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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 to Hennepin county People, 
 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, 2001 2005. 
 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 Minnesota 
 37.19  center for health care electronic data interchange established 
 37.20  in section 62J.57, and shall integrate the goals, objectives, 
 37.21  and activities of the center with those of the health data 
 37.22  institute'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 fee shall be set by the 
 43.19  commissioner under section 16A.1285 for 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 include an additional a late fee set 
 44.1   by the commissioner of $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 fee shall be set by the 
 44.25  commissioner under section 16A.1285 for 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 include an additional a late fee set 
 45.7   by the commissioner of $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 fee shall be set by the 
 45.31  commissioner under section 16A.1285 for 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 include an additional a late fee set 
 46.11  by the commissioner of $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 fee shall be set by the 
 46.30  commissioner under section 16A.1285 for 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 include an additional a late 
 47.10  fee set by the commissioner of $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, 2002 2003, 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, 2002 2003.  If an 
 50.14  agreement is not entered into by August 1, 2002 2003, any rules 
 50.15  adopted under this section are repealed effective August 1, 2002 
 50.16  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)      $1,017
 55.35                                       $7,055
 55.36  Non-JCAHO hospitals                  $762 plus $34 per bed
 56.1                                        $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          $517
 56.7                                        $1,512
 56.8   Boarding care homes                  $78 plus $19 per bed
 56.9                                        $183 plus $91 per bed
 56.10  Supervised living facilities         $78 plus $19 per bed
 56.11                                       $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 hospitals and, 
 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  hospitals and, 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 overall 
 57.25  hourly wage that is at least the minimum wage but does not 
 57.26  exceed $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 hospital or, 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; 
 58.2   and 
 58.3      (3) provide the facility with a letter of recommendation 
 58.4   from 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; and 
 58.15     (3) provide the facility with a letter of recommendation 
 58.16  from a health occupations or science educator. 
 58.17     (d) Hospitals and, 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  hospitals and, 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 hospital or, 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 physician 
 59.14  Education account is accounts 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  to this account these 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  balance in 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 after 
 59.27  1995, The commissioner may accept up to 12 22 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.  The 12 resident 
 59.33  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 the money 
 60.26  collected in the rural physician education account collections 
 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 HOMES OR, ICFMRS, OR HOME 
 60.36  HEALTH CARE AGENCIES.] 
 61.1      Subdivision 1.  [CREATION OF THE ACCOUNT.] An Education 
 61.2   account accounts in the health care access fund is and the 
 61.3   general fund are established for a loan forgiveness program for 
 61.4   nurses who agree to practice nursing in a nursing home or, 
 61.5   intermediate care facility for persons with mental retardation 
 61.6   or related conditions, or home health care agency.  The account 
 61.7   consists accounts consist of money appropriated by the 
 61.8   legislature and repayments and penalties collected under 
 61.9   subdivision 4.  Money from the account accounts 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 home or, 
 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 to ten 177 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 
 61.33  or, 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 home or, 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 the account 
 62.13  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 surcharge 
 73.19  requirement 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, 
 74.12    fewer than four constituents                        $100 $600
 74.13  Safe drinking water program inorganic chemistry, 
 74.14    four or more constituents                           $300 $600
 74.15  Clean water program chemistry metals, 
 74.16    fewer than four constituents                        $200 $800
 74.17  Safe drinking water program chemistry metals, 
 74.18    four 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 biennial 
 74.34  certification fee for a contract laboratory is 1.5 times the 
 74.35  total 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; and 
 77.30     (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 if 
 80.12  the community health board's application includes program 
 80.13  components for the purposes in clauses (1) to (4) in the 
 80.14  proposed geographic service area and the total expenditure for 
 80.15  injury-related programs under this clause does not exceed ten 
 80.16  percent of the total allocation under subdivision 3. 
 80.17     (b) Maternal and child health block grant money may be used 
 80.18  for purposes other than the purposes listed in this subdivision 
 80.19  only under the following conditions:  
 80.20     (1) the community health board or community health services 
 80.21  area can demonstrate that existing programs fully address the 
 80.22  needs of the highest risk target populations described in this 
 80.23  subdivision; or 
 80.24     (2) the money is used to continue projects that received 
 80.25  funding before creation of the maternal and child health block 
 80.26  grant 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 be 
 80.29  allocated at least the amount of maternal and child health 
 80.30  special project grant funds received in 1989, unless (1) the 
 80.31  local board of health provides equivalent alternative funding 
 80.32  for the project from another source; or (2) the local board of 
 80.33  health demonstrates that the need for the specific services 
 80.34  provided by the project has significantly decreased as a result 
 80.35  of changes in the demographic characteristics of the population, 
 80.36  or other factors that have a major impact on the demand for 
 81.1   services.  If the amount of federal funding to the state for the 
 81.2   maternal and child health block grant is decreased, these 
 81.3   projects must receive a proportional decrease as required in 
 81.4   subdivision 1.  Increases in allocation amounts to local boards 
 81.5   of health under subdivision 4 may be used to increase funding 
 81.6   levels for these projects may 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  subdivision 3 4a, 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 service 
 93.8   establishment operated by a school as defined in sections 
 93.9   120A.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; and 
 94.8      (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, and January 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 under this 
 98.10  subdivision paragraph (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 be 
 98.33  appropriated by another law for the instructional costs of 
 98.34  health professional programs at publicly funded academic health 
 98.35  centers and affiliated teaching institutions is 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; or 
 99.36     (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 2a or 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) is at least 65 years of age or older; and 
114.19     (2) is eligible as a qualified Medicare beneficiary 
114.20  according to section 256B.057, subdivision 3 or 3a, or is 
114.21  eligible under section 256B.057, subdivision 3 or 3a, and is 
114.22  also eligible for medical assistance or general assistance 
114.23  medical care with a spenddown as defined in section 256B.056, 
114.24  subdivision 5 enrollee 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 annual monthly 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 that 
122.32  MFIP-S is implemented in counties, medical assistance may be 
122.33  paid for a person receiving public assistance under the MFIP-S 
122.34  program.  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) Beginning January 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 and resource assets 
123.6   standards, or who would have been eligible but for excess income 
123.7   or assets, under the state's AFDC plan in effect as of July 16, 
123.8   1996, as required by the Personal Responsibility and Work 
123.9   Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 
123.10  Number 104-193 with 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 child one two through five 18 years 
124.21  of age in a family whose countable income is less no greater 
124.22  than 133 185 percent of the federal poverty guidelines for the 
124.23  same family size, is eligible for medical assistance.  A child 
124.24  six through 18 years of age, who was born after September 30, 
124.25  1983, in a family whose countable income is less than 100 
124.26  percent of the federal poverty guidelines for the same family 
124.27  size 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 greater than 200 than 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 be equal to ten percent of the person's gross 
125.26  earned and unearned income above 200 percent of federal poverty 
125.27  guidelines for the applicable family size up to the cost of 
125.28  coverage based 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 the 
128.19  applicable 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 wheelchair lift accessible van or 
136.18  stretcher-equipped stretcher-accessible vehicle and for those 
136.19  who do not need a wheelchair lift accessible van or 
136.20  stretcher-equipped stretcher-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 wheelchair lift 
136.24  accessible van or stretcher-equipped stretcher-accessible 
136.25  vehicle, may be reimbursed at a lower rate than special 
136.26  transportation provided to persons who need a wheelchair lift 
136.27  accessible van or stretcher-equipped stretcher-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, 1999 2001, medical 
136.34  assistance payments for ambulance services shall be increased by 
136.35  five percent paid 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 LODGING ACCESS 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 January 
140.21  1, 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 Personal 
140.33  Responsibility and Work Opportunity Reconciliation Act of 1996 
140.34  (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 to six 12 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 of 
141.4   age, except medical assistance may not be discontinued for that 
141.5   dependent child under 21 years of age within the six-month 
141.6   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 an 
141.9   additional six months if the person meets all requirements for 
141.10  the additional six months, according to title XIX of the Social 
141.11  Security Act, as amended by section 303 of the Family Support 
141.12  Act 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.] Beginning 
141.31  January 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 the 
142.7   Personal Responsibility and Work Opportunity Reconciliation Act 
142.8   of 1996 (PRWORA), Public Law Number 104-193 increased 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 a 
142.14  person 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 client and forward the amounts collected to 
145.35  the commissioner in the manner and at the times prescribed by 
145.36  the 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 premium 
146.5   due, 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 client 
147.5   premiums due under subdivision 12, the commissioner may withhold 
147.6   up to three percent of the county's final alternative care 
147.7   program 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; and 
160.9      (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; and 
162.5      (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 voluntary until 
164.1   July 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," Caesarean cesarean 
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 community 
166.31  clinics or other nonprofit community organizations, political 
166.32  subdivisions, professional associations, or other organizations 
166.33  that demonstrate the ability to provide dental services 
166.34  effectively to public program recipients.  Grants may be used to 
166.35  fund the costs related to coordinating access for recipients, 
166.36  developing and implementing patient care criteria, upgrading or 
167.1   establishing new facilities, acquiring furnishings or equipment, 
167.2   recruiting new providers, or other development costs that will 
167.3   improve access to dental care in a region.  In awarding grants, 
167.4   the commissioner shall give priority to applicants that plan to 
167.5   serve areas of the state in which the number of dental providers 
167.6   is not currently sufficient to meet the needs of recipients of 
167.7   public programs or uninsured individuals.  The commissioner 
167.8   shall consider the following in awarding the grants:  (i) 
167.9   potential to successfully increase access to an underserved 
167.10  population; (ii) the ability to raise matching funds; (iii) the 
167.11  long-term viability of the project to improve access beyond the 
167.12  period of initial funding; (iv) the efficiency in the use of the 
167.13  funding; and (v) the experience of the proposers in providing 
167.14  services to the target population. 
167.15     The commissioner shall monitor the grants and may terminate 
167.16  a grant if the grantee does not increase dental access for 
167.17  public program recipients.  The commissioner shall consider 
167.18  grants for the following: 
167.19     (i) implementation of new programs or continued expansion 
167.20  of current access programs that have demonstrated success in 
167.21  providing dental services in underserved areas; 
167.22     (ii) a pilot program for utilizing hygienists outside of a 
167.23  traditional dental office to provide dental hygiene services; 
167.24  and 
167.25     (iii) a program that organizes a network of volunteer 
167.26  dentists, establishes a system to refer eligible individuals to 
167.27  volunteer dentists, and through that network provides donated 
167.28  dental care services to public program recipients or uninsured 
167.29  individuals. 
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; and 
167.33     (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.05 and for medical assistance under sections 
169.34  256B.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.05 and for medical assistance under sections 
170.3   256B.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, 
170.23  medical 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 
171.1   transitional medical assistance and child 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" for farm and nonfarm 
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 CHILDREN UNDER 
171.29  AGE 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 commissioner shall 
173.14  use individuals' social security numbers as identifiers for 
173.15  purposes of administering the plan and conduct data matches to 
173.16  verify income.  Applicants shall submit evidence of individual 
173.17  and family income, earned and unearned, such as the most recent 
173.18  income tax return, wage slips, or other documentation that is 
173.19  determined by the commissioner as necessary to verify income 
173.20  eligibility or 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 plan within one calendar month after the due date 
174.17  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 than 150 225 
175.5   percent of the federal poverty guidelines are eligible without 
175.6   meeting the requirements of subdivision 2, as long as they 
175.7   maintain continuous coverage in the MinnesotaCare program or 
175.8   medical assistance.  Children who apply for MinnesotaCare on or 
175.9   after the implementation date of the employer-subsidized health 
175.10  coverage program as described in Laws 1998, chapter 407, article 
175.11  5, section 45, who have family gross incomes that are equal to 
175.12  or less than 150 percent of the federal poverty guidelines, must 
175.13  meet the requirements of subdivision 2 to be eligible for 
175.14  MinnesotaCare subdivisions 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 this requirement subdivision, 
176.17  subsidized health coverage means health coverage for which the 
176.18  employer pays at least 50 60 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 original 
176.33  children's health plan and children in families with income 
176.34  equal to or less than 150 percent of the federal poverty 
176.35  guidelines, who have other health insurance, are eligible if the 
176.36  coverage: 
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; or 
177.6      (v) vision coverage; 
177.7      (2) requires a deductible of $100 or more per person per 
177.8   year; or 
177.9      (3) lacks coverage because the child has exceeded the 
177.10  maximum coverage for a particular diagnosis or the policy 
177.11  excludes 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 gross individual or family income for 
179.31  individuals or families with incomes below the limits for the 
179.32  medical assistance program for families and children in effect 
179.33  on 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 to children families with children who are eligible to 
180.33  receive expanded services according to section 256L.03, 
180.34  subdivision 1a 256L.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 
181.14  June 30, 2001 January 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 under section 256B.501 sections 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 residential program cost report 
184.10  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 including any investments, efficiency 
184.14  incentives, 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 recent desk-audited cost income and expense report or 
184.21  the estimated resident days in the projected receivership 
184.22  period.  The payment rate adjustment must meet the conditions in 
184.23  Minnesota Rules, parts 9553.0010 to 9553.0080, and remains 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 county with an original 
185.10  allocation for the preceding year that is equal to or less than 
185.11  the guaranteed floor minimum index shall have a guaranteed floor 
185.12  equal to its original allocation for the preceding year.  Each 
185.13  county with an original allocation for the preceding year that 
185.14  is greater than the guaranteed floor minimum index shall 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. 
185.21     For calendar year 1993, the guaranteed floor minimum index 
185.22  shall be $20,000.  For each subsequent year, the index shall be 
185.23  adjusted by the projected change in the average value in the 
185.24  United States Department of Labor Bureau of Labor Statistics 
185.25  consumer 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 year 1998 2002 rate for vendors may not 
186.24  increase more than three 3.5 percent above the rate approved in 
186.25  effect on January 1, 1997 2001.  The calendar year 1999 2003 
186.26  rate for vendors may not increase more than three 3.5 percent 
186.27  above the rate in effect on January 1, 1998 2002. 
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  program to assist for individuals with functional limitations 
187.21  and their families in purchasing and securing supports which the 
187.22  individuals need to live as independently and productively in 
187.23  the community as possible who 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 
187.33  facility services; 
187.34     (2) provide consumers more control, flexibility, and 
187.35  responsibility over the needed supports their 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, home 
189.15  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, and adaptive aids 
189.18  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.056 or the person is eligible for and 
189.33  has been approved to receive services under alternative care 
189.34  services as determined under section 256B.0913 or 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 of nursing 
190.25  facility residents, residents of intermediate care facilities 
190.26  for persons with mental retardation, and the recipients 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 assistance or 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 and alternative 
193.12  care program, personal care attendant assistant services, home 
193.13  health aide services, or nursing facility private 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 services or, in situations 
193.27  where an individual is unable to obtain the support needed from 
193.28  the program of origination due to the unavailability of service 
193.29  providers at the time or the location where the supports are 
193.30  needed, the allocation will be based on the county's best 
193.31  estimate of the nonfederal dollars that would have been expended 
193.32  if 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   from the alternative care account and the 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 commissioner shall may 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  exceed 80 percent of the total nonfederal dollars expended on 
194.20  the individual by the program of origination except for the 
194.21  developmental disabilities family support grant program which 
194.22  can be approved up to 100 percent of the nonfederal dollars and 
194.23  in situations as described in paragraph (b), clause (3).  In 
194.24  situations where exceptional need exists or the individual's 
194.25  need for support increases, up to 100 percent of the nonfederal 
194.26  dollars expended may be allocated to the county.  Allocations 
194.27  that exceed 80 percent of the nonfederal dollars expended on the 
194.28  individual by the program of origination must be approved by the 
194.29  commissioner.  The remainder of the amount expended on the 
194.30  individual by the program of origination will be used in the 
194.31  following proportions:  half will be made available to the 
194.32  consumer support grant program and participating counties for 
194.33  consumer training, resource development, and other costs, and 
194.34  half 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; and 
195.20     (7) apply for a federal waiver or take any other action 
195.21  necessary to maximize federal funding for the program by 
195.22  September 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  home and when, without the provision of private duty nursing, 
196.12  their 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 the spouse of the 
196.31  recipient or the parent or foster 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 home and when, without the provision of 
197.7   personal 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 
197.35  if 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, 
198.1   and Notwithstanding 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 recipient under the fiscal agent option 
198.18  according 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 will consult with assist the 
198.24  recipient or responsible party and to 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 last 30 180 days of the recipient's residency in that 
202.6   facility and may not exceed more than two six 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 every 62 60 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 health aide services 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) consulting qualified professional of personal care 
213.13  assistant services under the fiscal agent intermediary 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  are the 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 to five nine 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 a licensed nurse or a home 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 limit nurse and home health aide visits to no more than 
219.11  one visit each per 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 
222.34  9505.0500 9505.0501 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 services including 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.  [FISCAL AGENT INTERMEDIARY OPTION AVAILABLE FOR 
230.16  PERSONAL CARE ASSISTANT SERVICES.] (a) "Fiscal agent option" is 
230.17  an option that allows the recipient to: 
230.18     (1) use a fiscal agent instead of a personal care provider 
230.19  organization; 
230.20     (2) supervise the personal care assistant; and 
230.21     (3) use a consulting professional. 
230.22     The commissioner may allow a recipient of personal care 
230.23  assistant services to use a fiscal agent intermediary 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 fiscal agent 
230.30  intermediary option. 
230.31     (b) The recipient or responsible party shall: 
230.32     (1) hire, and terminate the personal care assistant and 
230.33  consulting professional, with the fiscal agent recruit, 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 consulting 
231.1   professional and orient and train the personal care assistant in 
231.2   areas that do not require professional delegation as determined 
231.3   by the county public health nurse verify 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 in 
231.7   areas that do not require professional delegation as determined 
231.8   in the assessment; 
231.9      (4) cooperate with a consulting develop a service plan 
231.10  based on physician orders and public health nurse assessment 
231.11  with the assistance of a qualified professional and implement 
231.12  recommendations pertaining to the health and safety of the 
231.13  recipient, 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 supervise 
231.17  the 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 worked 
231.20  by 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 a 
231.24  consulting (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 consulting 
231.28  (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 fiscal agent intermediary shall be to:
231.34     (1) bill the medical assistance program for personal care 
231.35  assistant and consulting qualified professional services; 
231.36     (2) request and secure background checks on personal care 
232.1   assistants and consulting qualified professionals according to 
232.2   section 245A.04; 
232.3      (3) pay the personal care assistant and consulting 
232.4   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 and document keep records hours worked by the 
232.9   personal care assistant and consulting qualified 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 
232.14  agent intermediary; and 
232.15     (8) enter into a written agreement as specified in 
232.16  paragraph (f) before services are provided. 
232.17     (d) The fiscal agent intermediary: 
232.18     (1) may not be related to the recipient, consulting 
232.19  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 and consulting qualified professional to the 
232.24  extent specified in this section. 
232.25     The fiscal agent intermediary or owners of the entity that 
232.26  provides fiscal agent intermediary 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, the consulting qualified professional 
232.31  providing assistance to the recipient shall meet the 
232.32  qualifications specified in section 256B.0625, subdivision 19c.  
232.33  The consulting qualified professional shall assist the recipient 
232.34  in developing and revising a plan to meet the 
232.35  recipient's assessed needs, and supervise the performance of 
232.36  delegated tasks, as determined by the public health nurse as 
233.1   assessed by the public health nurse.  In performing this 
233.2   function, the consulting qualified professional must visit the 
233.3   recipient in the recipient's home at least once annually.  
233.4   The consulting qualified professional must report to the local 
233.5   county public health nurse concerns relating to the health and 
233.6   safety of the recipient, and any suspected abuse, neglect, or 
233.7   financial exploitation of the recipient to the appropriate 
233.8   authorities.  
233.9      (f) The fiscal agent intermediary, recipient or responsible 
233.10  party, personal care assistant, and consulting qualified 
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  and those providing professional consultation the qualified 
233.18  professional; 
233.19     (3) the administrative fee of the fiscal agent intermediary 
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 and those providing professional consultation the 
233.26  qualified professional. 
233.27     (g) The rates paid for personal care assistant services, 
233.28  qualified professional assistance services, and fiscal agency 
233.29  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 fiscal agent intermediary 
233.33  specified in paragraph (f), the remainder of the rates paid to 
233.34  the fiscal agent intermediary must be used to pay for the salary 
233.35  and benefits for the personal care assistant or those providing 
233.36  professional consultation the 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   fiscal agent intermediary: 
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.  The 
234.15  county public health nurse shall determine the services that 
234.16  require professional delegation, if any, and the amount and 
234.17  frequency 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 fiscal agent intermediary option if: 
234.24     (1) it has been determined by the consulting qualified 
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 fiscal agent intermediary 
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 the nonwaivered regular private duty nursing 
235.13  rates paid for serving a single individual who is not ventilator 
235.14  dependent, 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 or 
244.22  care 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 of the 
256.12  preadmission screening program long-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 placements by assessing applicants and 
256.19  residents and offering cost-effective alternatives appropriate 
256.20  for the person's needs and to provide transition assistance 
256.21  after admission.  Further, the goal of the program these 
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 THE 
258.1   PREADMISSION SCREENING LONG-TERM CARE CONSULTATION TEAM.] (a) A 
258.2   local screening long-term care consultation team shall be 
258.3   established by the county board of commissioners.  Each local 
258.4   screening consultation team shall consist of screeners who are a 
258.5   at least one social worker and a at 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 most 
258.13  appropriate care for each individual screened.  Two or more 
258.14  counties may collaborate to establish a joint local screening 
258.15  consultation team or teams. 
258.16     (b) In assessing a person's needs, screeners shall have a 
258.17  physician available for consultation and shall consider the 
258.18  assessment of the individual's attending physician, if any.  The 
258.19  individual's physician shall be included if the physician 
258.20  chooses to participate.  Other personnel may be included on the 
258.21  team 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 FORMS ADMINISTRATIVE 
266.22  ACTIVITY.] The commissioner shall minimize the number of forms 
266.23  required in the preadmission screening process provision of 
266.24  long-term care consultation services and shall limit the 
266.25  screening document to items necessary for care community 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 FOR PREADMISSION SCREENING LONG-TERM 
266.31  CARE CONSULTATION SERVICES.] (a) The total screening payment 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 for screenings long-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 
267.7   for screening determined 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 for screening activities long-term care 
267.20  consultation services are available to the county or counties to 
267.21  cover staff salaries and expenses to provide the screening 
267.22  function services described in subdivision 1a.  The lead agency 
267.23  county shall employ, or contract with other agencies to employ, 
267.24  within the limits of available funding, sufficient personnel 
267.25  to conduct the preadmission screening activity provide 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.  The local agency county 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 local screening consultation 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  the local county agency has 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 II PASARR OBRA 
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 allowing screening 
268.32  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 in paragraphs (b) and (c) subdivision 4a, paragraph (c).
269.1      (c) The local county mental health authority or the state 
269.2   mental retardation authority under Public Law Numbers 100-203 
269.3   and 101-508 may prohibit admission to a nursing facility, if the 
269.4   individual does not meet the nursing facility level of care 
269.5   criteria or needs specialized services as defined in Public Law 
269.6   Numbers 100-203 and 101-508.  For purposes of this section, 
269.7   "specialized services" for a person with mental retardation or a 
269.8   related condition means "active treatment" as that term is 
269.9   defined in Code of Federal Regulations, title 42, section 
269.10  483.440(a)(1). 
269.11     (e) Appeals from the screening team's recommendation or the 
269.12  county agency's final decision shall be made according to 
269.13  section 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 for or access to 
269.18  home and community-based services for frail elderly persons, in 
269.19  order to limit nursing facility placements.  The program is 
269.20  designed to support frail elderly 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 for frail elderly people.  Further, the goals of the 
269.24  program are: 
269.25     (1) to contain medical assistance expenditures by providing 
269.26  funding care in the community at a cost the same or less than 
269.27  nursing 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 to all frail older Minnesotans.  This 
269.34  includes: 
269.35     (1) persons who are receiving medical assistance and served 
269.36  under the medical assistance program or the Medicaid waiver 
270.1   program; 
270.2      (2) persons age 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 and served under subject to 
270.6   subdivisions 4 to 13; and 
270.7      (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 been screened by the county screening 
270.15  team or, if previously screened and served under the alternative 
270.16  care program, assessed by the local county social worker or 
270.17  public health nurse determined 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 be financially eligible for medical 
270.23  assistance within 180 days of admission to a nursing facility; 
270.24     (4) the person meets the asset transfer requirements of is 
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 facility 
270.28  admission or continued stay for the person if alternative care 
270.29  services were not available; 
270.30     (6) the person needs services that are not available at 
270.31  that time in the county funded through other county, state, or 
270.32  federal funding sources; 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 statewide average monthly medical assistance payment for 
270.36  nursing facility care at the individual's case mix 
271.1   classification weighted 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 or adaptations 
271.28  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 basis throughout the year in which they are 
271.31  purchased for 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   limit calculated described in this paragraph. 
272.2      (b) Individuals who meet the criteria in paragraph (a) and 
272.3   who have been approved for alternative care funding are called 
272.4   180-day eligible clients. 
272.5      (c) The statewide average payment for nursing facility care 
272.6   is the statewide average monthly nursing facility rate in effect 
272.7   on July 1 of the fiscal year in which the cost is incurred, less 
272.8   the statewide average monthly income of nursing facility 
272.9   residents who are age 65 or older and who are medical assistance 
272.10  recipients in the month of March of the previous fiscal year.  
272.11  This monthly limit does not prohibit the 180-day eligible client 
272.12  from paying for additional services needed or desired.  
272.13     (d) In determining the total costs of alternative care 
272.14  services for one month, the costs of all services funded by the 
272.15  alternative care program, including supplies and equipment, must 
272.16  be 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 commissioner or 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, the 
272.25  county must bill medical 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  for services reimbursable under the federally approved elderly 
272.29  waiver program plan.  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 home or, certified 
272.36  boarding care home, hospital, or intermediate care facility, 
273.1   except for case management services which are being provided 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; and 
273.29     (19) "other services" including includes discretionary 
273.30  funds and direct cash payments to clients, approved by the 
273.31  county agency following 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   used only to supplement and not to 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 standards defined specified 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 care daily rate shall be negotiated 
274.23  between the county agency and the foster care provider.  The 
274.24  rate established under this section shall not exceed 75 percent 
274.25  of the state average monthly nursing home payment for the case 
274.26  mix classification to which the individual receiving foster care 
274.27  is assigned, and it must allow for other alternative care 
274.28  services 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 services may be provided by a personal 
274.34  care 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 relative of 
275.1   the client who 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 ensure 
275.4   nursing if the county agency ensures supervision of this service 
275.5   by a registered nurse or mental health practitioner.  Covered 
275.6   personal care services defined in section 256B.0627, subdivision 
275.7   4, must meet applicable standards in Minnesota Rules, part 
275.8   9505.0335. 
275.9      (f) A county may use alternative care funds to purchase 
275.10  medical supplies and equipment without prior approval from the 
275.11  commissioner when:  (1) there is no other funding source; (2) 
275.12  the supplies and equipment are specified in the individual's 
275.13  care plan as medically necessary to enable the individual to 
275.14  remain in the community according to the criteria in Minnesota 
275.15  Rules, part 9505.0210, item A; and (3) the supplies and 
275.16  equipment represent an effective and appropriate use of 
275.17  alternative care funds.  A county may use alternative care funds 
275.18  to purchase supplies and equipment from a non-Medicaid certified 
275.19  vendor if the cost for the items is less than that of a Medicaid 
275.20  vendor.  A county is not required to contract with a provider of 
275.21  supplies and equipment if the monthly cost of the supplies and 
275.22  equipment 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 care center 
275.34  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.  
277.1      Individuals receiving assisted living services will not 
277.2   receive both assisted living services and homemaking services.  
277.3   Individualized means services are chosen and designed 
277.4   specifically for each resident's needs, rather than provided or 
277.5   offered to all residents regardless of their illnesses, 
277.6   disabilities, 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 described and licensed in 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.  The 
278.13  rate 
278.14     (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 monthly medical assistance nursing 
278.21  facility payment rate of the case mix resident class to which 
278.22  the 180-day alternative care eligible client would be assigned 
278.23  under Minnesota Rules, parts 9549.0050 to 9549.0059, unless the 
278.24  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 services are provided by a home care described 
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 and are provided 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 are 
279.15  defined as nonmedical care, supervision and oversight, provided 
279.16  to a functionally impaired adult.  Companions may assist the 
279.17  individual with such tasks as meal preparation, laundry and 
279.18  shopping, but do not perform these activities as discrete 
279.19  services.  The provision of companion services does not entail 
279.20  hands-on medical care.  Providers may also perform light 
279.21  housekeeping tasks which are incidental to the care and 
279.22  supervision of the recipient.  This service must be approved by 
279.23  the case manager as part of the care plan.  Companion services 
279.24  must be provided by individuals or organizations who are under 
279.25  contract with the local agency to provide the service.  Any 
279.26  person related to the waiver recipient by blood, marriage or 
279.27  adoption cannot be reimbursed under this service.  Persons 
279.28  providing companion services will be monitored by the case 
279.29  manager. 
279.30     (l) For purposes of this section, training for direct 
279.31  informal caregivers is defined as a classroom or home course of 
279.32  instruction which may include:  transfer and lifting skills, 
279.33  nutrition, personal and physical cares, home safety in a home 
279.34  environment, stress reduction and management, behavioral 
279.35  management, long-term care decision making, care coordination 
279.36  and family dynamics.  The training is provided to an informal 
280.1   unpaid caregiver of a 180-day eligible client which enables the 
280.2   caregiver to deliver care in a home setting with high levels of 
280.3   quality.  The training must be approved by the case manager as 
280.4   part of the individual care plan.  Individuals, agencies, and 
280.5   educational facilities which provide caregiver training and 
280.6   education 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" 
280.9   provided to an alternative care program recipient if those 
280.10  services prevent, shorten, or delay institutionalization.  These 
280.11  services may which include use of "discretionary funds" for 
280.12  services that are not otherwise defined in this section and 
280.13  direct cash payments to the recipient client for the purpose of 
280.14  purchasing the recipient's services.  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  representative under section 256.476, subdivision 2, paragraph 
280.24  (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 a 
280.34  service which meets the purpose and goals of the program as 
280.35  listed in subdivision 1; 
280.36     (4) cash payments must also meet the criteria of and are 
281.1   governed by the procedures and liability protection established 
281.2   in section 256.476, subdivision 4, paragraphs (b) through (h), 
281.3   and recipients of cash grants must meet the requirements in 
281.4   section 256.476, subdivision 10; and cash 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 must ensure the health and 
283.5   safety of the individual client and not 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 each 180-day 
283.23  eligible alternative 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 provide 
283.35  documentation to the commissioner verifying that the 
283.36  individual's alternative care is not available at that time 
284.1   through 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 lead 
284.16  agency shall document to the commissioner that the agency made 
284.17  reasonable efforts to inform potential providers of the 
284.18  anticipated need for services under the alternative care program 
284.19  or waiver programs under sections 256B.0915 and 256B.49, 
284.20  including a minimum of 14 days' written advance notice of the 
284.21  opportunity to be selected as a service provider and an annual 
284.22  public meeting with providers to explain and review the criteria 
284.23  for selection.  The lead agency shall also document to the 
284.24  commissioner that the agency allowed potential providers an 
284.25  opportunity to be selected to contract with the county agency.  
284.26  Funds reimbursed to counties under this subdivision Alternative 
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 shall 
285.13  provide a written statement of the reasons for not selecting 
285.14  providers. 
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  only 180-day alternative 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 shall 
285.24  allocate to county agencies the state funds available for 
285.25  alternative care for persons eligible under subdivision 2.  The 
285.26  allocation for fiscal year 1992 shall be calculated using a base 
285.27  that is adjusted to exclude the medical assistance share of 
285.28  alternative care expenditures.  The adjusted base is calculated 
285.29  by multiplying each county's allocation for fiscal year 1991 by 
285.30  the percentage of county alternative care expenditures for 
285.31  180-day eligible clients.  The percentage is determined based on 
285.32  expenditures for services rendered in fiscal year 1989 or 
285.33  calendar 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 the county alternative care program expenditures for 
286.7   180-day eligible clients as defined in paragraph (b) are 95 
286.8   percent or more of its the 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 the county alternative care program expenditures for 
286.13  180-day eligible clients as defined in paragraph (b) are less 
286.14  than 95 percent of its the 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 an 
286.19  increased allocation if annualized service costs for the month 
286.20  of May 1991 for 180-day eligible clients are greater than the 
286.21  allocation otherwise determined.  A county may apply for this 
286.22  increase by reporting projected expenditures for May to the 
286.23  commissioner by June 1, 1991.  The amount of the allocation may 
286.24  exceed the amount calculated in paragraph (b).  The projected 
286.25  expenditures for May must be based on actual 180-day eligible 
286.26  client caseload and the individual cost of clients' care plans.  
286.27  If a county does not report its expenditures for May, the amount 
286.28  in paragraph (c) or (d) shall be used. 
286.29     (f) Calculations for paragraphs (c) and (d) are to be made 
286.30  as follows:  for each county, the determination of expenditures 
286.31  shall be based on payments for services rendered from April 1 
286.32  through March 31 in the base year, to the extent that claims 
286.33  have been submitted by June 1 of that year.  Calculations for 
286.34  paragraphs (c) and (d) must also include the funds transferred 
286.35  to the consumer support grant program for clients who have 
286.36  transferred to that program from April 1 through March 31 in the 
287.1   base year.  
287.2      (g) For the biennium ending June 30, 2001, the allocation 
287.3   of state funds to county agencies shall be calculated as 
287.4   described 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 for fiscal year 2000 or 
287.7   2001 a 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 in paragraph 
287.10  (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 applications by June 1 
288.12  each year, for county agencies to apply for 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  funding by 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 1992 
288.21  shall be determined using the previous fiscal year's allocation, 
288.22  including any targeted funds, as the base and then applying the 
288.23  criteria under subdivision 10, paragraphs (c), (d), and (f), to 
288.24  the 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  all 180-day alternative 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 
288.34  medical assistance income standard recipient'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 has 
290.3   been approved for alternative care-funded assisted living 
290.4   services; 
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  for the preadmission screening program long-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 under 
290.35  section 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 biennial 
291.2   plan shall include: 
291.3      (1) information on the administration of the preadmission 
291.4   screening program; 
291.5      (2) information on the administration of the home and 
291.6   community-based services waivers for the elderly under section 
291.7   256B.0915, and for the disabled under section 256B.49; and 
291.8      (3) information on the administration of the alternative 
291.9   care program. 
291.10     Sec. 27.  Minnesota Statutes 2000, section 256B.0913, 
291.11  subdivision 14, is amended to read: 
291.12     Subd. 14.  [REIMBURSEMENT PAYMENT AND RATE ADJUSTMENTS.] (a)
291.13  Reimbursement Payment for expenditures for the provided 
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 receive reimbursement payment, 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 may be reimbursed authorize service payment for 
291.27  actual costs up to the greater of the county's current approved 
291.28  rate or 60 percent of the maximum rate in fiscal year 1994 and 
291.29  65 percent of the maximum rate in fiscal year 1995 for each 
291.30  alternative 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 the 
291.35  maximum rate for home delivered meals to $4.50 per meal To 
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 secure 
292.32  approval of additional elderly waiver slots sufficient to serve 
292.33  persons who will qualify under the revised income standard 
292.34  described in paragraph (a) before implementing section 
292.35  256B.0913, subdivision 16. 
292.36     (c) In implementing this subdivision, the commissioner 
293.1   shall consider allowing persons who would otherwise be eligible 
293.2   for the alternative care program but would qualify for the 
293.3   elderly waiver with a spenddown to remain on the alternative 
293.4   care 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, REIMBURSEMENT PAYMENTS, 
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 the statewide 
293.15  average payment weighted average monthly nursing facility rate 
293.16  of the case mix resident class to which the elderly waiver 
293.17  client would be assigned under the medical assistance case mix 
293.18  reimbursement 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 
294.1   adaptations environmental modifications are or will be purchased 
294.2   for an elderly waiver services recipient, the client, the costs 
294.3   may be prorated on a monthly basis throughout the year in which 
294.4   they are purchased for up to 12 consecutive months beginning 
294.5   with the month of purchase.  If the monthly cost of a 
294.6   recipient's other waivered services exceeds the monthly limit 
294.7   established in this paragraph (b), the annual cost of the all 
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 limit calculated in this paragraph.  The statewide 
294.11  average payment rate is calculated by determining the statewide 
294.12  average monthly nursing home rate, effective July 1 of the 
294.13  fiscal year in which the cost is incurred, less the statewide 
294.14  average monthly income of nursing home residents who are age 65 
294.15  or older, and who are medical assistance recipients in the month 
294.16  of March of the previous state fiscal year.  The annual cost 
294.17  divided by 12 of elderly or disabled waivered services of 
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 elderly or 
294.21  disabled waivered services shall be the greater of the monthly 
294.22  payment 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) the 
294.28  statewide average payment of the case mix resident class to 
294.29  which the resident would be assigned under the medical 
294.30  assistance case mix reimbursement system, provided that until 
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 facility 
295.22  disabled waiver, a county may purchase extended supplies and 
295.23  equipment without prior approval from the commissioner when 
295.24  there is no other funding source and the supplies and equipment 
295.25  are specified in the individual's care plan as medically 
295.26  necessary to enable the individual to remain in the community 
295.27  according to the criteria in Minnesota Rules, part 9505.0210, 
295.28  items 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 care daily rate for the elderly 
295.32  and disabled waivers shall 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 this 
295.36  section shall not exceed the state average monthly nursing home 
296.1   payment for the case mix classification to which the individual 
296.2   receiving foster care is assigned; the rate must allow for other 
296.3   waiver and medical assistance home care services to be 
296.4   authorized 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 rates 
296.9   for elderly and community alternatives for disabled individuals 
296.10  (CADI) waivers shall be made to the vendor as a monthly rate 
296.11  negotiated with the county agency based on an individualized 
296.12  service plan for each resident.  The rate shall not exceed the 
296.13  nonfederal share of the greater of either the statewide or any 
296.14  of the geographic groups' weighted average monthly medical 
296.15  assistance nursing facility payment rate of the case mix 
296.16  resident class to which the elderly or disabled client would be 
296.17  assigned under Minnesota Rules, parts 9549.0050 to 9549.0059, 
296.18  unless the services are provided by a home care provider 
296.19  licensed by the department of health and are provided in a 
296.20  building that is registered as a housing with services 
296.21  establishment under chapter 144D and that provides 24-hour 
296.22  supervision.  For alternative care assisted living projects 
296.23  established under Laws 1988, chapter 689, article 2, section 
296.24  256, monthly rates may not exceed 65 percent of the greater of 
296.25  either the statewide or any of the geographic groups' weighted 
296.26  average monthly medical assistance nursing facility payment rate 
296.27  for the case mix resident class to which the elderly or disabled 
296.28  client would be assigned under Minnesota Rules, parts 9549.0050 
296.29  to 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 may be reimbursed authorize payment for actual 
297.34  costs up to the greater of the county's current approved rate or 
297.35  60 percent of the maximum rate in fiscal year 1994 and 65 
297.36  percent of the maximum rate in fiscal year 1995 for each service 
298.1   within 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 the 
298.8   maximum 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 individuals 
298.36  waiver, and nursing facility disabled waivers, county may use 
299.1   waiver funds for the cost of minor adaptations to a client's 
299.2   residence or vehicle without prior approval from the 
299.3   commissioner if there is no other source of funding and the 
299.4   adaptation: 
299.5      (1) is necessary to avoid institutionalization; 
299.6      (2) has no utility apart from the needs of the client; and 
299.7      (3) meets the criteria in Minnesota Rules, part 9505.0210, 
299.8   items A and B.  
299.9   For purposes of this subdivision, "residence" means the client's 
299.10  own home, the client's family residence, or a family foster 
299.11  home.  For purposes of this subdivision, "vehicle" means the 
299.12  client's vehicle, the client's family vehicle, or the client's 
299.13  family foster home vehicle. 
299.14     (l) The commissioner shall establish a maximum rate unit 
299.15  for baths provided by an adult day care provider that are not 
299.16  included in the provider's contractual daily or hourly rate. 
299.17  This maximum rate must equal the home health aide extended rate 
299.18  and shall be paid for baths provided to clients served under the 
299.19  elderly 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 elderly or disabled 
299.24  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 costs also include 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; or 
326.20     (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 for 
328.26  expenditures does not carry forward into the following 
328.27  biennium.  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 hospitalized for at least six 
341.7   months and 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 the highest multiple bedroom payment rate for a 
341.34  Minnesota nursing facility, as initially established by the 
341.35  commissioner for the rate year facility'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.431 and are located in a county 
347.5   participating 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, and July 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 for 
362.8   this 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 annually prepare a summary of report 
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, 2001 2003. 
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      For fiscal year the biennium beginning July 1, 2000 2001, 
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 to proposals a proposal to build a 
368.9   replacement facilities facility 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 that may include includes a public or private 
373.7   institution of higher education, work force center, county, and 
373.8   one or more eligible employers, but must include a public or 
373.9   private institution of higher education and one or more eligible 
373.10  employers employer. 
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 
373.25  provide at least a 50 percent match from local resources for 
373.26  money appropriated under this section.  The local match 
373.27  requirement must be satisfied on an overall program basis but 
373.28  need not be satisfied for each particular client.  The local 
373.29  match requirement may be reduced for consortia that include a 
373.30  relatively large number of small employers whose financial 
373.31  contribution has been reduced in accordance with section 116L.15.
373.32  In-kind services and expenditures under section 116L.13, 
373.33  subdivision 2, may be used to meet this local match 
373.34  requirement.  The grant application must specify the financial 
373.35  contribution from each member of the consortium satisfy 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; and 
385.13     (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, the registrant, bureau 
391.28  of criminal apprehension, the commissioner 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