement that complies with federal law. The 569.7 commissioner shall develop procedures for the financial 569.8 institutions to charge and collect the fee. Payment of the fee 569.9 is limited by the amount of the appropriation for this purpose. 569.10 If the appropriation is insufficient, or if fund availability in 569.11 the fourth quarter would allow payments for actual costs in 569.12 excess of $150, the commissioner shall prorate the available 569.13 funds among the financial institutions that have submitted a 569.14 claim for the fee. No financial institution shall charge or 569.15 collect a fee that exceeds its actual costs of complying with 569.16 this section. The commissioner, together with an advisory group 569.17 consisting of representatives of the financial institutions in 569.18 the state, shalldetermine a fee structure that minimizes the569.19cost to the state and reasonably meets the needs of the569.20financial institutions, and shall report to the chairs of the569.21judiciary committees in the house of representatives and the569.22senate by February 1, 1998, a recommended fee structure for569.23inclusion in this sectionevaluate whether the fee paid to 569.24 financial institutions compensates them for their actual costs, 569.25 including start-up costs, of complying with this section and 569.26 shall submit a report to the legislature by July 1, 2002, with a 569.27 recommendation for retaining or modifying the fee. 569.28 Sec. 2. Minnesota Statutes 2000, section 256.01, 569.29 subdivision 2, is amended to read: 569.30 Subd. 2. [SPECIFIC POWERS.] Subject to the provisions of 569.31 section 241.021, subdivision 2, the commissioner of human 569.32 services shall: 569.33 (1) Administer and supervise all forms of public assistance 569.34 provided for by state law and other welfare activities or 569.35 services as are vested in the commissioner. Administration and 569.36 supervision of human services activities or services includes, 570.1 but is not limited to, assuring timely and accurate distribution 570.2 of benefits, completeness of service, and quality program 570.3 management. In addition to administering and supervising human 570.4 services activities vested by law in the department, the 570.5 commissioner shall have the authority to: 570.6 (a) require county agency participation in training and 570.7 technical assistance programs to promote compliance with 570.8 statutes, rules, federal laws, regulations, and policies 570.9 governing human services; 570.10 (b) monitor, on an ongoing basis, the performance of county 570.11 agencies in the operation and administration of human services, 570.12 enforce compliance with statutes, rules, federal laws, 570.13 regulations, and policies governing welfare services and promote 570.14 excellence of administration and program operation; 570.15 (c) develop a quality control program or other monitoring 570.16 program to review county performance and accuracy of benefit 570.17 determinations; 570.18 (d) require county agencies to make an adjustment to the 570.19 public assistance benefits issued to any individual consistent 570.20 with federal law and regulation and state law and rule and to 570.21 issue or recover benefits as appropriate; 570.22 (e) delay or deny payment of all or part of the state and 570.23 federal share of benefits and administrative reimbursement 570.24 according to the procedures set forth in section 256.017; 570.25 (f) make contracts with and grants to public and private 570.26 agencies and organizations, both profit and nonprofit, and 570.27 individuals, using appropriated funds; and 570.28 (g) enter into contractual agreements with federally 570.29 recognized Indian tribes with a reservation in Minnesota to the 570.30 extent necessary for the tribe to operate a federally approved 570.31 family assistance program or any other program under the 570.32 supervision of the commissioner. The commissioner shall consult 570.33 with the affected county or counties in the contractual 570.34 agreement negotiations, if the county or counties wish to be 570.35 included, in order to avoid the duplication of county and tribal 570.36 assistance program services. The commissioner may establish 571.1 necessary accounts for the purposes of receiving and disbursing 571.2 funds as necessary for the operation of the programs. 571.3 (2) Inform county agencies, on a timely basis, of changes 571.4 in statute, rule, federal law, regulation, and policy necessary 571.5 to county agency administration of the programs. 571.6 (3) Administer and supervise all child welfare activities; 571.7 promote the enforcement of laws protecting handicapped, 571.8 dependent, neglected and delinquent children, and children born 571.9 to mothers who were not married to the children's fathers at the 571.10 times of the conception nor at the births of the children; 571.11 license and supervise child-caring and child-placing agencies 571.12 and institutions; supervise the care of children in boarding and 571.13 foster homes or in private institutions; and generally perform 571.14 all functions relating to the field of child welfare now vested 571.15 in the state board of control. 571.16 (4) Administer and supervise all noninstitutional service 571.17 to handicapped persons, including those who are visually 571.18 impaired, hearing impaired, or physically impaired or otherwise 571.19 handicapped. The commissioner may provide and contract for the 571.20 care and treatment of qualified indigent children in facilities 571.21 other than those located and available at state hospitals when 571.22 it is not feasible to provide the service in state hospitals. 571.23 (5) Assist and actively cooperate with other departments, 571.24 agencies and institutions, local, state, and federal, by 571.25 performing services in conformity with the purposes of Laws 571.26 1939, chapter 431. 571.27 (6) Act as the agent of and cooperate with the federal 571.28 government in matters of mutual concern relative to and in 571.29 conformity with the provisions of Laws 1939, chapter 431, 571.30 including the administration of any federal funds granted to the 571.31 state to aid in the performance of any functions of the 571.32 commissioner as specified in Laws 1939, chapter 431, and 571.33 including the promulgation of rules making uniformly available 571.34 medical care benefits to all recipients of public assistance, at 571.35 such times as the federal government increases its participation 571.36 in assistance expenditures for medical care to recipients of 572.1 public assistance, the cost thereof to be borne in the same 572.2 proportion as are grants of aid to said recipients. 572.3 (7) Establish and maintain any administrative units 572.4 reasonably necessary for the performance of administrative 572.5 functions common to all divisions of the department. 572.6 (8) Act as designated guardian of both the estate and the 572.7 person of all the wards of the state of Minnesota, whether by 572.8 operation of law or by an order of court, without any further 572.9 act or proceeding whatever, except as to persons committed as 572.10 mentally retarded. For children under the guardianship of the 572.11 commissioner whose interests would be best served by adoptive 572.12 placement, the commissioner may contract with a licensed 572.13 child-placing agency to provide adoption services. A contract 572.14 with a licensed child-placing agency must be designed to 572.15 supplement existing county efforts and may not replace existing 572.16 county programs, unless the replacement is agreed to by the 572.17 county board and the appropriate exclusive bargaining 572.18 representative or the commissioner has evidence that child 572.19 placements of the county continue to be substantially below that 572.20 of other counties. Funds encumbered and obligated under an 572.21 agreement for a specific child shall remain available until the 572.22 terms of the agreement are fulfilled or the agreement is 572.23 terminated. 572.24 (9) Act as coordinating referral and informational center 572.25 on requests for service for newly arrived immigrants coming to 572.26 Minnesota. 572.27 (10) The specific enumeration of powers and duties as 572.28 hereinabove set forth shall in no way be construed to be a 572.29 limitation upon the general transfer of powers herein contained. 572.30 (11) Establish county, regional, or statewide schedules of 572.31 maximum fees and charges which may be paid by county agencies 572.32 for medical, dental, surgical, hospital, nursing and nursing 572.33 home care and medicine and medical supplies under all programs 572.34 of medical care provided by the state and for congregate living 572.35 care under the income maintenance programs. 572.36 (12) Have the authority to conduct and administer 573.1 experimental projects to test methods and procedures of 573.2 administering assistance and services to recipients or potential 573.3 recipients of public welfare. To carry out such experimental 573.4 projects, it is further provided that the commissioner of human 573.5 services is authorized to waive the enforcement of existing 573.6 specific statutory program requirements, rules, and standards in 573.7 one or more counties. The order establishing the waiver shall 573.8 provide alternative methods and procedures of administration, 573.9 shall not be in conflict with the basic purposes, coverage, or 573.10 benefits provided by law, and in no event shall the duration of 573.11 a project exceed four years. It is further provided that no 573.12 order establishing an experimental project as authorized by the 573.13 provisions of this section shall become effective until the 573.14 following conditions have been met: 573.15 (a) The secretary of health and human services of the 573.16 United States has agreed, for the same project, to waive state 573.17 plan requirements relative to statewide uniformity. 573.18 (b) A comprehensive plan, including estimated project 573.19 costs, shall be approved by the legislative advisory commission 573.20 and filed with the commissioner of administration. 573.21 (13) According to federal requirements, establish 573.22 procedures to be followed by local welfare boards in creating 573.23 citizen advisory committees, including procedures for selection 573.24 of committee members. 573.25 (14) Allocate federal fiscal disallowances or sanctions 573.26 which are based on quality control error rates for the aid to 573.27 families with dependent children program formerly codified in 573.28 sections 256.72 to 256.87, medical assistance, or food stamp 573.29 program in the following manner: 573.30 (a) One-half of the total amount of the disallowance shall 573.31 be borne by the county boards responsible for administering the 573.32 programs. For the medical assistance and the AFDC program 573.33 formerly codified in sections 256.72 to 256.87, disallowances 573.34 shall be shared by each county board in the same proportion as 573.35 that county's expenditures for the sanctioned program are to the 573.36 total of all counties' expenditures for the AFDC program 574.1 formerly codified in sections 256.72 to 256.87, and medical 574.2 assistance programs. For the food stamp program, sanctions 574.3 shall be shared by each county board, with 50 percent of the 574.4 sanction being distributed to each county in the same proportion 574.5 as that county's administrative costs for food stamps are to the 574.6 total of all food stamp administrative costs for all counties, 574.7 and 50 percent of the sanctions being distributed to each county 574.8 in the same proportion as that county's value of food stamp 574.9 benefits issued are to the total of all benefits issued for all 574.10 counties. Each county shall pay its share of the disallowance 574.11 to the state of Minnesota. When a county fails to pay the 574.12 amount due hereunder, the commissioner may deduct the amount 574.13 from reimbursement otherwise due the county, or the attorney 574.14 general, upon the request of the commissioner, may institute 574.15 civil action to recover the amount due. 574.16 (b) Notwithstanding the provisions of paragraph (a), if the 574.17 disallowance results from knowing noncompliance by one or more 574.18 counties with a specific program instruction, and that knowing 574.19 noncompliance is a matter of official county board record, the 574.20 commissioner may require payment or recover from the county or 574.21 counties, in the manner prescribed in paragraph (a), an amount 574.22 equal to the portion of the total disallowance which resulted 574.23 from the noncompliance, and may distribute the balance of the 574.24 disallowance according to paragraph (a). 574.25 (15) Develop and implement special projects that maximize 574.26 reimbursements and result in the recovery of money to the 574.27 state. For the purpose of recovering state money, the 574.28 commissioner may enter into contracts with third parties. Any 574.29 recoveries that result from projects or contracts entered into 574.30 under this paragraph shall be deposited in the state treasury 574.31 and credited to a special account until the balance in the 574.32 account reaches $1,000,000. When the balance in the account 574.33 exceeds $1,000,000, the excess shall be transferred and credited 574.34 to the general fund. All money in the account is appropriated 574.35 to the commissioner for the purposes of this paragraph. 574.36 (16) Have the authority to make direct payments to 575.1 facilities providing shelter to women and their children 575.2 according to section 256D.05, subdivision 3. Upon the written 575.3 request of a shelter facility that has been denied payments 575.4 under section 256D.05, subdivision 3, the commissioner shall 575.5 review all relevant evidence and make a determination within 30 575.6 days of the request for review regarding issuance of direct 575.7 payments to the shelter facility. Failure to act within 30 days 575.8 shall be considered a determination not to issue direct payments. 575.9 (17) Have the authority to establish and enforce the 575.10 following county reporting requirements: 575.11 (a) The commissioner shall establish fiscal and statistical 575.12 reporting requirements necessary to account for the expenditure 575.13 of funds allocated to counties for human services programs. 575.14 When establishing financial and statistical reporting 575.15 requirements, the commissioner shall evaluate all reports, in 575.16 consultation with the counties, to determine if the reports can 575.17 be simplified or the number of reports can be reduced. 575.18 (b) The county board shall submit monthly or quarterly 575.19 reports to the department as required by the commissioner. 575.20 Monthly reports are due no later than 15 working days after the 575.21 end of the month. Quarterly reports are due no later than 30 575.22 calendar days after the end of the quarter, unless the 575.23 commissioner determines that the deadline must be shortened to 575.24 20 calendar days to avoid jeopardizing compliance with federal 575.25 deadlines or risking a loss of federal funding. Only reports 575.26 that are complete, legible, and in the required format shall be 575.27 accepted by the commissioner. 575.28 (c) If the required reports are not received by the 575.29 deadlines established in clause (b), the commissioner may delay 575.30 payments and withhold funds from the county board until the next 575.31 reporting period. When the report is needed to account for the 575.32 use of federal funds and the late report results in a reduction 575.33 in federal funding, the commissioner shall withhold from the 575.34 county boards with late reports an amount equal to the reduction 575.35 in federal funding until full federal funding is received. 575.36 (d) A county board that submits reports that are late, 576.1 illegible, incomplete, or not in the required format for two out 576.2 of three consecutive reporting periods is considered 576.3 noncompliant. When a county board is found to be noncompliant, 576.4 the commissioner shall notify the county board of the reason the 576.5 county board is considered noncompliant and request that the 576.6 county board develop a corrective action plan stating how the 576.7 county board plans to correct the problem. The corrective 576.8 action plan must be submitted to the commissioner within 45 days 576.9 after the date the county board received notice of noncompliance. 576.10 (e) The final deadline for fiscal reports or amendments to 576.11 fiscal reports is one year after the date the report was 576.12 originally due. If the commissioner does not receive a report 576.13 by the final deadline, the county board forfeits the funding 576.14 associated with the report for that reporting period and the 576.15 county board must repay any funds associated with the report 576.16 received for that reporting period. 576.17 (f) The commissioner may not delay payments, withhold 576.18 funds, or require repayment under paragraph (c) or (e) if the 576.19 county demonstrates that the commissioner failed to provide 576.20 appropriate forms, guidelines, and technical assistance to 576.21 enable the county to comply with the requirements. If the 576.22 county board disagrees with an action taken by the commissioner 576.23 under paragraph (c) or (e), the county board may appeal the 576.24 action according to sections 14.57 to 14.69. 576.25 (g) Counties subject to withholding of funds under 576.26 paragraph (c) or forfeiture or repayment of funds under 576.27 paragraph (e) shall not reduce or withhold benefits or services 576.28 to clients to cover costs incurred due to actions taken by the 576.29 commissioner under paragraph (c) or (e). 576.30 (18) Allocate federal fiscal disallowances or sanctions for 576.31 audit exceptions when federal fiscal disallowances or sanctions 576.32 are based on a statewide random sample for the foster care 576.33 program under title IV-E of the Social Security Act, United 576.34 States Code, title 42, in direct proportion to each county's 576.35 title IV-E foster care maintenance claim for that period. 576.36 (19) Be responsible for ensuring the detection, prevention, 577.1 investigation, and resolution of fraudulent activities or 577.2 behavior by applicants, recipients, and other participants in 577.3 the human services programs administered by the department. 577.4 (20) Require county agencies to identify overpayments, 577.5 establish claims, and utilize all available and cost-beneficial 577.6 methodologies to collect and recover these overpayments in the 577.7 human services programs administered by the department. 577.8 (21) Have the authority to administer a drug rebate program 577.9 for drugs purchased pursuant to the prescription drug program 577.10 established under section 256.955 after the beneficiary's 577.11 satisfaction of any deductible established in the program. The 577.12 commissioner shall require a rebate agreement from all 577.13 manufacturers of covered drugs as defined in section 256B.0625, 577.14 subdivision 13. Rebate agreements for prescription drugs 577.15 delivered on or after July 1, 2002, must include rebates for 577.16 individuals covered under the prescription drug program who are 577.17 under 65 years of age. For each drug, the amount of the rebate 577.18 shall be equal to the basic rebate as defined for purposes of 577.19 the federal rebate program in United States Code, title 42, 577.20 section 1396r-8(c)(1). This basic rebate shall be applied to 577.21 single-source and multiple-source drugs. The manufacturers must 577.22 provide full payment within 30 days of receipt of the state 577.23 invoice for the rebate within the terms and conditions used for 577.24 the federal rebate program established pursuant to section 1927 577.25 of title XIX of the Social Security Act. The manufacturers must 577.26 provide the commissioner with any information necessary to 577.27 verify the rebate determined per drug. The rebate program shall 577.28 utilize the terms and conditions used for the federal rebate 577.29 program established pursuant to section 1927 of title XIX of the 577.30 Social Security Act. 577.31 (22) Operate the department's communication systems account 577.32 established in Laws 1993, First Special Session chapter 1, 577.33 article 1, section 2, subdivision 2, to manage shared 577.34 communication costs necessary for the operation of the programs 577.35 the commissioner supervises. A communications account may also 577.36 be established for each regional treatment center which operates 578.1 communications systems. Each account must be used to manage 578.2 shared communication costs necessary for the operations of the 578.3 programs the commissioner supervises. The commissioner may 578.4 distribute the costs of operating and maintaining communication 578.5 systems to participants in a manner that reflects actual usage. 578.6 Costs may include acquisition, licensing, insurance, 578.7 maintenance, repair, staff time and other costs as determined by 578.8 the commissioner. Nonprofit organizations and state, county, 578.9 and local government agencies involved in the operation of 578.10 programs the commissioner supervises may participate in the use 578.11 of the department's communications technology and share in the 578.12 cost of operation. The commissioner may accept on behalf of the 578.13 state any gift, bequest, devise or personal property of any 578.14 kind, or money tendered to the state for any lawful purpose 578.15 pertaining to the communication activities of the department. 578.16 Any money received for this purpose must be deposited in the 578.17 department's communication systems accounts. Money collected by 578.18 the commissioner for the use of communication systems must be 578.19 deposited in the state communication systems account and is 578.20 appropriated to the commissioner for purposes of this section. 578.21 (23) Receive any federal matching money that is made 578.22 available through the medical assistance program for the 578.23 consumer satisfaction survey. Any federal money received for 578.24 the survey is appropriated to the commissioner for this 578.25 purpose. The commissioner may expend the federal money received 578.26 for the consumer satisfaction survey in either year of the 578.27 biennium. 578.28 (24) Incorporate cost reimbursement claims from First Call 578.29 Minnesota into the federal cost reimbursement claiming processes 578.30 of the department according to federal law, rule, and 578.31 regulations. Any reimbursement received is appropriated to the 578.32 commissioner and shall be disbursed to First Call Minnesota 578.33 according to normal department payment schedules. 578.34 (25) Develop recommended standards for foster care homes 578.35 that address the components of specialized therapeutic services 578.36 to be provided by foster care homes with those services. 579.1 (26) In consultation with county child support 579.2 representatives and county attorneys, adopt rules, in accordance 579.3 with chapter 14, that are necessary for the operation of a 579.4 statewide child support county performance management program. 579.5 Sec. 3. Minnesota Statutes 2000, section 256.741, 579.6 subdivision 1, is amended to read: 579.7 Subdivision 1. [PUBLIC ASSISTANCE.] (a) The term "direct 579.8 support" as used in this chapter and chapters 257, 518, and 518C 579.9 refers to an assigned support payment from an obligor which is 579.10 paid directly to a recipient of TANF or MFIP. 579.11 (b) The term "public assistance" as used in this chapter 579.12 and chapters 257, 518, and 518C, includes any form of assistance 579.13 provided under the AFDC program formerly codified in sections 579.14 256.72 to 256.87, MFIP and MFIP-R formerly codified under 579.15 chapter 256, MFIP under chapter 256J, work first program under 579.16 chapter 256K; child care assistance provided through the child 579.17 care fund under chapter 119B; any form of medical assistance 579.18 under chapter 256B; MinnesotaCare under chapter 256L; and foster 579.19 care as provided under title IV-E of the Social Security Act. 579.20(b)(c) The term "child support agency" as used in this 579.21 section refers to the public authority responsible for child 579.22 support enforcement. 579.23(c)(d) The term "public assistance agency" as used in this 579.24 section refers to a public authority providing public assistance 579.25 to an individual. 579.26 Sec. 4. Minnesota Statutes 2000, section 256.741, 579.27 subdivision 5, is amended to read: 579.28 Subd. 5. [COOPERATION WITH CHILD SUPPORT ENFORCEMENT.] 579.29 After notification from a public assistance agency that an 579.30 individual has applied for or is receiving any form of public 579.31 assistance, the child support agency shall determine whether the 579.32 party is cooperating with the agency in establishing paternity, 579.33 child support, modification of an existing child support order, 579.34 or enforcement of an existing child support order. The public 579.35 assistance agency shall notify each applicant or recipient in 579.36 writing of the right to claim a good cause exemption from 580.1 cooperating with the requirements in this section. A copy of 580.2 the notice must be furnished to the applicant or recipient, and 580.3 the applicant or recipient and a representative from the public 580.4 authority shall acknowledge receipt of the notice by signing and 580.5 dating a copy of the notice. The individual shall cooperate 580.6 with the child support agency by: 580.7 (1) providing all known information regarding the alleged 580.8 father or obligor, including name, address, social security 580.9 number, telephone number, place of employment or school, and the 580.10 names and addresses of any relatives; 580.11 (2) appearing at interviews, hearings and legal 580.12 proceedings; 580.13 (3) submitting to genetic tests including genetic testing 580.14 of the child, under a judicial or administrative order; and 580.15 (4) providing additional information known by the 580.16 individual as necessary for cooperating in good faith with the 580.17 child support agency. 580.18 The caregiver of a minor child must cooperate with the 580.19 efforts of the public authority to collect support according to 580.20 this subdivision. A caregiver mustforward tonotify the public 580.21 authority of all support the caregiver receives during the 580.22 period the assignment of support required under subdivision 2 is 580.23 in effect.Support received by a caregiver and not forwarded to580.24the public authority must be repaid to the child support580.25enforcement unit for any month following the date on which580.26initial eligibility is determinedDirect support retained by a 580.27 caregiver must be counted as unearned income when determining 580.28 the amount of the assistance payment,except as provided under580.29subdivision 8, paragraph (b), clause (4)and repaid to the child 580.30 support agency for any month when the direct support retained is 580.31 greater than the court-ordered child support and the assistance 580.32 payment and the obligor owes support arrears. 580.33 Sec. 5. Minnesota Statutes 2000, section 256.741, 580.34 subdivision 8, is amended to read: 580.35 Subd. 8. [REFUSAL TO COOPERATE WITH SUPPORT REQUIREMENTS.] 580.36 (a) Failure by a caregiver to satisfy any of the requirements of 581.1 subdivision 5 constitutes refusal to cooperate, and the 581.2 sanctions under paragraph (b) apply. The IV-D agency must 581.3 determine whether a caregiver has refused to cooperate according 581.4 to subdivision 5. 581.5 (b) Determination by the IV-D agency that a caregiver has 581.6 refused to cooperate has the following effects: 581.7 (1) a caregiver is subject to the applicable sanctions 581.8 under section 256J.46; 581.9 (2) a caregiver who is not a parent of a minor child in an 581.10 assistance unit may choose to remove the child from the 581.11 assistance unit unless the child is required to be in the 581.12 assistance unit; and 581.13 (3) a parental caregiver who refuses to cooperate is 581.14 ineligible for medical assistance; and581.15(4) direct support retained by a caregiver must be counted581.16as unearned income when determining the amount of the assistance581.17payment. 581.18 Sec. 6. Minnesota Statutes 2000, section 256.979, 581.19 subdivision 5, is amended to read: 581.20 Subd. 5. [PATERNITY ESTABLISHMENT AND CHILD SUPPORT ORDER 581.21 ESTABLISHMENT AND MODIFICATION BONUS INCENTIVES.] (a) A bonus 581.22 incentive program is created to increase the number of paternity 581.23 establishments and establishment and modifications of child 581.24 support orders done by county child support enforcement agencies. 581.25 (b) A bonus must be awarded to a county child support 581.26 agency for eachcasechild for which the agency completes a 581.27 paternity or child support order establishment or modification 581.28 through judicial or administrative processes. 581.29 (c) The rate of bonus incentive is $100 per child for each 581.30 paternity or child support order establishment and modification 581.31 set in a specific dollar amount. 581.32 (d) No bonus shall be paid for a modification that is a 581.33 result of a termination of child care costs according to section 581.34 518.551, subdivision 5, paragraph (b), or due solely to a 581.35 reduction of child care expenses. 581.36 Sec. 7. Minnesota Statutes 2000, section 256.979, 582.1 subdivision 6, is amended to read: 582.2 Subd. 6. [CLAIMS FOR BONUS INCENTIVE.] (a) The 582.3 commissioner of human services and the county agency shall 582.4 develop procedures for the claims process and criteria using 582.5 automated systems where possible. 582.6 (b) Only one county agency may receive a bonus per 582.7 paternity establishment or child support order establishment or 582.8 modification for eachcasechild. The county agency completing 582.9 the action or procedure needed to establish paternity or a child 582.10 support order or modify an order is the county agency entitled 582.11 to claim the bonus incentive. 582.12 (c) Disputed claims must be submitted to the commissioner 582.13 of human services and the commissioner's decision is final. 582.14(d) For purposes of this section, "case" means a family582.15unit for whom the county agency is providing child support582.16enforcement services.582.17 Sec. 8. Minnesota Statutes 2000, section 393.07, is 582.18 amended by adding a subdivision to read: 582.19 Subd. 9a. [ADMINISTRATIVE PENALTIES.] (a) The public 582.20 authority, as defined in section 518.54, may sanction an 582.21 employer or payor of funds up to $700 for failing to comply with 582.22 section 518.5513, subdivision 5, paragraph (a), clauses (5) and 582.23 (8), if: 582.24 (1) the public authority mails the employer or payor of 582.25 funds a notice of an administrative sanction, at the employer's 582.26 or payor's of funds last known address, which includes the date 582.27 the sanction will take effect, the amount of the sanction, the 582.28 reason for imposing the sanction, and the corrective action that 582.29 must be taken to avoid the sanction; and 582.30 (2) the employer or payor of funds fails to correct the 582.31 violation before the effective date of the sanction. 582.32 (b) The public authority shall include with the sanction 582.33 notice an additional notice of the right to appeal the sanction 582.34 and the process for making the appeal. 582.35 (c) Unless an appeal is made, the administrative 582.36 determination of the sanction is final and binding. 583.1 Sec. 9. Minnesota Statutes 2000, section 518.551, 583.2 subdivision 13, is amended to read: 583.3 Subd. 13. [DRIVER'S LICENSE SUSPENSION.] (a) Upon motion 583.4 of an obligee, which has been properly served on the obligor and 583.5 upon which there has been an opportunity for hearing, if a court 583.6 finds that the obligor has been or may be issued a driver's 583.7 license by the commissioner of public safety and the obligor is 583.8 in arrears in court-ordered child support or maintenance 583.9 payments, or both, in an amount equal to or greater than three 583.10 times the obligor's total monthly support and maintenance 583.11 payments and is not in compliance with a written payment 583.12 agreement regarding both current support and arrearages approved 583.13 by the court, a child support magistrate, or the public 583.14 authority, the court shall order the commissioner of public 583.15 safety to suspend the obligor's driver's license. The court's 583.16 order must be stayed for 90 days in order to allow the obligor 583.17 to execute a written payment agreement regarding both current 583.18 support and arrearages, which payment agreement must be approved 583.19 by either the court or the public authority responsible for 583.20 child support enforcement. If the obligor has not executed or 583.21 is not in compliance with a written payment agreement regarding 583.22 both current support and arrearages after the 90 days expires, 583.23 the court's order becomes effective and the commissioner of 583.24 public safety shall suspend the obligor's driver's license. The 583.25 remedy under this subdivision is in addition to any other 583.26 enforcement remedy available to the court. An obligee may not 583.27 bring a motion under this paragraph within 12 months of a denial 583.28 of a previous motion under this paragraph. 583.29 (b) If a public authority responsible for child support 583.30 enforcement determines that the obligor has been or may be 583.31 issued a driver's license by the commissioner of public safety 583.32 and the obligor is in arrears in court-ordered child support or 583.33 maintenance payments or both in an amount equal to or greater 583.34 than three times the obligor's total monthly support and 583.35 maintenance payments and not in compliance with a written 583.36 payment agreement regarding both current support and arrearages 584.1 approved by the court, a child support magistrate, or the public 584.2 authority, the public authority shall direct the commissioner of 584.3 public safety to suspend the obligor's driver's license. The 584.4 remedy under this subdivision is in addition to any other 584.5 enforcement remedy available to the public authority. 584.6 (c) At least 90 days prior to notifying the commissioner of 584.7 public safety according to paragraph (b), the public authority 584.8 must mail a written notice to the obligor at the obligor's last 584.9 known address, that it intends to seek suspension of the 584.10 obligor's driver's license and that the obligor must request a 584.11 hearing within 30 days in order to contest the suspension. If 584.12 the obligor makes a written request for a hearing within 30 days 584.13 of the date of the notice, a court hearing must be held. 584.14 Notwithstanding any law to the contrary, the obligor must be 584.15 served with 14 days' notice in writing specifying the time and 584.16 place of the hearing and the allegations against the obligor. 584.17 The notice may be served personally or by mail. If the public 584.18 authority does not receive a request for a hearing within 30 584.19 days of the date of the notice, and the obligor does not execute 584.20 a written payment agreement regarding both current support and 584.21 arrearages approved by the public authority within 90 days of 584.22 the date of the notice, the public authority shall direct the 584.23 commissioner of public safety to suspend the obligor's driver's 584.24 license under paragraph (b). 584.25 (d) At a hearing requested by the obligor under paragraph 584.26 (c), and on finding that the obligor is in arrears in 584.27 court-ordered child support or maintenance payments or both in 584.28 an amount equal to or greater than three times the obligor's 584.29 total monthly support and maintenance payments, the district 584.30 court or child support magistrate shall order the commissioner 584.31 of public safety to suspend the obligor's driver's license or 584.32 operating privileges unless the court or child support 584.33 magistrate determines that the obligor has executed and is in 584.34 compliance with a written payment agreement regarding both 584.35 current support and arrearages approved by the court, a child 584.36 support magistrate, or the public authority. 585.1 (e) An obligor whose driver's license or operating 585.2 privileges are suspended may provide proof to the public 585.3 authority responsible for child support enforcement that the 585.4 obligor is in compliance with all written payment agreements 585.5 regarding both current support and arrearages. Within 15 days 585.6 of the receipt of that proof, the public authority shall inform 585.7 the commissioner of public safety that the obligor's driver's 585.8 license or operating privileges should no longer be suspended. 585.9 (f) On January 15, 1997, and every two years after that, 585.10 the commissioner of human services shall submit a report to the 585.11 legislature that identifies the following information relevant 585.12 to the implementation of this section: 585.13 (1) the number of child support obligors notified of an 585.14 intent to suspend a driver's license; 585.15 (2) the amount collected in payments from the child support 585.16 obligors notified of an intent to suspend a driver's license; 585.17 (3) the number of cases paid in full and payment agreements 585.18 executed in response to notification of an intent to suspend a 585.19 driver's license; 585.20 (4) the number of cases in which there has been 585.21 notification and no payments or payment agreements; 585.22 (5) the number of driver's licenses suspended; and 585.23 (6) the cost of implementation and operation of the 585.24 requirements of this section. 585.25 (g) In addition to the criteria established under this 585.26 section for the suspension of an obligor's driver's license, a 585.27 court, a child support magistrate, or the public authority may 585.28 direct the commissioner of public safety to suspend the license 585.29 of a party who has failed, after receiving notice, to comply 585.30 with a subpoena relating to a paternity or child support 585.31 proceeding. Notice to an obligor of intent to suspend must be 585.32 served by first class mail at the obligor's last known address. 585.33 The notice must inform the obligor of the right to request a 585.34 hearing. If the obligor makes a written request within ten days 585.35 of the date of the hearing, a hearing must be held. At the 585.36 hearing, the only issues to be considered are mistake of fact 586.1 and whether the obligor received the subpoena. 586.2 (h) The license of an obligor who fails to remain in 586.3 compliance with an approved payment agreement may be 586.4 suspended if the obligor misses one month's payment. Notice to 586.5 the obligor ofanintent to suspend under this paragraph must be 586.6served by first class mailmailed to the obligor at the 586.7 obligor's last known addressand must include a notice of586.8hearing. This notice must inform the obligor that unless the 586.9 delinquency on the payment agreement is paid in full within 30 586.10 days of the date of notice or the obligor requests a hearing, 586.11 the public authority will direct the department of public safety 586.12 to suspend the obligor's license. If the obligor does not pay 586.13 the delinquency in full or request a hearing within 30 days of 586.14 the date of notice, the public authority may direct the 586.15 department of public safety to suspend the obligor's license. 586.16 If the obligor requests a hearing to determine failure to comply 586.17 with the payment agreement, the notice of hearing must beserved586.18uponmailed to the obligor at the obligor's last known address 586.19 not less than ten days before the date of the hearing. If the 586.20 obligor appears at the hearing and thejudgedistrict court or 586.21 child support magistrate determines that the obligor has failed 586.22 to comply with an approved payment agreement, thejudgedistrict 586.23 court or child support magistrate shallnotifyorder the 586.24 department of public safety to suspend the obligor's 586.25 licenseunder paragraph (c). If the obligor fails to appear at 586.26 the hearing, the public authority maynotifydirect the 586.27 department of public safety to suspend the obligor's 586.28 licenseunder paragraph (c). 586.29 Sec. 10. Minnesota Statutes 2000, section 518.5513, 586.30 subdivision 5, is amended to read: 586.31 Subd. 5. [ADMINISTRATIVE AUTHORITY.] (a) The public 586.32 authority may take the following actions relating to 586.33 establishment of paternity or to establishment, modification, or 586.34 enforcement of support orders, without the necessity of 586.35 obtaining an order from any judicial or administrative tribunal: 586.36 (1) recognize and enforce orders of child support agencies 587.1 of other states; 587.2 (2) upon request for genetic testing by a child, parent, or 587.3 any alleged parent, and using the procedure in paragraph (b), 587.4 order the child, parent, or alleged parent to submit to blood or 587.5 genetic testing for the purpose of establishing paternity; 587.6 (3) subpoena financial or other information needed to 587.7 establish, modify, or enforce a child support order andrequest587.8sanctionssanction a party for failure to respond to a subpoena; 587.9 (4) upon notice to the obligor, obligee, and the 587.10 appropriate court, direct the obligor or other payor to change 587.11 the payee to the central collections unit under sections 587.12 518.5851 to 518.5853; 587.13 (5) order income withholding of child support under section 587.14 518.6111 and sanction an employer or payor of funds pursuant to 587.15 section 393.07, subdivision 9a, for failing to comply with an 587.16 income withholding notice; 587.17 (6) secure assets to satisfy the debt or arrearage in cases 587.18 in which there is a support debt or arrearage by: 587.19 (i) intercepting or seizing periodic or lump sum payments 587.20 from state or local agencies, including unemployment benefits, 587.21 workers' compensation payments, judgments, settlements, 587.22 lotteries, and other lump sum payments; 587.23 (ii) attaching and seizing assets of the obligor held in 587.24 financial institutions or public or private retirement funds; 587.25 and 587.26 (iii) imposing liens in accordance with section 548.091 587.27 and, in appropriate cases, forcing the sale of property and the 587.28 distribution of proceeds; 587.29 (7) for the purpose of securing overdue support, increase 587.30 the amount of the monthly support payments by an additional 587.31 amount equal to 20 percent of the monthly support payment to 587.32 include amounts for debts or arrearages; and 587.33 (8) subpoena an employer or payor of funds to provide 587.34 promptly information on the employment, compensation, and 587.35 benefits of an individual employed by that employer as an 587.36 employee or contractor, andto request sanctionssanction an 588.1 employer or payor of funds pursuant to section 393.07, 588.2 subdivision 9a, for failure to respond to the subpoenaas588.3provided by law. 588.4 (b) A request for genetic testing by a child, parent, or 588.5 alleged parent must be supported by a sworn statement by the 588.6 person requesting genetic testing alleging paternity, which sets 588.7 forth facts establishing a reasonable possibility of the 588.8 requisite sexual contact between the parties, or denying 588.9 paternity, and setting forth facts establishing a reasonable 588.10 possibility of the nonexistence of sexual contact between the 588.11 alleged parties. The order for genetic tests may be served 588.12 anywhere within the state and served outside the state in the 588.13 same manner as prescribed by law for service of subpoenas issued 588.14 by the district court of this state. If the child, parent, or 588.15 alleged parent fails to comply with the genetic testing order, 588.16 the public authority may seek to enforce that order in district 588.17 court through a motion to compel testing. No results obtained 588.18 through genetic testing done in response to an order issued 588.19 under this section may be used in any criminal proceeding. 588.20 (c) Subpoenas may be served anywhere within the state and 588.21 served outside the state in the same manner as prescribed by law 588.22 for service of process of subpoenas issued by the district court 588.23 of this state. When a subpoena under this subdivision is served 588.24 on a third-party recordkeeper, written notice of the subpoena 588.25 shall be mailed to the person who is the subject of the 588.26 subpoenaed material at the person's last known address within 588.27 three days of the day the subpoena is served. This notice 588.28 provision does not apply if there is reasonable cause to believe 588.29 the giving of the notice may lead to interference with the 588.30 production of the subpoenaed documents. 588.31 (d) A person served with a subpoena may make a written 588.32 objection to the public authority or court before the time 588.33 specified in the subpoena for compliance. The public authority 588.34 or the court shall cancel or modify the subpoena, if 588.35 appropriate. The public authority shall pay the reasonable 588.36 costs of producing the documents, if requested. 589.1 (e) Subpoenas are enforceable in the same manner as 589.2 subpoenas of the district court. Upon motion of the county 589.3 attorney, the court may issue an order directing the production 589.4 of the records. Failure to comply with the court order may 589.5 subject the person who fails to comply to civil or criminal 589.6 contempt of court. 589.7 (f) The administrative actions under this subdivision are 589.8 subject to due process safeguards, including requirements for 589.9 notice, opportunity to contest the action, and opportunity to 589.10 appeal the order to the judge, judicial officer, or child 589.11 support magistrate. 589.12 Sec. 11. Minnesota Statutes 2000, section 518.575, 589.13 subdivision 1, is amended to read: 589.14 Subdivision 1. [MAKING NAMES PUBLIC.] At least once each 589.15 year, the commissioner of human services, in consultation with 589.16 the attorney general,shallmay publish a list of the names and 589.17 other identifying information of no more than 25 persons who (1) 589.18 are child support obligors, (2) are at least $10,000 in arrears, 589.19 (3) are not in compliance with a written payment agreement 589.20 regarding both current support and arrearages approved by the 589.21 court, a child support magistrate, or the public authority, (4) 589.22 cannot currently be located by the public authority for the 589.23 purposes of enforcing a support order, and (5) have not made a 589.24 support payment except tax intercept payments, in the preceding 589.25 12 months. 589.26 Identifying information may include the obligor's name, 589.27 last known address, amount owed, date of birth, photograph, the 589.28 number of children for whom support is owed, and any additional 589.29 information about the obligor that would assist in identifying 589.30 or locating the obligor. The commissioner and attorney general 589.31 may use posters, media presentations, electronic technology, and 589.32 other means that the commissioner and attorney general determine 589.33 are appropriate for dissemination of the information, including 589.34 publication on the Internet. The commissioner and attorney 589.35 general may make any or all of the identifying information 589.36 regarding these persons public. Information regarding an 590.1 obligor who meets the criteria in this subdivision will only be 590.2 made public subsequent to that person's selection by the 590.3 commissioner and attorney general. 590.4 Before making public the name of the obligor, the 590.5 department of human services shall send a notice to the 590.6 obligor's last known address which states the department's 590.7 intention to make public information on the obligor. The notice 590.8 must also provide an opportunity to have the obligor's name 590.9 removed from the list by paying the arrearage or by entering 590.10 into an agreement to pay the arrearage, or by providing 590.11 information to the public authority that there is good cause not 590.12 to make the information public. The notice must include the 590.13 final date when the payment or agreement can be accepted. 590.14 The department of human services shall obtain the written 590.15 consent of the obligee to make the name of the obligor public. 590.16 Sec. 12. Minnesota Statutes 2000, section 518.5851, is 590.17 amended by adding a subdivision to read: 590.18 Subd. 7. [UNCLAIMED SUPPORT FUNDS.] "Unclaimed support 590.19 funds" means any support payments collected by the public 590.20 authority from the obligor, which have not been disbursed to the 590.21 obligee or public authority. 590.22 Sec. 13. Minnesota Statutes 2000, section 518.5853, is 590.23 amended by adding a subdivision to read: 590.24 Subd. 12. [UNCLAIMED SUPPORT FUNDS.] (a) If support 590.25 payments have not been disbursed to an obligee because the 590.26 obligee is not located, the public authority shall continue 590.27 locate efforts for one year from the date the public authority 590.28 determines that the obligee is not located. 590.29 (b) If the public authority is unable to locate the obligee 590.30 after one year, the public authority shall mail a written notice 590.31 to the obligee at the obligee's last known address. The notice 590.32 shall give the obligee 60 days to contact the public authority. 590.33 If the obligee does not contact the public authority within 60 590.34 days from the date of notice, the public authority shall: 590.35 (1) close the nonpublic assistance portion of the case; 590.36 (2) disburse unclaimed support funds to pay public 591.1 assistance arrears. If public assistance arrears remain after 591.2 disbursing the unclaimed support funds, the public authority may 591.3 continue enforcement and collection of child support until all 591.4 public assistance arrears have been paid. If there are no 591.5 public assistance arrears, or unclaimed support funds remain 591.6 after paying public assistance arrears, remaining unclaimed 591.7 support funds shall be returned to the obligor; and 591.8 (3) mail, when all public assistance arrears have been paid 591.9 the public authority, to the obligor at the obligor's last known 591.10 address a written notice of termination of income withholding 591.11 and case closure due to the public authority's inability to 591.12 locate the obligee. The notice must indicate that the obligor's 591.13 support or maintenance obligation will remain in effect until 591.14 further order of the court and must inform the obligor that the 591.15 obligor can contact the public authority for assistance to 591.16 modify the order. A copy of the form prepared by the state 591.17 court administrator's office under section 518.64, subdivision 591.18 5, must be included with the notice. 591.19 (c) If the obligor is not located when attempting to return 591.20 unclaimed support funds, the public authority shall continue 591.21 locate efforts for one year from the date the public authority 591.22 determines that the obligor is not located. If the public 591.23 authority is unable to locate the obligor after one year, the 591.24 funds shall be treated as unclaimed property according to 591.25 federal law and chapter 345. 591.26 Sec. 14. Minnesota Statutes 2000, section 518.6111, 591.27 subdivision 5, is amended to read: 591.28 Subd. 5. [PAYOR OF FUNDS RESPONSIBILITIES.] (a) An order 591.29 for or notice of withholding is binding on a payor of funds upon 591.30 receipt. Withholding must begin no later than the first pay 591.31 period that occurs after 14 days following the date of receipt 591.32 of the order for or notice of withholding. In the case of a 591.33 financial institution, preauthorized transfers must occur in 591.34 accordance with a court-ordered payment schedule. 591.35 (b) A payor of funds shall withhold from the income payable 591.36 to the obligor the amount specified in the order or notice of 592.1 withholding and amounts specified under subdivisions 6 and 9 and 592.2 shall remit the amounts withheld to the public authority within 592.3 seven business days of the date the obligor is paid the 592.4 remainder of the income. The payor of funds shall include with 592.5 the remittance the social security number of the obligor, the 592.6 case type indicator as provided by the public authority and the 592.7 date the obligor is paid the remainder of the income. The 592.8 obligor is considered to have paid the amount withheld as of the 592.9 date the obligor received the remainder of the income. A payor 592.10 of funds may combine all amounts withheld from one pay period 592.11 into one payment to each public authority, but shall separately 592.12 identify each obligor making payment. 592.13 (c) A payor of funds shall not discharge, or refuse to 592.14 hire, or otherwise discipline an employee as a result of wage or 592.15 salary withholding authorized by this section. A payor of funds 592.16 shall be liable to the obligee for any amounts required to be 592.17 withheld. A payor of funds that fails to withhold or transfer 592.18 funds in accordance with this section is also liable to the 592.19 obligee for interest on the funds at the rate applicable to 592.20 judgments under section 549.09, computed from the date the funds 592.21 were required to be withheld or transferred. A payor of funds 592.22 is liable for reasonable attorney fees of the obligee or public 592.23 authority incurred in enforcing the liability under this 592.24 paragraph. A payor of funds that has failed to comply with the 592.25 requirements of this section is subject to contempt sanctions 592.26 under section 518.615. If the payor of funds is an employer or 592.27 independent contractor and violates this subdivision, a court 592.28 may award the obligor twice the wages lost as a result of this 592.29 violation. If a court finds a payor of funds violated this 592.30 subdivision, the court shall impose a civil fine of not less 592.31 than $500. The liabilities in this paragraph apply to 592.32 intentional noncompliance with this section. 592.33 (d) If a single employee is subject to multiple withholding 592.34 orders or multiple notices of withholding for the support of 592.35 more than one child, the payor of funds shall comply with all of 592.36 the orders or notices to the extent that the total amount 593.1 withheld from the obligor's income does not exceed the limits 593.2 imposed under the Consumer Credit Protection Act, United States 593.3 Code, title 15, section 1673(b), giving priority to amounts 593.4 designated in each order or notice as current support as follows: 593.5 (1) if the total of the amounts designated in the orders 593.6 for or notices of withholding as current support exceeds the 593.7 amount available for income withholding, the payor of funds 593.8 shall allocate to each order or notice an amount for current 593.9 support equal to the amount designated in that order or notice 593.10 as current support, divided by the total of the amounts 593.11 designated in the orders or notices as current support, 593.12 multiplied by the amount of the income available for income 593.13 withholding; and 593.14 (2) if the total of the amounts designated in the orders 593.15 for or notices of withholding as current support does not exceed 593.16 the amount available for income withholding, the payor of funds 593.17 shall pay the amounts designated as current support, and shall 593.18 allocate to each order or notice an amount for past due support, 593.19 equal to the amount designated in that order or notice as past 593.20 due support, divided by the total of the amounts designated in 593.21 the orders or notices as past due support, multiplied by the 593.22 amount of income remaining available for income withholding 593.23 after the payment of current support. 593.24 (e) When an order for or notice of withholding is in effect 593.25 and the obligor's employment is terminated, the obligor and the 593.26 payor of funds shall notify the public authority of the 593.27 termination within ten days of the termination date. The 593.28 termination notice shall include the obligor's home address and 593.29 the name and address of the obligor's new payor of funds, if 593.30 known. 593.31 (f) A payor of funds may deduct one dollar from the 593.32 obligor's remaining salary for each payment made pursuant to an 593.33 order for or notice of withholding under this section to cover 593.34 the expenses of withholding. 593.35 Sec. 15. Minnesota Statutes 2000, section 518.6195, is 593.36 amended to read: 594.1 518.6195 [COLLECTION; ARREARS ONLY.] 594.2 (a) Remedies available for the collection and enforcement 594.3 of support in this chapter and chapters 256, 257, and 518C also 594.4 apply to cases in which the child or children for whom support 594.5 is owed are emancipated and the obligor owes past support or has 594.6 an accumulated arrearage as of the date of the youngest child's 594.7 emancipation. Child support arrearages under this section 594.8 include arrearages for child support, medical support, child 594.9 care, pregnancy and birth expenses, and unreimbursed medical 594.10 expenses as defined in section 518.171. 594.11 (b) This section applies retroactively to any support 594.12 arrearage that accrued on or before the date of enactment and to 594.13 all arrearages accruing after the date of enactment. 594.14 (c) Past support or pregnancy and confinement expenses 594.15 ordered for which the obligor has specific court ordered terms 594.16 for repayment may not be enforced using drivers' and 594.17 occupational or professional license suspension, credit bureau 594.18 reporting, and additional income withholding under section 594.19 518.6111, subdivision 10, paragraph (a), unless the obligor 594.20 fails to comply with the terms of the court order for repayment. 594.21 (d) If an arrearage exists at the time a support order 594.22 would otherwise terminate and section 518.6111, subdivision 10, 594.23 paragraph (c), does not apply to this section, the arrearage 594.24 shall be repaid in an amount equal to the current support order 594.25 plus an additional 20 percent of the monthly child support 594.26 obligation until all arrears have been paid in full, absent a 594.27 court order to the contrary. 594.28 (e) If an arrearage exists according to a support order 594.29 which fails to establish a monthly support obligation in a 594.30 specific dollar amount, the public authority, if it provides 594.31 child support services, or the obligee, may establish a payment 594.32 agreement which shall equal what the obligor would pay for 594.33 current support after application of section 518.551, plus an 594.34 additional 20 percent of the current support obligation, until 594.35 all arrears have been paid in full. If the obligor fails to 594.36 enter into or comply with a payment agreement, the public 595.1 authority, if it provides child support services, or the 595.2 obligee, may move the district court or child support 595.3 magistrate, if section 484.702 applies, for an order 595.4 establishing repayment terms. It shall be presumed that the 595.5 obligor is able to repay arrears at a rate which at a minimum 595.6 equals a current monthly obligation after application of section 595.7 518.551, plus an additional 20 percent of the current monthly 595.8 obligation. 595.9 Sec. 16. Minnesota Statutes 2000, section 518.64, 595.10 subdivision 2, is amended to read: 595.11 Subd. 2. [MODIFICATION.] (a) The terms of an order 595.12 respecting maintenance or support may be modified upon a showing 595.13 of one or more of the following: (1) substantially increased or 595.14 decreased earnings of a party; (2) substantially increased or 595.15 decreased need of a party or the child or children that are the 595.16 subject of these proceedings; (3) receipt of assistance under 595.17 the AFDC program formerly codified under sections 256.72 to 595.18 256.87 or 256B.01 to 256B.40, or chapter 256J or 256K; (4) a 595.19 change in the cost of living for either party as measured by the 595.20 federal bureau of statistics, any of which makes the terms 595.21 unreasonable and unfair; (5) extraordinary medical expenses of 595.22 the child not provided for under section 518.171; or (6) the 595.23 addition of work-related or education-related child care 595.24 expenses of the obligee or a substantial increase or decrease in 595.25 existing work-related or education-related child care expenses. 595.26 On a motion to modify support, the needs of any child the 595.27 obligor has after the entry of the support order that is the 595.28 subject of a modification motion shall be considered as provided 595.29 by section 518.551, subdivision 5f. 595.30 (b) It is presumed that there has been a substantial change 595.31 in circumstances under paragraph (a) and the terms of a current 595.32 support order shall be rebuttably presumed to be unreasonable 595.33 and unfair if: 595.34 (1) the application of the child support guidelines in 595.35 section 518.551, subdivision 5, to the current circumstances of 595.36 the parties results in a calculated court order that is at least 596.1 20 percent and at least $50 per month higher or lower than the 596.2 current support order; 596.3 (2) the medical support provisions of the order established 596.4 under section 518.171 are not enforceable by the public 596.5 authority or the custodial parent; 596.6 (3) health coverage ordered under section 518.171 is not 596.7 available to the child for whom the order is established by the 596.8 parent ordered to provide; or 596.9 (4) the existing support obligation is in the form of a 596.10 statement of percentage and not a specific dollar amount. 596.11 (c) On a motion for modification of maintenance, including 596.12 a motion for the extension of the duration of a maintenance 596.13 award, the court shall apply, in addition to all other relevant 596.14 factors, the factors for an award of maintenance under section 596.15 518.552 that exist at the time of the motion. On a motion for 596.16 modification of support, the court: 596.17 (1) shall apply section 518.551, subdivision 5, and shall 596.18 not consider the financial circumstances of each party's spouse, 596.19 if any; and 596.20 (2) shall not consider compensation received by a party for 596.21 employment in excess of a 40-hour work week, provided that the 596.22 party demonstrates, and the court finds, that: 596.23 (i) the excess employment began after entry of the existing 596.24 support order; 596.25 (ii) the excess employment is voluntary and not a condition 596.26 of employment; 596.27 (iii) the excess employment is in the nature of additional, 596.28 part-time employment, or overtime employment compensable by the 596.29 hour or fractions of an hour; 596.30 (iv) the party's compensation structure has not been 596.31 changed for the purpose of affecting a support or maintenance 596.32 obligation; 596.33 (v) in the case of an obligor, current child support 596.34 payments are at least equal to the guidelines amount based on 596.35 income not excluded under this clause; and 596.36 (vi) in the case of an obligor who is in arrears in child 597.1 support payments to the obligee, any net income from excess 597.2 employment must be used to pay the arrearages until the 597.3 arrearages are paid in full. 597.4 (d) A modification of support or maintenance, including 597.5 interest that accrued pursuant to section 548.091, may be made 597.6 retroactive only with respect to any period during which the 597.7 petitioning party has pending a motion for modification but only 597.8 from the date of service of notice of the motion on the 597.9 responding party and on the public authority if public 597.10 assistance is being furnished or the county attorney is the 597.11 attorney of record. However, modification may be applied to an 597.12 earlier period if the court makes express findings that: 597.13 (1) the party seeking modification was precluded from 597.14 serving a motion by reason of a significant physical or mental 597.15 disability, a material misrepresentation of another party, or 597.16 fraud upon the court and that the party seeking modification, 597.17 when no longer precluded, promptly served a motion; 597.18 (2) the party seeking modification was a recipient of 597.19 federal Supplemental Security Income (SSI), Title II Older 597.20 Americans, Survivor's Disability Insurance (OASDI), other 597.21 disability benefits, or public assistance based upon need during 597.22 the period for which retroactive modification is sought;or597.23 (3) the order for which the party seeks amendment was 597.24 entered by default, the party shows good cause for not 597.25 appearing, and the record contains no factual evidence, or 597.26 clearly erroneous evidence regarding the individual obligor's 597.27 ability to pay.; or 597.28 (4) the party seeking modification was institutionalized or 597.29 incarcerated for an offense other than nonsupport of a child 597.30 during the period for which retroactive modification is sought 597.31 and lacked the financial ability to pay the support ordered 597.32 during that time period. In determining whether to allow the 597.33 retroactive modification, the court shall consider whether and 597.34 when a request was made to the public authority for support 597.35 modification. 597.36 The court may provide that a reduction in the amount allocated 598.1 for child care expenses based on a substantial decrease in the 598.2 expenses is effective as of the date the expenses decreased. 598.3 (e) Except for an award of the right of occupancy of the 598.4 homestead, provided in section 518.63, all divisions of real and 598.5 personal property provided by section 518.58 shall be final, and 598.6 may be revoked or modified only where the court finds the 598.7 existence of conditions that justify reopening a judgment under 598.8 the laws of this state, including motions under section 518.145, 598.9 subdivision 2. The court may impose a lien or charge on the 598.10 divided property at any time while the property, or subsequently 598.11 acquired property, is owned by the parties or either of them, 598.12 for the payment of maintenance or support money, or may 598.13 sequester the property as is provided by section 518.24. 598.14 (f) The court need not hold an evidentiary hearing on a 598.15 motion for modification of maintenance or support. 598.16 (g) Section 518.14 shall govern the award of attorney fees 598.17 for motions brought under this subdivision. 598.18 Sec. 17. Minnesota Statutes 2000, section 518.641, 598.19 subdivision 1, is amended to read: 598.20 Subdivision 1. [REQUIREMENT.] (a) An orderfor598.21 establishing, modifying, or enforcing maintenance or child 598.22 support shall provide for a biennial adjustment in the amount to 598.23 be paid based on a change in the cost of living. An order that 598.24 provides for a cost-of-living adjustment shall specify the 598.25 cost-of-living index to be applied and the date on which the 598.26 cost-of-living adjustment shall become effective. The court may 598.27 use the consumer price index for all urban consumers, 598.28 Minneapolis-St. Paul (CPI-U), the consumer price index for wage 598.29 earners and clerical, Minneapolis-St. Paul (CPI-W), or another 598.30 cost-of-living index published by the department of labor which 598.31 it specifically finds is more appropriate. Cost-of-living 598.32 increases under this section shall be compounded. The court may 598.33 also increase the amount by more than the cost-of-living 598.34 adjustment by agreement of the parties or by making further 598.35 findings. 598.36 (b) The adjustment becomes effective on the first of May of 599.1 the year in which it is made, for cases in which payment is made 599.2 to the public authority. For cases in which payment is not made 599.3 to the public authority, application for an adjustment may be 599.4 made in any month but no application for an adjustment may be 599.5 made sooner than two years after the date of the dissolution 599.6 decree. A court may waive the requirement of the cost-of-living 599.7 clause if it expressly finds that the obligor's occupation or 599.8 income, or both, does not provide for cost-of-living adjustment 599.9 or that the order for maintenance or child support has a 599.10 provision such as a step increase that has the effect of a 599.11 cost-of-living clause. The court may waive a cost-of-living 599.12 adjustment in a maintenance order if the parties so agree in 599.13 writing. The commissioner of human services may promulgate 599.14 rules for child support adjustments under this section in 599.15 accordance with the rulemaking provisions of chapter 14. Notice 599.16 of this statute must comply with section 518.68, subdivision 2. 599.17 Sec. 18. Minnesota Statutes 2000, section 518.641, 599.18 subdivision 2, is amended to read: 599.19 Subd. 2. [CONDITIONSNOTICE.] No adjustment under this 599.20 section may be made unless the order provides for it anduntil599.21the following conditions are met:599.22(a) the obligee serves notice of the application for599.23adjustment by mail on the obligor at the obligor's last known599.24address at least 20 days before the effective date of the599.25adjustment;599.26(b) the notice to the obligor informs the obligor of the599.27date on which the adjustment in payments will become effective;599.28(c) after receipt of notice and before the effective day of599.29the adjustment, the obligor fails to request a hearing on the599.30issue of whether the adjustment should take effect, and ex599.31parte, to stay imposition of the adjustment pending outcome of599.32the hearing; or599.33(d) the public authoritythe public authority or the 599.34 obligee, if the obligee is requesting the cost-of-living 599.35 adjustment, sends notice ofits application forthe intended 599.36 adjustment to the obligor at the obligor's last known address at 600.1 least 20 days before the effective date of the adjustment, and. 600.2 The noticeinformsshall inform the obligor of the date on which 600.3 the adjustment will become effective and the procedures for 600.4 contesting the adjustmentaccording to section 484.702. 600.5 Sec. 19. Minnesota Statutes 2000, section 518.641, is 600.6 amended by adding a subdivision to read: 600.7 Subd. 2a. [PROCEDURES FOR CONTESTING ADJUSTMENT.] (a) To 600.8 contest cost-of-living adjustments initiated by the public 600.9 authority or an obligee who has applied for or is receiving 600.10 child support and maintenance collection services from the 600.11 public authority, other than income withholding only services, 600.12 the obligor, before the effective date of the adjustment, must: 600.13 (1) file a motion contesting the cost-of-living adjustment 600.14 with the court administrator; and 600.15 (2) serve the motion by first-class mail on the public 600.16 authority and the obligee. 600.17 The hearing shall take place in the expedited child support 600.18 process as governed by section 484.702. 600.19 (b) To contest cost-of-living adjustments initiated by an 600.20 obligee who is not receiving child support and maintenance 600.21 collection services from the public authority, or for an obligee 600.22 who receives income withholding only services from the public 600.23 authority, the obligor must, before the effective date of the 600.24 adjustment: 600.25 (1) file a motion contesting the cost-of-living adjustment 600.26 with the court administrator; and 600.27 (2) serve the motion by first-class mail on the obligee. 600.28 The hearing shall take place in district court. 600.29 (c) Upon receipt of a motion contesting the cost-of-living 600.30 adjustment, the cost-of-living adjustment shall be stayed 600.31 pending further order of the court. 600.32 (d) The court administrator shall make available pro se 600.33 motion forms for contesting a cost-of-living adjustment under 600.34 this subdivision. 600.35 Sec. 20. Minnesota Statutes 2000, section 518.641, 600.36 subdivision 3, is amended to read: 601.1 Subd. 3. [RESULT OF HEARING.] If, at a hearing pursuant to 601.2 this section, the obligor establishes an insufficient cost of 601.3 living or other increase in income that prevents fulfillment of 601.4 the adjusted maintenance or child support obligation, the 601.5 court or child support magistrate may direct that all or part of 601.6 the adjustment not take effect. If, at the hearing, the obligor 601.7 does not establish this insufficient increase in income, the 601.8 adjustment shall take effect as of the date it would have become 601.9 effective had no hearing been requested. 601.10 Sec. 21. Minnesota Statutes 2000, section 548.091, 601.11 subdivision 1a, is amended to read: 601.12 Subd. 1a. [CHILD SUPPORT JUDGMENT BY OPERATION OF LAW.] 601.13 (a) Any payment or installment of support required by a judgment 601.14 or decree of dissolution or legal separation, determination of 601.15 parentage, an order under chapter 518C, an order under section 601.16 256.87, or an order under section 260B.331 or 260C.331, that is 601.17 not paid or withheld from the obligor's income as required under 601.18 section 518.6111, or which is ordered as child support by 601.19 judgment, decree, or order by a court in any other state, is a 601.20 judgment by operation of law on and after the date it is due, is 601.21 entitled to full faith and credit in this state and any other 601.22 state, and shall be entered and docketed by the court 601.23 administrator on the filing of affidavits as provided in 601.24 subdivision 2a. Except as otherwise provided by paragraph (b), 601.25 interest accrues from the date the unpaid amount due is greater 601.26 than the current support due at the annual rate provided in 601.27 section 549.09, subdivision 1, plus two percent, not to exceed 601.28 an annual rate of 18 percent. A payment or installment of 601.29 support that becomes a judgment by operation of law between the 601.30 date on which a party served notice of a motion for modification 601.31 under section 518.64, subdivision 2, and the date of the court's 601.32 order on modification may be modified under that subdivision. 601.33 (b) Notwithstanding the provisions of section 549.09, upon 601.34 motion to the court and upon proof by the obligor of 36 601.35 consecutive months of complete and timely payments of both 601.36 current support and court-ordered paybacks of a child support 602.1 debt or arrearage, the court may order interest on the remaining 602.2 debt or arrearage to stop accruing. Timely payments are those 602.3 made in the month in which they are due. If, after that time, 602.4 the obligor fails to make complete and timely payments of both 602.5 current support and court-ordered paybacks of child support debt 602.6 or arrearage, the public authority or the obligee may move the 602.7 court for the reinstatement of interest as of the month in which 602.8 the obligor ceased making complete and timely payments. 602.9 The court shall provide copies of all orders issued under 602.10 this section to the public authority. The commissioner of human 602.11 services shall prepare and make available to the court and the 602.12 parties forms to be submitted by the parties in support of a 602.13 motion under this paragraph. 602.14 (c) Notwithstanding the provisions of section 549.09, upon 602.15 motion to the court, the court may order interest on a child 602.16 support debt to stop accruing where the court finds that the 602.17 obligor is: 602.18 (1) unable to pay support because of a significant physical 602.19 or mental disability;or602.20 (2) a recipient of Supplemental Security Income (SSI), 602.21 Title II Older Americans Survivor's Disability Insurance 602.22 (OASDI), other disability benefits, or public assistance based 602.23 upon need; or 602.24 (3) institutionalized or incarcerated for at least 30 days 602.25 for an offense other than nonsupport of the child or children 602.26 involved, and is otherwise financially unable to pay support. 602.27 Sec. 22. [REPEALER.] 602.28 Minnesota Statutes 2000, section 518.641, subdivisions 4 602.29 and 5, are repealed. 602.30 ARTICLE 14 602.31 DEPARTMENT OF HUMAN SERVICES LICENSING 602.32 Section 1. Minnesota Statutes 2000, section 13.46, 602.33 subdivision 4, is amended to read: 602.34 Subd. 4. [LICENSING DATA.] (a) As used in this subdivision: 602.35 (1) "licensing data" means all data collected, maintained, 602.36 used, or disseminated by the welfare system pertaining to 603.1 persons licensed or registered or who apply for licensure or 603.2 registration or who formerly were licensed or registered under 603.3 the authority of the commissioner of human services; 603.4 (2) "client" means a person who is receiving services from 603.5 a licensee or from an applicant for licensure; and 603.6 (3) "personal and personal financial data" means social 603.7 security numbers, identity of and letters of reference, 603.8 insurance information, reports from the bureau of criminal 603.9 apprehension, health examination reports, and social/home 603.10 studies. 603.11 (b)(1) Except as provided in paragraph (c), the following 603.12 data on current and former licensees are public: name, address, 603.13 telephone number of licensees, licensed capacity, type of client 603.14 preferred, variances granted, type of dwelling, name and 603.15 relationship of other family members, previous license history, 603.16 class of license, and the existence and status of complaints. 603.17 When disciplinary action has been taken against a licensee or 603.18 the complaint is resolved, the following data are public: the 603.19 substance of the complaint, the findings of the investigation of 603.20 the complaint, the record of informal resolution of a licensing 603.21 violation, orders of hearing, findings of fact, conclusions of 603.22 law, and specifications of the final disciplinary action 603.23 contained in the record of disciplinary action. 603.24 (2) The following data on persons subject to 603.25 disqualification under section 245A.04 in connection with a 603.26 license to provide family day care for children, child care 603.27 center services, foster care for children in the provider's 603.28 home, or foster care or day care services for adults in the 603.29 provider's home, are public: the nature of any disqualification 603.30 set aside under section 245A.04, subdivision 3b, and the reasons 603.31 for setting aside the disqualification; and the reasons for 603.32 granting any variance under section 245A.04, subdivision 9. 603.33 (3) When maltreatment is substantiated under section 603.34 626.556 or 626.557 and the victim and the substantiated 603.35 perpetrator are affiliated with a program licensed under chapter 603.36 245A, the commissioner of human services, local social services 604.1 agency, or county welfare agency may inform the license holder 604.2 where the maltreatment occurred of the identity of the 604.3 substantiated perpetrator and the victim. 604.4 (c) The following are private data on individuals under 604.5 section 13.02, subdivision 12, or nonpublic data under section 604.6 13.02, subdivision 9: personal and personal financial data on 604.7 family day care program and family foster care program 604.8 applicants and licensees and their family members who provide 604.9 services under the license. 604.10 (d) The following are private data on individuals: the 604.11 identity of persons who have made reports concerning licensees 604.12 or applicants that appear in inactive investigative data, and 604.13 the records of clients or employees of the licensee or applicant 604.14 for licensure whose records are received by the licensing agency 604.15 for purposes of review or in anticipation of a contested 604.16 matter. The names of reporters under sections 626.556 and 604.17 626.557 may be disclosed only as provided in section 626.556, 604.18 subdivision 11, or 626.557, subdivision 12b. 604.19 (e) Data classified as private, confidential, nonpublic, or 604.20 protected nonpublic under this subdivision become public data if 604.21 submitted to a court or administrative law judge as part of a 604.22 disciplinary proceeding in which there is a public hearing 604.23 concerning the disciplinary action. 604.24 (f) Data generated in the course of licensing 604.25 investigations that relate to an alleged violation of law are 604.26 investigative data under subdivision 3. 604.27 (g) Data that are not public data collected, maintained, 604.28 used, or disseminated under this subdivision that relate to or 604.29 are derived from a report as defined in section 626.556, 604.30 subdivision 2, are subject to the destruction provisions of 604.31 section 626.556, subdivision 11. 604.32 (h) Upon request, not public data collected, maintained, 604.33 used, or disseminated under this subdivision that relate to or 604.34 are derived from a report of substantiated maltreatment as 604.35 defined in section 626.556 or 626.557 may be exchanged with the 604.36 department of health for purposes of completing background 605.1 studies pursuant to section 144.057. 605.2 (i) Data on individuals collected according to licensing 605.3 activities under chapter 245A, and data on individuals collected 605.4 by the commissioner of human services according to maltreatment 605.5 investigations under sections 626.556 and 626.557, may be shared 605.6 with the department of human rights, the department of health, 605.7 the department of corrections, the ombudsman for mental health 605.8 and retardation, and the individual's professional regulatory 605.9 board when there is reason to believe that laws or standards 605.10 under the jurisdiction of those agencies may have been violated. 605.11 (j) In addition to the notice of determinations required 605.12 under section 626.556, subdivision 10f, if the commissioner or 605.13 the local social services agency has determined that an 605.14 individual is a substantiated perpetrator of maltreatment of a 605.15 child based on sexual abuse, as defined in section 626.556, 605.16 subdivision 2, and the commissioner or local social services 605.17 agency knows that the individual is a person responsible for a 605.18 child's care in another facility, the commissioner or local 605.19 social services agency shall notify the head of that facility of 605.20 this determination. The notification must include an 605.21 explanation of the individual's available appeal rights and the 605.22 status of any appeal. If a notice is given under this 605.23 paragraph, the government entity making the notification shall 605.24 provide a copy of the notice to the individual who is the 605.25 subject of the notice. 605.26 Sec. 2. Minnesota Statutes 2000, section 144.057, 605.27 subdivision 3, is amended to read: 605.28 Subd. 3. [RECONSIDERATIONS.] The commissioner of health 605.29 shall review and decide reconsideration requests, including the 605.30 granting of variances, in accordance with the procedures and 605.31 criteria contained in chapter 245A and Minnesota Rules, parts 605.32 9543.3000 to 9543.3090. The commissioner's decision shall be 605.33 provided to the individual and to the department of human 605.34 services. Except as provided under section 245A.04, 605.35 subdivisions 3b, paragraphs (e) and (f); and 3c, paragraph (a), 605.36 the commissioner's decision to grant or deny a reconsideration 606.1 of disqualification is the final administrative agency action. 606.2 Sec. 3. Minnesota Statutes 2000, section 214.104, is 606.3 amended to read: 606.4 214.104 [HEALTH-RELATED LICENSING BOARDS; DETERMINATIONS 606.5 REGARDINGDISQUALIFICATIONS FORMALTREATMENT.] 606.6 (a) A health-related licensing board shall make 606.7 determinations as to whetherlicenseesregulated persons who are 606.8 under the board's jurisdiction should bedisqualified under606.9section 245A.04, subdivision 3d, from positions allowing direct606.10contact with persons receiving servicesthe subject of 606.11 disciplinary or corrective action because of substantiated 606.12 maltreatment under section 626.556 or 626.557.A determination606.13under this section may be done as part of an investigation under606.14section 214.103.The board shall make a determinationwithin 90606.15days ofupon receipt, and after the review, of an investigation 606.16 memorandum or other notice of substantiated maltreatment under 606.17 section 626.556 or 626.557, or of a notice from the commissioner 606.18 of human services that a background study of alicensee606.19 regulated person shows substantiated maltreatment.The board606.20shall also make a determination under this section upon606.21consideration of the licensure of an individual who was subject606.22to disqualification before licensure because of substantiated606.23maltreatment.606.24(b) In making a determination under this section, the board606.25shall consider the nature and extent of any injury or harm606.26resulting from the conduct that would constitute grounds for606.27disqualification, the seriousness of the misconduct, the extent606.28that disqualification is necessary to protect persons receiving606.29services or the public, and other factors specified in section606.30245A.04, subdivision 3b, paragraph (b).606.31(c) The board shall determine the duration and extent of606.32the disqualification or may establish conditions under which the606.33licensee may hold a position allowing direct contact with606.34persons receiving services or in a licensed facility.606.35 (b) Upon completion of its review of a report of 606.36 substantiated maltreatment, the board shall notify the 607.1 commissioner of human servicesand the lead agency that607.2conducted an investigation under section 626.556 or 626.557, as607.3applicable,of its determination. The board shall notify the 607.4 commissioner of human services if, following a review of the 607.5 report of substantiated maltreatment, the board determines that 607.6 it does not have jurisdiction in the matter and the commissioner 607.7 shall make the appropriate disqualification decision regarding 607.8 the regulated person as otherwise provided in chapter 245A. The 607.9 board shall also notify the commissioner of health or the 607.10 commissioner of human services immediately upon receipt of 607.11 knowledge of a facility or program allowing a regulated person 607.12 to provide direct contact services at the facility or program 607.13 while not complying with requirements placed on the regulated 607.14 person. 607.15 (c) In addition to any other remedy provided by law, the 607.16 board may, through its designated board member, temporarily 607.17 suspend the license of a licensee; deny a credential to an 607.18 applicant; or require the regulated person to be continuously 607.19 supervised, if the board finds there is probable cause to 607.20 believe the regulated person referred to the board according to 607.21 paragraph (a) poses an immediate risk of harm to vulnerable 607.22 persons. The board shall consider all relevant information 607.23 available, which may include but is not limited to: 607.24 (1) the extent the action is needed to protect persons 607.25 receiving services or the public; 607.26 (2) the recency of the maltreatment; 607.27 (3) the number of incidents of maltreatment; 607.28 (4) the intrusiveness or violence of the maltreatment; and 607.29 (5) the vulnerability of the victim of maltreatment. 607.30 The action shall take effect upon written notice to the 607.31 regulated person, served by certified mail, specifying the 607.32 statute violated. The board shall notify the commissioner of 607.33 health or the commissioner of human services of the suspension 607.34 or denial of a credential. The action shall remain in effect 607.35 until the board issues a temporary stay or a final order in the 607.36 matter after a hearing or upon agreement between the board and 608.1 the regulated person. At the time the board issues the notice, 608.2 the regulated person shall inform the board of all settings in 608.3 which the regulated person is employed or practices. The board 608.4 shall inform all known employment and practice settings of the 608.5 board action and schedule a disciplinary hearing to be held 608.6 under chapter 14. The board shall provide the regulated person 608.7 with at least 30 days' notice of the hearing, unless the parties 608.8 agree to a hearing date that provides less than 30 days' notice, 608.9 and shall schedule the hearing to begin no later than 90 days 608.10 after issuance of the notice of hearing. 608.11 Sec. 4. Minnesota Statutes 2000, section 245A.03, 608.12 subdivision 2b, is amended to read: 608.13 Subd. 2b. [EXCEPTION.] The provision in subdivision 2, 608.14 clause (2), does not apply to: 608.15 (1) a child care provider who as an applicant for licensure 608.16 or as a license holder has received a license denial under 608.17 section 245A.05, afineconditional license under section 608.18 245A.06, or a sanction under section 245A.07 from the 608.19 commissioner that has not been reversed on appeal; or 608.20 (2) a child care provider, or a child care provider who has 608.21 a household member who, as a result of a licensing process, has 608.22 a disqualification under this chapter that has not been set 608.23 aside by the commissioner. 608.24 Sec. 5. Minnesota Statutes 2000, section 245A.04, 608.25 subdivision 3a, is amended to read: 608.26 Subd. 3a. [NOTIFICATION TO SUBJECT AND LICENSE HOLDER OF 608.27 STUDY RESULTS; DETERMINATION OF RISK OF HARM.] (a) The 608.28 commissioner shall notify the applicant or license holder and 608.29 the individual who is the subject of the study, in writing or by 608.30 electronic transmission, of the results of the study. When the 608.31 study is completed, a notice that the study was undertaken and 608.32 completed shall be maintained in the personnel files of the 608.33 program. For studies on individuals pertaining to a license to 608.34 provide family day care or group family day care, foster care 608.35 for children in the provider's own home, or foster care or day 608.36 care services for adults in the provider's own home, the 609.1 commissioner is not required to provide a separate notice of the 609.2 background study results to the individual who is the subject of 609.3 the study unless the study results in a disqualification of the 609.4 individual. 609.5 The commissioner shall notify the individual studied if the 609.6 information in the study indicates the individual is 609.7 disqualified from direct contact with persons served by the 609.8 program. The commissioner shall disclose the information 609.9 causing disqualification and instructions on how to request a 609.10 reconsideration of the disqualification to the individual 609.11 studied. An applicant or license holder who is not the subject 609.12 of the study shall be informed that the commissioner has found 609.13 information that disqualifies the subject from direct contact 609.14 with persons served by the program. However, only the 609.15 individual studied must be informed of the information contained 609.16 in the subject's background study unless theonlybasis for the 609.17 disqualification is failure to cooperate, substantiated 609.18 maltreatment under section 626.556 or 626.557, the Data 609.19 Practices Act provides for release of the information, or the 609.20 individual studied authorizes the release of the 609.21 information. When a disqualification is based on the subject's 609.22 failure to cooperate with the background study or substantiated 609.23 maltreatment under section 626.556 or 626.557, the agency that 609.24 initiated the study shall be informed by the commissioner of the 609.25 reason for the disqualification. 609.26 (b) Except as provided in subdivision 3d, paragraph (b), if 609.27 the commissioner determines that the individual studied has a 609.28 disqualifying characteristic, the commissioner shall review the 609.29 information immediately available and make a determination as to 609.30 the subject's immediate risk of harm to persons served by the 609.31 program where the individual studied will have direct contact. 609.32 The commissioner shall consider all relevant information 609.33 available, including the following factors in determining the 609.34 immediate risk of harm: the recency of the disqualifying 609.35 characteristic; the recency of discharge from probation for the 609.36 crimes; the number of disqualifying characteristics; the 610.1 intrusiveness or violence of the disqualifying characteristic; 610.2 the vulnerability of the victim involved in the disqualifying 610.3 characteristic; and the similarity of the victim to the persons 610.4 served by the program where the individual studied will have 610.5 direct contact. The commissioner may determine that the 610.6 evaluation of the information immediately available gives the 610.7 commissioner reason to believe one of the following: 610.8 (1) The individual poses an imminent risk of harm to 610.9 persons served by the program where the individual studied will 610.10 have direct contact. If the commissioner determines that an 610.11 individual studied poses an imminent risk of harm to persons 610.12 served by the program where the individual studied will have 610.13 direct contact, the individual and the license holder must be 610.14 sent a notice of disqualification. The commissioner shall order 610.15 the license holder to immediately remove the individual studied 610.16 from direct contact. The notice to the individual studied must 610.17 include an explanation of the basis of this determination. 610.18 (2) The individual poses a risk of harm requiring 610.19 continuous supervision while providing direct contact services 610.20 during the period in which the subject may request a 610.21 reconsideration. If the commissioner determines that an 610.22 individual studied poses a risk of harm that requires continuous 610.23 supervision, the individual and the license holder must be sent 610.24 a notice of disqualification. The commissioner shall order the 610.25 license holder to immediately remove the individual studied from 610.26 direct contact services or assure that the individual studied is 610.27 within sight or hearing of another staff person when providing 610.28 direct contact services during the period in which the 610.29 individual may request a reconsideration of the 610.30 disqualification. If the individual studied does not submit a 610.31 timely request for reconsideration, or the individual submits a 610.32 timely request for reconsideration, but the disqualification is 610.33 not set aside for that license holder, the license holder will 610.34 be notified of the disqualification and ordered to immediately 610.35 remove the individual from any position allowing direct contact 610.36 with persons receiving services from the license holder. 611.1 (3) The individual does not pose an imminent risk of harm 611.2 or a risk of harm requiring continuous supervision while 611.3 providing direct contact services during the period in which the 611.4 subject may request a reconsideration. If the commissioner 611.5 determines that an individual studied does not pose a risk of 611.6 harm that requires continuous supervision, only the individual 611.7 must be sent a notice of disqualification. The license holder 611.8 must be sent a notice that more time is needed to complete the 611.9 individual's background study. If the individual studied 611.10 submits a timely request for reconsideration, and if the 611.11 disqualification is set aside for that license holder, the 611.12 license holder will receive the same notification received by 611.13 license holders in cases where the individual studied has no 611.14 disqualifying characteristic. If the individual studied does 611.15 not submit a timely request for reconsideration, or the 611.16 individual submits a timely request for reconsideration, but the 611.17 disqualification is not set aside for that license holder, the 611.18 license holder will be notified of the disqualification and 611.19 ordered to immediately remove the individual from any position 611.20 allowing direct contact with persons receiving services from the 611.21 license holder. 611.22 (c) County licensing agencies performing duties under this 611.23 subdivision may develop an alternative system for determining 611.24 the subject's immediate risk of harm to persons served by the 611.25 program, providing the notices under paragraph (b), and 611.26 documenting the action taken by the county licensing agency. 611.27 Each county licensing agency's implementation of the alternative 611.28 system is subject to approval by the commissioner. 611.29 Notwithstanding this alternative system, county licensing 611.30 agencies shall complete the requirements of paragraph (a). 611.31 Sec. 6. Minnesota Statutes 2000, section 245A.04, 611.32 subdivision 3b, is amended to read: 611.33 Subd. 3b. [RECONSIDERATION OF DISQUALIFICATION.] (a) The 611.34 individual who is the subject of the disqualification may 611.35 request a reconsideration of the disqualification. 611.36 The individual must submit the request for reconsideration 612.1 to the commissioner in writing. A request for reconsideration 612.2 for an individual who has been sent a notice of disqualification 612.3 under subdivision 3a, paragraph (b), clause (1) or (2), must be 612.4 submitted within 30 calendar days of the disqualified 612.5 individual's receipt of the notice of disqualification. A 612.6 request for reconsideration for an individual who has been sent 612.7 a notice of disqualification under subdivision 3a, paragraph 612.8 (b), clause (3), must be submitted within 15 calendar days of 612.9 the disqualified individual's receipt of the notice of 612.10 disqualification. An individual who was determined to have 612.11 maltreated a child under section 626.556 or a vulnerable adult 612.12 under section 626.557, and who was disqualified under this 612.13 section on the basis of serious or recurring maltreatment, may 612.14 request reconsideration of both the maltreatment and the 612.15 disqualification determinations. The request for 612.16 reconsideration of the maltreatment determination and the 612.17 disqualification must be submitted within 30 calendar days of 612.18 the individual's receipt of the notice of disqualification. 612.19 Removal of a disqualified individual from direct contact shall 612.20 be ordered if the individual does not request reconsideration 612.21 within the prescribed time, and for an individual who submits a 612.22 timely request for reconsideration, if the disqualification is 612.23 not set aside. The individual must present information showing 612.24 that: 612.25 (1) the information the commissioner relied upon is 612.26 incorrect or inaccurate. If the basis of a reconsideration 612.27 request is that a maltreatment determination or disposition 612.28 under section 626.556 or 626.557 is incorrect, and the 612.29 commissioner has issued a final order in an appeal of that 612.30 determination or disposition under section 256.045 or 245A.08, 612.31 subdivision 5, the commissioner's order is conclusive on the 612.32 issue of maltreatment. If the individual did not request 612.33 reconsideration of the maltreatment determination, the 612.34 maltreatment determination is deemed conclusive; or 612.35 (2) the subject of the study does not pose a risk of harm 612.36 to any person served by the applicant or license holder. 613.1 (b) The commissioner shall rescind the disqualification if 613.2 the commissioner finds that the information relied on to 613.3 disqualify the subject is incorrect. The commissioner may set 613.4 aside the disqualification under this section if the 613.5 commissioner finds that theinformation the commissioner relied613.6upon is incorrect or theindividual does not pose a risk of harm 613.7 to any person served by the applicant or license holder. In 613.8 determining that an individual does not pose a risk of harm, the 613.9 commissioner shall consider the consequences of the event or 613.10 events that lead to disqualification, whether there is more than 613.11 one disqualifying event, the vulnerability of the victim at the 613.12 time of the event, the time elapsed without a repeat of the same 613.13 or similar event, documentation of successful completion by the 613.14 individual studied of training or rehabilitation pertinent to 613.15 the event, and any other information relevant to 613.16 reconsideration. In reviewing a disqualification under this 613.17 section, the commissioner shall give preeminent weight to the 613.18 safety of each person to be served by the license holder or 613.19 applicant over the interests of the license holder or applicant. 613.20 (c) Unless the information the commissioner relied on in 613.21 disqualifying an individual is incorrect, the commissioner may 613.22 not set aside the disqualification of an individual in 613.23 connection with a license to provide family day care for 613.24 children, foster care for children in the provider's own home, 613.25 or foster care or day care services for adults in the provider's 613.26 own home if: 613.27 (1) less than ten years have passed since the discharge of 613.28 the sentence imposed for the offense; and the individual has 613.29 been convicted of a violation of any offense listed in sections 613.30 609.20 (manslaughter in the first degree), 609.205 (manslaughter 613.31 in the second degree), criminal vehicular homicide under 609.21 613.32 (criminal vehicular homicide and injury), 609.215 (aiding 613.33 suicide or aiding attempted suicide), felony violations under 613.34 609.221 to 609.2231 (assault in the first, second, third, or 613.35 fourth degree), 609.713 (terroristic threats), 609.235 (use of 613.36 drugs to injure or to facilitate crime), 609.24 (simple 614.1 robbery), 609.245 (aggravated robbery), 609.25 (kidnapping), 614.2 609.255 (false imprisonment), 609.561 or 609.562 (arson in the 614.3 first or second degree), 609.71 (riot), burglary in the first or 614.4 second degree under 609.582 (burglary), 609.66 (dangerous 614.5 weapon), 609.665 (spring guns), 609.67 (machine guns and 614.6 short-barreled shotguns), 609.749 (harassment; stalking), 614.7 152.021 or 152.022 (controlled substance crime in the first or 614.8 second degree), 152.023, subdivision 1, clause (3) or (4), or 614.9 subdivision 2, clause (4) (controlled substance crime in the 614.10 third degree), 152.024, subdivision 1, clause (2), (3), or (4) 614.11 (controlled substance crime in the fourth degree), 609.224, 614.12 subdivision 2, paragraph (c) (fifth-degree assault by a 614.13 caregiver against a vulnerable adult), 609.228 (great bodily 614.14 harm caused by distribution of drugs), 609.23 (mistreatment of 614.15 persons confined), 609.231 (mistreatment of residents or 614.16 patients), 609.2325 (criminal abuse of a vulnerable adult), 614.17 609.233 (criminal neglect of a vulnerable adult), 609.2335 614.18 (financial exploitation of a vulnerable adult), 609.234 (failure 614.19 to report), 609.265 (abduction), 609.2664 to 609.2665 614.20 (manslaughter of an unborn child in the first or second degree), 614.21 609.267 to 609.2672 (assault of an unborn child in the first, 614.22 second, or third degree), 609.268 (injury or death of an unborn 614.23 child in the commission of a crime), 617.293 (disseminating or 614.24 displaying harmful material to minors), a gross misdemeanor 614.25 offense under 609.324, subdivision 1 (other prohibited acts), a 614.26 gross misdemeanor offense under 609.378 (neglect or endangerment 614.27 of a child), a gross misdemeanor offense under 609.377 614.28 (malicious punishment of a child), 609.72, subdivision 3 614.29 (disorderly conduct against a vulnerable adult); or an attempt 614.30 or conspiracy to commit any of these offenses, as each of these 614.31 offenses is defined in Minnesota Statutes; or an offense in any 614.32 other state, the elements of which are substantially similar to 614.33 the elements of any of the foregoing offenses; 614.34 (2) regardless of how much time has passed since the 614.35 discharge of the sentence imposed for the offense, the 614.36 individual was convicted of a violation of any offense listed in 615.1 sections 609.185 to 609.195 (murder in the first, second, or 615.2 third degree), 609.2661 to 609.2663 (murder of an unborn child 615.3 in the first, second, or third degree), a felony offense under 615.4 609.377 (malicious punishment of a child), a felony offense 615.5 under 609.324, subdivision 1 (other prohibited acts), a felony 615.6 offense under 609.378 (neglect or endangerment of a child), 615.7 609.322 (solicitation, inducement, and promotion of 615.8 prostitution), 609.342 to 609.345 (criminal sexual conduct in 615.9 the first, second, third, or fourth degree), 609.352 615.10 (solicitation of children to engage in sexual conduct), 617.246 615.11 (use of minors in a sexual performance), 617.247 (possession of 615.12 pictorial representations of a minor), 609.365 (incest), a 615.13 felony offense under sections 609.2242 and 609.2243 (domestic 615.14 assault), a felony offense of spousal abuse, a felony offense of 615.15 child abuse or neglect, a felony offense of a crime against 615.16 children, or an attempt or conspiracy to commit any of these 615.17 offenses as defined in Minnesota Statutes, or an offense in any 615.18 other state, the elements of which are substantially similar to 615.19 any of the foregoing offenses; 615.20 (3) within the seven years preceding the study, the 615.21 individual committed an act that constitutes maltreatment of a 615.22 child under section 626.556, subdivision 10e, and that resulted 615.23 in substantial bodily harm as defined in section 609.02, 615.24 subdivision 7a, or substantial mental or emotional harm as 615.25 supported by competent psychological or psychiatric evidence; or 615.26 (4) within the seven years preceding the study, the 615.27 individual was determined under section 626.557 to be the 615.28 perpetrator of a substantiated incident of maltreatment of a 615.29 vulnerable adult that resulted in substantial bodily harm as 615.30 defined in section 609.02, subdivision 7a, or substantial mental 615.31 or emotional harm as supported by competent psychological or 615.32 psychiatric evidence. 615.33 In the case of any ground for disqualification under 615.34 clauses (1) to (4), if the act was committed by an individual 615.35 other than the applicant or license holder residing in the 615.36 applicant's or license holder's home, the applicant or license 616.1 holder may seek reconsideration when the individual who 616.2 committed the act no longer resides in the home. 616.3 The disqualification periods provided under clauses (1), 616.4 (3), and (4) are the minimum applicable disqualification 616.5 periods. The commissioner may determine that an individual 616.6 should continue to be disqualified from licensure because the 616.7 license holder or applicant poses a risk of harm to a person 616.8 served by that individual after the minimum disqualification 616.9 period has passed. 616.10 (d) The commissioner shall respond in writing or by 616.11 electronic transmission to all reconsideration requests for 616.12 which the basis for the request is that the information relied 616.13 upon by the commissioner to disqualify is incorrect or 616.14 inaccurate within 30 working days of receipt of a request and 616.15 all relevant information. If the basis for the request is that 616.16 the individual does not pose a risk of harm, the commissioner 616.17 shall respond to the request within 15 working days after 616.18 receiving the request for reconsideration and all relevant 616.19 information. If the request is based on both the correctness or 616.20 accuracy of the information relied on to disqualify the 616.21 individual and the risk of harm, the commissioner shall respond 616.22 to the request within 45 working days after receiving the 616.23 request for reconsideration and all relevant information. If 616.24 the disqualification is set aside, the commissioner shall notify 616.25 the applicant or license holder in writing or by electronic 616.26 transmission of the decision. 616.27 (e) Except as provided in subdivision 3c,the616.28commissioner's decision to disqualify an individual, including616.29the decision to grant or deny a rescission or set aside a616.30disqualification under this section, is the final administrative616.31agency action and shall not be subject to further review in a616.32contested case under chapter 14 involving a negative licensing616.33appeal taken in response to the disqualification or involving an616.34accuracy and completeness appeal under section 13.04if a 616.35 disqualification is not set aside or is not rescinded, an 616.36 individual who was disqualified on the basis of a preponderance 617.1 of evidence that the individual committed an act or acts that 617.2 meet the definition of any of the crimes lists in subdivision 617.3 3d, clauses (1) to (4); or for failure to make required reports 617.4 under section 626.556, subdivision 3, or 626.557, subdivision 3, 617.5 pursuant to subdivision 3d, clause (4), may request a fair 617.6 hearing under section 256.045. Except as provided under 617.7 subdivision 3c, the commissioner's final order for an individual 617.8 under this paragraph is conclusive on the issue of maltreatment 617.9 and disqualification, including for purposes of subsequent 617.10 studies conducted under section 245A.03, subdivision 3, and is 617.11 the only administrative appeal of the final agency 617.12 determination, specifically, including a challenge to the 617.13 accuracy and completeness of data under section 13.04. 617.14 (f) Except as provided under subdivision 3c, if an 617.15 individual was disqualified on the basis of a determination of 617.16 maltreatment under section 626.556 or 626.557, which was serious 617.17 or recurring, and the individual has requested reconsideration 617.18 of the maltreatment determination under section 626.556, 617.19 subdivision 10i, or 626.557, subdivision 9d, and also requested 617.20 reconsideration of the disqualification under this subdivision, 617.21 reconsideration of the maltreatment determination and 617.22 reconsideration of the disqualification shall be consolidated 617.23 into a single reconsideration. For maltreatment and 617.24 disqualification determinations made by county agencies, the 617.25 consolidated reconsideration shall be conducted by the county 617.26 agency. Except as provided under subdivision 3c, if an 617.27 individual who was disqualified on the basis of serious 617.28 recurring maltreatment requests a fair hearing on the 617.29 maltreatment determination under section 626.556, subdivision 617.30 10i, or 626.557, subdivision 9d, the scope of the fair hearing 617.31 under section 256.045 shall include the maltreatment 617.32 determination and the disqualification. Except as provided 617.33 under subdivision 3c, the commissioner's final order for an 617.34 individual under this paragraph is conclusive on the issue of 617.35 maltreatment and disqualification, including for purposes of 617.36 subsequent studies conducted under section 245A.04, subdivision 618.1 3, and is the only administrative appeal of the final agency 618.2 determination, specifically, including a challenge to the 618.3 accuracy and completeness of data under section 13.04. 618.4 Sec. 7. Minnesota Statutes 2000, section 245A.04, 618.5 subdivision 3c, is amended to read: 618.6 Subd. 3c. [CONTESTED CASE.] (a) Notwithstanding 618.7 subdivision 3b, paragraphs (e) and (f), if a disqualification is 618.8 not set aside, a person who is an employee of an employer, as 618.9 defined in section 179A.03, subdivision 15, may request a 618.10 contested case hearing under chapter 14. If the 618.11 disqualification which was not set aside or was not rescinded 618.12 was based on a maltreatment determination, the scope of the 618.13 contested case hearing includes the maltreatment determination 618.14 and the disqualification. In these cases, a fair hearing as 618.15 defined in section 256.045 must not be conducted. Rules adopted 618.16 under this chapter may not preclude an employee in a contested 618.17 case hearing for disqualification from submitting evidence 618.18 concerning information gathered under subdivision 3, paragraph 618.19 (e). 618.20 (b) If a disqualification for which reconsideration was 618.21 requested and which was not set aside or was not rescinded under 618.22 subdivision 3b, is the basis for a denial of a license under 618.23 section 245A.05 or a licensing sanction under section 245A.07, 618.24 the license holder has the right to a contested case hearing 618.25 under chapter 14 and Minnesota Rules, parts 1400.8550 to 618.26 1400.8612. The appeal must be submitted in accordance with 618.27 section 245A.05 or 245A.07, subdivision 3. As provided for 618.28 under section 245A.08, subdivision 2a, the scope of the 618.29 consolidated contested case hearing shall include the 618.30 disqualification and the licensing sanction. If the 618.31 disqualification was based on a determination of substantiated 618.32 serious or recurring maltreatment under section 626.556 or 618.33 626.557, the appeal must be submitted in accordance with 618.34 sections 245A.07, subdivision 3, and 626.556, subdivision 10i, 618.35 or 626.557, subdivision 9d. As provided for under section 618.36 245A.08, subdivision 2a, the scope of the contested case hearing 619.1 shall include the maltreatment determination, the 619.2 disqualification, and the licensing sanction. In such cases, a 619.3 fair hearing shall not be conducted under section 256.045. 619.4 (c) If a maltreatment determination or disqualification, 619.5 which was not set aside or was not rescinded under subdivision 619.6 3b, is the basis for licensing sanction under section 245A.07, 619.7 and the disqualified subject is an individual other than the 619.8 license holder and upon whom a background study must be 619.9 conducted under subdivision 3, the hearing of all parties may be 619.10 consolidated into a single contested case hearing upon consent 619.11 of all parties and the administrative law judge. 619.12 (d) The commissioner's final order under section 245A.08, 619.13 subdivision 5, is conclusive on the issue of maltreatment and 619.14 disqualification, including for purposes of subsequent 619.15 background studies. The contested case hearing under this 619.16 subdivision is the only administrative appeal of the final 619.17 agency determination, specifically, including a challenge to the 619.18 accuracy and completeness of data under section 13.04. 619.19 Sec. 8. Minnesota Statutes 2000, section 245A.04, 619.20 subdivision 3d, is amended to read: 619.21 Subd. 3d. [DISQUALIFICATION.] (a) Except as provided in 619.22 paragraph (b), when a background study completed under 619.23 subdivision 3 shows any of the following: a conviction of one 619.24 or more crimes listed in clauses (1) to (4); the individual has 619.25 admitted to or a preponderance of the evidence indicates the 619.26 individual has committed an act or acts that meet the definition 619.27 of any of the crimes listed in clauses (1) to (4); or an 619.28 investigation results in an administrative determination listed 619.29 under clause (4), the individual shall be disqualified from any 619.30 position allowing direct contact with persons receiving services 619.31 from the license holder and for individuals studied under 619.32 section 245A.04, subdivision 3, clauses (2), (6), and (7), the 619.33 individual shall also be disqualified from access to a person 619.34 receiving services from the license holder: 619.35 (1) regardless of how much time has passed since the 619.36 discharge of the sentence imposed for the offense, and unless 620.1 otherwise specified, regardless of the level of the conviction, 620.2 the individual was convicted of any of the following offenses: 620.3 sections 609.185 (murder in the first degree); 609.19 (murder in 620.4 the second degree); 609.195 (murder in the third degree); 620.5 609.2661 (murder of an unborn child in the first degree); 620.6 609.2662 (murder of an unborn child in the second degree); 620.7 609.2663 (murder of an unborn child in the third degree); 620.8 609.322 (solicitation, inducement, and promotion of 620.9 prostitution); 609.342 (criminal sexual conduct in the first 620.10 degree); 609.343 (criminal sexual conduct in the second degree); 620.11 609.344 (criminal sexual conduct in the third degree); 609.345 620.12 (criminal sexual conduct in the fourth degree); 609.352 620.13 (solicitation of children to engage in sexual conduct); 609.365 620.14 (incest); felony offense under 609.377 (malicious punishment of 620.15 a child); a felony offense under 609.378 (neglect or 620.16 endangerment of a child); a felony offense under 609.324, 620.17 subdivision 1 (other prohibited acts); 617.246 (use of minors in 620.18 sexual performance prohibited); 617.247 (possession of pictorial 620.19 representations of minors); a felony offense under sections 620.20 609.2242 and 609.2243 (domestic assault), a felony offense of 620.21 spousal abuse, a felony offense of child abuse or neglect, a 620.22 felony offense of a crime against children; or attempt or 620.23 conspiracy to commit any of these offenses as defined in 620.24 Minnesota Statutes, or an offense in any other state or country, 620.25 where the elements are substantially similar to any of the 620.26 offenses listed in this clause; 620.27 (2) if less than 15 years have passed since the discharge 620.28 of the sentence imposed for the offense; and the individual has 620.29 received a felony conviction for a violation of any of these 620.30 offenses: sections 609.20 (manslaughter in the first degree); 620.31 609.205 (manslaughter in the second degree); 609.21 (criminal 620.32 vehicular homicide and injury); 609.215 (suicide); 609.221 to 620.33 609.2231 (assault in the first, second, third, or fourth 620.34 degree); repeat offenses under 609.224 (assault in the fifth 620.35 degree); repeat offenses under 609.3451 (criminal sexual conduct 620.36 in the fifth degree); 609.713 (terroristic threats); 609.235 621.1 (use of drugs to injure or facilitate crime); 609.24 (simple 621.2 robbery); 609.245 (aggravated robbery); 609.25 (kidnapping); 621.3 609.255 (false imprisonment); 609.561 (arson in the first 621.4 degree); 609.562 (arson in the second degree); 609.563 (arson in 621.5 the third degree); repeat offenses under 617.23 (indecent 621.6 exposure; penalties); repeat offenses under 617.241 (obscene 621.7 materials and performances; distribution and exhibition 621.8 prohibited; penalty); 609.71 (riot); 609.66 (dangerous weapons); 621.9 609.67 (machine guns and short-barreled shotguns); 609.749 621.10 (harassment; stalking; penalties); 609.228 (great bodily harm 621.11 caused by distribution of drugs); 609.2325 (criminal abuse of a 621.12 vulnerable adult); 609.2664 (manslaughter of an unborn child in 621.13 the first degree); 609.2665 (manslaughter of an unborn child in 621.14 the second degree); 609.267 (assault of an unborn child in the 621.15 first degree); 609.2671 (assault of an unborn child in the 621.16 second degree); 609.268 (injury or death of an unborn child in 621.17 the commission of a crime); 609.52 (theft); 609.2335 (financial 621.18 exploitation of a vulnerable adult); 609.521 (possession of 621.19 shoplifting gear); 609.582 (burglary); 609.625 (aggravated 621.20 forgery); 609.63 (forgery); 609.631 (check forgery; offering a 621.21 forged check); 609.635 (obtaining signature by false pretense); 621.22 609.27 (coercion); 609.275 (attempt to coerce); 609.687 621.23 (adulteration); 260C.301 (grounds for termination of parental 621.24 rights); and chapter 152 (drugs; controlled substance). An 621.25 attempt or conspiracy to commit any of these offenses, as each 621.26 of these offenses is defined in Minnesota Statutes; or an 621.27 offense in any other state or country, the elements of which are 621.28 substantially similar to the elements of the offenses in this 621.29 clause. If the individual studied is convicted of one of the 621.30 felonies listed in this clause, but the sentence is a gross 621.31 misdemeanor or misdemeanor disposition, the lookback period for 621.32 the conviction is the period applicable to the disposition, that 621.33 is the period for gross misdemeanors or misdemeanors; 621.34 (3) if less than ten years have passed since the discharge 621.35 of the sentence imposed for the offense; and the individual has 621.36 received a gross misdemeanor conviction for a violation of any 622.1 of the following offenses: sections 609.224 (assault in the 622.2 fifth degree); 609.2242 and 609.2243 (domestic assault); 622.3 violation of an order for protection under 518B.01, subdivision 622.4 14; 609.3451 (criminal sexual conduct in the fifth degree); 622.5 repeat offenses under 609.746 (interference with privacy); 622.6 repeat offenses under 617.23 (indecent exposure); 617.241 622.7 (obscene materials and performances); 617.243 (indecent 622.8 literature, distribution); 617.293 (harmful materials; 622.9 dissemination and display to minors prohibited); 609.71 (riot); 622.10 609.66 (dangerous weapons); 609.749 (harassment; stalking; 622.11 penalties); 609.224, subdivision 2, paragraph (c) (assault in 622.12 the fifth degree by a caregiver against a vulnerable adult); 622.13 609.23 (mistreatment of persons confined); 609.231 (mistreatment 622.14 of residents or patients); 609.2325 (criminal abuse of a 622.15 vulnerable adult); 609.233 (criminal neglect of a vulnerable 622.16 adult); 609.2335 (financial exploitation of a vulnerable adult); 622.17 609.234 (failure to report maltreatment of a vulnerable adult); 622.18 609.72, subdivision 3 (disorderly conduct against a vulnerable 622.19 adult); 609.265 (abduction); 609.378 (neglect or endangerment of 622.20 a child); 609.377 (malicious punishment of a child); 609.324, 622.21 subdivision 1a (other prohibited acts; minor engaged in 622.22 prostitution); 609.33 (disorderly house); 609.52 (theft); 622.23 609.582 (burglary); 609.631 (check forgery; offering a forged 622.24 check); 609.275 (attempt to coerce); or an attempt or conspiracy 622.25 to commit any of these offenses, as each of these offenses is 622.26 defined in Minnesota Statutes; or an offense in any other state 622.27 or country, the elements of which are substantially similar to 622.28 the elements of any of the offenses listed in this clause. If 622.29 the defendant is convicted of one of the gross misdemeanors 622.30 listed in this clause, but the sentence is a misdemeanor 622.31 disposition, the lookback period for the conviction is the 622.32 period applicable to misdemeanors; or 622.33 (4) if less than seven years have passed since the 622.34 discharge of the sentence imposed for the offense; and the 622.35 individual has received a misdemeanor conviction for a violation 622.36 of any of the following offenses: sections 609.224 (assault in 623.1 the fifth degree); 609.2242 (domestic assault); violation of an 623.2 order for protection under 518B.01 (Domestic Abuse Act); 623.3 violation of an order for protection under 609.3232 (protective 623.4 order authorized; procedures; penalties); 609.746 (interference 623.5 with privacy); 609.79 (obscene or harassing phone calls); 623.6 609.795 (letter, telegram, or package; opening; harassment); 623.7 617.23 (indecent exposure; penalties); 609.2672 (assault of an 623.8 unborn child in the third degree); 617.293 (harmful materials; 623.9 dissemination and display to minors prohibited); 609.66 623.10 (dangerous weapons); 609.665 (spring guns); 609.2335 (financial 623.11 exploitation of a vulnerable adult); 609.234 (failure to report 623.12 maltreatment of a vulnerable adult); 609.52 (theft); 609.27 623.13 (coercion); or an attempt or conspiracy to commit any of these 623.14 offenses, as each of these offenses is defined in Minnesota 623.15 Statutes; or an offense in any other state or country, the 623.16 elements of which are substantially similar to the elements of 623.17 any of the offenses listed in this clause; failure to make 623.18 required reports under section 626.556, subdivision 3, or 623.19 626.557, subdivision 3, for incidents in which: (i) the final 623.20 disposition under section 626.556 or 626.557 was substantiated 623.21 maltreatment, and (ii) the maltreatment was recurring or 623.22 serious; or substantiated serious or recurring maltreatment of a 623.23 minor under section 626.556 or of a vulnerable adult under 623.24 section 626.557 for which there is a preponderance of evidence 623.25 that the maltreatment occurred, and that the subject was 623.26 responsible for the maltreatment. 623.27 For the purposes of this section, "serious maltreatment" 623.28 means sexual abuse; maltreatment resulting in death; or 623.29 maltreatment resulting in serious injury which reasonably 623.30 requires the care of a physician whether or not the care of a 623.31 physician was sought; or abuse resulting in serious injury. For 623.32 purposes of this section, "abuse resulting in serious injury" 623.33 means: bruises, bites, skin laceration or tissue damage; 623.34 fractures; dislocations; evidence of internal injuries; head 623.35 injuries with loss of consciousness; extensive second-degree or 623.36 third-degree burns and other burns for which complications are 624.1 present; extensive second-degree or third-degree frostbite, and 624.2 others for which complications are present; irreversible 624.3 mobility or avulsion of teeth; injuries to the eyeball; 624.4 ingestion of foreign substances and objects that are harmful; 624.5 near drowning; and heat exhaustion or sunstroke. For purposes 624.6 of this section, "care of a physician" is treatment received or 624.7 ordered by a physician, but does not include diagnostic testing, 624.8 assessment, or observation. For the purposes of this section, 624.9 "recurring maltreatment" means more than one incident of 624.10 maltreatment for which there is a preponderance of evidence that 624.11 the maltreatment occurred, and that the subject was responsible 624.12 for the maltreatment. For purposes of this section, "access" 624.13 means physical access to an individual receiving services or the 624.14 individual's personal property without continuous, direct 624.15 supervision as defined in section 245A.04, subdivision 3, 624.16 paragraph (b), clause (2). 624.17 (b)IfExcept for background studies related to child 624.18 foster care, adult foster care, or family child care licensure, 624.19 when the subject of a background study islicensedregulated by 624.20 a health-related licensing board as defined in chapter 214, and 624.21 the regulated person has been determined to have been 624.22 responsible for substantiated maltreatment under section 626.556 624.23 or 626.557, instead of the commissioner making a decision 624.24 regarding disqualification, the board shall makethea 624.25 determinationregarding a disqualification under this624.26subdivision based on a finding of substantiated maltreatment624.27under section 626.556 or 626.557. The commissioner shall notify624.28the health-related licensing board if a background study shows624.29that a licensee would be disqualified because of substantiated624.30maltreatment and the board shall make a determination under624.31section 214.104.whether to impose disciplinary or corrective 624.32 action under chapter 214. 624.33 (1) The commissioner shall notify the health-related 624.34 licensing board: 624.35 (i) upon completion of a background study that produces a 624.36 record showing that the individual was determined to have been 625.1 responsible for substantiated maltreatment; 625.2 (ii) upon the commissioner's completion of an investigation 625.3 that determined the individual was responsible for substantiated 625.4 maltreatment; or 625.5 (iii) upon receipt from another agency of a finding of 625.6 substantiated maltreatment for which the individual was 625.7 responsible. 625.8 (2) The commissioner's notice shall indicate whether the 625.9 individual would have been disqualified by the commissioner for 625.10 the substantiated maltreatment if the individual were not 625.11 regulated by the board. The commissioner shall concurrently 625.12 send this notice to the individual. 625.13 (3) Notwithstanding the exclusion from this subdivision for 625.14 individuals who provide child foster care, adult foster care, or 625.15 family child care, when the commissioner or a local agency has 625.16 reason to believe that the direct contact services provided by 625.17 the individual may fall within the jurisdiction of a 625.18 health-related licensing board, a referral shall be made to the 625.19 board as provided in this section. 625.20 (4) If, upon review of the information provided by the 625.21 commissioner, a health-related licensing board informs the 625.22 commissioner that the board does not have jurisdiction to take 625.23 disciplinary or corrective action, the commissioner shall make 625.24 the appropriate disqualification decision regarding the 625.25 individual as otherwise provided in this chapter. 625.26 (5) The commissioner has the authority to monitor the 625.27 facility's compliance with any requirements that the 625.28 health-related licensing board places on regulated persons 625.29 practicing in a facility either during the period pending a 625.30 final decision on a disciplinary or corrective action or as a 625.31 result of a disciplinary or corrective action. The commissioner 625.32 has the authority to order the immediate removal of a regulated 625.33 person from direct contact or access when a board issues an 625.34 order of temporary suspension based on a determination that the 625.35 regulated person poses an immediate risk of harm to persons 625.36 receiving services in a licensed facility. 626.1 (6) A facility that allows a regulated person to provide 626.2 direct contact services while not complying with the 626.3 requirements imposed by the health-related licensing board is 626.4 subject to action by the commissioner as specified under 626.5 sections 245A.06 and 245A.07. 626.6 (7) The commissioner shall notify a health-related 626.7 licensing board immediately upon receipt of knowledge of 626.8 noncompliance with requirements placed on a facility or upon a 626.9 person regulated by the board. 626.10 Sec. 9. Minnesota Statutes 2000, section 245A.05, is 626.11 amended to read: 626.12 245A.05 [DENIAL OF APPLICATION.] 626.13 The commissioner may deny a license if an applicant fails 626.14 to comply with applicable laws or rules, or knowingly withholds 626.15 relevant information from or gives false or misleading 626.16 information to the commissioner in connection with an 626.17 application for a license or during an investigation. An 626.18 applicant whose application has been denied by the commissioner 626.19 must be given notice of the denial. Notice must be given by 626.20 certified mail. The notice must state the reasons the 626.21 application was denied and must inform the applicant of the 626.22 right to a contested case hearing under chapter 14 and Minnesota 626.23 Rules, parts 1400.8550 to 1400.8612. The applicant may appeal 626.24 the denial by notifying the commissioner in writing by certified 626.25 mail within 20 calendar days after receiving notice that the 626.26 application was denied. Section 245A.08 applies to hearings 626.27 held to appeal the commissioner's denial of an application. 626.28 Sec. 10. Minnesota Statutes 2000, section 245A.06, is 626.29 amended to read: 626.30 245A.06 [CORRECTION ORDER ANDFINESCONDITIONAL LICENSE.] 626.31 Subdivision 1. [CONTENTS OF CORRECTION ORDERSOR FINESAND 626.32 CONDITIONAL LICENSES.] (a) If the commissioner finds that the 626.33 applicant or license holder has failed to comply with an 626.34 applicable law or rule and this failure does not imminently 626.35 endanger the health, safety, or rights of the persons served by 626.36 the program, the commissioner may issue a correction order and 627.1 an order of conditional license toor impose a fine onthe 627.2 applicant or license holder. When issuing a conditional 627.3 license, the commissioner shall consider the nature, chronicity, 627.4 or severity of the violation of law or rule and the effect of 627.5 the violation on the health, safety, or rights of persons served 627.6 by the program. The correction order orfineconditional 627.7 license must state: 627.8 (1) the conditions that constitute a violation of the law 627.9 or rule; 627.10 (2) the specific law or rule violated; 627.11 (3) the time allowed to correct each violation; and 627.12 (4) if afine is imposed, the amount of the finelicense is 627.13 made conditional, the length and terms of the conditional 627.14 license. 627.15 (b) Nothing in this section prohibits the commissioner from 627.16 proposing a sanction as specified in section 245A.07, prior to 627.17 issuing a correction order orfineconditional license. 627.18 Subd. 2. [RECONSIDERATION OF CORRECTION ORDERS.] If the 627.19 applicant or license holder believes that the contents of the 627.20 commissioner's correction order are in error, the applicant or 627.21 license holder may ask the department of human services to 627.22 reconsider the parts of the correction order that are alleged to 627.23 be in error. The request for reconsideration must be in writing 627.24 and received by the commissioner within 20 calendar days after 627.25 receipt of the correction order by the applicant or license 627.26 holder, and: 627.27 (1) specify the parts of the correction order that are 627.28 alleged to be in error; 627.29 (2) explain why they are in error; and 627.30 (3) include documentation to support the allegation of 627.31 error. 627.32 A request for reconsideration does not stay any provisions 627.33 or requirements of the correction order. The commissioner's 627.34 disposition of a request for reconsideration is final and not 627.35 subject to appeal under chapter 14. 627.36 Subd. 3. [FAILURE TO COMPLY.] If the commissioner finds 628.1 that the applicant or license holder has not corrected the 628.2 violations specified in the correction order or conditional 628.3 license, the commissioner may impose a fine and order other 628.4 licensing sanctions pursuant to section 245A.07.If a fine was628.5imposed and the violation was not corrected, the commissioner628.6may impose an additional fine. This section does not prohibit628.7the commissioner from seeking a court order, denying an628.8application, or suspending, revoking, or making conditional the628.9license in addition to imposing a fine.628.10 Subd. 4. [NOTICE OFFINECONDITIONAL LICENSE; 628.11 RECONSIDERATION OFFINECONDITIONAL LICENSE.]A license holder628.12who is ordered to pay a fineIf a license is made conditional, 628.13 the license holder must be notified of the order by certified 628.14 mail. The notice must be mailed to the address shown on the 628.15 application or the last known address of the license holder. 628.16 The notice must state the reasons thefineconditional license 628.17 was ordered and must inform the license holder of the 628.18responsibility for payment of fines in subdivision 7 and the628.19 right to request reconsideration of thefineconditional license 628.20 by the commissioner. The license holder may request 628.21 reconsideration of the orderto forfeit a fineof conditional 628.22 license by notifying the commissioner by certified mailwithin628.2320 calendar days after receiving the order. The request must be 628.24 in writing and must be received by the commissioner within ten 628.25 calendar days after the license holder received the order. The 628.26 license holder may submit with the request for reconsideration 628.27 written argument or evidence in support of the request for 628.28 reconsideration. A timely request for reconsideration shall 628.29 stayforfeiture of the fineimposition of the terms of the 628.30 conditional license until the commissioner issues a decision on 628.31 the request for reconsideration.The request for628.32reconsideration must be in writing and:628.33(1) specify the parts of the violation that are alleged to628.34be in error;628.35(2) explain why they are in error;628.36(3) include documentation to support the allegation of629.1error; and629.2(4) any other information relevant to the fine or the629.3amount of the fine.629.4 The commissioner's disposition of a request for 629.5 reconsideration is final and not subject to appeal under chapter 629.6 14. 629.7Subd. 5. [FORFEITURE OF FINES.] The license holder shall629.8pay the fines assessed on or before the payment date specified629.9in the commissioner's order. If the license holder fails to629.10fully comply with the order, the commissioner shall issue a629.11second fine or suspend the license until the license holder629.12complies. If the license holder receives state funds, the629.13state, county, or municipal agencies or departments responsible629.14for administering the funds shall withhold payments and recover629.15any payments made while the license is suspended for failure to629.16pay a fine.629.17Subd. 5a. [ACCRUAL OF FINES.] A license holder shall629.18promptly notify the commissioner of human services, in writing,629.19when a violation specified in an order to forfeit is corrected.629.20If upon reinspection the commissioner determines that a629.21violation has not been corrected as indicated by the order to629.22forfeit, the commissioner may issue a second fine. The629.23commissioner shall notify the license holder by certified mail629.24that a second fine has been assessed. The license holder may629.25request reconsideration of the second fine under the provisions629.26of subdivision 4.629.27Subd. 6. [AMOUNT OF FINES.] Fines shall be assessed as629.28follows:629.29(1) the license holder shall forfeit $1,000 for each629.30occurrence of violation of law or rule prohibiting the629.31maltreatment of children or the maltreatment of vulnerable629.32adults, including but not limited to corporal punishment,629.33illegal or unauthorized use of physical, mechanical, or chemical629.34restraints, and illegal or unauthorized use of aversive or629.35deprivation procedures;629.36(2) the license holder shall forfeit $200 for each630.1occurrence of a violation of law or rule governing matters of630.2health, safety, or supervision, including but not limited to the630.3provision of adequate staff to child or adult ratios; and630.4(3) the license holder shall forfeit $100 for each630.5occurrence of a violation of law or rule other than those630.6included in clauses (1) and (2).630.7For the purposes of this section, "occurrence" means each630.8violation identified in the commissioner's forfeiture order.630.9Subd. 7. [RESPONSIBILITY FOR PAYMENT OF FINES.] When a630.10fine has been assessed, the license holder may not avoid payment630.11by closing, selling, or otherwise transferring the licensed630.12program to a third party. In such an event, the license holder630.13will be personally liable for payment. In the case of a630.14corporation, each controlling individual is personally and630.15jointly liable for payment.630.16Fines for child care centers must be assessed according to630.17this section.630.18 Sec. 11. Minnesota Statutes 2000, section 245A.07, is 630.19 amended to read: 630.20 245A.07 [SANCTIONS.] 630.21 Subdivision 1. [SANCTIONS AVAILABLE.] In addition to 630.22ordering forfeiture of finesmaking a license conditional under 630.23 section 245A.06, the commissioner may propose to suspend,or 630.24 revoke, or make conditionalthe license, impose a fine, or 630.25 secure an injunction against the continuing operation of the 630.26 program of a license holder who does not comply with applicable 630.27 law or rule. When applying sanctions authorized under this 630.28 section, the commissioner shall consider the nature, chronicity, 630.29 or severity of the violation of law or rule and the effect of 630.30 the violation on the health, safety, or rights of persons served 630.31 by the program. 630.32 Subd. 2. [IMMEDIATE SUSPENSION IN CASES OF IMMINENT DANGER630.33TO HEALTH, SAFETY, OR RIGHTSTEMPORARY IMMEDIATE SUSPENSION.] If 630.34 the license holder's actions or failure to comply with 630.35 applicable law or rulehas placedposes an imminent risk of harm 630.36 to the health, safety, or rights of persons served by the 631.1 programin imminent danger, the commissioner shall act 631.2 immediately to temporarily suspend the license. No state funds 631.3 shall be made available or be expended by any agency or 631.4 department of state, county, or municipal government for use by 631.5 a license holder regulated under this chapter while a license is 631.6 under immediate suspension. A notice stating the reasons for 631.7 the immediate suspension and informing the license holder of the 631.8 right toa contested casean expedited hearing under chapter 631.9 14 and Minnesota Rules, parts 1400.8550 to 1400.8612, must be 631.10 delivered by personal service to the address shown on the 631.11 application or the last known address of the license holder. 631.12 The license holder may appeal an order immediately suspending a 631.13 license. The appeal of an order immediately suspending a 631.14 license must be made in writing by certified mail and must be 631.15 received by the commissioner within five calendar days after the 631.16 license holder receives notice that the license has been 631.17 immediately suspended. A license holder and any controlling 631.18 individual shall discontinue operation of the program upon 631.19 receipt of the commissioner's order to immediately suspend the 631.20 license. 631.21 Subd. 2a. [IMMEDIATE SUSPENSION EXPEDITED HEARING.] (a) 631.22 Within five working days of receipt of the license holder's 631.23 timely appeal, the commissioner shall request assignment of an 631.24 administrative law judge. The request must include a proposed 631.25 date, time, and place of a hearing. A hearing must be conducted 631.26 by an administrative law judge within 30 calendar days of the 631.27 request for assignment, unless an extension is requested by 631.28 either party and granted by the administrative law judge for 631.29 good cause. The commissioner shall issue a notice of hearing by 631.30 certified mail at least ten working days before the hearing. 631.31 The scope of the hearing shall be limited solely to the issue of 631.32 whether the temporary immediate suspension should remain in 631.33 effect pending the commissioner's final order under section 631.34 245A.08, regarding a licensing sanction issued under subdivision 631.35 3 following the immediate suspension. The burden of proof in 631.36 expedited hearings under this subdivision shall be limited to 632.1 the commissioner's demonstration that reasonable cause exists to 632.2 believe that the license holder's actions or failure to comply 632.3 with applicable law or rule poses an imminent risk of harm to 632.4 the health, safety, or rights of persons served by the program. 632.5 (b) The administrative law judge shall issue findings of 632.6 fact, conclusions, and a recommendation within ten working days 632.7 from the date of hearing. The commissioner's final order shall 632.8 be issued within ten working days from receipt of the 632.9 recommendation of the administrative law judge. Within 90 632.10 calendar days after a final order affirming an immediate 632.11 suspension, the commissioner shall make a determination 632.12 regarding whether a final licensing sanction shall be issued 632.13 under subdivision 3. The license holder shall continue to be 632.14 prohibited from operation of the program during this 90-day 632.15 period. 632.16 Subd. 3. [LICENSE SUSPENSION, REVOCATION,DENIALOR 632.17CONDITIONAL LICENSEFINE.] The commissioner may suspend,or 632.18 revoke, make conditional, or denya license, or impose a fine if 632.19an applicant ora license holder fails to comply fully with 632.20 applicable laws or rules, or knowingly withholds relevant 632.21 information from or gives false or misleading information to the 632.22 commissioner in connection with an application for a license or 632.23 during an investigation. A license holder who has had a license 632.24 suspended, revoked,or made conditionalor has been ordered to 632.25 pay a fine must be given notice of the action by certified 632.26 mail. The notice must be mailed to the address shown on the 632.27 application or the last known address of the license holder. 632.28 The notice must state the reasons the license was suspended, 632.29 revoked, ormade conditionala fine was ordered. 632.30 (a) If the license was suspended or revoked, the notice 632.31 must inform the license holder of the right to a contested case 632.32 hearing under chapter 14 and Minnesota Rules, parts 1400.8550 to 632.33 1400.8612. The license holder may appeal an order suspending or 632.34 revoking a license. The appeal of an order suspending or 632.35 revoking a license must be made in writing by certified mail and 632.36 must be received by the commissioner within ten calendar days 633.1 after the license holder receives notice that the license has 633.2 been suspended or revoked. 633.3 (b)If the license was made conditional, the notice must633.4inform the license holder of the right to request a633.5reconsideration by the commissioner. The request for633.6reconsideration must be made in writing by certified mail and633.7must be received by the commissioner within ten calendar days633.8after the license holder receives notice that the license has633.9been made conditional. The license holder may submit with the633.10request for reconsideration written argument or evidence in633.11support of the request for reconsideration. The commissioner's633.12disposition of a request for reconsideration is final and is not633.13subject to appeal under chapter 14(1) If the license holder was 633.14 ordered to pay a fine, the notice must inform the license holder 633.15 of the responsibility for payment of fines and the right to a 633.16 contested case hearing under chapter 14 and Minnesota Rules, 633.17 parts 1400.8550 to 1400.8612. The appeal of an order to pay a 633.18 fine must be made in writing by certified mail and must be 633.19 received by the commissioner within ten calendar days after the 633.20 license holder receives notice that the fine has been ordered. 633.21 (2) The license holder shall pay the fines assessed on or 633.22 before the payment date specified. If the license holder fails 633.23 to fully comply with the order, the commissioner may issue a 633.24 second fine or suspend the license until the license holder 633.25 complies. If the license holder receives state funds, the 633.26 state, county, or municipal agencies or departments responsible 633.27 for administering the funds shall withhold payments and recover 633.28 any payments made while the license is suspended for failure to 633.29 pay a fine. A timely appeal shall stay payment of the fine 633.30 until the commissioner issues a final order. 633.31 (3) A license holder shall promptly notify the commissioner 633.32 of human services, in writing, when a violation specified in the 633.33 order to forfeit a fine is corrected. If upon reinspection the 633.34 commissioner determines that a violation has not been corrected 633.35 as indicated by the order to forfeit a fine, the commissioner 633.36 may issue a second fine. The commissioner shall notify the 634.1 license holder by certified mail that a second fine has been 634.2 assessed. The license holder may appeal the second fine as 634.3 provided under this subdivision. 634.4 (4) Fines shall be assessed as follows: the license holder 634.5 shall forfeit $1,000 for each determination of maltreatment of a 634.6 child under section 626.556 or the maltreatment of a vulnerable 634.7 adult under section 626.557; the license holder shall forfeit 634.8 $200 for each occurrence of a violation of law or rule governing 634.9 matters of health, safety, or supervision, including failure to 634.10 submit a background study; and the license holder shall forfeit 634.11 $100 for each occurrence of a violation of law or rule other 634.12 than those subject to a $1,000 or $200 fine above. For purposes 634.13 of this section, "occurrence" means each violation identified in 634.14 the commissioner's fine order. 634.15 (5) When a fine has been assessed, the license holder may 634.16 not avoid payment by closing, selling, or otherwise transferring 634.17 the licensed program to a third party. In such an event, the 634.18 license holder will be personally liable for payment. In the 634.19 case of a corporation, each controlling individual is personally 634.20 and jointly liable for payment. 634.21 Subd. 4. [ADOPTION AGENCY VIOLATIONS.] If a license holder 634.22 licensed to place children for adoption fails to provide 634.23 services as described in the disclosure form required by section 634.24 259.37, subdivision 2, the sanctions under this section may be 634.25 imposed. 634.26 Sec. 12. Minnesota Statutes 2000, section 245A.08, is 634.27 amended to read: 634.28 245A.08 [HEARINGS.] 634.29 Subdivision 1. [RECEIPT OF APPEAL; CONDUCT OF HEARING.] 634.30 Upon receiving a timely appeal or petition pursuant to 634.31 section 245A.04, subdivision 3c, 245A.05, or 245A.07, 634.32 subdivision 3, the commissioner shall issue a notice of and 634.33 order for hearing to the appellant under chapter 14 and 634.34 Minnesota Rules, parts 1400.8550 to 1400.8612. 634.35 Subd. 2. [CONDUCT OF HEARINGS.] At any hearing provided 634.36 for by section 245A.04, subdivision 3c, 245A.05, or 245A.07, 635.1 subdivision 3, the appellant may be represented by counsel and 635.2 has the right to call, examine, and cross-examine witnesses. 635.3 The administrative law judge may require the presence of 635.4 witnesses and evidence by subpoena on behalf of any party. 635.5 Subd. 2a. [CONSOLIDATED CONTESTED CASE HEARINGS FOR 635.6 SANCTIONS BASED ON MALTREATMENT DETERMINATIONS AND 635.7 DISQUALIFICATIONS.] (a) When a licensing sanction under section 635.8 245A.07, subdivision 3, is based on a disqualification for which 635.9 reconsideration was requested and which was not set aside or was 635.10 not rescinded under section 245A.04, subdivision 3b, the scope 635.11 of the contested case hearing shall include the disqualification 635.12 and the licensing sanction. When the licensing sanction is 635.13 based on a determination of maltreatment under section 626.556 635.14 or 626.557, or a disqualification for serious or recurring 635.15 maltreatment which was not set aside, the scope of the contested 635.16 case hearing shall include the maltreatment determination, 635.17 disqualification, and the licensing sanction. In such cases, a 635.18 fair hearing under section 256.045 shall not be conducted as 635.19 provided for in sections 626.556, subdivision 10i, and 626.557, 635.20 subdivision 9d. 635.21 (b) In consolidated contested case hearings regarding 635.22 sanctions issued in family child care, child foster care, and 635.23 adult foster care, the county attorney shall defend the 635.24 commissioner's orders in accordance with section 245A.16, 635.25 subdivision 4. 635.26 (c) The commissioner's final order under subdivision 5 is 635.27 the final agency action on the issue of maltreatment and 635.28 disqualification, including for purposes of subsequent 635.29 background studies under section 245A.04, subdivision 3, and is 635.30 the only administrative appeal of the final agency 635.31 determination, specifically, including a challenge to the 635.32 accuracy and completeness of data under section 13.04. 635.33 (d) When consolidated hearings under this subdivision 635.34 involve a licensing sanction based on a previous maltreatment 635.35 determination for which the commissioner has issued a final 635.36 order in an appeal of that determination under section 256.045, 636.1 or the individual failed to exercise their right to appeal the 636.2 previous maltreatment determination under section 626.556, 636.3 subdivision 10i, or 626.557, subdivision 9d, the commissioner's 636.4 order is conclusive on the issue of maltreatment. In such 636.5 cases, the scope of the administrative law judge's review shall 636.6 be limited to the disqualification and the licensing sanction. 636.7 In the case of a licensing sanction issued to a facility based 636.8 on a maltreatment determination regarding an individual who is 636.9 not the license holder or a household member, the scope of the 636.10 administrative law judge's review includes the maltreatment 636.11 determination. 636.12 (e) If a maltreatment determination or disqualification, 636.13 which was not set aside or was not rescinded under section 636.14 245A.04, subdivision 3b, is the basis for a licensing sanction 636.15 under section 245A.07, and the disqualified subject is an 636.16 individual other than the license holder and upon whom a 636.17 background study must be conducted under section 245A.04, 636.18 subdivision 3, the hearings of all parties may be consolidated 636.19 into a single contested case hearing upon consent of all parties 636.20 and the administrative law judge. 636.21 Subd. 3. [BURDEN OF PROOF.] (a) At a hearing regarding 636.22suspension, immediate suspension, or revocation of a license for636.23family day care or foster carea licensing sanction under 636.24 section 245.07, including consolidated hearings under 636.25 subdivision 2a, the commissioner may demonstrate reasonable 636.26 cause for action taken by submitting statements, reports, or 636.27 affidavits to substantiate the allegations that the license 636.28 holder failed to comply fully with applicable law or rule. If 636.29 the commissioner demonstrates that reasonable cause existed, the 636.30 burden of proofin hearings involving suspension, immediate636.31suspension, or revocation of a family day care or foster care636.32licenseshifts to the license holder to demonstrate by a 636.33 preponderance of the evidence that the license holder was in 636.34 full compliance with those laws or rules that the commissioner 636.35 alleges the license holder violated, at the time that the 636.36 commissioner alleges the violations of law or rules occurred. 637.1 (b) At a hearing on denial of an application, the applicant 637.2 bears the burden of proof to demonstrate by a preponderance of 637.3 the evidence that the appellant has complied fully withsections637.4245A.01 to 245A.15chapter 245A and other applicable law or rule 637.5 and that the application should be approved and a license 637.6 granted. 637.7(c) At all other hearings under this section, the637.8commissioner bears the burden of proof to demonstrate, by a637.9preponderance of the evidence, that the violations of law or637.10rule alleged by the commissioner occurred.637.11 Subd. 4. [RECOMMENDATION OF ADMINISTRATIVE LAW JUDGE.] The 637.12 administrative law judge shall recommend whether or not the 637.13 commissioner's order should be affirmed. The recommendations 637.14 must be consistent with this chapter and the rules of the 637.15 commissioner. The recommendations must be in writing and 637.16 accompanied by findings of fact and conclusions and must be 637.17 mailed to the parties by certified mail to their last known 637.18 addresses as shown on the license or application. 637.19 Subd. 5. [NOTICE OF THE COMMISSIONER'S FINAL ORDER.] After 637.20 considering the findings of fact, conclusions, and 637.21 recommendations of the administrative law judge, the 637.22 commissioner shall issue a final order. The commissioner shall 637.23 consider, but shall not be bound by, the recommendations of the 637.24 administrative law judge. The appellant must be notified of the 637.25 commissioner's final order as required by chapter 14 and 637.26 Minnesota Rules, parts 1400.8550 to 1400.8612. The notice must 637.27 also contain information about the appellant's rights under 637.28 chapter 14 and Minnesota Rules, parts 1400.8550 to 1400.8612. 637.29 The institution of proceedings for judicial review of the 637.30 commissioner's final order shall not stay the enforcement of the 637.31 final order except as provided in section 14.65. A license 637.32 holder and each controlling individual of a license holder whose 637.33 license has been revoked because of noncompliance with 637.34 applicable law or rule must not be granted a license for five 637.35 years following the revocation. An applicant whose application 637.36 was denied must not be granted a license for two years following 638.1 a denial, unless the applicant's subsequent application contains 638.2 new information which constitutes a substantial change in the 638.3 conditions that caused the previous denial. 638.4 Sec. 13. Minnesota Statutes 2000, section 245A.16, 638.5 subdivision 1, is amended to read: 638.6 Subdivision 1. [DELEGATION OF AUTHORITY TO AGENCIES.] (a) 638.7 County agencies and private agencies that have been designated 638.8 or licensed by the commissioner to perform licensing functions 638.9 and activities under section 245A.04, to recommend denial of 638.10 applicants under section 245A.05, to issue correction orders, to 638.11 issue variances, and recommendfinesa conditional license under 638.12 section 245A.06, or to recommend suspending,or revoking, and638.13making licenses probationarya license or issuing a fine under 638.14 section 245A.07, shall comply with rules and directives of the 638.15 commissioner governing those functions and with this section. 638.16 (b) For family day care programs, the commissioner may 638.17 authorize licensing reviews every two years after a licensee has 638.18 had at least one annual review. 638.19 Sec. 14. Minnesota Statutes 2000, section 245B.08, 638.20 subdivision 3, is amended to read: 638.21 Subd. 3. [SANCTIONS AVAILABLE.] Nothing in this 638.22 subdivision shall be construed to limit the commissioner's 638.23 authority to suspend,or revoke, or make conditionala license 638.24 or issue a fine at any timea licenseunder section 245A.07; 638.25 make correction orders andrequire finesmake a license 638.26 conditional for failure to comply with applicable laws or rules 638.27 under section 245A.06; or deny an application for license under 638.28 section 245A.05. 638.29 Sec. 15. Minnesota Statutes 2000, section 256.045, 638.30 subdivision 3, is amended to read: 638.31 Subd. 3. [STATE AGENCY HEARINGS.] (a) State agency 638.32 hearings are available for the following: (1) any person 638.33 applying for, receiving or having received public assistance, 638.34 medical care, or a program of social services granted by the 638.35 state agency or a county agency or the federal Food Stamp Act 638.36 whose application for assistance is denied, not acted upon with 639.1 reasonable promptness, or whose assistance is suspended, 639.2 reduced, terminated, or claimed to have been incorrectly paid; 639.3 (2) any patient or relative aggrieved by an order of the 639.4 commissioner under section 252.27; (3) a party aggrieved by a 639.5 ruling of a prepaid health plan; (4) except as provided under 639.6 chapter 245A, any individual or facility determined by a lead 639.7 agency to have maltreated a vulnerable adult under section 639.8 626.557 after they have exercised their right to administrative 639.9 reconsideration under section 626.557; (5) any person whose 639.10 claim for foster care payment according to a placement of the 639.11 child resulting from a child protection assessment under section 639.12 626.556 is denied or not acted upon with reasonable promptness, 639.13 regardless of funding source; (6) any person to whom a right of 639.14 appeal according to this section is given by other provision of 639.15 law; (7) an applicant aggrieved by an adverse decision to an 639.16 application for a hardship waiver under section 639.17 256B.15;or(8) except as provided under chapter 245A, an 639.18 individual or facility determined to have maltreated a minor 639.19 under section 626.556, after the individual or facility has 639.20 exercised the right to administrative reconsideration under 639.21 section 626.556; or (9) except as provided under chapter 245A, 639.22 an individual disqualified under section 245A.04, subdivision 639.23 3d, on the basis of serious or recurring maltreatment; a 639.24 preponderance of the evidence that the individual has committed 639.25 an act or acts that meet the definition of any of the crimes 639.26 listed in clauses (1) to (4) of that subdivision; or for failing 639.27 to make reports required under section 626.556, subdivision 3, 639.28 or 626.557, subdivision 3. Hearings regarding a maltreatment 639.29 determination under clause (4) or (8) and a disqualification 639.30 under clause (9) in which the basis for a disqualification is 639.31 serious and recurring maltreatment, which has not been set aside 639.32 or rescinded under section 245A.04, subdivision 3b, shall be 639.33 consolidated into a single fair hearing. In such cases, the 639.34 scope of review by the human services referee shall include both 639.35 the maltreatment determination and the disqualification. The 639.36 failure to exercise the right to an administrative 640.1 reconsideration shall not be a bar to a hearing under this 640.2 section if federal law provides an individual the right to a 640.3 hearing to dispute a finding of maltreatment. Individuals and 640.4 organizations specified in this section may contest the 640.5 specified action, decision, or final disposition before the 640.6 state agency by submitting a written request for a hearing to 640.7 the state agency within 30 days after receiving written notice 640.8 of the action, decision, or final disposition, or within 90 days 640.9 of such written notice if the applicant, recipient, patient, or 640.10 relative shows good cause why the request was not submitted 640.11 within the 30-day time limit. 640.12 The hearing for an individual or facility under clause 640.13 (4)or, (8), or (9) is the only administrative appeal to the 640.14 final agency determination specifically, including a challenge 640.15 to the accuracy and completeness of data under section 13.04. 640.16 Hearings requested under clause (4) apply only to incidents of 640.17 maltreatment that occur on or after October 1, 1995. Hearings 640.18 requested by nursing assistants in nursing homes alleged to have 640.19 maltreated a resident prior to October 1, 1995, shall be held as 640.20 a contested case proceeding under the provisions of chapter 14. 640.21 Hearings requested under clause (8) apply only to incidents of 640.22 maltreatment that occur on or after July 1, 1997. A hearing for 640.23 an individual or facility under clause (8) is only available 640.24 when there is no juvenile court or adult criminal action 640.25 pending. If such action is filed in either court while an 640.26 administrative review is pending, the administrative review must 640.27 be suspended until the judicial actions are completed. If the 640.28 juvenile court action or criminal charge is dismissed or the 640.29 criminal action overturned, the matter may be considered in an 640.30 administrative hearing. 640.31 For purposes of this section, bargaining unit grievance 640.32 procedures are not an administrative appeal. 640.33 The scope of hearings involving claims to foster care 640.34 payments under clause (5) shall be limited to the issue of 640.35 whether the county is legally responsible for a child's 640.36 placement under court order or voluntary placement agreement 641.1 and, if so, the correct amount of foster care payment to be made 641.2 on the child's behalf and shall not include review of the 641.3 propriety of the county's child protection determination or 641.4 child placement decision. 641.5 (b) A vendor of medical care as defined in section 256B.02, 641.6 subdivision 7, or a vendor under contract with a county agency 641.7 to provide social services under section 256E.08, subdivision 4, 641.8 is not a party and may not request a hearing under this section, 641.9 except if assisting a recipient as provided in subdivision 4. 641.10 (c) An applicant or recipient is not entitled to receive 641.11 social services beyond the services included in the amended 641.12 community social services plan developed under section 256E.081, 641.13 subdivision 3, if the county agency has met the requirements in 641.14 section 256E.081. 641.15 (d) The commissioner may summarily affirm the county or 641.16 state agency's proposed action without a hearing when the sole 641.17 issue is an automatic change due to a change in state or federal 641.18 law. 641.19 Sec. 16. Minnesota Statutes 2000, section 256.045, 641.20 subdivision 3b, is amended to read: 641.21 Subd. 3b. [STANDARD OF EVIDENCE FOR MALTREATMENT AND 641.22 DISQUALIFICATION HEARINGS.] The state human services referee 641.23 shall determine that maltreatment has occurred if a 641.24 preponderance of evidence exists to support the final 641.25 disposition under sections 626.556 and 626.557. For purposes of 641.26 hearings regarding disqualification, the state human services 641.27 referee shall affirm the proposed disqualification in an appeal 641.28 under subdivision 3, paragraph (a), clause (9), if a 641.29 preponderance of the evidence shows the individual has: 641.30 (1) committed maltreatment under section 626.556 or 641.31 626.557, which is serious or recurring; 641.32 (2) committed an act or acts meeting the definition of any 641.33 of the crimes listed in section 245A.04, subdivision 3d, clauses 641.34 (1) to (4); or 641.35 (3) failed to make required reports under section 626.556 641.36 or 626.557, for incidents in which: 642.1 (i) the final disposition under section 626.556 or 626.557 642.2 was substantiated maltreatment; and 642.3 (ii) the maltreatment was recurring or serious; or 642.4 substantiated serious or recurring maltreatment of a minor under 642.5 section 626.556 or of a vulnerable adult under section 626.557 642.6 for which there is a preponderance of evidence that the 642.7 maltreatment occurred, and that the subject was responsible for 642.8 the maltreatment. If the disqualification is affirmed, the 642.9 state human services referee shall determine whether the 642.10 individual poses a risk of harm in accordance with the 642.11 requirements of section 245A.04, subdivision 3b. 642.12 The state human services referee shall recommend an order 642.13 to the commissioner of health or human services, as applicable, 642.14 who shall issue a final order. The commissioner shall affirm, 642.15 reverse, or modify the final disposition. Any order of the 642.16 commissioner issued in accordance with this subdivision is 642.17 conclusive upon the parties unless appeal is taken in the manner 642.18 provided in subdivision 7. Except as provided under section 642.19 245A.04, subdivisions 3b, paragraphs (e) and (f), and 3c, in any 642.20 licensing appeal under chapter 245A and sections 144.50 to 642.21 144.58 and 144A.02 to 144A.46, the commissioner's determination 642.22 as to maltreatment is conclusive. 642.23 Sec. 17. Minnesota Statutes 2000, section 256.045, 642.24 subdivision 4, is amended to read: 642.25 Subd. 4. [CONDUCT OF HEARINGS.] (a) All hearings held 642.26 pursuant to subdivision 3, 3a, 3b, or 4a shall be conducted 642.27 according to the provisions of the federal Social Security Act 642.28 and the regulations implemented in accordance with that act to 642.29 enable this state to qualify for federal grants-in-aid, and 642.30 according to the rules and written policies of the commissioner 642.31 of human services. County agencies shall install equipment 642.32 necessary to conduct telephone hearings. A state human services 642.33 referee may schedule a telephone conference hearing when the 642.34 distance or time required to travel to the county agency offices 642.35 will cause a delay in the issuance of an order, or to promote 642.36 efficiency, or at the mutual request of the parties. Hearings 643.1 may be conducted by telephone conferences unless the applicant, 643.2 recipient, former recipient, person, or facility contesting 643.3 maltreatment objects. The hearing shall not be held earlier 643.4 than five days after filing of the required notice with the 643.5 county or state agency. The state human services referee shall 643.6 notify all interested persons of the time, date, and location of 643.7 the hearing at least five days before the date of the hearing. 643.8 Interested persons may be represented by legal counsel or other 643.9 representative of their choice, including a provider of therapy 643.10 services, at the hearing and may appear personally, testify and 643.11 offer evidence, and examine and cross-examine witnesses. The 643.12 applicant, recipient, former recipient, person, or facility 643.13 contesting maltreatment shall have the opportunity to examine 643.14 the contents of the case file and all documents and records to 643.15 be used by the county or state agency at the hearing at a 643.16 reasonable time before the date of the hearing and during the 643.17 hearing. In hearings under subdivision 3, paragraph (a), 643.18 clauses (4)and, (8), and (9), either party may subpoena the 643.19 private data relating to the investigation prepared by the 643.20 agency under section 626.556 or 626.557 that is not otherwise 643.21 accessible under section 13.04, provided the identity of the 643.22 reporter may not be disclosed. 643.23 (b) The private data obtained by subpoena in a hearing 643.24 under subdivision 3, paragraph (a), clause (4)or, (8), or (9), 643.25 must be subject to a protective order which prohibits its 643.26 disclosure for any other purpose outside the hearing provided 643.27 for in this section without prior order of the district court. 643.28 Disclosure without court order is punishable by a sentence of 643.29 not more than 90 days imprisonment or a fine of not more than 643.30 $700, or both. These restrictions on the use of private data do 643.31 not prohibit access to the data under section 13.03, subdivision 643.32 6. Except for appeals under subdivision 3, paragraph (a), 643.33 clauses (4), (5),and(8), and (9), upon request, the county 643.34 agency shall provide reimbursement for transportation, child 643.35 care, photocopying, medical assessment, witness fee, and other 643.36 necessary and reasonable costs incurred by the applicant, 644.1 recipient, or former recipient in connection with the appeal. 644.2 All evidence, except that privileged by law, commonly accepted 644.3 by reasonable people in the conduct of their affairs as having 644.4 probative value with respect to the issues shall be submitted at 644.5 the hearing and such hearing shall not be "a contested case" 644.6 within the meaning of section 14.02, subdivision 3. The agency 644.7 must present its evidence prior to or at the hearing, and may 644.8 not submit evidence after the hearing except by agreement of the 644.9 parties at the hearing, provided the petitioner has the 644.10 opportunity to respond. 644.11 Sec. 18. Minnesota Statutes 2000, section 626.556, 644.12 subdivision 10i, is amended to read: 644.13 Subd. 10i. [ADMINISTRATIVE RECONSIDERATION OF FINAL 644.14 DETERMINATION OF MALTREATMENT AND DISQUALIFICATION BASED ON 644.15 SERIOUS OR RECURRING MALTREATMENT.] (a) Except as provided under 644.16 paragraph (e), an individual or facility that the commissioner 644.17 or a local social service agency determines has maltreated a 644.18 child, or the child's designee, regardless of the determination, 644.19 who contests the investigating agency's final determination 644.20 regarding maltreatment, may request the investigating agency to 644.21 reconsider its final determination regarding maltreatment. The 644.22 request for reconsideration must be submitted in writing to the 644.23 investigating agency within 15 calendar days after receipt of 644.24 notice of the final determination regarding maltreatment. An 644.25 individual who was determined to have maltreated a child under 644.26 this section and who was disqualified on the basis of serious or 644.27 recurring maltreatment under section 245A.04, subdivision 3d, 644.28 may request reconsideration of the maltreatment determination 644.29 and the disqualification. The request for reconsideration of 644.30 the maltreatment determination and the disqualification must be 644.31 submitted within 30 calendar days of the individual's receipt of 644.32 the notice of disqualification under section 245A.04, 644.33 subdivision 3a. 644.34 (b) Except as provided under paragraphs (e) and (f), if the 644.35 investigating agency denies the request or fails to act upon the 644.36 request within 15 calendar days after receiving the request for 645.1 reconsideration, the person or facility entitled to a fair 645.2 hearing under section 256.045 may submit to the commissioner of 645.3 human services a written request for a hearing under that 645.4 section. 645.5 (c) If, as a result of the reconsideration, the 645.6 investigating agency changes the final determination of 645.7 maltreatment, that agency shall notify the parties specified in 645.8 subdivisions 10b, 10d, and 10f. 645.9 (d) Except as provided under paragraph (f), if an 645.10 individual or facility contests the investigating agency's final 645.11 determination regarding maltreatment by requesting a fair 645.12 hearing under section 256.045, the commissioner of human 645.13 services shall assure that the hearing is conducted and a 645.14 decision is reached within 90 days of receipt of the request for 645.15 a hearing. The time for action on the decision may be extended 645.16 for as many days as the hearing is postponed or the record is 645.17 held open for the benefit of either party. 645.18 (e) If an individual was disqualified under section 645.19 245A.04, subdivision 3d, on the basis of a determination of 645.20 maltreatment, which was serious or recurring, and the individual 645.21 has requested reconsideration of the maltreatment determination 645.22 under paragraph (a) and requested reconsideration of the 645.23 disqualification under section 245A.04, subdivision 3b, 645.24 reconsideration of the maltreatment determination and 645.25 reconsideration of the disqualification shall be consolidated 645.26 into a single reconsideration. If an individual disqualified on 645.27 the basis of a determination of maltreatment, which was serious 645.28 or recurring requests a fair hearing under paragraph (b), the 645.29 scope of the fair hearing shall include the maltreatment 645.30 determination and the disqualification. 645.31 (f) If a maltreatment determination or a disqualification 645.32 based on serious or recurring maltreatment is the basis for a 645.33 licensing sanction under section 245A.07, the license holder has 645.34 the right to a contested case hearing under chapter 14 and 645.35 Minnesota Rules, parts 1400.8550 to 1400.8612. As provided for 645.36 under section 245A.08, subdivision 2a, the scope of the 646.1 contested case hearing shall include the maltreatment 646.2 determination, disqualification, and licensing sanction. In 646.3 such cases, a fair hearing regarding the maltreatment 646.4 determination shall not be conducted under paragraph (b). If 646.5 the disqualified subject is an individual other than the license 646.6 holder and upon whom a background study must be conducted under 646.7 section 245A.04, subdivision 3, the hearings of all parties may 646.8 be consolidated into a single contested case hearing upon 646.9 consent of all parties and the administrative law judge. 646.10 Sec. 19. Minnesota Statutes 2000, section 626.557, 646.11 subdivision 3, is amended to read: 646.12 Subd. 3. [TIMING OF REPORT.] (a) A mandated reporter who 646.13 has reason to believe that a vulnerable adult is being or has 646.14 been maltreated, or who has knowledge that a vulnerable adult 646.15 has sustained a physical injury which is not reasonably 646.16 explained shall immediately report the information to the common 646.17 entry point. If an individual is a vulnerable adult solely 646.18 because the individual is admitted to a facility, a mandated 646.19 reporter is not required to report suspected maltreatment of the 646.20 individual that occurred prior to admission, unless: 646.21 (1) the individual was admitted to the facility from 646.22 another facility and the reporter has reason to believe the 646.23 vulnerable adult was maltreated in the previous facility; or 646.24 (2) the reporter knows or has reason to believe that the 646.25 individual is a vulnerable adult as defined in section 626.5572, 646.26 subdivision 21, clause (4). 646.27 (b) A person not required to report under the provisions of 646.28 this section may voluntarily report as described above. 646.29 (c) Nothing in this section requires a report of known or 646.30 suspected maltreatment, if the reporter knows or has reason to 646.31 know that a report has been made to the common entry point. 646.32 (d) Nothing in this section shall preclude a reporter from 646.33 also reporting to a law enforcement agency. 646.34 (e) a mandated reporter who knows or has reason to believe 646.35 that an error under section 626.5572, subdivision 17, paragraph 646.36 (c), clause (5), occurred must make a report under this 647.1 subdivision. If the reporter or facility at any time believes 647.2 that an investigation by a lead agency will determine or should 647.3 determine that the reported error was not neglect according to 647.4 the criteria under section 626.5572, subdivision 17, paragraph 647.5 (c), clause (5), the reporter or facility may provide to the 647.6 common entry point or directly to the lead agency information 647.7 explaining how the event meets the criteria under section 647.8 626.557, subdivision 17, paragraph (c), clause (5). The lead 647.9 agency shall consider this information when making an initial 647.10 disposition of the report under subdivision 9c. 647.11 Sec. 20. Minnesota Statutes 2000, section 626.557, 647.12 subdivision 9d, is amended to read: 647.13 Subd. 9d. [ADMINISTRATIVE RECONSIDERATION OF FINAL 647.14 DISPOSITION OF MALTREATMENT AND DISQUALIFICATION BASED ON 647.15 SERIOUS OR RECURRING MALTREATMENT; REVIEW PANEL.] (a) Except as 647.16 provided under paragraph (e), any individual or facility which a 647.17 lead agency determines has maltreated a vulnerable adult, or the 647.18 vulnerable adult or an interested person acting on behalf of the 647.19 vulnerable adult, regardless of the lead agency's determination, 647.20 who contests the lead agency's final disposition of an 647.21 allegation of maltreatment, may request the lead agency to 647.22 reconsider its final disposition. The request for 647.23 reconsideration must be submitted in writing to the lead agency 647.24 within 15 calendar days after receipt of notice of final 647.25 disposition or, if the request is made by an interested person 647.26 who is not entitled to notice, within 15 days after receipt of 647.27 the notice by the vulnerable adult or the vulnerable adult's 647.28 legal guardian. An individual who was determined to have 647.29 maltreated a vulnerable adult under this section and who was 647.30 disqualified on the basis of serious or recurring maltreatment 647.31 under section 245A.04, subdivision 3d, may request 647.32 reconsideration of the maltreatment determination and the 647.33 disqualification. The request for reconsideration of the 647.34 maltreatment determination and the disqualification must be 647.35 submitted within 30 calendar days of the individual's receipt of 647.36 the notice of disqualification under section 245A.04, 648.1 subdivision 3a. 648.2 (b) Except as provided under paragraphs (e) and (f), if the 648.3 lead agency denies the request or fails to act upon the request 648.4 within 15 calendar days after receiving the request for 648.5 reconsideration, the person or facility entitled to a fair 648.6 hearing under section 256.045, may submit to the commissioner of 648.7 human services a written request for a hearing under that 648.8 statute. The vulnerable adult, or an interested person acting 648.9 on behalf of the vulnerable adult, may request a review by the 648.10 vulnerable adult maltreatment review panel under section 256.021 648.11 if the lead agency denies the request or fails to act upon the 648.12 request, or if the vulnerable adult or interested person 648.13 contests a reconsidered disposition. The lead agency shall 648.14 notify persons who request reconsideration of their rights under 648.15 this paragraph. The request must be submitted in writing to the 648.16 review panel and a copy sent to the lead agency within 30 648.17 calendar days of receipt of notice of a denial of a request for 648.18 reconsideration or of a reconsidered disposition. The request 648.19 must specifically identify the aspects of the agency 648.20 determination with which the person is dissatisfied. 648.21 (c) If, as a result of a reconsideration or review, the 648.22 lead agency changes the final disposition, it shall notify the 648.23 parties specified in subdivision 9c, paragraph (d). 648.24 (d) For purposes of this subdivision, "interested person 648.25 acting on behalf of the vulnerable adult" means a person 648.26 designated in writing by the vulnerable adult to act on behalf 648.27 of the vulnerable adult, or a legal guardian or conservator or 648.28 other legal representative, a proxy or health care agent 648.29 appointed under chapter 145B or 145C, or an individual who is 648.30 related to the vulnerable adult, as defined in section 245A.02, 648.31 subdivision 13. 648.32 (e) If an individual was disqualified under section 648.33 245A.04, subdivision 3d, on the basis of a determination of 648.34 maltreatment, which was serious or recurring, and the individual 648.35 has requested reconsideration of the maltreatment determination 648.36 under paragraph (a) and reconsideration of the disqualification 649.1 under section 245A.04, subdivision 3b, reconsideration of the 649.2 maltreatment determination and requested reconsideration of the 649.3 disqualification shall be consolidated into a single 649.4 reconsideration. If an individual who was disqualified on the 649.5 basis of serious or recurring maltreatment requests a fair 649.6 hearing under paragraph (b), the scope of the fair hearing shall 649.7 include the maltreatment determination and the disqualification. 649.8 (f) If a maltreatment determination or a disqualification 649.9 based on serious or recurring maltreatment is the basis for a 649.10 licensing sanction under section 245A.07, the license holder has 649.11 the right to a contested case hearing under chapter 14 and 649.12 Minnesota Rules, parts 1400.8550 to 1400.8612. As provided for 649.13 under section 245A.08, the scope of the contested case hearing 649.14 shall include the maltreatment determination, disqualification, 649.15 and licensing sanction. In such cases, a fair hearing shall not 649.16 be conducted under paragraph (b). If the disqualified subject 649.17 is an individual other than the license holder and upon whom a 649.18 background study must be conducted under section 245A.04, 649.19 subdivision 3, the hearings of all parties may be consolidated 649.20 into a single contested case hearing upon consent of all parties 649.21 and the administrative law judge. 649.22 (g) Until August 1, 2002, an individual or facility that 649.23 was determined by the commissioner of human services or the 649.24 commissioner of health to be responsible for neglect under 649.25 section 626.5572, subdivision 17, after October 1, 1995, and 649.26 before August 1, 2001, that believes that the finding of neglect 649.27 does not meet an amended definition of neglect may request a 649.28 reconsideration of the determination of neglect. The 649.29 commissioner of human services or the commissioner of health 649.30 shall mail a notice to the last known address of individuals who 649.31 are eligible to seek this reconsideration. The request for 649.32 reconsideration must state how the established findings no 649.33 longer meet the elements of the definition of neglect. The 649.34 commissioner shall review the request for reconsideration and 649.35 make a determination within 15 calendar days. The 649.36 commissioner's decision on this reconsideration is the final 650.1 agency action. 650.2 (1) For purposes of compliance with the data destruction 650.3 schedule under section 626.557, subdivision 12b, paragraph (d), 650.4 when a finding of substantiated maltreatment has been changed as 650.5 a result of a reconsideration under this paragraph, the date of 650.6 the original finding of a substantiated maltreatment must be 650.7 used to calculate the destruction date. 650.8 (2) For purposes of any background studies under section 650.9 245A.04, when a determination of substantiated maltreatment has 650.10 been changed as a result of a reconsideration under this 650.11 paragraph, any prior disqualification of the individual under 650.12 section 245A.04 that was based on this determination of 650.13 maltreatment shall be rescinded, and for future background 650.14 studies under section 245A.04 the commissioner must not use the 650.15 previous determination of substantiated maltreatment as a basis 650.16 for disqualification or as a basis for referring the 650.17 individual's maltreatment history to a health-related licensing 650.18 board under section 245A.04, subdivision 3d, paragraph (b). 650.19 Sec. 21. Minnesota Statutes 2000, section 626.5572, 650.20 subdivision 17, is amended to read: 650.21 Subd. 17. [NEGLECT.] "Neglect" means: 650.22 (a) The failure or omission by a caregiver to supply a 650.23 vulnerable adult with care or services, including but not 650.24 limited to, food, clothing, shelter, health care, or supervision 650.25 which is: 650.26 (1) reasonable and necessary to obtain or maintain the 650.27 vulnerable adult's physical or mental health or safety, 650.28 considering the physical and mental capacity or dysfunction of 650.29 the vulnerable adult; and 650.30 (2) which is not the result of an accident or therapeutic 650.31 conduct. 650.32 (b) The absence or likelihood of absence of care or 650.33 services, including but not limited to, food, clothing, shelter, 650.34 health care, or supervision necessary to maintain the physical 650.35 and mental health of the vulnerable adult which a reasonable 650.36 person would deem essential to obtain or maintain the vulnerable 651.1 adult's health, safety, or comfort considering the physical or 651.2 mental capacity or dysfunction of the vulnerable adult. 651.3 (c) For purposes of this section, a vulnerable adult is not 651.4 neglected for the sole reason that: 651.5 (1) the vulnerable adult or a person with authority to make 651.6 health care decisions for the vulnerable adult under sections 651.7 144.651, 144A.44, chapter 145B, 145C, or 252A, or section 651.8 253B.03, or 525.539 to 525.6199, refuses consent or withdraws 651.9 consent, consistent with that authority and within the boundary 651.10 of reasonable medical practice, to any therapeutic conduct, 651.11 including any care, service, or procedure to diagnose, maintain, 651.12 or treat the physical or mental condition of the vulnerable 651.13 adult, or, where permitted under law, to provide nutrition and 651.14 hydration parenterally or through intubation; this paragraph 651.15 does not enlarge or diminish rights otherwise held under law by: 651.16 (i) a vulnerable adult or a person acting on behalf of a 651.17 vulnerable adult, including an involved family member, to 651.18 consent to or refuse consent for therapeutic conduct; or 651.19 (ii) a caregiver to offer or provide or refuse to offer or 651.20 provide therapeutic conduct; or 651.21 (2) the vulnerable adult, a person with authority to make 651.22 health care decisions for the vulnerable adult, or a caregiver 651.23 in good faith selects and depends upon spiritual means or prayer 651.24 for treatment or care of disease or remedial care of the 651.25 vulnerable adult in lieu of medical care, provided that this is 651.26 consistent with the prior practice or belief of the vulnerable 651.27 adult or with the expressed intentions of the vulnerable adult; 651.28 (3) the vulnerable adult, who is not impaired in judgment 651.29 or capacity by mental or emotional dysfunction or undue 651.30 influence, engages in sexual contact with: 651.31 (i) a person including a facility staff person when a 651.32 consensual sexual personal relationship existed prior to the 651.33 caregiving relationship; or 651.34 (ii) a personal care attendant, regardless of whether the 651.35 consensual sexual personal relationship existed prior to the 651.36 caregiving relationship; or 652.1 (4) an individual makes an error in the provision of 652.2 therapeutic conduct to a vulnerable adult which: (i)does not 652.3 result in injury or harm which reasonably requires medical or 652.4 mental health care; or, if it reasonably requires care,652.5 (5) an individual makes an error in the provision of 652.6 therapeutic conduct to a vulnerable adult that results in injury 652.7 or harm, which reasonably requires the care of a physician; and: 652.8 (i) the necessary care issought andprovided in a timely 652.9 fashion as dictated by the condition of the vulnerable adult; 652.10and the injury or harm that required care does not result in652.11substantial acute, or chronic injury or illness, or permanent652.12disability above and beyond the vulnerable adult's preexisting652.13condition; 652.14 (ii) is after receiving care, the health status of the 652.15 vulnerable adult can be reasonably expected to be restored to 652.16 the vulnerable adult's preexisting condition; 652.17 (iii) the error is not part of a pattern of errors by the 652.18 individual; 652.19 (iv) if in a facility, the error is immediately reported as 652.20 required under section 626.557, and recorded internallyby the652.21employee or person providing servicesin the facilityin order652.22to evaluate and identify corrective action; 652.23 (v) if in a facility, the facility identifies and takes 652.24 corrective action and implements measures designed to reduce the 652.25 risk of further occurrence of this error and similar errors; and 652.26(iii) is(vi) if in a facility, the actions required under 652.27 items (iv) and (v) are sufficiently documented for review and 652.28 evaluation by the facility and any applicable licensing, 652.29 certification, and ombudsman agency; and652.30(iv) is not part of a pattern of errors by the individual. 652.31 (d) Nothing in this definition requires a caregiver, if 652.32 regulated, to provide services in excess of those required by 652.33 the caregiver's license, certification, registration, or other 652.34 regulation. 652.35 (e) If the findings of an investigation by a lead agency 652.36 result in a determination of substantiated maltreatment for the 653.1 sole reason that the actions required of a facility under 653.2 paragraph (c), clause (5), item (iv), (v), or (vi), were not 653.3 taken, then the facility is subject to a correction order. This 653.4 must not alter the lead agency's determination of mitigating 653.5 factors under section 626.557, subdivision 9c, paragraph (c). 653.6 Sec. 22. [FEDERAL LAW CHANGE REQUEST OR WAIVER.] 653.7 The commissioner of health or human services, whichever is 653.8 appropriate, shall pursue changes to federal law necessary to 653.9 allow greater discretion on disciplinary activities of 653.10 unlicensed health care workers, and apply for necessary federal 653.11 waivers or approval that would allow for a set-aside process 653.12 related to disqualifications for nurse aides in nursing homes by 653.13 July 1, 2001. 653.14 Sec. 23. [WAIVER FROM FEDERAL RULES AND REGULATIONS.] 653.15 By January 2002, the commissioner of health shall work with 653.16 providers to examine federal rules and regulations prohibiting 653.17 neglect, abuse, and financial exploitation of residents in 653.18 licensed nursing facilities and shall apply for federal waivers 653.19 to: 653.20 (1) allow the use of Minnesota Statutes, section 626.5572, 653.21 to control the identification and prevention of maltreatment of 653.22 residents in licensed nursing facilities, rather than the 653.23 definitions under federal rules and regulations; and 653.24 (2) allow the use of Minnesota Statutes, sections 214.104, 653.25 245A.04, and 626.557, to control the disqualification or 653.26 discipline of any persons providing services to residents in 653.27 licensed nursing facilities, rather than the nurse aide registry 653.28 or other exclusionary provisions of federal rules and 653.29 regulations. 653.30 Sec. 24. [EFFECTIVE DATES.] 653.31 (a) Sections 19; 20, paragraph (g); and 21 are effective 653.32 the day following final enactment. 653.33 (b) Sections 1; 3; 5; 8; 22; and 23 are effective July 1, 653.34 2001. 653.35 (c) Sections 2; 4; 6; 7; 9 to 18; and 20, paragraphs (a), 653.36 (b), (e), and (f), are effective January 1, 2002. 654.1 ARTICLE 15 654.2 MISCELLANEOUS 654.3 Section 1. [144.582] [PROHIBITING CERTAIN ACTIONS AGAINST 654.4 NURSES.] 654.5 Subdivision 1. [PROHIBITED ACTIONS.] Except as provided in 654.6 subdivision 2, a hospital or other entity licensed under 654.7 sections 144.50 to 144.58, and its agent; a hospice licensed 654.8 under section 144A.48, and its agent; or another health care 654.9 facility licensed by the commissioner of health, and the 654.10 facility's agent, is prohibited from taking action against a 654.11 nurse solely on the grounds that the nurse fails to accept an 654.12 assignment of additional consecutive hours at the facility in 654.13 excess of an agreed upon, predetermined work shift, if the nurse 654.14 declines to work additional hours because doing so may, in the 654.15 nurse's judgment, jeopardize patient safety. A nurse who fails 654.16 to accept additional hours under this subdivision must document 654.17 in writing why, in the nurse's judgment, the additional work 654.18 hours may jeopardize patient safety. This subdivision does not 654.19 apply to a nursing facility, an intermediate care facility for 654.20 persons with mental retardation, or a licensed boarding care 654.21 facility. 654.22 Subd. 2. [EMERGENCY.] Notwithstanding subdivision 1, a 654.23 nurse may be scheduled for duty or required to continue on duty 654.24 for more than one normal work period in an emergency. 654.25 Subd. 3. [DEFINITIONS.] For purposes of this section, the 654.26 following terms have the meanings given them: 654.27 (1) "emergency" means a period when replacement staff are 654.28 not able to report for duty for the next shift because of 654.29 unusual circumstances such as a disease outbreak, adverse 654.30 weather conditions, natural disasters, or, in the case of nurse 654.31 supervisors, a strike; 654.32 (2) "normal work period" means 12 or fewer consecutive 654.33 hours consistent with a predetermined work shift; 654.34 (3) "nurse" has the meaning given in section 148.171, 654.35 subdivision 9; and 654.36 (4) "taking action against" means discharging; 655.1 disciplining; threatening; reporting to the board of nursing; 655.2 discriminating against; or penalizing regarding compensation, 655.3 terms, conditions, location, or privileges of employment. 655.4 Subd. 4. [NOTIFICATION.] Each health care facility subject 655.5 to subdivision 1 shall post on each nursing unit in an area to 655.6 which all employees have access the following statement: "This 655.7 facility is prohibited by law from taking any action against a 655.8 nurse who fails to accept a request or order to work additional 655.9 hours at the facility in excess of the predetermined work shift 655.10 if, in the nurse's judgment, working the additional hours may 655.11 jeopardize patient safety." The facility shall also post 655.12 adjacent to the statement the telephone number of the Minnesota 655.13 department of health facility and provider compliance division. 655.14 Sec. 2. Minnesota Statutes 2000, section 148.212, is 655.15 amended to read: 655.16 148.212 [TEMPORARY PERMIT.] 655.17 Upon receipt of the applicable licensure or reregistration 655.18 fee and permit fee, and in accordance with rules of the board, 655.19 the board may issue a nonrenewable temporary permit to practice 655.20 professional or practical nursing to an applicant for licensure 655.21 or reregistration who is not the subject of a pending 655.22 investigation or disciplinary action, nor disqualified for any 655.23 other reason, under the following circumstances: 655.24 (a) The applicant for licensure by examination under 655.25 section 148.211, subdivision 1, has graduated from an approved 655.26 nursing program within the 60 days preceding board receipt of an 655.27 affidavit of graduation or transcript and has been authorized by 655.28 the board to write the licensure examination for the first time 655.29 in the United States. The permit holder must practice 655.30 professional or practical nursing under the direct supervision 655.31 of a registered nurse. The permit is valid from the date of 655.32 issue until the date the board takes action on the application 655.33 or for 60 days whichever occurs first. 655.34 (b) The applicant for licensure by endorsement under 655.35 section 148.211, subdivision 2, is currently licensed to 655.36 practice professional or practical nursing in another state, 656.1 territory, or Canadian province. The permit is valid from 656.2 submission of a proper request until the date of board action on 656.3 the application. 656.4 (c) The applicant for licensure by endorsement under 656.5 section 148.211, subdivision 2, or for reregistration under 656.6 section 148.231, subdivision 5, is currently registered in a 656.7 formal, structured refresher course or its equivalent for nurses 656.8 that includes clinical practice. 656.9 (d) The applicant for licensure by examination under 656.10 section 148.211, subdivision 1, has been issued a Commission on 656.11 Graduates of Foreign Nursing Schools certificate, has completed 656.12 all requirements for licensure except the examination, and has 656.13 been authorized by the board to write the licensure examination 656.14 for the first time in the United States. The permit holder must 656.15 practice professional nursing under the direct supervision of a 656.16 registered nurse. The permit is valid from the date of issue 656.17 until the date the board takes action on the application or for 656.18 60 days, whichever occurs first. 656.19 Sec. 3. Minnesota Statutes 2000, section 148.263, 656.20 subdivision 2, is amended to read: 656.21 Subd. 2. [INSTITUTIONS.] (a) The chief nursing executive 656.22 or chief administrative officer of any hospital, clinic, prepaid 656.23 medical plan, or other health care institution or organization 656.24 located in this state shall report to the board any action taken 656.25 by the institution or organization or any of its administrators 656.26 or committees to revoke, suspend, limit, or condition a nurse's 656.27 privilege to practice in the institution, or as part of the 656.28 organization, any denial of privileges, any dismissal from 656.29 employment, or any other disciplinary action. The institution 656.30 or organization shall also report the resignation of any nurse 656.31 before the conclusion of any disciplinary proceeding, or before 656.32 commencement of formal charges, but after the nurse had 656.33 knowledge that formal charges were contemplated or in 656.34 preparation. The reporting described by this subdivision is 656.35 required only if the action pertains to grounds for disciplinary 656.36 action under section 148.261. 657.1 (b) This subdivision does not require any entity to report 657.2 the refusal of a nurse to accept an assignment of additional 657.3 hours in excess of an agreed upon, predetermined work schedule. 657.4 Sec. 4. Minnesota Statutes 2000, section 148.284, is 657.5 amended to read: 657.6 148.284 [CERTIFICATION OF ADVANCED PRACTICE REGISTERED 657.7 NURSES.] 657.8 (a) No person shall practice advanced practice registered 657.9 nursing or use any title, abbreviation, or other designation 657.10 tending to imply that the person is an advanced practice 657.11 registered nurse, clinical nurse specialist, nurse anesthetist, 657.12 nurse-midwife, or nurse practitioner unless the person is 657.13 certified for such advanced practice registered nursing by a 657.14 national nurse certification organization. 657.15 (b) Paragraph (a) does not apply to an advanced practice 657.16 registered nurse who is within six months after completion of an 657.17 advanced practice registered nurse course of study and is 657.18 awaiting certification, provided that the person has not 657.19 previously failed the certification examination. 657.20 (c) An advanced practice registered nurse who has completed 657.21 a formal course of study as an advanced practice registered 657.22 nurse and has been certified by a national nurse certification 657.23 organization prior to January 1, 1999, may continue to practice 657.24 in the field of nursing in which the advanced practice 657.25 registered nurse is practicing as of July 1, 1999, regardless of 657.26 the type of certification held if the advanced practice 657.27 registered nurse is not eligible for the proper certification. 657.28 Sec. 5. Minnesota Statutes 2000, section 214.001, is 657.29 amended by adding a subdivision to read: 657.30 Subd. 4. [INFORMATION FROM COUNCIL OF HEALTH BOARDS.] The 657.31 chair of a standing committee in either house of the legislature 657.32 may request information from the council of health boards on 657.33 proposals relating to the regulation of health occupations. 657.34 Sec. 6. Minnesota Statutes 2000, section 214.002, 657.35 subdivision 1, is amended to read: 657.36 Subdivision 1. [WRITTEN REPORT.] Within 15 days of the 658.1 introduction of a bill proposing new or expanded regulation of 658.2 an occupation, the proponents of the new or expanded regulation 658.3 shall submit a written report to the chair of the standing 658.4 committee in each house of the legislature to which the bill was 658.5 referred and to the council of health boards setting out the 658.6 information required by this section. If a committee chair 658.7 requests that the report be submitted earlier, but no fewer than 658.8 five days from introduction of the bill, the proponents shall 658.9 comply with the request. 658.10 Sec. 7. Minnesota Statutes 2000, section 214.01, is 658.11 amended by adding a subdivision to read: 658.12 Subd. 1a. [COUNCIL OF HEALTH BOARDS.] "Council of health 658.13 boards" means a collaborative body established by the 658.14 health-related licensing boards. 658.15 Sec. 8. [214.025] [COUNCIL OF HEALTH BOARDS.] 658.16 The health-related licensing boards may establish a council 658.17 of health boards consisting of representatives of the 658.18 health-related licensing boards and the emergency medical 658.19 services regulatory board. When reviewing legislation or 658.20 legislative proposals relating to the regulation of health 658.21 occupations, the council shall include the commissioner of 658.22 health or a designee. 658.23 Sec. 9. [214.105] [HEALTH-RELATED LICENSING BOARDS AND 658.24 COMMISSIONER OF HEALTH; DEFAULT ON FEDERAL LOANS OR SERVICE 658.25 OBLIGATIONS.] 658.26 Subdivision 1. [SUSPENSION OF LICENSE.] If the 658.27 commissioner of health or a health-related licensing board 658.28 receives a report from a federal agency certifying that a person 658.29 licensed by the commissioner or board is in nonpayment, default, 658.30 or breach of a repayment or service obligation under any federal 658.31 educational loan, loan repayment, or service conditional 658.32 scholarship program, the commissioner or board may suspend the 658.33 person's license within 30 days of receipt of the report. The 658.34 commissioner or board shall consider the reasons for nonpayment, 658.35 default, or breach of a repayment or service obligation and may 658.36 not suspend the person's license in cases of total and permanent 659.1 disability or long-term temporary disability lasting more than a 659.2 year. Prior to the suspension, the person must be given notice 659.3 of the board's or commissioner's intended action and must be 659.4 given the opportunity for a hearing before the board or 659.5 commissioner before the suspension takes effect. 659.6 Subd. 2. [ISSUANCE, REINSTATEMENT, RENEWAL OF 659.7 LICENSE.] The commissioner or a health-related licensing board 659.8 shall not issue, reinstate, or renew a license that has been 659.9 suspended under this section until the person whose license was 659.10 suspended provides the commissioner or board with a written 659.11 release issued by the federal agency that reported the person to 659.12 the commissioner or board. The written release must state that 659.13 the person is making payments on the loan or satisfying the 659.14 service requirements in accordance with an agreement approved by 659.15 the federal agency. If the person has continued to meet all 659.16 other requirements for licensure during the period of license 659.17 suspension, the commissioner or board must reinstate the 659.18 person's license upon receipt of the written release. 659.19 Sec. 10. Minnesota Statutes 2000, section 245.98, is 659.20 amended by adding a subdivision to read: 659.21 Subd. 6. [TREATMENT.] (a) The commissioner of human 659.22 services shall develop and maintain a comprehensive program for 659.23 the treatment of problem and pathological gambling. This 659.24 program should include primary treatment, crisis intervention, 659.25 assessment and pretreatment services, transitional and 659.26 after-care services, and intervention and support services, 659.27 including financial, budget, and debt restitution counseling. 659.28 The program should also provide services for family members and 659.29 other victims whether or not the pathological or problem gambler 659.30 is in treatment. The program should encourage multidisciplinary 659.31 providers and different programming models, including inpatient, 659.32 residential, halfway houses, and treatment in chemical 659.33 dependency programs and other institutions. 659.34 (b) The commissioner of human services shall develop 659.35 programs for gambling prevention, intervention, and treatment 659.36 for underserved populations, including youth and seniors, and 660.1 high-risk or vulnerable populations. The commissioner shall 660.2 consult with appropriate councils, representatives, and agency 660.3 groups to gather information about specific populations and 660.4 tailor appropriate gambling-related services for those 660.5 populations. 660.6 Sec. 11. Minnesota Statutes 2000, section 245.982, is 660.7 amended to read: 660.8 245.982 [COMPULSIVE GAMBLING PROGRAM SUPPORT.] 660.9 In order to addresstheproblemofand compulsive gambling 660.10in this, the state, the compulsive gambling fund should attempt660.11to assess the beneficiaries of gambling, on a percentage basis660.12according to the revenue they receive from gambling, for the660.13costs of programs to help problem gamblers and their families.660.14In that light, the governor is requested to contact the chairs660.15of the 11 tribal governments in this state and request a660.16contribution of funds for the compulsive gambling program. The660.17governor should seek a total supplemental contribution of660.18$643,000. Funds received from the tribal governments in this660.19state shall be deposited in the Indian gaming revolving660.20accountof Minnesota should make sure that its prevention and 660.21 treatment efforts are sufficient to meet the needs of problem 660.22 gamblers and their families. Furthermore, the costs of 660.23 compulsive gambling programs should be funded out of the lottery 660.24 prize fund, and if available, with support from other gambling 660.25 enterprises instead of with state general fund appropriations. 660.26 Sec. 12. Minnesota Statutes 2000, section 256I.05, 660.27 subdivision 1d, is amended to read: 660.28 Subd. 1d. [SUPPLEMENTARY SERVICE RATES FOR CERTAIN 660.29 FACILITIES SERVING PERSONS WITH MENTAL ILLNESS OR CHEMICAL 660.30 DEPENDENCY.] Notwithstanding the provisions of subdivisions 1a 660.31 and 1cfor the fiscal year ending June 30, 1998, a county agency 660.32 may negotiate a supplementary service rate in addition to the 660.33 board and lodging rate for facilities licensed and registered by 660.34 the Minnesota department of health under section 157.17 prior to 660.35 December 31, 1996, if the facility meets the following criteria: 660.36 (1) at least 75 percent of the residents have a primary 661.1 diagnosis of mental illness, chemical dependency, or both, and 661.2 have related special needs; 661.3 (2) the facility provides 24-hour, on-site, year-round 661.4 supportive services by qualified staff capable of intervention 661.5 in a crisis of persons with late-state inebriety or mental 661.6 illness who are vulnerable to abuse or neglect; 661.7 (3) the services at the facility include, but are not 661.8 limited to: 661.9 (i) secure central storage of medication; 661.10 (ii) reminders and monitoring of medication for 661.11 self-administration; 661.12 (iii) support for developing an individual medical and 661.13 social service plan, updating the plan, and monitoring 661.14 compliance with the plan; and 661.15 (iv) assistance with setting up meetings, appointments, and 661.16 transportation to access medical, chemical health, and mental 661.17 health service providers; 661.18 (4) each resident has a documented need for at least one of 661.19 the services provided; 661.20 (5) each resident has been offered an opportunity to apply 661.21 for admission to a licensed residential treatment program for 661.22 mental illness, chemical dependency, or both, have refused that 661.23 offer, and the offer and their refusal has been documented to 661.24 writing; and 661.25 (6) the residents are not eligible for home and 661.26 community-based services waivers because of their unique need 661.27 for community support. 661.28 The total supplementary service rate must not exceed 661.29$57543.2 percent of the nonfederal share of the adult case mix 661.30 class A rate established for purposes of the community 661.31 alternatives for disabled individuals program. 661.32 Sec. 13. Minnesota Statutes 2000, section 256I.05, 661.33 subdivision 1e, is amended to read: 661.34 Subd. 1e. [SUPPLEMENTARY RATE FOR CERTAIN FACILITIES.] 661.35 Notwithstanding the provisions of subdivisions 1a and 1c, 661.36 beginning July 1,19992001, a county agency shall negotiate a 662.1 supplementary rate in addition to the rate specified in 662.2 subdivision 1, equal to2541 percent of the amount specified in 662.3 subdivision 1a, including any legislatively authorized 662.4 inflationary adjustments, for a group residential housing 662.5 provider that: 662.6 (1) is located in Hennepin county and has had a group 662.7 residential housing contract with the county since June 1996; 662.8 (2) operates in three separate locations a 56-bed facility, 662.9 a 40-bed facility, and a 30-bed facility; and 662.10 (3) serves a chemically dependent clientele, providing 24 662.11 hours per day supervision and limiting a resident's maximum 662.12 length of stay to 13 months out of a consecutive 24-month period. 662.13 Sec. 14. Minnesota Statutes 2000, section 256I.05, is 662.14 amended by adding a subdivision to read: 662.15 Subd. 1f. [SUPPLEMENTARY SERVICE RATE INCREASES ON OR 662.16 AFTER JULY 1, 2001.] For rate years beginning on or after July 662.17 1, 2001, a county agency may increase the supplementary service 662.18 rate for recipients of assistance under section 256I.04 who 662.19 reside in a residence that is licensed by the commissioner of 662.20 health as a boarding care home but is not certified for purposes 662.21 of the medical assistance program. The supplementary service 662.22 rate shall not exceed the nonfederal share of the statewide 662.23 weighted average monthly medical assistance nursing facility 662.24 payment rate for case mix class A. 662.25 Sec. 15. [299A.76] [SUICIDE STATISTICS.] 662.26 (a) The commissioner of public safety shall not: 662.27 (1) include any statistics on committing suicide or 662.28 attempting suicide in any compilation of crime statistics 662.29 published by the commissioner; or 662.30 (2) label as a crime statistic, any data on committing 662.31 suicide or attempting suicide. 662.32 (b) This section does not apply to the crimes of aiding 662.33 suicide under section 609.215, subdivision 1, or aiding 662.34 attempted suicide under section 609.215, subdivision 2, or to 662.35 statistics on a suicide directly related to the commission of a 662.36 crime. 663.1 Sec. 16. Minnesota Statutes 2000, section 609.115, 663.2 subdivision 9, is amended to read: 663.3 Subd. 9. [COMPULSIVE GAMBLING ASSESSMENT REQUIRED.] (a) If 663.4 a person is convicted of theft under section 609.52, 663.5 embezzlement of public funds under section 609.54, or forgery 663.6 under section 609.625, 609.63, or 609.631, the probation officer 663.7 shall determine in the report prepared under subdivision 1 663.8 whether or not compulsive gambling contributed to the commission 663.9 of the offense. If so, the report shall contain the results of 663.10 a compulsive gambling assessment conducted in accordance with 663.11 this subdivision. The probation officer shall make an 663.12 appointment for the offender to undergo the assessment if so 663.13 indicated. 663.14 (b) The compulsive gambling assessment report must include 663.15 a recommended level of treatment for the offender if the 663.16 assessor concludes that the offender is in need of compulsive 663.17 gambling treatment. The assessment must be conducted by an 663.18 assessor qualified under section 245.98, subdivision 2a, to 663.19 perform these assessments or to provide compulsive gambling 663.20 treatment. An assessor providing a compulsive gambling 663.21 assessment may not have any direct or shared financial interest 663.22 or referral relationship resulting in shared financial gain with 663.23 a treatment provider. If an independent assessor is not 663.24 available, the probation officer may use the services of an 663.25 assessor with a financial interest or referral relationship as 663.26 authorized under rules adopted by the commissioner of human 663.27 services under section 245.98, subdivision 2a. 663.28 (c) The commissioner of human services shall reimburse the 663.29 assessor for the costs associated with a compulsive gambling 663.30 assessment at a rate established by the commissioner up to a 663.31 maximum of$100$200 for each assessment. The commissioner 663.32 shall reimburse these costs after receiving written verification 663.33 from the probation officer that the assessment was performed and 663.34 found acceptable. 663.35 Sec. 17. Laws 1998, chapter 407, article 8, section 9, is 663.36 amended to read: 664.1 Sec. 9. [PREVALENCE STUDY.] 664.2If funding is available,(a) The compulsive gambling 664.3 program shall providebaseline prevalencestudies to identify 664.4those at highest risk of developing a compulsive gambling664.5problem, including a replication in 1999 of the 1994 adult664.6prevalence surveythe prevalence of pathological and problem 664.7 gambling and, to the extent possible, the demographic and 664.8 socioeconomic characteristics of these gamblers. The study must 664.9 be completed by January 15, 2003. 664.10 (b) The compulsive gambling program shall also study the 664.11 impact of problem gambling on Minnesota. The studies may 664.12 include the effect of gambling on children of parental gamblers, 664.13 the prevalence of gambling in underserved populations and 664.14 developmentally disabled populations, the impact of gambling on 664.15 crime, and the prevalence of school-based gambling. 664.16 Sec. 18. Laws 1999, chapter 152, section 4, is amended to 664.17 read: 664.18 Sec. 4. [REPORT.] 664.19 The task force shall present a report recommending a new 664.20 payment rate structure to the legislature by January 15, 2000, 664.21 and shall make recommendations to the commissioner of human 664.22 services regarding the implementation of the pilot project for 664.23 the individualized payment rate structure, so the pilot project 664.24 can be implemented by January 1, 2002, as required in section 664.25 3. The task force expires onMarch 15, 2000December 30, 2003. 664.26 Sec. 19. Laws 1999, chapter 245, article 10, section 10, 664.27 as amended by Laws 2000, chapter 488, article 9, section 30, is 664.28 amended to read: 664.29 Sec. 10. [REPEALER.] 664.30(a) Minnesota Statutes 1998, section 256.973, is repealed664.31effective June 30, 2002.664.32(b)Laws 1997, chapter 225, article 6, section 8, is 664.33 repealed. 664.34 Sec. 20. [DAY TRAINING AND HABILITATION PAYMENT STRUCTURE 664.35 PILOT PROJECT.] 664.36 Subdivision 1. [INDIVIDUALIZED PAYMENT RATE 665.1 STRUCTURE.] Notwithstanding Minnesota Statutes, sections 665.2 252.451, subdivision 5; and 252.46; and Minnesota Rules, part 665.3 9525.1290, subpart 1, items A and B, after federal waivers have 665.4 been approved and the legislature has authorized the pilot 665.5 project, the commissioner of human services shall initiate a 665.6 pilot project for the individualized payment rate structure 665.7 described in this section and section 3. The pilot project 665.8 shall include actual transfers of funds, not simulated 665.9 transfers. The pilot project may include all or some of the 665.10 vendors in up to eight counties, with no more than two counties 665.11 from the seven-county Minneapolis-St. Paul metropolitan area. 665.12 Subd. 2. [SUNSET.] The pilot project shall sunset upon 665.13 implementation of a new statewide rate structure to be 665.14 recommended by the task force described in subdivision 3, in its 665.15 report to the legislature on December 1, 2003. The rates of 665.16 vendors participating in the pilot project must be modified to 665.17 be consistent with the new statewide rate structure, if 665.18 implemented. 665.19 Subd. 3. [TASK FORCE RESPONSIBILITIES.] The day training 665.20 and habilitation task force established under Laws 1999, chapter 665.21 152, section 4, shall evaluate at least six months of the pilot 665.22 project authorized under subdivision 1, and by December 1, 2003, 665.23 shall report to the legislature with recommendations regarding 665.24 whether the pilot project individualized payment rate structure 665.25 should be implemented statewide and with recommendations for any 665.26 amendments that should be made before statewide implementation. 665.27 These recommendations shall be made in a report to the chairs of 665.28 the house health and human services policy and finance 665.29 committees and the senate health and family security committee 665.30 and finance division. 665.31 Subd. 4. [RATE SETTING.] (a) The rate structure under this 665.32 section is intended to allow a county to authorize an individual 665.33 rate for each client in the vendor's program based on the needs 665.34 and expected outcomes of the individual client. Rates shall be 665.35 based on an authorized package of services for each individual 665.36 over a typical time frame. Rates may be established across 666.1 multiple sites run by a single vendor. 666.2 (b) With county concurrence, a vendor shall establish up to 666.3 four levels of service, A through D, based on the intensity of 666.4 services provided to an individual client of day training and 666.5 habilitation services. Service level A shall be the highest 666.6 intensity of services, marked primarily, but not exclusively, by 666.7 a one-to-one client-to-staff ratio. Service level D shall be 666.8 the lowest intensity of services. The county shall document the 666.9 vendor's description of the type and amount of services 666.10 associated with each service level. 666.11 (c) For each vendor, a county board shall establish a 666.12 dollar value for one hour of service at each of the service 666.13 levels defined in paragraph (b). In establishing these values 666.14 for existing vendors transitioning from the payment rate 666.15 structure under Minnesota Statutes, section 252.46, subdivision 666.16 1, the county board shall follow the formula and guidelines 666.17 developed by the day training and habilitation task force under 666.18 paragraph (e). 666.19 (d) A vendor may elect to maintain a single transportation 666.20 rate or may elect to establish up to five types of 666.21 transportation services: public transportation, public special 666.22 transportation, nonambulatory transportation, out-of-service 666.23 area transportation, and ambulatory transportation. For vendors 666.24 that elect to establish multiple transportation services, the 666.25 county board shall establish a dollar value for a round trip on 666.26 each type of transportation service offered through the vendor. 666.27 With vendor concurrence, the county may also establish a uniform 666.28 one-way trip value for some or all of the transportation service 666.29 types. 666.30 (e) In conducting the pilot project, the county board shall 666.31 ensure that the vendor translates the vendor's existing program 666.32 and transportation rates to the rates and values in the pilot 666.33 project by using the conversion calculations for services and 666.34 transportation approved by the day training and habilitation 666.35 task force established under Laws 1999, chapter 152, and 666.36 included in the task force's recommendations to the 667.1 legislature. The conversion calculation may be amended by the 667.2 task force with the approval of the commissioner and any 667.3 amendments shall become effective upon notification to the pilot 667.4 project counties from the commissioner. The calculation shall 667.5 take the total reimbursement dollars available to the vendor and 667.6 divide by the units of service expected at each service level 667.7 and of each transportation type. In determining the total 667.8 reimbursement dollars available to a vendor, the vendor shall 667.9 multiply the vendor's current per diem rate for both services 667.10 and transportation, including any new rate increases, by the 667.11 vendor's actual utilization for the year prior to implementation 667.12 of the pilot project. Vendors shall be allowed to allocate 667.13 available reimbursement dollars between service and 667.14 transportation before the vendor's service level and 667.15 transportation values are calculated. After translating its 667.16 existing service and transportation rates to the service level 667.17 and transportation values under the pilot, the vendor shall 667.18 project its expected reimbursement income using the expected 667.19 service and transportation packages for its existing clients, 667.20 based on current service authorizations. If the projected 667.21 reimbursement income is less than the vendor would have received 667.22 under the payment structure of Minnesota Statutes, section 667.23 252.46, the vendor and the county, with the approval of the 667.24 commissioner, shall adjust the vendor's service level and 667.25 transportation values to eliminate the shortfall. The 667.26 commissioner shall report all adjustments to the day training 667.27 and habilitation task force for consideration of possible 667.28 modifications to the pilot project individualized payment rate 667.29 structure. 667.30 Subd. 5. [INDIVIDUAL RATE AUTHORIZATION.] (a) As part of 667.31 its annual authorization of services for each client under 667.32 Minnesota Statutes, section 252.44, paragraph (a), clause (1), 667.33 and Minnesota Rules, part 9525.0016, subpart 12, the county 667.34 shall authorize and document a service package and a 667.35 transportation package as follows: 667.36 (1) the service package shall include the amount and type 668.1 of services at each applicable service level to be provided to 668.2 the client over a package period. An individual client may 668.3 receive services at multiple service levels over the course of 668.4 the package period. The service package rate shall be the sum 668.5 of the amount of services at each level over the package period, 668.6 multiplied by the dollar value for each service level; 668.7 (2) the transportation package shall include the amount and 668.8 type of transportation services to be provided to the client 668.9 over the package period. The transportation package rate shall 668.10 be the sum of the amount of transportation services, multiplied 668.11 by the dollar value associated with the type of transportation 668.12 service authorized for the client; 668.13 (3) the package period shall be established by the county, 668.14 and may be one week, two weeks, or one month; and 668.15 (4) the individual rate authorization may be reviewed and 668.16 modified by the county at any time and must be reviewed and 668.17 reauthorized by the county at least annually. 668.18 (b) For purposes of the pilot project, a service day under 668.19 Minnesota Statutes, sections 245B.06 and 252.44, includes any 668.20 day in which a client receives any reimbursable service from a 668.21 vendor or attends employment arranged by the vendor. 668.22 Subd. 6. [BILLING FOR SERVICES.] The vendor shall bill 668.23 for, and shall be reimbursed for, the service package rate and 668.24 transportation package rate for the package period as authorized 668.25 by the county for each client in the vendor's program. The 668.26 length of the package period shall not affect the timing or 668.27 frequency of vendors' submissions of claims for payment under 668.28 the Medicaid Management Information System II (MMIS) or its 668.29 successors. 668.30 Subd. 7. [NOTIFICATION OF CHANGE IN CLIENT NEEDS.] The 668.31 vendor shall notify an individual client's case manager if the 668.32 vendor has knowledge of a material change in the client's needs 668.33 that may indicate a need for a change in service authorization. 668.34 Factors that would require such notice include, but are not 668.35 limited to, significant changes in medical status, residential 668.36 placement, attendance patterns, behavioral needs, or skill 669.1 functioning. The vendor shall notify the case manager as soon 669.2 as possible but no later than 30 calendar days after becoming 669.3 aware of the change in needs. The service authorization for the 669.4 client shall not change until the county authorizes a new 669.5 service and transportation package for the client in accordance 669.6 with the provisions in Minnesota Statutes, section 256B.092. 669.7 Subd. 8. [COUNTY BOARD RESPONSIBILITIES.] For each vendor 669.8 with rates established under this section, the county board 669.9 shall document the vendor's description of the type and amount 669.10 of services associated with each service level, the vendor's 669.11 service level values, the vendor's transportation values, and 669.12 the package period that will be used to determine the rate for 669.13 each individual client. The county shall establish a package 669.14 period of one week, two weeks, or one month. 669.15 Sec. 21. [ESTABLISHMENT OF NEW FEE FOR COMPULSIVE GAMBLING 669.16 TREATMENT PROVIDERS.] 669.17 The commissioner of human services, in consultation with 669.18 compulsive gambling treatment providers, shall establish a fee 669.19 structure, which increases the rates provided for purposes of 669.20 gambling treatment. The fee structure must reflect the real 669.21 costs associated with providing treatment services and should be 669.22 sufficient to attract new and retain existing compulsive 669.23 gambling treatment providers. The new rate structure must be 669.24 implemented no later than October 1, 2001. 669.25 Sec. 22. [PROGRAM OPTIONS FOR CERTAIN PERSONS WITH 669.26 DEVELOPMENTAL DISABILITIES.] 669.27 (a) The commissioner of human services shall ensure that 669.28 services continue to be available to persons with developmental 669.29 disabilities who were covered by social services supplemental 669.30 grants prior to July 1, 2001. Services shall be provided in 669.31 priority order as follows: 669.32 (1) to the extent possible, the commissioner shall 669.33 establish for these persons targeted slots under the home and 669.34 community-based waivered services program for persons with 669.35 mental retardation or related conditions; 669.36 (2) those persons who cannot be accommodated under clause 670.1 (1) shall, to the extent possible, be provided services through 670.2 other home and community-based waivered services programs; 670.3 (3) notwithstanding Minnesota Statutes, section 256I.04, 670.4 subdivision 2a, those persons who cannot be served by a waiver 670.5 program under clause (1) or (2) shall be eligible for services 670.6 under Minnesota Statutes, chapter 256I; and 670.7 (4) any remaining persons shall continue to receive 670.8 services through community social services supplemental grants 670.9 to the affected counties. 670.10 (b) This section applies only to individuals receiving 670.11 services under social services supplemental grants as of June 670.12 30, 2001. 670.13 Sec. 23. [STUDY OF DAY TRAINING AND HABILITATION VENDOR 670.14 RATES.] 670.15 The commissioner shall identify the vendors with the lowest 670.16 rates or underfunded programs in the state and make 670.17 recommendations to reconcile the discrepancies prior to the 670.18 implementation of the individualized payment rate structure. 670.19 Sec. 24. [FEDERAL APPROVAL.] 670.20 The commissioner shall seek any amendments to the state 670.21 Medicaid plan and any waivers necessary to permit implementation 670.22 of the day training and habilitation individualized payment 670.23 structure pilot project within the timelines specified. When 670.24 the necessary waivers are approved by the federal government, 670.25 the commissioner shall obtain authorization from the legislature 670.26 before implementing the pilot project. 670.27 Sec. 25. [REPEALER.] 670.28 Minnesota Statutes 2000, section 256E.06, subdivision 2b, 670.29 is repealed. 670.30 Sec. 26. [EFFECTIVE DATE.] 670.31 The repealer in section 23 is effective July 1, 2003. 670.32 ARTICLE 16 670.33 CRIMINAL JUSTICE 670.34 Section 1. [CRIMINAL JUSTICE APPROPRIATIONS.] 670.35 The sums shown in the columns marked "APPROPRIATIONS" are 670.36 appropriated from the general fund, or another fund named, to 671.1 the agencies and for the purposes specified in this act, to be 671.2 available for the fiscal years indicated for each purpose. The 671.3 figures "2002" and "2003" where used in this article, mean that 671.4 the appropriation or appropriations listed under them are 671.5 available for the year ending June 30, 2002, or June 30, 2003, 671.6 respectively. 671.7 SUMMARY BY FUND 671.8 2002 2003 TOTAL 671.9 General $ 413,130,000 $ 428,035,000 $ 841,165,000 671.10 Special Revenue $ 1,389,000 $ 1,242,000 $ 2,631,000 671.11 TOTAL $ 414,519,000 $ 429,277,000 $ 843,796,000 671.12 APPROPRIATIONS 671.13 Available for the Year 671.14 Ending June 30 671.15 2002 2003 671.16 Sec. 2. BOARD OF PUBLIC DEFENSE 671.17 Subdivision 1. Total 671.18 Appropriation 51,030,000 54,716,000 671.19 None of this appropriation shall be 671.20 used to pay for lawsuits against public 671.21 agencies or public officials to change 671.22 social or public policy. 671.23 During the biennium ending June 30, 671.24 2003, the state public defender may, 671.25 with the approval of the commissioner 671.26 of finance, transfer funds for 671.27 transcript costs from the office of 671.28 administrative services to the state 671.29 public defender. 671.30 The amounts that may be spent from this 671.31 appropriation for each program are 671.32 specified in the following subdivisions. 671.33 Subd. 2. State Public 671.34 Defender 671.35 3,450,000 3,734,000 671.36 $109,000 the first year and $227,000 671.37 the second year are for salary and 671.38 benefit increases. 671.39 Subd. 3. Administrative Services 671.40 Office 671.41 2,467,000 2,553,000 671.42 $300,000 the first year and $310,000 671.43 the second year are for the statewide 671.44 corrections information system project. 671.45 $32,000 the first year and $68,000 the 671.46 second year are for salary and benefit 671.47 increases. 672.1 Subd. 4. District Public 672.2 Defense 672.3 45,113,000 48,429,000 672.4 $1,326,000 the first year and 672.5 $1,366,000 the second year are for 672.6 grants to the five existing public 672.7 defense corporations under Minnesota 672.8 Statutes, section 611.216. 672.9 $1,315,000 the first year and 672.10 $3,276,000 the second year are for the 672.11 part-time public defender viability 672.12 initiative. 672.13 Sec. 3. CORRECTIONS 672.14 Subdivision 1. Total 672.15 Appropriation 362,641,000 373,675,000 672.16 Summary by Fund 672.17 General 361,252,000 372,433,000 672.18 Special Revenue 1,389,000 1,242,000 672.19 The amounts that may be spent from this 672.20 appropriation for each program are 672.21 specified in the following subdivisions. 672.22 Any unencumbered balances remaining in 672.23 the first year do not cancel but are 672.24 available for the second year of the 672.25 biennium. 672.26 Positions and administrative money may 672.27 be transferred within the department of 672.28 corrections as the commissioner 672.29 considers necessary, upon the advance 672.30 approval of the commissioner of finance. 672.31 For the biennium ending June 30, 2003, 672.32 the commissioner of corrections may, 672.33 with the approval of the commissioner 672.34 of finance, transfer funds to or from 672.35 salaries. 672.36 During the biennium ending June 30, 672.37 2003, the commissioner may enter into 672.38 contracts with private corporations or 672.39 governmental units of the state of 672.40 Minnesota to house adult offenders 672.41 committed to the commissioner of 672.42 corrections. Every effort shall be 672.43 made to house individuals committed to 672.44 the commissioner of corrections in 672.45 Minnesota correctional facilities. 672.46 During the biennium ending June 30, 672.47 2003, if it is necessary to reduce 672.48 services or staffing within a 672.49 correctional facility, the commissioner 672.50 or the commissioner's designee shall 672.51 meet with affected exclusive 672.52 representatives. The commissioner 672.53 shall make every reasonable effort to 672.54 retain correctional officer and prison 672.55 industry employees should reductions be 672.56 necessary. 673.1 Subd. 2. Correctional 673.2 Institutions 673.3 Summary by Fund 673.4 General Fund 225,765,000 230,147,000 673.5 Special Revenue Fund 932,000 785,000 673.6 If the commissioner contracts with 673.7 other states, local units of 673.8 government, or the federal government 673.9 to rent beds in the Rush City 673.10 correctional facility under Minnesota 673.11 Statutes, section 243.51, subdivision 673.12 1, to the extent possible, the 673.13 commissioner shall charge a per diem 673.14 under the contract that is equal to or 673.15 greater than the per diem cost of 673.16 housing Minnesota inmates in the 673.17 facility. This per diem cost shall be 673.18 based on the assumption that the 673.19 facility is at or near capacity. 673.20 Notwithstanding any laws to the 673.21 contrary, the commissioner may use the 673.22 per diem monies to operate the state 673.23 correctional institutions. 673.24 The commissioner may use any cost 673.25 savings generated through the 673.26 implementation of a per diem reduction 673.27 plan for capital improvements, which 673.28 will contribute to further per diem 673.29 reductions at adult correctional 673.30 facilities. 673.31 Subd. 3. Juvenile Services 673.32 13,984,000 14,283,000 673.33 In order to maximize federal IV-E 673.34 funding for state committed juvenile 673.35 girls, the department of corrections 673.36 shall make necessary changes to the 673.37 Mesabi Academy facility and program in 673.38 order to be in compliance with IV-E 673.39 guidelines and requirements. IV-E 673.40 reimbursement revenue shall be 673.41 deposited in the state general fund. 673.42 Subd. 4. Community Services 673.43 Summary by Fund 673.44 General 107,923,000 114,168,000 673.45 Special Revenue 150,000 150,000 673.46 All money received by the commissioner 673.47 pursuant to the domestic abuse 673.48 investigation fee under Minnesota 673.49 Statutes, section 609.2244, is 673.50 available for use by the commissioner 673.51 and is appropriated annually to the 673.52 commissioner for costs related to 673.53 conducting the investigations. 673.54 $6,125,000 the first year and 673.55 $7,464,000 the second year are for an 673.56 increase in community correction act 673.57 grants under Minnesota Statutes, 674.1 section 401.10. These appropriations 674.2 may not be used to supplant existing 674.3 probation officer positions, or 674.4 existing correctional services or 674.5 programs. Counties receiving grants 674.6 under this appropriation shall consider 674.7 using a portion of the grant to 674.8 increase supervision of high risk 674.9 domestic abuse offenders who are on 674.10 probation, conditional release, or 674.11 supervised release by means of caseload 674.12 reduction so that the number of 674.13 offenders supervised by officers with 674.14 specialized caseloads is reduced. 674.15 $932,000 the first year and $1,277,000 674.16 the second year are for probation and 674.17 supervised release services. 674.18 $621,000 the first year and $851,000 674.19 the second year are for county 674.20 probation officer reimbursements. 674.21 $1,265,000 the first year and 674.22 $1,335,000 the second year are for 674.23 grants related to restorative justice 674.24 programs as defined in Minnesota 674.25 Statutes, section 611A.775. Grant 674.26 awards must be allocated in a balanced 674.27 manner among rural, suburban, and urban 674.28 organizations operating restorative 674.29 justice programs. Preference must be 674.30 given to organizations or programs that: 674.31 (1) are currently operating and have 674.32 had successful results; 674.33 (2) are community-based; and 674.34 (3) are supported by both private and 674.35 public funding. 674.36 $4,283,000 the first year and 674.37 $8,000,000 the second year are for 674.38 juvenile residential treatment grants. 674.39 Subd. 5. Management Services 674.40 Summary by Fund 674.41 General Fund 13,580,000 13,835,000 674.42 Special Revenue Fund 307,000 307,000 674.43 $750,000 the first year and $750,000 is 674.44 second year are for the CriMNet project 674.45 component to develop statewide systems 674.46 for tracking offenders in jail or 674.47 prison or under community supervision. 674.48 Sec. 4. CORRECTIONS OMBUDSMAN 323,000 336,000 674.49 Sec. 5. SENTENCING GUIDELINES 674.50 COMMISSION 525,000 550,000 674.51 Sec. 6. Minnesota Statutes 2000, section 15A.083, 674.52 subdivision 4, is amended to read: 674.53 Subd. 4. [RANGES FOR OTHER JUDICIAL POSITIONS.] Salaries 675.1 or salary ranges are provided for the following positions in the 675.2 judicial branch of government. The appointing authority of any 675.3 position for which a salary range has been provided shall fix 675.4 the individual salary within the prescribed range, considering 675.5 the qualifications and overall performance of the employee. The 675.6 supreme court shall set the salary of the state court 675.7 administrator and the salaries of district court 675.8 administrators. The salary of the state court administrator or 675.9 a district court administrator may not exceed the salary of a 675.10 district court judge. If district court administrators die, the 675.11 amounts of their unpaid salaries for the months in which their 675.12 deaths occur must be paid to their estates. The salary of the 675.13 state public defendermust be 95 percent of the salary of the675.14attorney generalshall be fixed by the state board of public 675.15 defense but must not exceed the salary of a district court judge. 675.16 Salary or Range 675.17 Effective 675.18 July 1, 1994 675.19 Board on judicial standards 675.20 executive director $44,000-60,000 675.21 Sec. 7. Minnesota Statutes 2000, section 241.272, 675.22 subdivision 6, is amended to read: 675.23 Subd. 6. [USE OF FEES.] Excluding correctional fees 675.24 collected from offenders supervised by department agents under 675.25 the authority of section 244.19, subdivision 1, paragraph (a), 675.26 clause (3), all correctional fees collected under this section 675.27 go to the general fund. One-half of the fees collected by 675.28 agents under the authority of section 244.19, subdivision 1, 675.29 paragraph (a), clause (3), shall go to the county treasurer in 675.30 the county where supervision is provided. The remaining 675.31 one-half of the fees go to the general fund. Fees retained by 675.32 counties may only be used in accordance with section 244.18, 675.33 subdivision 6. 675.34 Sec. 8. Minnesota Statutes 2000, section 242.192, is 675.35 amended to read: 675.36 242.192 [CHARGES TO COUNTIES.] 676.1 (a) Until June 30,20012002, the commissioner shall charge 676.2 counties or other appropriate jurisdictions 65 percent of the 676.3 per diem cost of confinement, excluding educational costs and 676.4 nonbillable service, of juveniles at the Minnesota correctional 676.5 facility-Red Wing and of juvenile females committed to the 676.6 commissioner of corrections. This charge applies to juveniles 676.7 committed to the commissioner of corrections and juveniles 676.8 admitted to the Minnesota correctional facility-Red Wing under 676.9 established admissions criteria. This charge applies to both 676.10 counties that participate in the Community Corrections Act and 676.11 those that do not. The commissioner shall determine the per 676.12 diem cost of confinement based on projected population, pricing 676.13 incentives, market conditions, and the requirement that expense 676.14 and revenue balance out over a period of two years. All money 676.15 received under this section must be deposited in the state 676.16 treasury and credited to the general fund. 676.17 (b) Until June 30,20012002, the department of corrections 676.18 shall be responsible for 35 percent of the per diem cost of 676.19 confinement described in this section. 676.20 Sec. 9. Minnesota Statutes 2000, section 611.23, is 676.21 amended to read: 676.22 611.23 [OFFICE OF STATE PUBLIC DEFENDER; APPOINTMENT; 676.23 SALARY.] 676.24 The state public defender is responsible to the state board 676.25 of public defense. The state public defender shall be appointed 676.26 by the state board of public defense for a term of four years, 676.27 except as otherwise provided in this section, and until a 676.28 successor is appointed and qualified. The state public defender 676.29 shall be a full-time qualified attorney, licensed to practice 676.30 law in this state, serve in the unclassified service of the 676.31 state, and be removed only for cause by the appointing 676.32 authority. Vacancies in the office shall be filled by the 676.33 appointing authority for the unexpired term. The salary of the 676.34 state public defender shall be fixed by the state board of 676.35 public defense but must not exceed the salary ofthe chief676.36deputy attorney generala district court judge. Terms of the 677.1 state public defender shall commence on July 1. The state 677.2 public defender shall devote full time to the performance of 677.3 duties and shall not engage in the general practice of law. 677.4 Sec. 10. Laws 1999, chapter 216, article 1, section 13, 677.5 subdivision 4, is amended to read: 677.6 Subd. 4. Community Services 677.7 Summary by Fund 677.8 General 95,327,000 97,416,000 677.9 Special Revenue 90,000 90,000 677.10 All money received by the commissioner 677.11 of corrections pursuant to the domestic 677.12 abuse investigation fee under Minnesota 677.13 Statutes, section 609.2244, is 677.14 available for use by the commissioner 677.15 and is appropriated annually to the 677.16 commissioner of corrections for costs 677.17 related to conducting the 677.18 investigations. 677.19 $500,000 the first year and $500,000 677.20 the second year are for increased 677.21 funding for intensive community 677.22 supervision. 677.23 $1,500,000 the first year and 677.24 $3,500,000 the second year are for a 677.25 statewide probation and supervised 677.26 release caseload and workload reduction 677.27 grant program. Counties that deliver 677.28 correctional services through Minnesota 677.29 Statutes, chapter 244, and that qualify 677.30 for new probation officers under this 677.31 program shall receive full 677.32 reimbursement for the officers' 677.33 salaries and reimbursement for the 677.34 officers' benefits and support as set 677.35 forth in the probations standards task 677.36 force report, not to exceed $70,000 per 677.37 officer annually. Positions funded by 677.38 this appropriation may not supplant 677.39 existing services. Position control 677.40 numbers for these positions must be 677.41 annually reported to the commissioner 677.42 of corrections. 677.43 The commissioner shall distribute money 677.44 appropriated for state and county 677.45 probation officer caseload and workload 677.46 reduction, increased supervised release 677.47 and probation services, and county 677.48 probation officer reimbursement 677.49 according to the formula contained in 677.50 Minnesota Statutes, section 401.10. 677.51 These appropriations may not be used to 677.52 supplant existing state or county 677.53 probation officer positions or existing 677.54 correctional services or programs. The 677.55 money appropriated under this provision 677.56 is intended to reduce state and county 677.57 probation officer caseload and workload 677.58 overcrowding and to increase 677.59 supervision of individuals sentenced to 678.1 probation at the county level. This 678.2 increased supervision may be 678.3 accomplished through a variety of 678.4 methods, including, but not limited to: 678.5 (1) innovative technology services, 678.6 such as automated probation reporting 678.7 systems and electronic monitoring; 678.8 (2) prevention and diversion programs; 678.9 (3) intergovernmental cooperation 678.10 agreements between local governments 678.11 and appropriate community resources; 678.12 and 678.13 (4) traditional probation program 678.14 services. 678.15 By January 15, 2001, the commissioner 678.16 of corrections shall report to the 678.17 chairs and ranking minority members of 678.18 the senate and house committees and 678.19 divisions having jurisdiction over 678.20 criminal justice funding on the 678.21 outcomes achieved through the use of 678.22 state probation caseload reduction 678.23 appropriations made since 1995. The 678.24 commissioner shall, to the extent 678.25 possible, include an analysis of the 678.26 ongoing results relating to the 678.27 measures described in the uniform 678.28 statewide probation outcome measures 678.29 workgroup's 1998 report to the 678.30 legislature. 678.31 $150,000 each year is for a grant to 678.32 the Dodge-Filmore-Olmsted community 678.33 corrections agency for a pilot project 678.34 to increase supervision of sex 678.35 offenders who are on probation, 678.36 intensive community supervision, 678.37 supervised release, or intensive 678.38 supervised release by means of caseload 678.39 reduction. The grant shall be used to 678.40 reduce the number of offenders 678.41 supervised by officers with specialized 678.42 caseloads to an average of 35 678.43 offenders. This is a one-time 678.44 appropriation. The grant recipient 678.45 shall report by January 15, 2002, to 678.46 the House and Senate committees and 678.47 divisions with jurisdiction over 678.48 criminal justice policy and funding on 678.49 the outcomes of the pilot project. 678.50 $175,000 the first year and $175,000 678.51 the second year are for county 678.52 probation officer reimbursements. 678.53 $50,000 the first year and $50,000 the 678.54 second year are for the emergency 678.55 housing initiative. The commissioner 678.56 of corrections may enter into rental 678.57 agreements per industry standards for 678.58 emergency housing. 678.59 $150,000 the first year and $150,000 678.60 the second year are for probation and 678.61 supervised release services. 679.1 $250,000 the first year and $250,000 679.2 the second year are for increased 679.3 funding of the sentencing to service 679.4 program and for a housing coordinator 679.5 for the institution work crews in the 679.6 sentencing to serve program. 679.7 $25,000 the first year and $25,000 the 679.8 second year are for sex offender 679.9 transition programming. 679.10 $250,000 each year is for increased bed 679.11 capacity for work release offenders. 679.12 $50,000 each year is for programming 679.13 for adult female offenders. 679.14 The following amounts are one-time 679.15 appropriations for the statewide 679.16 productive day initiative program 679.17 defined in Minnesota Statutes, section 679.18 241.275: 679.19 $472,000 to the Hennepin county 679.20 community corrections agency; 679.21 $472,000 to the Ramsey county community 679.22 corrections agency; 679.23 $590,000 to the Arrowhead regional 679.24 community corrections agency; 679.25 $425,000 to the Dodge-Fillmore-Olmsted 679.26 community corrections agency; 679.27 $283,000 to the Anoka county community 679.28 corrections agency; and 679.29 $118,000 to the Tri-county (Polk, 679.30 Norman, and Red Lake) community 679.31 corrections agency. 679.32 $250,000 the first year and $250,000 679.33 the second year are for grants to 679.34 Dakota county for the community justice 679.35 zone pilot project described in article 679.36 2, section 24. This is a one-time 679.37 appropriation. 679.38 $230,000 the first year is for grants 679.39 related to restorative justice 679.40 programs. The commissioner may make 679.41 grants to fund new as well as existing 679.42 programs. This is a one-time 679.43 appropriation. 679.44 The money appropriated for restorative 679.45 justice program grants under this 679.46 subdivision may be used to fund the use 679.47 of restorative justice in domestic 679.48 abuse cases, except in cases where the 679.49 restorative justice process that is 679.50 used includes a meeting at which the 679.51 offender and victim are both present at 679.52 the same time. "Domestic abuse" has 679.53 the meaning given in Minnesota 679.54 Statutes, section 518B.01, subdivision 679.55 2. 679.56 $25,000 each year is for the juvenile 679.57 mentoring project. This is a one-time 680.1 appropriation.